Objective To investigate the correlation of ultrasonographic characteristics and pathologic features for malignant mullerian mixed tumor(MMMT)and determine the diagnostic value of ultrasonography.Methods The uItrasonographic features of 10 MMMTs were analyzed retrospectively and the sonographic findings were compared with histological results and discussed the correlation.Results The morphologic features of US and histology were well associated.Large,solitary lesion,ill-defined irregular shape,honeycombed heterogenous echo-pattern,scattered cystic areas and increased irregular peripheral/internal color flow were typical US findings.Logistic regression analysis showed the type of tumor liquefaction to be the most significant independent predictor of vascularity.Conclusions Ultrasonography is helpful for the diagnosis of MMMT,the uhrasonographic characteristics of MMMT are well correlated to its pathologic features.

Objective To evaluate the reproducibility of quality intima-media thickness(QIMT) and quality arterial stiffness (QAS) technique in assessment of carotid under different measuring methods.Methods Between December 2012 and January 2014,carotid QIMT and QAS examinations were carried out in 30 health volunteers.QIMT and QAS indicators included IMT in QIMT and distensibility coefficient (DC),compliance coefficient(CC),stiffness index α(α),stiffness index β(β),pulse wave velocity(PWV) in QAS.The measurement employed unilateral/once,bilateral/twice,and unilateral/twice methods.Using intra observer and inter-observer variability,the reproducibility was compared between different QIMT and QAS indicators and measuring methods.Results Extremely high level of intra-observer reproducibility was found for both QIMT and QAS technique (ICC＞0.8).QIMT also showed an excellent inter observer reproducibility (ICC＞0.8).In contrast,the reproducibility of QAS technique varied in different indicators (PWV ＞ β ≈ α ＞ CC ＞ DC) and method ( unilateral/once ＞ bilateral/twice ＞ unilateral/twice).Conclusions QIMT measurement was highly reproducible.Whereas the reproducibility of QAS technique varied in different indicators and methods.Due to low reproducibility,the study result did not support the clinical application of DC indicator and unilateral/once method.

BACKGROUND:There is often space between implant and bone during immediate implantation.Whether biological membrane is needed to guide bone regeneration remains poorly understood.OBJECTIVE:To createdifferent sizes of space between femurand implantsindogs and to observe the effects of biological membrane on bone regeneration capacity of bone defects surrounding implants.DESIGN,TIME AND SETTING:A self-control animal experiment was performed at the Laboratory Animal Center,Norman Bethune College of Medicine,Jilin University and School of Stomatology,Jilin University between March and December 2005.MATERIALS:BLB hydroxyapatite-coated implant was provided by Beijing Leiden Biomaterial Co.,Ltd.,China;BME-10X collagen membrane was purchased from Fujian Better Biotechnology Co..Ltd.,China.METHODS:BLB implants were installed in the bilateral proximal femoral bone to create standard gradient bone defects with horizontal width 3 mm.vertical depth 5 mm,and horizontal lengths of 0,1,2,3,and 4 mm Bone defects on the left femur were sutured directly and those on the right femur were covered with biological membrane prior to suture.All animals were sacrificed at 3 months after surgery.Specimens containing implants were harvested to prepare tissue blocks for radiological observation.MAIN OUTCOME MEASURES:The quantity,color,and texture of newly formed bone surrounding implants were observed from the surface and profile levels.The implant-bone integration and new bone formation were also examined by soft X-ray photography.RESULTS:Grossobservation results revealed that when the horizontal length of bone defect was 3 mm or less,there was no significant differenee in bone density between the newly formed bone and the host bone no matter whether biological membrane existed or not;when the horizontal length of bone defect was 4 mm the bone density was better when biological membranes were used than not.Soft X-ray photography results revealed that when the horizontal length ofbone defect was 3 mm or less.no significant difference in bone density and bone trabecular morphology and orientating was found between newly formed bone and host bone no matter whether biological membrane was used or not;in the 4-mm-length bone defect areas.implants contacted with newly formed bone directly,but the calcified degree ofnewly formed bone was poor,bone trabecula was thin,and bone trabecular course was irregular,nevertheless,the calcified degree of newly formed bone was better under the condition of being with biological membrane than without biological membrane.CONCLUSION:Biological membrane exhibits strong capacity to promote the regeneration and repair of bone defect tissue with a horizontal length of 3 mm or less,and plays an important role in repatr of large sizes of bone detect

Objective To observe the clinical features, phenotypes and genotypes in a Chinese family with choroideremia (CHM). Methods A Chinese four-generation family (15 members) with CHM, including 5 patients (4 males/1 female), 2 female carriers and 8 healthy members, was enrolled in this study. Initially all family members underwent best corrected visual acuity (BCVA), indirect ophthalmoscopy, fundus fluorescein angiography, optical coherence tomography (OCT), visual field and full view electroretinogram (ERG). BCVA was followed up for 3 years. Venous blood samples were collected, and all of the 15 coding exons and flanking intron regions were amplified in the proband by polymerase chain reaction followed by direct sequencing. Protein structure was modeled based on the protein data bank and mutations in DeepView v4.0.1 to predict the effect of the mutations. A total of 180 healthy volunteers were enrolled as control group to matching CHM gene sequences. Results The visual acuity (VA) of 3/4 adult male patients began to decrease at less than 10, 10 and 30 years old, the average BCVA was 0.43. There were characteristic signs and symptoms of CHM including narrow visual field, extinguished rod and cone response in ERG, disappeared junction line and intermediate line of photoreceptor inner segment/outer segment on OCT. After 3 years, the mean BCVA decreased to 0.11. The BCVA of one young male patient was 1.0 in both eyes with minor changes fundus and visual field. The VA of the female patient began to decrease at 50 years old, her BCVA of two eyes were 0.5 and 0.25, respectively. The fundus changes were typical of CHM, with relative scotomas in the peripheral visual field of OD, and big scotomas in the OS. After 3 years, her mean BCVA decreased to 0.2. Of 2 female carriers, one had minor fundus changes (patches of pigmentary deposits, atrophy spots of retinal pigment epithelium cells), and the other was normal. A novel heterozygous c.1837G>A mutation in exon 15 of CHM was detected in the proband, which resulted in the substitution of serine by proline at codon 613 (p.D613N). Based on molecular modeling, the misfolded protein caused by the mutation might destabilize the structure of the helix that potentially could affect the global stability of the Rep-1 protein. Conclusions A novel c.1837G>A (p.D613N) mutation may be the causative mutation for CHM in this family. Female CHM carriers may have some signs and symptoms.

Objective To compare different noninvasive models in diagnosis of liver fibrosis in patients with chronic hepatitis B (CHB).Methods A total of 838 CHB patients admitted in Shenyang Sixth People’ s Hospital during March 2003 and October 2013 were enrolled in the study.All the patients received liver biopsy, blood and ultrasound examinations; the AST-to-ALT ratio ( AAR), AST to platelet ratio index ( APRI) , age platelet index ( API) , cirrhosis discriminant score ( CDS) , spleen to platelet ratio index ( SPRI) and age-spleen to platelet ratio index ( ASPRI) were obtained.Area under receiver operating characteristic curve (AUROC) was used to assess the clinical value of noninvasive models in diagnosis of significant liver fibrosis (S2-4), advanced liver fibrosis (S3-4) and early liver cirrhosis (S4).Results Among six noninvasive models, APRI had the lowest value of AUROCs ( <0.7), while ASPRI had the highest AUROCs value in diagnosis of liver fibrosis.The AUROCs of ASPRI in diagnosing significant liver fibrosis, advanced liver fibrosis and early liver cirrhosis were 0.861, 0.873 and 0.881 with the sensitivities of 69.4%, 76.9%and 87.0%, the specificities of 87.9%, 81.5% and 75.8%, the positive predictive values of 90.9%, 74.9%and 46.1%and the negative predictive values of 62.2%, 83.1%and 96.1%, respectively.Taking<5.2 and≥9.7 as the cut-off values for exclude significant liver fibrosis and diagnosis of significant liver fibrosis, respectively, 49.4%(414/838) of the patients may avoid liver biopsy with an accuracy of 92.3%(382/414).Conclusion ASPRI is of value in diagnosing significant liver fibrosis and early liver cirrhosis in patient with chronic hepatitis B, and the number of liver biopsy can be reduced.

Objective To investigate the relation between the expression of Caspase recruitment domain-containing membrane-associated guanylate kinase protein 1 (CARMA1),clinicopathological features of gastrointestinal mucosa-associated lymphoid tissue (MALT) lymphoma,diffuse large B cell lymphoma (DLBCL),and Helicobacter pylori (H.pylori) infection.Methods From January 1999 to March 2011,34 patients with DLBCL and 20 patients with MALT lymphoma were selected,and at same period 21 cases with reactive hyperplasia of gastrointestinal lymphoid tissue were enrolled in as control.The expression of CARMA1,Ki-67 and cytotoxin-associated gene A (CagA) at protein level were examined by immunohistochemistry.The relative expression quantity of CARMA1 mRNA was detected by real-time polymerase chain reaction (PCR).The condition of H.pylori infection in 25 gastric lymphoma and 10 controls was detected by methylene boric acid and blue staining or semi-nested PCR.Chi-square test was used for counting data analysis,t test for measurement data.Multivariate COX regression analysis was implemented for survival analysis.Survival curve was drawn by Kaplan-Meier method and analyzed by Log-rank test.Results The relative expression quantity of CARMA1 mRNA of 28 patients with DLBLC (3.073±1.846) was higher than that of 14 patients with MALT lymphoma,and the difference was statistically significant (F 0.975,P＜ 0.05).The positive rate of CARMA1 expression at protein level of gastrointestinal lymphoma group (75.9 ％,41/54) was higher than that of control group (47.6％,10/21),and the difference was statistically significant (x2 =5.568,P＜0.05),and the positive rate of CARMA1 expression of MALT lymphoma group (11/20) was lower than that of DLBCL group (88.2％,30/34),and the difference was statistically significant (x2 =5.900,P＜0.05).Among 42 patients with gastrointestinal lymphoma who received surgery,the relative expression quantity of CARMA1 mRNA in cases with high proliferation (2.885±1.837) was higher than that in cases with low proliferation.The expression of CARMA1 mRNA in the cases at advanced stage of the disease (4.416± 1.010) was higher than that in cases at early stage,and the difference was statistically significant (F=3.317 and 2.972,both P＜0.05).Among 54 patients with gastrointestinal lymphoma,the positive rate of CARMA1 expression at protein level of patients with high proliferation (88.6％,31/35) was higher that that of patients with low proliferation (10/19),and the difference was statistically significant (x22 ＝ 6.847,P＜0.05).There were no significant differences in relative expression quantity of CARMA1 mRNA and the positive rate of CARMA1 expression at protein level between 11 gastric lymphoma patients without H.pylori infection and 14 gastric lymphoma patients with H.pylori infection (both P＞0.05).The positive rate of CARMA1 expression at protein level of CagA positive and CagA negative H.pylori infected gastric lymphoma patients was 11/11 and 2/3.The expression of CARMA1 at protein level was correlated with the prognosis of gastrointestinal lymphoma (RR＝4.160,P＜0.05).In the 29 cases of patients with gastrointestinal MALT lymphoma and 18 cases of patients with DLBCL who were followed up,the survival situation of gastrointestinal lymphoma patients with CARMA1 positive expression rate over 50％ was worse than that of patients with the rate less than 50％,and the difference was statistically significant (x2=5.383 and 4.028,both P＜0.05).Conclusions CARMA1 might be involved in the pathogenesis and progression of MALT and DLBCL; and it might be a related factor of poor prognosis.There was no correlation between the expression of CARMA1 and H.pylori infection in these two lymphomas.

Objective To observe the ultrasonographic features of intravenous leiomyomatosis (IVL). Methods Ultrasonographic features, pathological results and the clinical manifestations of 7 patients with IVLs were analyzed retrospectively, and the causes of misdiagnosis were discussed as well. Results The median age of 7 IVL patients was 40 years old. Five patients underwent previously hysterectomy due to probable diagnosis of leiomyoma with the mean recurrent time of 13.8 months. Three lesions extended into the right atrium, 3 involved the inferior venous cava and 1 was confined in the pelvis venous. Ultrasonographic findings of IVL included uterine solid lesions with intravascular disease, solid occupied lesions in the pelvis with intravascular disease after hysterectomy, solid occupied lesions in the pelvis, large abdominal vessels and cardiac chambes with intravascular disease after hysterectomy. The main misdiagnosis cause was that IVL had similar ultrasonographic features with hysteromyoma, and intravascular lesions of IVL was hard to detect in the early stage. Conclusion Color Doppler ultrasonography is a valuable imaging mortality for detection and follow-up of IVL.

Abstract: Malaria, an infectious disease caused by Plasmodium infection, is one of the most important public health problems worldwide. Artemisinin-based combination therapies (ACTs) are recommended by WHO as the first-line treatment for uncomplicated P. falciparum malaria in malaria-endemic areas. The application of artemisinin and its derivatives has played an integral role in reducing the global incidence of malaria. However, in recent years, the emergence and spread of artemisinin resistance has brought great challenges to global malaria control and elimination. At present, the mutation of K13 gene on chromosome 13 of Plasmodium falciparum is most closely related to artemisinin resistance, but in recent years, studies have shown that K13 cannot explain all artemisinin resistance. This article reviews the recent research progress in the field of artemisinin resistance in Plasmodium falciparum, including definition of artemisinin resistance, detection methods and molecular markers related to resistance. In addition, some of the issues discussed in this review remain controversial and require further study.

Objective To study normal flora components of conjunctiva, explore the relationship between normal flora and ocu- lar bacterial infections.Methods The data of 1 198 bacterial cultures of conjunctiva in non-infectious cataract patients were re- viewed and compared with the results of 985 specimens of conjunctivitis, keratitis and endophthalmitis from January 2000 to December 2004.Results Positive culture of conjunctiva in non-infectious cataract patients was 628 in 1 198 specimens (52.4%).These bacteria including gram-positive cocci and gram-neganve bacilli constituted the normal flora of conjunctiva. Staphylococcus epidermidis was the predominant bacteria (51.1%, 341/667) and its prevalence increased during this 5-year period.S.epidermidis and S.aureus were also the most frequently isolated pathogens in specimens of conjunctivitis, keratitis and endophthalmitis.The correlation was statistically significant between the positive rate in normal eye and conjunctivitis or keratitis in terms of these two species, but not statistically significant between normal eye and endophthalmitis.The resistance rate of normal flora of conjunctiva to ampicillin, amikacin, tobramycin, ciprofloxacin, and ofloxacin increased year by year. The resistance rate to gentamicin and the combination of two drugs decreased.The changing resistant pattern was similar in pa- tients with eye infection.Conclusions There is a close relationship between the normal flora S.aureus and S.epidermidis of conjunctiva and the bacterial infection of ocular surface, but no significant correlation between normal flora and the pathogen of endophthalmitis.

Objective To determine the diagnostic value and clinical significance of sonographically detected fetal dysplastic kidney with normal amniotic fluid volume. Methods At the 2nd or 3rd trimester of gestation,the fetuses with unilateral or bilateral renal anomalies (ahnormal size,echo,shape or cyst of the kidney) and normal amniotic fluid volume received systemic ultrasound examination,autopsy or follow-up until after birth. The fetus with only dilated renal pelvis was not included. Results Eleven fetuses of dysplastic renal anomalies with normal amniotic fluid volume were identified by prenatal ultrasound. Among the five fetuses affected by unilateral multicystic kidney dysplasia (MCKD),the renal anomaly was isolated in four fetuses,and the other one was complicated with absence of the ipsilateral hand. One of the two fetuses of unilateral renal agenesis had no other associated anomaly and the other one was complicated with hydrocephalus,spina bifida,ipsilateral absent radius and single umbilical artery,correspongding to the VACTERL syndrome. Two fetuses of pelvic kidney and horseshoe kidney respectively was proved by postnatal ultrasound. One fetus was diagnosed as autosomal dominant polycystic kidney disease(ADPKD)on the basis of multiple renal cysts and a positive family history,the fetus also had cardiac rhabdomyoma. One fetus of bilateral normal sized hyperechoic kidneys was proved to be renal dysplasia by autopsy. Conclusions Unilateral MCKD is the most common type of fetal renal dysplasia which can be detected by prenatal ultrasound with normal amniotic fluid volume. Based on the sonographic characteristics and the family history,most of the dysplastic renal anomalies can be diagnosed prenatally and the prognosis can be predicted.