Objective To investigate the clinicopathologic features,the complications of splenectomy and the survival of epithelial ovarian cancer patients with splenic metastasis.Methods A retrospective study was performed of 32 pailents with epithelial ovarian cancer who underwent splenectomy for tumor cytoreduction at Zhejiang Cancer Hospital between Jan 1998 and Jun 2006.Results Of 32 patients,23 patients(72%)were serous adenocarcinoma and 9 were non-serous adenocarcinoma.According to pathological grade,none was of G1,11 were of G2,21 were of G3.Postoperatively,20 patients were left with no residual tumor.7 were with≤2 cm and 5 were with＞2 cm residual tumor.Postoperative complications developed in 8 patients(25%),including subphrenic abscess,wound infection,gastric perforation,gastrorrhagia,phlebothrombosis,and bowel obstruction.The median follow up was 38 months,estimated 2-year and 5-year overall survival were 70%and 36%.Univariate analysis revealed that histological grade,residual tumor and courses of chemotherapy were influencing factors of the survival(P＜0.05),but multivariate analysis indicated that only residual tumor and courses of chemotherapy independently influenced survival(P＜0.05).Conclusions In epithelial ovarian cancer patients with splenic metastasis,low grade serous adenocarcinoma is most common.Splenectomy as part of cytoreductive surgery is associated with modest morbidity and mortality.Residual tumor and courses of chemotherapy are independent factors associated with the prognosis of the patients.

Objective:To study the effects of group counseling which based on interpersonal activities and aimed at the college students with computer gaming addiction in China.Methods:Seventeen college students with computer game addiction were chosen as the experimental group,and 10 college students from another college were chosen as the control group.The two groups had no difference in the scores of Computer Gaming Addiction Invention(CGAI)and several other scales before group counseling.There were a pre-test and a post-test separately set when the group counseling was started and finished,focused on CGAI and negative emotions and cognitions.Results:In post-test,the score of CGAI in experimental group was significantly lower than that in control group[(92.6±16.7)vs.(105.9±13.0)] and lower than that in pre-test(98.9±16.4)by analysis of covariance(Ps<0.01).The scores of Beck Depression Inventory(BDI),Self-Rating Anxiety Scale(SAS),and the negative cognition of oneself in socical settings in experimental group were also lower than those in control group [(6.4±7.9)vs.(13.5±5.6),(39.7±6.4)vs.(49.9±10.3),(15.1±4.3)vs.(19.9±3.0),Ps<0.01],while the score of Rosenberg Self-Esteem Scale(SES)was higher than that of the control group [(29.3±2.9)vs.(24.6±4.8),P<0.01].Conclusion:Group counseling based on interpersonal activities has obvious effects on the college students with computer gaming addiction.

ObjectiveTo summarize the clinical features of ulcerative eolitis (UC) complicated by toxic megacolon for early diagnosis and proper treatment. MethodsSix cases of toxic megacolon in the patients suffered from UC in Peking Union Medical College Hospital from 1983 to 2010 were analyzed,and related literature was searched and reviewed.ResultsThe incidence of the toxic megacolon in the patients with UC in our center was 0.7％ (6/824),which was lower than those reported in the literature.There were always risk factors triggering the disease.The prognosis of the patients was poor,even after medical care and surgery intervention.Evaluation of the patients and making right timing to perform the surgery would improve the prognosis of the patients in foreign literature. ConclusionIt's crucial to make early diagnosis of the toxic megacolon in the patients suffered from UC. The right choice and timing to perform urgent surgery or selective surgery may improve their prognosis.

Objective To investigate the prognostic value of arterial blood lactate(Lac) and lactate clearance rate(LCR) for severe neonatal asphyxia.Methods One hundred and fifteen cases of severe neo natal asphyxia admitted in NICU of our hospital from January 2011 to October 2014 were retrospectively analyzed.Lac and LCR values were measured at multiple time points and were compared between those died (27 cases,the death group) and those survived (88 cases, the survival group).The correlation between prognosis and Lac as well asLCR was investigated.Receiver operating characteristic(ROC) curves were drawn to evaluate the prognostic value of Lac and LCR at different time points.Results No significant differences in initial lactate levels and neonatal critical illness score (NCIS) were detected between the two groups (P ＞0.05), while Lac and LCR values at 1 h,2 h,and 6 h showed significant differences between the two groups (P ＜ 0.05).The low-LCR group showed a higher rate of multiple organ dysfunction syndrome and mortality rates than the high-LCR group (44.64％ vs.15.25 ％, P =0.001;32.14％ vs.15.25 ％, P =0.033, respectively).Post-treatment Lac level was positively correlated with prognosis, while LCR at 1 h,2 h, and 6 h were negatively correlated with prognosis.Areas under curve of Lac ROC at 1 h,2 h, and 6 h were 0.625,0.719,and 0.835 respectively, while areas under curve of LCR ROC at 1 h, 2 h, and 6 h were 0.676,0.784, and 0.898 respectively.Conclusion Low LCR for severe neonatal asphyxia predicts poor prognosis.Lac level and LCR at 6 h after emergency treatment is a prognostic indicator for severe neonatal asphyxia.

Objective To investigate the expression of Na+/H + exchanger isoform-1 (NHE-1) during ischemia-reperfusion (IR)in rat lung tissue and determine whether cariporide preconditioning protects lung from inflammatory injury via inhibiting NHE-1 protein expression.Methods Twenty i-solated perfused lungs were randomly divided into 4 groups:the lungs in control group (group C) were continuously perfused for 120 min;the lungs in group IR were subjected to 30 min perfusion, followed by 60 min ischemia and 30 min reperfusion;in group LiCl preconditioning,the lungs were preconditioned with LiCl for 30 min,then continuously perfused for 90 min;in cariporide precondi-tioning+IR (CIR)group,the lungs were preconditioned with cariporide for 30 min,following 60 min ischemia and 30 min reperfusion.After reperfusion,the NHE-1 protein expression was determined by immunohistochemistry and the histopathologic change and pathology scores were ascertained from HE sections.Results The NHE-1 protein expression in lung tissue in groups IR and LiCl were signifi-cantly increased compared with groups C and CIR (P <0.05),and there was no difference between groups C and CIR.Histological examination revealed marked inflammatory changes in groups IR and LiCl,whereas no significant changes in lungs of groups C and CIR.The pathology score of lung in groups IR and LiCl were higher than that in groups C and CIR (P <0.05),and there was no differ-ence between the last two groups.Conclusion IR results in an increased NHE-1 protein expression in rat isolated perfused lung,and the selective NHE-1 inhibitor cariporide could repress the NHE-1 pro-tein expression,thereby decrease the lung inflammatory injury after IR.

Objective To explore the effects of lipoxinA4 on expression of cyclooxygenase-2 (COX-2) and prostaglandin E2 (PGE2) in rat primary lung fibroblast cells (LF) after lipopolysaccharide (LPS) challenge.Methods Primary lung fibroblast cells were incubated with various concentrations (0.1,1,10 μg/mL) of LPS for different lengths of time (3,6,9 h).Then primary lung fibroblast cells were still incubated in DMEM medium containing LPS in the presence or absence of lipoxinA4.After incubation,the supematant of medium was collected and the level of PGE2 was detected by using ELISA.The cells were harvested,and COX-2 protein was analyzed by Western blot.Results The model of acute inflammation in fibroblasts was well established by administering 1 μg/mL LPS in fibroblasts for 6 hours.Induction of COX-2 protein by LPS was inhibited by lipoxinA4.The levels of PGE2 in control group,LPS group and LPS + LipoxinA4 group were 55.84 pg/mL,411.73 pg/mL and 307.07 pg/mL,respectively,and there was a significantdifference between LPS group and LPS + LipoxinA4 group (P ＜0.01).Conclusion LipoxinA4 down-regulates the expression of the COX-2 induced by LPS in primary lung fibroblast cells and consequently inhibits the production of PGE2 in a dose dependent manner.

Objective To investigate the diagnostic values of serum free fatty acids (FFA) and urine podocalyxin (PCX) in the patients with type 2 diabetic nephropathy(DN).Methods A total of 120 patients with type 2 diabetes mellitus (DM) were enrolled,and they were divided into three groups,normal albumin group(NA),microalbuminuria group(MA) and heavy albuminuria group(HA),based on the urinary albumin-creatinine ratio(UACR).In addition,40 healthy persons participated in medical examination were selected as the control group.Serum FFA levels were detected by a biochemical analyzer and urine PCX levels by ELISA.The correlation between them was analyzed by Pearson correlation,and their diagnostic values in type 2 DN were evaluated by the receiver operating characteristic curve (ROC).Results Serum FFA levels in the NA,MA,HA and control groups were (0.61 ± 0.14),(0.81 ± 0.13),(0.95 ± 0.18) and (0.49 ± 0.11) mmol/L,respectively,and urine PCX levels were (1.86 ± 0.45),(4.47 ± 1.48),(6.72 ± 1.40)and(1.38 ±0.24) ng/mL,respectively.The levels of serum FFA and urine PCX in type 2 DM patients were significantly higher than those in the control group(P ＜ 0.05),and increased with the progression of type 2 DM.Pearson correlation analysis showed that serum FFA levels were positively correlated with urine PCX levels(r =0.73,P ＜ 0.05).The sensitivity of serum FFA,urine PCX and combined detection in the diagnosis of type 2 DN were 74.1％,80.6％ and 89.5％,respectively,and the latter significantly higher than the former two (P ＜ 0.05).Conclusion Serum FFA and urine PCX levels increase significantly in diabetic patients with renal injury,and both of them have important clinical values in the diagnosis of type 2 DN.

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Objective To evaluate MSCT appearance and impaction of Ⅴ, Ⅷ segments' hepatic venous congestion ( HVC ) on hepatic functional recovery in living donor liver transplantation (LDLT).Methods In this study, 83 patients undergoing LDLT in our hospital were included, all subjects received plain and contrast MSCT examinations at early stage (within 1 month) and later stage (3 months later) after LDLT. MSCT appearance of HVC was recorded, at the same time, gutamic pyruvic transaminase ( ALT),glutamic oxalacetic transaminase (AST), total bilirubin (TB) and prothrombin time (PT) of 1 to 7 days after LDLT between congestion group and non-congestion group were recorded and compared.Results Segments Ⅴ and Ⅷ congestion was identified by after LDLT CT scanning in 20 patients (24. 10% ). Congestion volume and congestion ratio was (218. 25 ± 130. 29) cm3 and 16. 68% ±8. 81%,respectively. HVC often appear as hypoattenuation on plain CT scan and arterial phase, mixed or hyperattenuation on portal vein phase. There was no significant difference of ALT, AST, TB and PT after LDLT between congestion group and non-congestion group (P ＞ 0. 05). Conclusions MSCT is a valuable method to evaluate Ⅴ, Ⅷ segments' HVC after LDLT, most HVC has no impaction on hepatic functional recovery in LDLT patients.

Objective To improve our understanding concerning radiographic manifestations of cryptogenic organizing pneumonia(COP).Methods The diagnosis of cryptogenie organizing pneumonia was made based on clinical and radiological features,and was verified with lung biopsy and pathological examination in 23 eases.All data were analyzed and relevant literatures were reviewed.Results CT scans revealed multi-patch shadows,patchy air-space consolidations in 15 cases,often located in predominantly subpleural and(or)both inferior lungs,with or ground-glass opacities,bronehieetasis,and cords.Lesion sites changed over time in some patients.Cortieosteroid treatment led to significant improvement in most cases.Conclusions The diagnosis of cryptogenic organizing pneumonia required the converging evidence from clinical and radilogieal manifestations as well as pathologies.It is important to appreciate CT manifestations of COP.