Objective To investigate clinical and imaging features of malignant transformation in monostotic fibrous dysplasia (FD).Methods Radiography (n=12),computed tomography (CT)(n=7)and magnetic resonance imaging (MRI)(n=5)data of 12 monostotic FD cases proved by surgery and pathology were retrospectively reviewed.Results Among 12 cases,6 cases underwent surgery.Their images showed osteolytic lesions in the operative area with direct signs of aggressiveness (poorly defined margin,cor-tical destruction and soft tissue mass).For the 6 cases without surgery,radiography and CT showed poorly margin,osteolytic le-sions within or near the area of ground-glass opacity.MRI showed lesions with heterogeneous signal intensity and pronounced con-trast-enhancement.Histopathologically,9 cases were osteosarcomas,2 cases were fibrosarcomas,and 1 case was malignant fibrous histiocytoma (MFH).Conclusion The imaging information of malignant transformation of FD can provide evidence of possible ma-lignancy.

Books ; Language ; Linguistics ; Medicine, Chinese Traditional ; Translations

Purpose To investigate the expression of Dkk3 and Cyclin D1 protein in human hepatocellular carcinoma (HCC) and clinical significance.Methods Immunohistochemistry was used to detect Dkk-3 and Cyclin D1 protein expression level in 80 cases of hepatocellular carcinoma and corresponding para-cancer tissue.Results The expression of Dkk-3 in hepatocellular carcinoma was significantly lower than those in corresponding para-cancer tissue (P ＜ 0.05) and the expression of Cyclin D1 in hepatocellular carcinoma was significantly higher than those in CoTesponding para-cancer tissue (P ＜ 0.05).The up-regulation of Cyclin D1 and the down-regulation of Dkk-3 proteins were correlated with pathologic differentiation degree (P ＜0.05).There was a significant inverse correlation between Dkk3 and Cyclin D1 expression (P =0.044,rs =-0.226).Conclusion The abnormal expression of Dkk-3 and Cyclin D1 gene in human hepatocellular carcinoma suggest that Dkk-3 and Cyclin D1 gene may play an important role in the development and progression of the cancer.The combination deteetion of the two biomarkers may provide valuable data for diagnosis and prognosis estimation of HCC.

Objective To investigate the epidemiology of fungemia and provide evidence for clinical therapy.Methods A retrospective survey was conducted with 42 cases of fungemia in our hospital from Jan 2002 to Jan 2011.Results Forty cases candida fungemia accounted for 95.2％ in 42 fugemia.The main pathogen agent was non-Candida albicans in candida fungemia,which were candida albicans(14.3％),candida parapsilosis (38.1％),candida glabrata (35.7 ％),candida tropicalis (2.4％).Eleven uneffecfive cases accounted for 26.2％.Multiple-factor analysis showed that neutropenia time ＞ 7 days,antibiotic using time ＞ 7 days and fungal infection history correlated with bad prognosis.Our study also showed that chemotherapy regiments including hormone、combining with other organs fungal infection and non-Candida albicans were risk factors of bad prognosis.Conclusion The main pathogen agent of fungimia is candida,especially non-Candida albicans.Neutropenia time ＞ 7 days,antibiotic using time ＞ 7 days and fungal infection history correlate with poor prognosis.

Objective To investigate the epidemiology of fungemia and provide evidence for clinical therapy.Methods A retrospective survey was done with the 42 cases of fungemia in our hospital.Results 42 cases of fungemia include 35 cases acute lymphoid leukemia,6 acute myloid leukemia.95.2％ of the fungemia pathogen agent was monilia.8 cases combined with bacterial septicemia,accounting for 19.0％.Drug sensitivity test showed that 2 cases were intermediary to Fluconazole,1 patient was resisdence to Amphotericin B but sensitive to Voriconazole,Itraconazole and fluorocytosine.The main risk factors of fungimia included using wide-spectrum antibiotic,neutophil less than 0.5 × 109/L,central venous indwelling catheter,age and the time of in hospital more than 15 days.Conclusion The effective measure to reduce fungemia morbitity is controlling risk factors.Timely and effectively antifungal therapy is also needed.

Objective To explore the clinical presentation,etiology of sepsis,common positions of in-fection and anti-infectious treatment of pediatric acute leukemia with septicemia resistance to carbapenem. Meth-ods A retrospective chart review of all pediatric acute leukemia with septicemia cases of Beijing Children 's Hospital from December 2011 to September 2015 were analyzed. All cases were selected based on the clinical presentation,at least one Gram-negative bacteria positive result of blood culture and were resistant to carbapen-em. The basic clinical characteristics and the results of blood culture and antimicrobial susceptibilities were ana-lyzed. Results All 45 cases with fever,among them 8 cases under went continued fever,The other 37 cases fe-ver days were ( 6. 1 ± 5. 2 ) d. Twenty-six cases had agranulocytosis. Agranulocytosis time from 2 to 79 days, mean days(15. 2 ± 16. 2)d. Significant difference of fever time between agranulocytosis team and non-agranulo-cytosis team was significant(P=0. 011). Twenty-three cases had infection positions among 45 cases. Lung,di-gestive tract,mouth and crissum were the common positions of infection. The quantum of blood culture samples were 711 parts. There were 162 parts resistant to carbapenems. The primary pathogens were pseudomonas aerugi-nosa,klebsiella pneumoniae, enterobacter cloacae and Escherichia coli. Among those 45 cases, 36 cases were cured,9 cases were ineffective treatment. Conclusion Pseudomonas aeruginosa, klebsiella pneumoniae, enter-robacter cloacae and Escherichia coli accounted for the most of G-bacteria infections resistant to carbapenem in our center. The incidence of septicemia was related to the level of granulocyte and duration of agranulocytosis.

Objective To measure hepatic ultrasonic integrated backscatter (IBS) in healthy rabbits as a non-invasive quantitative diagnostic means for hepatic steatosis, hepatic fibrosis, and liver cirrhosis; to determine the factors that may influence the IBS measurement. Methods Thirty-five healthy New Zealand white rabbits with normal liver function tests and normal liver biopsies were used in this study. HP Sonos 5500 image system with quantitative analysis function was used for IBS measurement. With the machine setting fixed, and optimal image obtained, left and right liver were divided into near, medial and far areas according to the depth. Further the measurements of IBS in different depth were performed respectively. Meanwhile, in the same liver the IBS image was collected and the change of IBS intensity was measured in various setting of machine index (MI), time gain compensation (TGC) and lateral gain compensation (LGC). Results Average image intensity (AII) of left liver (from near to far areas) was ( 25.38? 2.36)dB, ( 26.32? 2.38)dB, and ( 26.45? 2.28)dB, respectively. The AII of the right liver (from near to far areas) was ( 24.99? 2.23)dB, ( 24.92? 2.59)dB, and ( 25.38? 2.36)dB, respectively. The average standardized AII of image in left livers was significantly higher than that of the right (P

Objective To analyze the imaging characteristics and the diagnostic value of conventional MRI and indirect MR arthrography in shoulder joint injury.Methods MR imaging in90 patients with shoulder joint disease were retrospectively analyzed by two musculoskeletal radiologist based on the results of arthroseopic examination,including 57 cases of rotator cuff disease and 33 cases of recurrent shoulder instability.The result of the indirect MR arthrography and conventional MR was statistically compared by Fisher exact probability test.Results (1)In the group of rotator cuff disease,37 patients underwent indirect MRA,demonstrating 10 cases of partial-thickness rotator cuff tear and 1 case of missed diagnosis;demonstrating 17 cases of full-thickness rotator cuff tear and 2 cases of misdiagnosis.For partialthickness rotator cuff tear,the sensitivity,specificity and accuracy of indirect MR arthrography were 90.9%(10/11),92.3%(24/26),and 91.9%(34/37),respectively;for full-thickness rotator cuff tear,the sensitivity,specificity and accuracy of indirect MR arthrography were 89.5%(17/19),94.4%(17/18),and 91.9%(34/37),respectively.Indirect MR arthrography in the diagnosis of partial and full thickness rotator cuff was significantly better than conventional MR(P＜0.05).(2)In the group of recurrent shoulder instability,labium tear was found in 26 cases,Hill-sachs lesion in 27,reverse Hill-sachs in 2,bony Bankart lesion in 7,and capsular tear in 18 cases,respectively.Twenty patients underwent indirect MRA,demonstrating 14 cases of labrum tear,1 case of missed diagnosis,and 5 cases of normal labrum.For labrum tear,the sensitivity,specificity and accuracy of indirect MR arthrography were 93.3%(14/15),100.0%(5/5),and 95.0%(19/20),respectively.Indirect MR arthrography in the diagnosis of labrum tear was significantly better than conventional MR(P＜0.05).Conclusion MRI,especially indirect MR arthrography,is the most helpful method for the diagnoses of shoulder joint injury.

Objective To evaluate the application of tubular stomach gastroesophagostomy on the life quality after esophagectomy surgery.Methods From March 2011 to September 2011,66 cases of esophageal cancer patients were divided in two groups in randomized principles.Tirty-four cases in group of tubiform gastro surgery whose the stomach was cut into tubiform stomach in width of 4 cm.And 32 cases of conventional group and whose surgery method was adopted to maintain whole stomach but cut the cardia.And then,using statistical methods,life quality after esophagectomy (treatment related symptoms,general symptoms,daily life,social life,emotional activities) and the perioperative complications were evaluated in 3,6,12,24 months in comparison and analysis.Results Sixty-six surgeries of both group patients were successfully performed,tumor resection rate was 100％,and there was no intraoperative accident also no perioperative death.There was no statistical significance of perioperative complications of 2 groups (P ＞ 0.05).Life quality of tubiform gastro group had improved apparently more than conventional group at the 3rd,6th,12th and 24th month after surgery(78.68 ±2.23 vs 65.94± 4.13,83.79 ± 2.40 vs 66.84 ± 5.86,86.41 ± 1.94 vs 67.09 ± 4.43,89.02 ± 1.71 vs 68.88 ±3.53,P＜0.05).At each time point,there were statistically significant differences between tubiform gastro group and conventional group on treatment related symptoms,general symptoms,daily life,emotion activities (P ＜0.05).At the 3rd,6th month after surgery,tubiform gastro group and the conventional group had no statistically significant difference in the aspect of social life (P＞0.05).In the conventional group,the evaluation of quality of life at each time point after surgery and before a point in time in the same group showed no statistical significance (P＞0.05).Conclusion Tubiform gastro esophagectomy has a positive influence on life quality of patients of esophageal cancer after surgery prospectively.