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

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

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 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 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 identify and investigate B(A)02 allele in a patient. Methods Serological tests were performed with standard serological methods in a patient with B(A)02 allele. DNA sequences of all seven exons and exon-intron boundaries of ABO gene were analyzed by polymerase chain reaction (PCR), direct DNA sequencing and sequencing after gene cloning. In order to analyze the allele, PyMOL software was used to establish 3D model of Glycosyltransferases B (GTB). Results The serological results showed the characteristics of B(A) phenotype. DNA analysis revealed that ABO gene of the individual was heterozygous of B(A)02/O01 allele. 700C>G mutation was identified in B101 allele, which resulted in the amino acid substitution P234A in GTB. Through the analysis of the 3D structure of GTB, it was speculated that the P234A replacement affected the intermolecular forces of the 234 amino acid and Met-266, thus changed the conformation of the donor-binding pocket of GTB,that made GTB capable of recognizing and tranferring the GalNac to the H antigen, which can lead to the formation of the weak A antigen on membrane of red blood cells. Conclusion The P234A replacement can affect the spatial conformation of the specific recognition region conformed by Met-266 and Ala-268 residues, which leads to the antigenicity change of the ABO blood group.

Objective To evaluate the efficacy objectively and systematically between endoscopic and microscopic surgery for transsphenoidal pituitary adenoma by a Meta-analysis.Methods A systematic literature search of Medline,the Cochrane Library,the Web of Science and the Google Scholar were performed to recruit studies between January,1990 and May,2015 that compared endoscopic and microscopic approaches in the treatment of pituitary adenomas.A Meta-analysis(R-3.1.3) was conducted to estimate the effect of different operative procedures.Results A total of 22 studies including 3 randomized or quasi-randomized controlled trails and 19 case-control studies met the inclusion criteria.Among 1421 patients studied,733 of them were treated with endoscopic and 688 were treated with microscopic surgery.The rate of gross tumor removal was higher in patients who underwent endoscopic surgery (71％) than those who underwent microscopic surgery (56％)(P ＜ 0.05).The rate of remission of hypersecretion was also higher in patients who underwent endoscopic surgery(60％) than those who underwent microscopic surgery(54％),but the difference was not significantly(P ＞ 0.05).Conclusion The present study indicates that the endoscopic transsphenoidal approach is more effective than microscopic surgery in the treatment of pituitary adenomas.