Objective To discuss the cause, clinical features, diagnosis, treatment and prognosis of bladder and urethra leiomyoma combined with uterine leiomyoma. Methods The clinical data of 5 patients with bladder and urethra leiomyoma combined with uterine leiomyoma was analyzed retrospectively. All patients underwent surgical treatment, 3 cases were treated with enucleation of bladder leiomyoma, 1 case was treated with transurethral resection of bladder tumor (TURBT), 1 case was treated with enucleation of urethra leiomyoma,at the same time all patients were underwent hysteromyoma surgery, 1 case was treated with enucleation of partial uterine, 4 cases were treated with enucleation of hysteromyoma. Results Pathology examination showed that 4 cases were bladder leiomyoma, 1 case was urethra leiomyoma,5 cases combined with uterine leiomyoma. Patients were followed up 1-3 years,no tumor recurrence and metastasis. Conclusions Bladder and urethra leiomyoma is a kind of benign non-epithelial tumor without specific symptom,clinical rare,often merging with uterine leiomyoma, ultrasonography ,CT and cystoscopy scan could be main techniques for diagnosis mainly with surgical resection,prognosis is good. From clinical discovery bladder leiomyoma must notice patient whether at the same time merges with uterine leiomyoma.

Objective:To investigate the effect and mechanism of hypoxia-inducible factor-1α (HIF-1α)in perihematomal brain tissue on the early formation of edema in patients with hyper-tensive intracerebral hemorrhage.Methods:The perihematomal brain tissue in 32 patients with hypertensive intracerebral hemorrhage were treated with hematoma evacuation.The expressions of HIF-1α and vascular endothelial growth factor(VEGF)were measured by immunohistochem- istry staining technique.The volume of perihematomal edema was determined on the basis of reoperative head CT scan.The results of staining and the volume of edema were analyzed by using double-blind method.Resets:Neuron and vascular endothelial cell swelling were observed 4 hours after cerebral hemorrhage,and the scattered HIF-1α positive neurons were visible.The expressions of HIF-1α reached the peak(at 24 to 48 hours,and went on high expressions at 49 to 72 hours.There was significant difference as compared with the normal brain tissue(P＜0.01). There were positive correlations between the expressions of HIF-1α and VEGF (r=0.72,t=6.37,P＜0.01)and the volume of brain edema(r=0.64,t=4.56,P＜0.01).Conclusions: The expression of HIF-1α in perihematomal brain tissue of hypertensive cerebral hemorrhage iS associated with the early formation of cerebral edema.HIF-1α may accelerate the formation of brain edema by inducing and regulating the expression of VEGF.

ObjectiveTo summarize X-ray and CT findings of soft tissue and bone infections secondary to acquired immunodeficiency syndrome (AIDS).MethodsThe data of X-ray and CT findings of soft tissue and bone infections in 18 patients with AIDS were retrospectively collected and analyzed.ResultsOf 18 patients with AIDS,the CT features of soft tissue demonstrated that subcutaneous patchy high density in 1 case which considered as cellulitis,round low density lesions with ring enhancement in 6 cases which considered as soft tissue abscesses,heterogeneous density lesions with peripheral enhancement in 1 case which considered as pyomyositis.Of 18 patients with AIDS,septic arthritis was found in 4 cases involving knee lesion in 3 cases and hip lesion.In the 4 case,the X-ray films showed bony destruction in 2 cases and the CT showed bone destruction in 3 cases and arthroedema in 4 cases.Of 18 patients with AIDS,osteomyelitis was found in 9 cases of which tuberculosis was considered in 8 cases and vertebral involvement in 6 cases.In the 9 cases,the X-ray films and CT displayed bony destruction,hyperostosis,small sequestra,and intervertebral space narrowing.Of 18 patients with AIDS,costal lesions were found in 3 cases in which the CT showed expandable bony destruction.Of 18 patients with AIDS,ilium and cacroihac joint lesions were found in 1 case in which the X-ray films and CT showed bony destruction,sequestra,and joint widening.Of 18 patients with AIDS,chronic pyogenic osteomyelitis of femur was found in 1 case in which the X-ray films showed bony destruction,hyperostosis osteosclerosis,and periosteal reaction.Conclusion The X-ray and CT features of soft tissue and bone infections secondary to AIDS are characterized.The X-ray and CT are useful tools to early diagnose soft tissue and bone infections secondary to AIDS.

Objective To evaluate the role of hippocampal mammalian target of rapamycin (mTOR) signaling pathways in the cognitive dysfunction after splenectomy in aged rats.Methods Sixtythree male Sprague-Dawley rats,aged 18 months,weighing 400-540 g,were randomly divided into 3 groups (n=21 each) using a random number table:control group (group C),operation group (group O) and mTOR inhibitor rapamycin group (group M).Morris water maze test was performed to evaluate cognitive function before operation and at 1,3 and 7 days after operation.After the end of Morris water maze test carried out at 1,3 and 7 days after operation,7 rats selected randomly in each group were sacrificed,and the brains were removed for detection of the expression of mTOR and phosphorylated tau protein at Ser-396 site (pS396 tau) in hippocampal tissues by using Western blot.Results Compared with group C,the escape latency was significantly prolonged,the ratio of time spending in the target quadrant was decreased,and the expression of pS396 tau was up-regulated at 1 and 3 days after operation,and the expression of mTOR was up-regulated at each time points after operation in group O,and the escape latency was significantly prolonged,the ratio of time spending in the target quadrant was decreased,and the expression of mTOR and pS396 tau was up-regulated at 1 and 3 days after operation in group M.Compared with group O,the escape latency was significantly shorten,the ratio of time spending in the target quadrant was increased,and the expression of pS96 tau was down-regulated at 1 and 3 days after operation,and the expression of mTOR was down-regulated at each time point after operation in group M.Conclusion The hippocampal mTOR signaling pathways are involved in the development of cognitive dysfunction after splenectomy in aged rats.

The intrauterine growth retardation (IUGR) model was established by maternal nutrition restriction during mid- to late-gestation. IUGR rats had both impaired pancreatic development and islet β-cell dysfunction. As the animals grew, the rats gradually showed impaired glucose tolerance and decreased insulin sensitivity.

Objective To investigate the relationship between the cerebral circulation time and disease condition and prognosis in patients with acute subarachnoid hemorrhage. Methods DSA were performed to determine the cerebral circulation time (CCT) in 60 patients who had subarachnoid hemorrhage (SAH) within 3 days. The patients were divided into different groups according to the severity of the disease condition,patients with CSC score as 13-15 were assigned as group Ⅰ ,whose CCT was (13.45 ± 1. 89) s. Twenty two patients with GSC score as 3-12 were assigned as group Ⅱ ,whose CCT was (16.79 ± 2. 07) s. There were significant difference between the CCT of the two groups (t =3. 76,P = 0. 001). (2)Twenty-nine patients with Hunt-Hess grade as 1-2 were assigned as group 1,whose CCT was (13.06 ± 1. 83) s. Thirty one patients with Hunt-Hess grade as 3-5 were assigned as group 2, whose CCT was (15. 89 ± 2.06) s. There were significant difference between the CCT of the two groups (t = 3. 39, P =0. 003). (3) Seventeen patients with delayed ischemic damage were assigned as group A, whose CCT was (16. 84 ±1.91) s. Forty three patients without delayed ischemic damage were assigned as group B, whose CCT was (12.94 ± 1. 67) s. There were significant difference between the CCT of the two groups (t = 2. 23, P =0.025). (4)Forty-six patients with GOS score as 4-5 were assigned as group a,whose CCT was (13.07 ±1. 89)s. Fourteen patients with GSC score as 1-3 were assigned as group b,whose CCT was (17.11 ± 1. 71)s. There were significant difference between the CCT of the two groups (t = 3. 27, P = 0.008). Conclusion CCT may reflect the severity of the SAH in early onset patients and has prognostic value.

Genechip was applied to explore gene expression profile of islets in rats at various stages of pregnancy. Compared with the normal control group, differential expressions of hundreds of genes were detected during pregnancy. Reg3α gene expression was markedly increased during pregnancy, which may be related to islet regeneration.

Objective To determine the reference intervals for thyroid function tests during the second half of pregnancy (20-40 gestational weeks),and to assess the relationship between thyroid peroxidase antibody (TPOAb) levels and the incidence of gestational thyroid diseases.Methods Levels of thyroid stimulating hormone (TSH),free thyroxine (FT4),TPOAb and urinary iodine excretion were determined in 4 729 pregnant women,who received prenatal health care at First Affiliated Hospital of Nanjing Medical University from July 2011 to August 2013.Among these women,2 568 were selected using the recommendations of the American National Academy of Clinical Biochemistry,and were divided into five groups according to their gestational age:≥ 20 to ＜24 weeks (682 cases),≥ 24 to ＜28 weeks (1 322 cases),≥ 28 to ＜32 weeks (178 cases),≥ 32 to ＜36 weeks (185 cases) and ≥ 36 to ≤ 40 weeks (201 cases).Reference intervals of thyroid function tests in the second half of pregnancy were calculated.The reference values of thyroid functions in different gestational weeks were compared,and the reference intervals of thyroid functions in the second half of pregnancy were determined.The effects of maternal age and positive TPOAb on gestational thyroid diseases were analyzed.A non-parametric test,analysis of variance or Chi-square test was used for statistical analysis.Results (1) Reference intervals for maternal thyroid function in the second half of pregnancy in our hospital were established [TSH:0.65-5.27 mU/L and FT4:8.74-14.84 pmol/L].(2) The percentage of thyroid diseases was higher using the non-pregnancy reference intervals (TSH:0.27-4.20 mU/L and FT4:12.00-22.00 pmol/L) than using the pregnancy reference intervals [64.0％ (3 025/4 729) vs 16.1％ (763/4 729),x2=47.465,P ＜ 0.01],which manifested as a higher rate of clinical hypothyroidism and simple hypothyroxinemia [5.4％ (255/4 729) vs 0.4％ (20/4 729),x2=14.321;54.1％ (2 560/4 729) vs 9.1％ (429/4 729),x2=47.108;both P＜0.01] and a lower rate of subclinical and clinical hyperthyroidism [1.2％ (58/4 729) vs 3.3％ (155/4 729),x2=6.650;0.3％ (13/4 729) vs 0.6％ (27/4 729),x2=2.062;both P＜0.05].(3) The incidence of clinical hypothyroidism and simple hypothyroxinemia in pregnant women aged ＞30 years was higher than in those aged ≤ 30 years [0.7％ (10/1 377) vs 0.3％ (10/3 352),x2=4.257;11.7％ (161/1 377) vs 8.0％ (268/3 352),x2=16.102;both P＜0.05].The incidence of clinical hypothyroidism and clinical hyperthyroidism in TPOAb positive women was higher than that in TPOAb negative women [2.7％ (9/335) vs 0.3％ (11/4 394),x2=44.009;3.9％ (13/335) vs 1.2％ (52/4 394),x2=16.784;both P＜0.01].Conclusions The established pregnancy-specific reference ranges of thyroid function tests can reduce the missed diagnosis and misdiagnosis of gestational thyroid diseases.Maternal age ＞30 years and positive TPOAb may increase the risk ofgestational thyroid diseases.

Objective: To investigate the epidemiological characteristics of malaria in Hangzhou City from 2004 to 2021, so as to provide the evidence for formulating the post-elimination control strategy for malaria in Hangzhou City. Methods: The epidemic situation of malaria in Hangzhou City from 2004 to 2021 were collected from the National Information System for Disease Control and Prevention in China, and the temporal, spatial and human distributions of malaria cases and the source of malaria infections were analyzed in Hangzhou City during the pre-elimination stage (2004 to 2009), the elimination stage (2010 to 2015) and the post-elimination stage (2016 to 2021). Results: Totally 602 malaria cases were reported in Hangzhou City from 2004 to 2021,and the annual mean incidence of malaria was 0.22/105, 0.20/105 and 0.18/105 during the pre-elimination, elimination and post-elimination stages, appearing a tendency towards a decline. Men accounted for 63.96%, 85.07% and 93.75% of all malaria cases and there were 67.86%, 82.84% and 80.00% of cases at ages of 18 to 50 years during the pre-elimination, elimination and post-elimination stages, both appearing a tendency towards a decline (χ2trend=56.748, P<0.001; χ2trend=39.971, P<0.001). The predominant occupation of malaria cases shifted from farmers or migrant workers to multiple occupations, and the proportion of commercial servants increased from 4.87% during the pre-elimination stage to 24.38% during the post-elimination stage (χ2trend=73.308, P<0.001). The proportion of Plasmodium vivax malaria cases reduced from 96.43% during the pre-elimination stage to 7.50% during the post-elimination stage, and the proportion of P. falciparum malaria cases increased from 3.57% to 71.25%, while P. ovale, P. malariae and mixed infections were identified since 2010. There was a significant season-specific incidence of P. vivax malaria during the pre-elimination stage, and the period between May and October was an epidemic season; however, there was no season-specific incidence of P. vivax malaria during the elimination and post-elimination stages. The regional distribution of malaria cases presented a tendency towards a shift from suburb and rural areas to urban areas (χ2trend=74.229, P<0.001). No local cases were detected in Hangzhou City since 2010, and 94.22% of malaria cases were overseas imported cases after malaria elimination, including 90.61% from Africa. Conclusions oung and middle-aged men were high-risk populations for malaria in Hangzhou City from 2004 to 2021, and overseas commercial servants gradually became the predominant source of malaria infections, with malaria parasite species tending to be diverse. Improving the management of overseas imported cases and timely identification and treatment of cases are major interventions to consolidate malaria elimination achievements in Hangzhou City.

Objective To evaluate the etiology and CT features of thoracic lymphadenopathy in patients with acquired immunodeficiency syndrome (AIDS).Methods CT features of thoracic lymphadenopathy in 178 AIDS patients were retrospectively analyzed.Results Of 668 AIDS patients with thoracic lymphadenopathy,174 were proved to be infections including Penicilliosis marneffei (n =117),tuberculosis (n =42),cryptococcosis (n =10) and non-tuberculous mycobacteria (n =5).Four were proved to be tumors including 3 Kaposi's sarcomas and 1 lymphoma.The enlarged mediastinal and hilar lymph node presented as homogeneous soft-tissue density in 140 patients,with central low attenuation in 29 patients,as extreme low attenuation in 9 patients on plain CT scan and showed homogeneous enhancement in 28 patients,rim enhancement in 19 patients,non enhancement in 2 patients on enhanced CT scan.Accompanied CT findings included diffuse pulmonary micro-nodules (n =45),primary complex or similar primary complex (n =13),pleural effusion (n =59),pericardial effusion (n =24),sandwich sign in the small bowel mesentery (n =31).The CT findings of penicilliosis marneffei and tuberculosis were compared with chisquare test.There were significant differences on homogeneous soft-tissue density,central low attenuation,homogeneous enhancement,rim enhancement,diffuse pulmonary micro-nodules,primary complex or similar primary complex,sandwich sign,pleural effusion (x2 =32.62,43.82,12.13,15.72,11.76,11.06,5.44,4.07,P ＜ 0.05).Conclusions Thoracic lymphadenopathy can be caused by infections and tumors in AIDS.CT plays an important role for the differential diagnosis.