Objective To evaluate the clinical application of enhancement scan and angiography of dual-source computed tomography (CT) in purulent meningitis.Methods The clinical data,imaging data of enhancement scan and angiography of dual-source CT of 8 cases with purulent meningitis were analyzed retrospectively.Results There was linear or bead-like high intensity enhancement of different degree around the cistern,groove or the cerebral vessels in 6 cases,especially around the basal cistern and ambient cistern; a ring-like enhancement was shown in the temporal lobe in 1 case; fusiform change of the cerebral arteries was shown in angiography of dual-source CT in 2 cases.Conclusion Enhancement scan and angiography of dual-source CT is valuable for early diagnosis of purulent meningitis and improve the diagnosis rate.

Objective To study the clinical efficacy of cell block yielded by ultrasound-guided fine needle aspiration in the early diagnosis of thyroid cancer and differential diagnosis of thyroid follicular tumor.Methods Cytological smears were performed in 864 thyroid nodules by ultrasound-guided fine needle aspiration.Then the residual specimens were made as cell blocks.Diagnosis was made by observation of the organization structure of the cell block.Cell block sections from 78 nodules with diagnosis of follicular tumors were applied to the detection of immunocytochemical staining for minichromosome maintenance protein (MCM2), growth arrest and DNA damage-induced nuclear protein 153 (GADD153), and Ki-67.Results Satisfaction rate of cytological smear combined with cell block specimen was 94.3 ％ (815/864) and accuracy rate of the diagnosis was 94.0％ (766/815), which were higher than in cytological smear group (P＜0.01).The false negative rate of cytological smear combined with cell block specimen was 16.6％ (41/247)in diagnosis of thyroid cancer.Positive rate of M CM2 and GADD153 in thyroid follicular neoplasia were lower than that of follicular carcinoma (P ＜ 0.01).There was no significant difference between thyroid follicular neoplasia and follicular carcinoma in regard to positive rate of Ki-67 (P ＞ 0.05).Conclusions The combination of ultrasound-guided fine needle aspiration-yielded cell block and molecular markers has great significance in early diagnosis of thyroid cancer and differentially diagnosis of thyroid follicular tumor.

Objective To analyze the features of dynamic contrast-enhanced CT of blunt hepatic injury in rabbits. Methods The model of blunt hepatic injury was established in 40 New Zealand white rabbits with a steel ball falling down to the xiphoid process of the animals. Plain CT scan and dynamic contrast-enhanced CT scan (Hispeed spiral CT/2i, GE, America) of the liver were performed. Arterial,portal and balanced phases were respectively at 8-10 s, 35-40 s and 120-150 s after initiation of the contrast medium injection. The non-enhanced and enhanced images were compared in aspects of location and range of injury, tear of the liver capsule, active bleeding, involvement of the main hepatic veins and CT features of abdominal hemorrhage, which was further compared with the results of gross anatomy. Results The rate of plain CT scan was obviously lower than that of dynamic contrast-enhanced CT scan,which defined single tear in 13 patients, multiple lacerations in 18, liver subcapsular hematoma in seven,liver hematoma in nine, liver coated gap in 17, active bleeding in nine and main hepatic vein injury in five, with coincidence rates with the results of gross observation for 13/13,18/18,7/9,9/9,25/30,9/5and 5/4 respectively. According to Moore' s classification, CT/Laparotomy performed from grade Ⅰ to grade Ⅵ were 5/4 patients at grade Ⅰ , 15/13 at grade Ⅱ, 9/11 at grade, 5/6 at grade Ⅳ, 1/2 at grade Ⅴ, O at grade respectively. Conclusion Dynamic contrast-enhanced CT scan, especially at portal and balanced phases, is of great value for diagnoses of liver injuries and determination of injury severity.

Objective To study the protective role of pre-resolving mediator lipoxin A4(LXA4) in the NA+ -K+-ATPase in alveolar type Ⅱ (AT Ⅱ ) epithelial cells of rats exposed to lipopolysaccharide (LPS). Method The AT Ⅱ cells were isolated and purified, and divided randomly into control group (PBS), vehiculum (alcohol 0.7 μL/mL) group, LPS (1 μg/mL) group, LXA4(1/10 mol/mL) group and LPS (1 μg/mL LPS) + LXA4(1/10 mol/mL) group. After exposure to LPS and/or LXA4 for4 hours, NA+-K+ -ATPase and β1-subunits mRNA in AT Ⅱ epithelial cells were detected by using RT-PCR, and ATP, ADP, AMP, total adenine nucleotides (TAN) and energy charge (EC) were measured by using high performance liquid chromatography (HPLC), and then the activities of Na+-K+-ATPase were calculated accordingly. Results The NA+-K+-ATPase α-subunit and β-subunit mRNA were significantly decreased in LPS group ( P ＜ 0.05 vs. control group). However, the expressions of NA+ -K+-ATPase mRNA were significantly enhanced by application of LXA4 to AT Ⅱ epithelial cells exposed to LPS (P ＜0.05 vs. LPS group). The activities of NA+ -K+ -ATPase were enhanced in LPS group (P ＜0.05 vs. control group). Compared with control group and LPS group, the activities of NA+-K+-ATpase in LPS + LXA4 group were significantly increased (P ＜0.01 vs. control group; P ＜0.05 vs. LPS group). The EC of AT Ⅱ epithelial cells were higher in LPS group ( P ＜ 0.01 vs. control group). There were no significant differences in EC between control group and LPS + LXA4group(P ＞0.05). Conclusions The pro-resolving mediator LXA4 can enhance the expressions of NA + -K + -ATPase α-subunit and β-subunit mRNA, and the activities of NA + -K + -ATPase in AT Ⅱ epithelial cells or rats exposed to LPS, and ca also balance the metabolism of AT Ⅱ epithelial cells. These findings suggest that LXA4 plays an important role in lung edema clearance in lung injury induced by endotoxin, and the role is likely associated with the enhancement of the expressions of Na+ -K+ -AT-Pase α-subunit and β-subunit, and the activities of Na+ -K* -ATPase, maintaining the balance of metabolism of AT Ⅱ epithelial cells.

Eosine Yellowish-(YS) ; Frozen Sections ; Hematoxylin ; Humans ; Staining and Labeling

Objective To explore the application value of JCI standard and HIMSS 7 grade clinical closed loop system in pathological specimen handover. Methods The First Affiliated Hospital of Xiamen University adopted the traditional way to transfer pathological specimen in 2014, and improved the process under guidance of JCI standard in 2015. Then HIMSS 7 level clinical closed-loop system was applied to pathological handover on the basis of JCI standard guidance in 2017. Comparative analysis was made on the failure rate of the pathological specimen,the average handover time of pathological specimen and the timely rate of pathological frozen reports in the above 3 years. Results A comparison of the failure rate of pathological specimens found the following: That of 2015 was significantly lower than that of 2014 (P <0.05);and that of 2017(Jan. -Sept.) was significantly lower than that of 2015(P<0.01). A comparison of the handover timeliness of frozen digestive endoscopy specimens and a single frozen specimen handover duration found the following:That of 2015 was significantly shorter than that of 2014 (P< 0.01),and that of 2017 (Jan. - Sept.) was significantly shorter than that of 2015 (P < 0.01). A comparison of the timeliness of frozen specimen pathological reports found the following: that of 2015 was significantly better than that of 2014 (P< 0.05),and that of 2017 (Jan. -Sept.) was significantly better than that of 2015 (P< 0.05). Conclusions The guidance of JCI concept has reduced the failure rate of pathological specimen, shortened the average handover during, and improved the timeliness of pathological frozen specimen reports. Under the JCI standard guidance, the HIMSS 7 level clinical closed-loop system was applied to the pathological specimen handover process. This practice could significantly reduce the failure rate of pathological specimen and improve the pathological specimen handover efficiency. Furthermore,it is conducive to full-course tracking and dynamic management of such specimen.

Objective To study the application value of fine needle aspiration and cell block combined with molecular markers in early diagnosis of thyroid cancer and discriminate follicular tumor before operation.Methods Fine needle biopsy of thyroid nodules was guided by color ultrasound,then the sample acquired was used to make smear and the rest to make cell block.The pathological diagnosis on smear,cell block or combination of both was made respectively.Then,the Envision immunohistochemical method was empolyed to detect the expressions of CK19,Galectin-3 in cell block samples,which had been used for the diagnosis of papillary thyroid carcinoma or thyroid nodules from benign lesions after operation and to detect the expressions of DDIT3,ki-67 of cell block that had been used for the diagnosis of follicular tumor nodules.Results The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of cytopathology for the diagnosis of malignancy were 95.3％,94.7％,92.7％,96.6％ and 95.0％respectively;and the sensitivity,specificity and accuracy of the diagnosis used cell block alone or combined with smear were 88.1％,95.3％,92.3％ and 95.3％,94.7％,95.0％ respectively,which were higher than 53.8％,83.7％,71.3％ from smear correspondingly.The positive expression rate of CK19 and Galectin-3 of papillary thyroid carcinoma cell block were 100％ and 98.0％ respectively,higher than the value 17.7％ and 23.3 ％ of thyroid benign lesions (P ＜ 0.01);the positive expression rate of DDIT3 of thyroid follicular cancer cell block was 84.6％,higher than the value 35.1％ of follicular adenoma (P ＜ 0.01),there was no statistical significance of Positive expression rate of Ki-67 between thyroid follicular carcinoma and follicular adenoma cell block (P ＞ 0.05).Conclusions It was conducive to early diagnose thyroid cancer with detection of CK19,Galection-3 of cell block made by ultrasound-guided fine needle biopsy of thyroid nodules.And it was also significant for DDIT3 detection to early discriminate follicular neoplasm before operation.

OBJECTIVETo investigate the clinical significance of cell blocks obtained by ultrasound-guided fine needle aspiration in diagnosing parotid gland masses.

METHODSCell blocks were made in 285 parotid gland masses by ultrasound-guided fine needle aspiration. Diagnosis was conducted using the cell blocks. Non-tumor masses were subjected to conservative treatment, and cysts and tumors were treated with surgery. The cell block sections from masses with the diagnosis of adenoid cystic carcinoma (ACC) and pleomorphic adenoma (PA) were applied to the detection of immunocytochemical staining for the stem cell factor receptor CD117.

RESULTSThe satisfaction rate of the specimen was 95.1% (271/285). The accuracy rate of the diagnosis was 94.5% (256/271), the sensitivity was 87.0% (67/77), and the specificity was 98.1% (157/160). The positive rate of CD117 in ACC was 95.2% (20/21), whereas that in PA was 20.3% (25/123). The positive rate of CD117 in ACC was higher than that in PA (P<0.01).

CONCLUSIONSThe use of cell blocks obtained from ultrasound-guided fine needle aspiration, together with molecular marker detection, has great significance in diagnosing parotid gland masses.
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Adenoma, Pleomorphic ; Biopsy, Fine-Needle ; Carcinoma, Adenoid Cystic ; Cysts ; Female ; Humans ; Male ; Parotid Gland ; Parotid Neoplasms ; Personal Satisfaction ; Staining and Labeling ; Ultrasonics

Objective Iodine loading would be carried out on orthopedic titanium Kirschner-wire by electrophoretic deposition.And by this,a kind of orthopedic iodine-coated implant with antibacterial properties was supposed to be developed,that would provide a theoretical basis for the development of clinical orthopedic implants with antibacterial properties.Methods Iodine loading on the surface of titanium Kirschner-wire was carried out by electrophoretic deposition.PVP-I solution as 1 000 ppm,2 000 ppm and 4 000 ppm was prepared respectively (1 ppm=1 mg/kg=1 mg/L).Three kinds of iodine-coated orthopedic titanium Kirschner-wires with different iodine content were prepared by electrophoretic deposition at 200 V voltage for 30 min and then stoved after being washed with distilled water.The surface signs and composition structure of iodine coated titanium Kirschnerwire were studied through scanning electron microscopy (SEM) and energy dispersive spectrometer (EDS).Antibacterial experiments of Iodine coating titanium Kirschner needle were performed in vitro.Antimicrobial test:10 pieces of uncoated titanium Kirschner-wires;10 pieces of iodine-coated titanium Kirschner-wires with 1 000 ppm;10 pieces of iodine-coated titanium Kirschner-wires with 2 000 ppm;10 pieces of iodine-coated titanium wires with 4 000 ppm.Because iodine is easy to sublimate and does not withstand high temperature,all the titanium Kirschner needles are fumigated and disinfected by ethylene oxide (supported by the supply room of our hospital).Titanium wires were immersed respectively in 106 CFUJ/ml (ATCC25923) bacterial suspension of standard Staphylococcus aureus so that bacteria would be fully inoculated on the surface of the titanium wire.The sterilized titanium Kirschner needle was placed in a sterile culture cup and 30 ml suspension was added into the culture cup.The sterilized titanium Kirschner needle was completely immersed in the bacterial solutionand was kept at 37°C for 6 h before taking out.Take out the titanium Kirschner needle slowly,rinse the titanium Kirschner needle with 5 ml sterile PBS buffer,after rinsing the surface of titanium Kirschner needle,transfer the titanium Kirschner needle to the new sterile culture cup and add 5 ml sterile saline until the titanium Kirschner needle is completely immersed.Then put the titanium Kirschner needle into the ultrasonic oscillator to wash the surface of the bacteria fully.After 10 000 times dilution,100 μl was smeared on agar medium for culture (37°C) and the number of colonies was observed and counted 24 h later.Results The surface of three kinds of iodine coating titanium Kirschner-wires was covered with uniform iodized compound coating and had a brown look.The film structure was stable and there was no falling off after ultrasonic cleaning.SEM exhibited that the surface of Titanium Kirschner-wire is covered with a compact coating;the appearance structure is relatively flat and a slight collapse can be seen scattered in the surface of the wire.The results of EDS showed that the iodine content in the surface coating of 3 groups was 4.38 wt％,9.05 wt％ and 14.48 wt％.The bacteria growing on the surface of titanium needle were shaken down by ultrasonic vibration.The CFU counting was carried out after the bacterial solution being diluted,coated and cultured for 24 h.It can be seen that the antibacterial property increases continuously with the increase of iodine coating content.The antibacterial properties of iodine-coated implant which content 14.48 wt％ iodine was more than 1 orders of magnitude than the control group.The results showed that the plants coated with iodine had obvious antibacterial effect.Conclusion The iodine coated titanium wire was prepared by electrophoretic deposition,after being characterized by SEM,EDS and quantitative measurement,the successful loading of iodine was proved,the antibacterial experiment proved that the iodinecoated orthopedic titanium Kirschner-wire has a stronger antibacterial properties than the ordinary titanium Kirschner-wire under laboratory conditions.

Objective:To investigate the efficacy of Da Vinci robot-assisted surgery for mediastinal tumor, and summarize the value of Da Vinci system in mediastinal surgery.Methods:The clinical data of 339 cases of robot-assisted mediastinal mass in Shanghai Chest Hospital from April 2015 to September 2020 were retrospectively analyzed, to compare perioperative outcomes of robotic surgery and conventional video-assisted thoracoscopic surgery 2 949 cases.Results:All the operations were successfully completed as planned. No residual lesions, conversion or second operation was observed in the consecutive cohort. The operating time[(81.8±36.8)min vs.(95.6±58.3)min, P=0.015]and post-operation stay[(3.1±1.9)days vs.(3.8±2.3)days, P=0.002] were statistically shorter in robotic group than those inconventional thoracoscopic group. Intraoperative blood loss in two groups was similar[(43.2±22.6)ml vs.(44.0±33.4)ml, P>0.05]. Conclusion:The Da Vinci robot system in mediastinal surgery is safe and feasible with great perspective in the new age of minimally invasive thoracic surgery. Compared with thoracoscopic surgery, it can shorten the operation time and reduce the postoperative hospital stay. It has certain advantages in operator experience and patient recovery.