12E7 Antigen ; Antigens, CD ; metabolism ; Cell Adhesion Molecules ; metabolism ; Diagnosis, Differential ; Humans ; Kidney Neoplasms ; metabolism ; pathology ; surgery ; Male ; Middle Aged ; Nephrectomy ; Osteosarcoma ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Endometrial Neoplasms ; drug therapy ; pathology ; Female ; Humans ; Precancerous Conditions ; drug therapy ; pathology ; Progestins ; therapeutic use

Objective To explore possible mechanisms of hepatic fibrosis by investigating the ultrastructural dynamic changes of liver tissue, especially several kinds of cells related to hepatic fibrosis.. Methods. Murine schistosomal hepatic fibrosis model was established by infecting mice with Schistosoma japonicum cercariae. Routine transmission electron microscopy was used to observe the liver tissue. H.E. staining was used for examining the pathological changes. . Results . H.E. staining showed that the model was established successfully. Ultrastructural observation showed that at the 6th week after infection, the necrosis of hepatocytes around the acute granulomas occurred; the number of sinusoidal endothelial fenestrae and vitamin A droplets in fat-storing cells decreased; large phagosomes and rough endoplasmic reticulum could be seen in the cytoplasm of Kupffer′s cells. At the 8th week, steatosis was found in some hepatocytes, some microvilli emerged on a few inter-hepatocytic surfaces and the inter-hepatocytic spaces were enlarged. Large collagen fibrillar bundles filled in the perisinusoidal spaces, and capillarization of hepatic sinusoids was observed. Secretory vesicles filled with collagen fibrils appeared in the cytoplasm of fat-storing cells with large amount of collagenous fiber bundles surround the cells. Rough endoplasmic reticulum increased in Kupffer′s cells. At the 10th week, fat-storing cells were activated and transformed into myofibroblasts. At the 12th week, the number of myofibroblasts decreased but that of fibroblasts and fiber cells increased. . Conclusion . Activation of fat-storing cells and transformation from fat-storing cells into myofibroblasts are the critical link in the development of hepatic fibrogenesis following schistosome infection. Kupffer′s cells, necrotic hepatocytes and sinusoidal endothelial cells may relate to the activation of fat-storing cells. Capillarization of hepatic sinusoids possibly accelerates the development of hepatic fibrosis.

To explore the safety and efficacy of left atrial appendage (LAA) occlusion under the guidance of local anesthesia and modified transseptal puncture technology by coronary sinus assisted positioning in patients with nonvavular atrial fibrillation (NVAF). Methods: A total of 16 NVAF patients received local anesthesia and percutaneous LAmbre or Amplatzer cardiac plug occluder implantation. There were 12 males and the patients mean age was at (71.0±6.0) years with CHA2DS2-VASc score at (4.1±1.5); all patients had walfarin contradiction or with walfarin related side effect. Transseptal puncture was conducted by coronary sinus catheter as the anatomic location marker. Results: All 16 patients finished transseptal puncture and no relevant complication occurred. 15/16 (93.8%) patients had successful LAA occlusion, 1 patient was abandoned because of LAA anatomic structure variation. The mean operative time was (65.0±23.0) min and the mean X-ray exposure time was (12.0±3.0) min. The mean diameter of occluder was (32.5±6.0)mm. Conclusion: LAA occlusion was safe and effective with local anesthesia and modified transseptal puncture technology by coronary sinus assisted positioning in relevant patients.

Objective To investigate the clinical value of prenatal ultrasound in fetal meningocele and encephalocele.Methods Thirty nine fetuses with meningocele and encephalocele confirmed by prenatal ultrasound and abortion were acquired and their clinical data and sonographic features were retrospectively analyzed.Results Ultrasound screening in 111 620 cases showed 39 fetuses were with meningocele and encephalocele,accounting for 0.35％.Among them,16 cases were diagnosed with meningocele (including 1 case with two bulging parts) and 23 cases with encephalocele.Prenatal ultrasound could clearly detect the location and size fetal skull defect,and bulging features.According to their sonographic features,meningocele or encephalocele was determined.Conclusion Ultrasound could be a reliable prenatal screening method,provide an important basis for clinical intervention and have a significant clinical value in fetal meningocele and encephalocele.

PurposeTo explore the value of prenatal ultrasound in diagnosis of fetuses with limb body wall complex (LBWC).Material and MethodsThe ultrasound images and follow-up results were studied retrospectively in 20 cases of LBWC, and the ultrasonic features of LBWC were analyzed.ResultsAll 20 cases showed rather severe body wall defect and spinal abnormality, including 16 cases of abdominal wall defect, 4 cases of abdominal thoracoabdominal defect, 8 cases of idiopathic scoliosis, 2 cases of kyphosis, 3 cases of twist into a corner, 1 cases of distortion as S shape, and 6 cases of vertebral body arranged in disorder. Moreover, 16 cases presented abnormal umbilical cord,among which 11 had too short umbilical cord, 1 without umbilical cord, and 7 as single umbilical artery (3 cases with short cord). Five cases showed limb abnormalities, among which 2 cases were left lower limb absence, 1 cases as left upper limb absent, 1 cases as left foot varus and right foot slightly varus, and 1 cases as left foot drop.ConclusionPrenatal ultrasonography can accurately diagnose LBWC in time, so as to provide evidence for early clinical intervention.

Objective To explore the diagnosis and surgical treatment of pulmonary sequestration in adults. Methods Clinical data of 21 cases of pulmonary sequestration whose diagnosis was confirmed by surgical biopsy in our department from March 2009 to February 2016 were retrospectively analyzed. Divided the patients into the thoracotomy group (n=9) and the thoracoscope group (n=12) according to dif-ferent surgical methods, and compared the diagnosis and surgery of the two groups. Results Among the patients, 8 cases were diagnosed as pulmonary sequestration and the remaining 13 cases were misdiagnosed,with the misdiagnosis rate of 61. 9%. Intraoperative exploration dem-onstrated that the abnormal blood vessels were originated from thoracic aorta (n=14,66. 7%),abdominal aorta (n=4,19%),phrenic artery (n=3,14. 3%) and aortic arch (n=1,4. 8%), and there were 20 cases (95. 2%) of intralobar sequestration and 1 case (4. 8%) of ex-tralobar sequestration. Patients underwent thoracotomy and patients underwent video-assisted thoracoscopic surgery were of no significant differences in operative time (P=0. 104),blood loss (P=0. 209),chest tube duration (P=0. 511),drainage volume (P=0. 135) and postoperative hospital stay (P=0. 450). All the patients recovered well after surgery. Conclusion As pulmonary sequestration lacks specific clinical manifestations,missed diagnosis and misdiagnosis are very common in patients. Chest enhanced CT and CT angiography are effective diagnostic methods at present. Both thoracotomy and VATS can achieve good therapeutic effects.

Objective: To explore the safety and efficacy of left atrial (LA) endocardial vagal denervation catheter ablation for treating the patients with refractory vasovagal syncope (VVS).
Methods: A total of 57 consecutive refractory VVS patients with severe symptom and positive response to head-up tilt test (HUT) were enrolled. There were 22 male at the mean age of (43 ± 13) years. The patients had no response or couldn’t tolerate routine treatment. LA model was re-established by three-dimensional mapping system, 10 patients received high-frequency stimulation technique for ganglionated plexi (GP) ablation and 47 received regional catheter ablation at 5 anatomic sites of GP for LA endocardial vagal denervation treatment. In-operative vagal response including hypotension, sinus bradycardia or asystole were observed, the endpoint of ablation was abolition of evoked vagal relfexes. Periodical follow-up was conducted to record the syncope recurrence and to re-examine ECG and HUT in all patients.
Results: There were 52/57(91.2%) patients had positive vagal response by radiofrequency application and reached the endpoint of ablation; 4 patients couldn’t receive obvious evoked vagal relfexes. During (36 ± 22) months follow-up period, there were 52 (91.2%) cases without syncope recurrence, 11 cases still having palpitation, amaurosis and dizziness as the precursors of syncope while the symptoms were much better then they were before. No complication occurred.
Conclusion: LA endocardial vagal denervation catheter ablation is a safe and effective method for treating the patients with refractory VVS, it may also effectively prevent VVS recurrence.

Objective To evaluate three dimensional fetal heart structure by sono-automatic volume count (SonoAVC) with spatio-temporal image correlation(STIC). Methods The heart volumes datas were acquired by STIC in 32 fetuses with postnatally confirmed diagnoses(20 cases of normal heart, 12 cases of complex congenital heart disease between 20 - 37 gestional weeks), then the volume datas were analyzed offline. SonoAVC software automaticly searched hypoechoic and anechoic structures, and assigned individual colors,and this can be corrected by manual splitting and/or removing and merging of individual segments.Results Individual segments of fetal heat could be separated,and digital casts were generated. The digital casts were obtained successfully in 4cases of transposition of the great arteries(TGA) ,2 cases of tetralogy of Follot,1 case of Ebstein's anomaly, 1 case of double-outlet right ventricle and 20 cases of normal heart.Conclusions Combination of STIC and SonoAVC can demonstrate the size, shape and connection of fetal cardiac cavities and great arteries in three dimensional spatial context. It has the potential both to help in obtaining strctural diagnostic,and to generate 3D visual displays for consultation and teaching.

Objective To probe the diagnostic efficacy of fetal eehocardiography for characterizing complex congenital heart diseases.Methods Fetal echocardiography was performed on 49 cases of fetal complex congenital heart disease, the ultrasonic diagnosis was compared retrospectively with pathological results after autopsy.Results Antenatal sonographic diagnosis was in agreement with the pathological results in 42 cases (85.71 %), 7 cases were disagreed with pathological diagnosis (antenatal sonographic diagnosis was discrepancy in 3 cases, 4 cases were partially mis-classified).Twenty-four cases were combined with extra-cardiac malformations.Nine cases had chromosomal abnormality.Conclusions Fetal echocardiography is highly accurate for antenatal diagnosis of complex congenital heart disease, but it is hard to detect some type of cardiac anomalies.