Objective To assess the role of MRI in the preoperative characterization and local staging of testicular neoplasms.Methods A retrospective study of 24 patients suspected of testicular neoplasm was conducted.The histological diagnosis of testicular neoplasms was made and local extension of testicular malignancy was evaluated.The MRI findings were correlated with the pathologic results.Results Histological examination revealed 26 intratesticular lesions,14 of which were nalignant,including 4 cases of diffuse large B cell lymphoma,7 cases of seminoma,2 cases of embryonal carcinoma,one case of teratoma.Twelve lesions were benign,including 5 cases of epidermoid cyst,2 cases of simple cyst,2 cases of inflammatory granuloma,2 cases of testicular mediastinal tubular expansion and one case of testicular pseudo fibroma.Six malignant testicular tumors were confined within the testis,4 invaded the testicular tunicae or epididymis,2 invaded the spermatic cord,and 2 invaded the scrotal wall.The accuracy of MRI in the diagnosis of intratesticular lesions was 92％.The accuracy of MRI diagnosis in the local staging of testicular tunors was 86％.Conclusions MRI is highly accurate in the preoperative characterization and local staging of testicular neoplasms.It is of great significance to the clinical diagnosis and treatment.

Objective To investigate the applicetion value of combined ultrasonic scalpel in laparoscopic cholecystectomy(LC).Methods 140 patients with acute and chronic cholecystitis,gallbladder stone patients,received intraoperative ultrasound combined electrosurgical knife,suction devices auxiliary red line LC.The clinical effects were observed.Results 138 cases were completed cholecystectomy.Blood loss ( 8.16 ± 1.85 ) ml,operation time(38.13 ±4.35) min,Postoperative hospital stay(3.25 ± 1.18)d,4 cases of intraoperative rupture of the gallbladder,Hepatobiliary burns in 1 case,2 cases because of dense adhesions around the gallbladder and gallbladder more extensive anatomical triangle unclear laparotomy.Conclusion The rational use of combined high-frequency ultrasonic scalpel knife,suction devices auxiliary red laparoscopic cholecystectomy,surgical conditions that meet medicalrecords,are safe and reliable,quicker recovery can be achieved by minimally invasive medical treatments.

Antineoplastic agents-induced pulmonary toxicity is one of important reasons causing respiratory failure,which clinical manifestations are pulmonary inflammation,allergic reaction,vascular permeability reaction and pulmonary vascular disease.All of these may be caused by drug toxicity,immune response and increased capillary permeability and so on.Because of the nonspecific performance,it is important to exclude the other lung diseases.Once the diagnosis is clear,the antineoplastic gents should be immediately stopped and the patients should be timely administered high-dose eorticosteroid therapy.How to reduce the pulmonary toxicity induced by antineoplastic agents is becoming one of the future focuses about antineoplastic agents research.

Objective To evaluate effectiveness of clinical pharmacists'intervention in perioperative antimicrobial use in type Ⅰ incisional surgery.Methods Clinical data of 1398 patients undergoing type Ⅰ incisional surgery in a hospital between January and December 2014 were analyzed retrospectively,633 patients who underwent surgery between January and June were as pre-intervention group,765 patients who underwent surgery between July and December were as post-intervention group (clinical pharmacists were assigned to strengthen the management and control of rational antimicrobial use),antimicrobial prophylaxis between pre-intervention group and post-interven-tion group were compared.Results In pre- and post-intervention groups,antimicrobial prophylaxis were 56.71%and 28.37% respectively(χ2= 113.26,P<0.05). Rational selection rates of antimicrobial types were 60.45% and 89.86% respectively,rational rates of administration time were 49.58% and 82.49% respectively,the rates of anti-microbial prophylaxis course≤24 hours were 11.42% and 29.95% respectively,>24 hours were 88.58% and 70.05% respectively,combination antimicrobial use were 10.31% and 0 respectively,the differences between before and after intervention were all statistically significant (all P<0.05). Incidence of surgical site infection in pre-and post-intervention groups were 0.79% (5/633)and 0.26% (2/765)respectively(P= 0.255).Conclusion Through clini-cal pharmacists'intervention in perioperative antimicrobial prophylaxis in type Ⅰ incisional surgery,antimicrobial prophylax-is rate decreased dramatically,antimicrobial management is more standardized,scientific and systematic.

Autoimmune Diseases ; diagnosis ; etiology ; therapy ; Humans ; Immunoglobulin G ; adverse effects ; blood ; chemistry

The study of 102 T2DM patients and 55 non-diabetes subjects showed that the average and largest IMT of carotid arterier had positive relation with age and HOMA-IR, and negative relation with insulin sensitivity.

Purpose:To study the effect of amifostine on ef ficacy in patients with advanced non-small-cell lung cancer(NSCLC) treated w ith chemotherapy and the protection of amifostine on myelosuppression induced by chemotherapy and to investigate major adverse reaction induced by amfostine. Methods:33 patients with advanced NSCLC were randomly divided i nto protection group (amosfostine + MMC +VDS + DDP) and control group (MMC + VDS + DDP), The regimen was given every 4 weeks , All enrolled patients were evalua ted for efficacy and hematologic toxicity after 3 cycles of treatment , Patients in both groups were well-matched for baseline disease characteristics. Results:In protection group (PG) , the response rate was 40% (1 CR , 5 PR , 6 NC , 3 PD), whereas in control group (CG) , the response rate was 33.3% (0 CR , 5 CR , 8 NC , 2 PD), the differentce of response rates betwee n two the groups was not statistically significant (P=0.705). The minimum wh ite blood cell (WBC) counts after chemotherapy in treatment group and in control group were (3.387?1.169)?109/L and (2.46?0.98)?109/L respectively (P =0.026). The minimum blood platelet cell (BPC) counts in PG and in CG were (11 4.53?48.24)?109 /L and (88.2?32.83)?109 /L respectively (P=0.091) . The minimum hemoglobin (HB) counts in CG and in CG were (94.4?14.69)g/L and (89 .33?13.98)g/L respectively (P=0.341). Grade (Ⅱ-Ⅳ) leukopenia rate in PG and in CG were 66.7% (10/15) and 33.3% (5/15) respectively (P= 0.068), Gr ade (Ⅱ-Ⅳ) thrombocytopenia rate in PG and in CG were 33.3% (5/15) and 20% (3/ 15) respectively (P= 0.409), Grade (Ⅱ-Ⅳ) hypochromia rate in PG and in CG were 53.3% (8/15) and 46.7% (7/15) respectively (P= 0.715). Major ad verse effects of amifostine were mild hypotension , nausea and vomiting , dizzin ess , malaise etc. Conclusions:Amifostine does not reduce the efficacy of chemothe rapy in patients with advanced NSCLC , it can reduce the hematologic toxicity as sociated with chemotherapy of MVP regimen , the adverse effects of amifostine ar e mild.

[Objective]To explore the relationship between Pglycoprotein,survivin expression and chemotherapy outcome.[Method]The expressions of P-glycoprotein,and of survivin were examined by the immunohistochemistry in 38 specimens of preoperation biopsy of osteosarecomas.[Result]The response rate of the P-glycoprotein positive group was lower than that of P-glycoprotein negative group.The response rate of the survivin overexpression group was significant lower than survivin was found to be more valuable in predicting chemotherapy results.[Conclusion]The expressions of P-glycoprotein,and of survivin are clearly associated with osteosarcomas response to chemotherapy in osteosarecoma and survivin is a more valuable parameter.

AIM:To investigate the role of imperatorin in reversing the resistance of the PC 9 CD133+cell sub-sets to gefitinib.METHODS:MTT assay was performed to evaluate the viability of PC 9 cells treated with imperatorin and gefitinib.The expression of c-met, activation of caspases and phosphorylation of epidermal growth factor receptor (EGFR), PI3K and AKT in the PC9 cells treated with imperatorin and gefitinib were determined by Western blot .The percentage of CD133 +cell subsets population and the apoptotic rate of the PC 9 cells treated with imperatorin and gefitinib were analyzed by flow cytometry .RESULTS:The sensitivity of the PC 9 CD133 +cell subsets to gefitinib was significantly lower than that of the PC9 CD133 -cell subsets.Treatment with gefitinib alone significantly inhibited the protein levels of EGFR /PI3K/AKT in the PC9 CD133 -cell subsets but not the PC 9 CD133 +cell subsets .Treatment with gefitinib alone increased the percentage of CD133 +cell subsets population in the PC9 cells.However, combination of gefitinib with imperatorin signifi-cantly inhibited the enrichment of CD 133 +cell subsets population .Imperatorin down-regulated c-met expression , sugges-ting the c-met was the target of imperatorin in the PC9 CD133 +cell subsets.The results of MTT assay, Western blot analy-sis and flow cytometry indicated that imperatorin increased the gefitinib induced inhibition of PI 3K/AKT protein levels by down-regulating the expression of c-met, which subsequently induced the cleavage of caspases and apoptosis in the PC 9 CD133 +cell subsets.CONCLUSION:Imperatorin increases the sensitivity of lung cancer CD 133 +cell subsets to gefitinib by down-regulating the expression of c-met, and the synergistic anti-tumor effect exists between imperatorin and gefitinib .

Objective Aprotinin, a serine proteinase inhibitor, has been reported to reduce blood loss significantly in patients undergoing cardiac surgery with CPB, heart and liver transplantation. The aim of this study was to evaluate the effect of aprotinin on intraoperative blood loss, transfusion requirement and blood coagulation during liver cancer resection.Methods Eighty-two ASA Ⅰ -Ⅲ patients ( 51 male, 31 female ) aged 33-65 yr undergoing liver cancer resection ( 61 partial hepatectomy, 21 extirpation of liver cancer) were studied. The patients were randomly divided into 2 groups : aprotinin group received a bolus of aprotinin 1 112 EPU after induction of anesthesia, followed by continuous aprotinin infusion at 278 EPU?h-1 until 2 h after operation ( n = 40); control group received normal saline instead of aprotinin ( n = 42) . The patients were premedicated with sodium luminal, droperidol-fentanyl and atropine. Anesthesia was induced with midazolam 2 mg, thiopental 5 mg?kg-1 and succinylcholine 1.5 mg? kg-1 . After tracheal intubation the patient was mechanically ventilated (VT = 8-12 ml?kg-1 ) and PaCO2 was maintained at about 35 mm Hg, Anesthesia was maintained with N2O/O2 , fentanyl and vecuroniurn. Venous blood samples were taken before induction of anesthesia (baseline) , 0.5 h, 2 h and 4 h after skin incision and 6 h and 12 h after operation for routine blood tests, thromboelastography ( TEG), and determination of activated partial thromboplastin time (APTT), thromboplastin time (TT) prothrombin time (PT) and plasma fibrinogen concentration (Fig) . Intraoperative blood loss and amount of blood transfused were recorded. Results The preoperative hypercoagulable state was ameliorated and coagulation was maintained within the normal range in aprotinin group; while in control group the hypercoagulable state was aggravated during operation and at the end of operation it changed to hypocoagulable state. The intraoperative blood loss and amount of blood infused were significantly less in aprotinin group than in control group. Conclusion The use of aprotinin during liver cancer resection results in reduction in intraoperative blood loss and less transfusion requirement.