Objective To analyze the clinical characteristics of acute hematogenous pulmonary tuberculosis and tuberculous meningitis in pregnant women after in vitro fertilization and embryo transfer (IVF-ET).Methods Clinical data of 11 cases of hematogenous pulmonary tuberculosis and tuberculous meningitis in women after IVF-ET admitted in Hangzhou Red Cross Hospital from January 2003 to October 2012 were retrospectively analyzed.Results The clinical manifestations of acute hematogenous pulmonary tuberculosis and tuberculous meningitis were non-specific.All cases presented with fever,and some were accompanied by headache,but no typical respiratory manifestation was observed.Chest X-ray showed typical military lesions.Miscarriage occurred in 11 patients within 2 to 5 weeks after the onset of fever,including 3 received artificial abortion.Conclusions The outcome of hematogenous pulmonary tuberculosis in pregnant women after IVF-ET is less favorable.Physicians should be aware of tuberculosis in pregnant women after IVF-ET,especially for those with long-term fever and not responding to anti-inflammatory treatment.

Objective To investigate the causes, management, and prevention of complications in laparoscopic gynecologic surgery. Methods A retrospective analysis was made on clinical data of 4413 cases of laparoscopic gynecologic surgery from September 1995 to June 2006 in this hoapital. Results Among 4413 cases, complications occurred in 71 cases, the overall rate being 1.6% (71/4413). Out of the 71 cases, an open surgery was required in 10 cases (14.1%). Complications included 5 cases of bladder injury, 4 cases of intestinal injury, 5 cases of massive haemorrhage, 8 cases of incision hematoma and drainage bleeding, 1 case of greater omentum hernia, 9 cases of perineal emphysema, 12 cases of skin congestion, 2 cases of head hematoma, 2 cases of brachial plexus nerve injury, 1 case of infective shock, 15 cases of abnormal incision healing, 1 case of lower limb thrombosis, and 6 cases of residual cervical cyst. Conclusions Complications of laparoscopic gynecologic surgery are correlated with the difficulty of operation and the skillfulness of operator.

OBJECTIVE:To improve the production and circulation mode of Chinese traditional medicinal materials(CTMM).METHODS:The current status of the production and circulation mode of CTMM was analyzed,and the problems and their causes in this mode was discussed,then the suggestions were put forward on the basis of analysis.RESULTS&CONCLUSION:The present mode needed improvement in the aspect of quality control,the improvement in general adminis?trative policy for CTMM,training of professionals,protection of medicinal resources,regulation of market,and establishment of famous brands of traditional medicines can all help the quality control.

Transitional cell carcinoma of the urinary bladder is the most common cancer of the urinary tract and is characterized by frequent recurrence. Like the other malignant tumor, the genetic alterations leading to neoplastic transformation of the urothelium are related with the activation of oncogenes and loss of functional tumor suppressor genes. Cyclin D1 is a putative protooncogene as cell cycle regulator essential for G1 phase progression and is frequently overexpressed in several human tumor. In this study we performed immunohistochemical stainings of cyclin D1 and p53 in both primary and recurrent transitional cell carcinomas of urinary bladder from 56 patients including 20 cases of recurrent tumor, and compared their results with histopathologic features. The results were as follows. Cyclin D1 immunoreactivity was found in 10 of 10 cases (100%) of grade 1, 25 of 41 (61%) cases of grade 2, and 11 of 25 (44%) cases of grade 3 transitional cell carcinomas. p53 immunoreactivity was found in 40% of grade 1, 63% of grade 2, and 87% of grade 3 lesions. Cyclin D1 expression was significantly higher in Ta and T1 lesions than T2 to T4 by pathologic tumor stage. Conversely p53 immunoreactivity was increased in proportion to the T classification. Cyclin D1 was de creased in recurrent transitional cell carcinomas, compared with primary transitional cell carcinomas. However, there was no statistical significance. In conclusion, cyclin D1 immunoreactivity is associated with low histologic grade and low tumor stage. And there is inverse relationship between the cyclin D1 and p53 overexpression.
Carcinoma, Transitional Cell* ; Cell Cycle ; Classification ; Cyclin D1* ; Cyclins* ; G1 Phase ; Genes, Tumor Suppressor ; Humans ; Oncogenes ; Recurrence ; Urinary Bladder* ; Urologic Neoplasms ; Urothelium

With 2mm-thick CT scanning during the rapid infusion of contrast material(TICT), cerebral aneurysms arising from the circle of Willis and adjacent vessels can be directly visualized. Twenty-five patients who had cerebral aneurysm confirmed by surgery were examined with TIGT and digital subtraction angiography. The authors examined TIGT prospectively to assess the detection rate of the cerebal aneurysms and to evaluate the clinical usefulness of TIGT. The detection rates of aneurysms by TIGT and digital subtraction angiography were 68% and 84%, respectively. TIGT is a rapid, safe and reliable method in the evaluation of patients with suspected cerebral aneurysm, permitting direct visualization of the aneurysm.
Aneurysm ; Angiography, Digital Subtraction ; Circle of Willis ; Humans ; Intracranial Aneurysm* ; Methods ; Prospective Studies ; Tomography, X-Ray Computed

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OBJECTIVE:To observe the clinical efficacy of the Humai powder for chemotherapy phlebitis. METHODS:80 pa-tients with chemotherapy phlebitis were randomly divided into treatment group and control group with 40 cases in each group. Treat-ment group was given Humai powder for external use,1 h/time,2 times/d;control group was given Hirudoid cream for external use,2 times/day. Venous pain,red and swollen disappearance time,and overall clinical efficacy were compared between 2 groups after treatment 48 hours. RESULTS:The time of red and swollen disappearance and pain disappearance in treatment group were shorter than in control group,with statistical significance (P<0.05);there was no statistical significance in clinical efficacy (cure rate + significant efficiency)between 2 groups(P>0.05),while cure rate of treatment group was significantly higher than that of control group (P<0.05). CONCLUSIONS:Humai powder can relieve clinical symptom of patients with chemotherapy phlebitis and has high cure rate.

Objective To investigate the clinical characteristics,diagnosis and treatment of necrotizing fasciitis (NF).Methods The authors reviewed and analyzed clinical manifestations,auxiliary examinations,treatments and prognoses of 14 patients who had been diagnosed with NF and hospitalized in the Children's Hospital of Anhui province between Jan 2007 and Sep 2013.Results Among the patients included in this study,eight cases were male and six cases were female.The average age was (15.86 ± 10.48) month,The time of abnormal temperature was (10.64 ± 5.64) d,hospital day was (29.07 ± 16.30) d,numbers of debridements were (3.07 ± 1.33) times.All patients had septic shock in which 5 cases had multiple organ failure.Diseases were found on hips (5 cases),lower limbs (4 cases),back (2 cases),perineum (2 cases),and neck (1 case).Blood culture showed staphylococcus aureus in six cases (1 case of methicillin-resistant staphylococcus aureus),pseudomonas aeruginosa in four cases and angina group of streptococcus pneumoniae in one case.No obvious bacteria growth was observed in three cases.CT examinations reflected subcutaneous gas formation in 11 cases but skin and subcutaneous tissue edema and fascial thickening in all cases.All cases of NF were further confirmed with soft tissue biopsies.Early symptoms resembled those of cellulitis.As the diseases progressed,other symptoms appeared such as skin ulceration,bullae formation and gas formation in the tissues.All patients were treated with surgical debridements (vacuum sealing drainage continuous drainage in 5 cases),appropriate antibiotic coverage and colloid supporting treatments.Seven patients were healed (50.00％,7/14),four had skin grafts (28.57％,4/14) and 3 died(21.43％,3/14).Six cases were found having limited physical activities in two year follow-up visits.Conclusion NF is a rare but potentially fatal disease.It is commonly found on the perineum,abdominal wall and extremities.NF can easily lead to septic shock and multiple organ failure.Early detection,surgical debridement and proper drainage along with appropriate antibiotic coverage can decrease mortality rates.

PURPOSE: Congenital Iobar agenesis of the liver is a rare anomaly. We report five cases (three cases of right Iobar agenesis and two cases of left Iobar agenesis) and discuss the radiologic findings of this congenital anomaly. MATERIALS AND METHODS: Between July, 1992 and February, 1993, three cases of right Iobar agenesis and two cases of left Iobar agenesis of the liver were diagnosed by means of computed tomography(CT) and/or sonography. MR imging was performed in two patients, cholangiography in two, and digital subtraction angiography in one. RESULTS: The main findings of right Iobar agenesis of the liver were nonvisualization of the right portal vein and absence of liver tissue to the right of gallbladder. The findings of left Iobar agenesis were nonvisualization of left portal vein, absence of liver tissue to the left of the gallbladder, and absence of ligamentum teres. The ancillary finding of the Iobar agenesis was visualization of less than three hepatic veins. CONCLUSION: It is important to consider Iobar agenesis of the liver in differential diagnosis when imaging studies reveal abnormal portal vein branches, unusual position of gallblader, absence of ligamentum teres, and visualization of less than three hepatic veins.
Angiography, Digital Subtraction ; Cholangiography ; Diagnosis, Differential ; Gallbladder ; Hepatic Veins ; Humans ; Liver ; Portal Vein

In order to meet the requirements of medical teaching contents and curriculum system reform, we adopt the experience ofHarvard University School of Medicine to integrate Biochemistry and Cell Biology into a new one—— "Chemistry and Biology of theCell". We have carried out the integration of the two courses three times. In this new course, repeated contents have been reduced, thelinkage of the two courses has been increased, and the burden of students was lightened,which makes students contact the clinic earlierand enables to improve the students' ability to solve problems.