The patient, female, 27 years old. The scalp neoplasm had been found at her right temple 10 years ago. At first, the size of the tumor was just like a soybean, and did not grow obviously in the past nine and a half years. But the tumor increased fast in these six months, almost as large as the pigeon egg now. The physical examination showed that: A spherical tumor locates in the right temple near the right ear; the size of the tumor is 3 cm X 4 cm X 3 cm; the surface is smooth, no tenderness, no obvious mobile base, skull defect not touched. Primary diagnosis: the scalp cyst or lipoma. Under the local anesthesia we remove the neoplasm, during the operation we found the lesion located in the subcutaneous tissue layer, involved the galea aponeurosis layer, the skull surface are smooth and complete. The tumor was completely removed. We cut the mass and found a cystic cavity sized 3 cmX4 cm, which contained gray jerry-built materials, contained oil and a mass of hair, the capsule wall was complete. Postoperative pathological report: The tumor is cystic look throught the microscope, the capsule wall is squamous epithelium, containing keratinized material and hair. The pathological diagnosis is teratoma. The incision healed primarily, no recurrence found for about a year.
Female ; Humans ; Lipoma ; Neoplasm Recurrence, Local ; Scalp ; pathology ; Skin Neoplasms ; pathology ; surgery ; Skull ; Subcutaneous Tissue ; Teratoma ; pathology ; surgery

Adult ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Cyclophosphamide ; administration & dosage ; Diagnosis, Differential ; Female ; Humans ; Panniculitis ; drug therapy ; pathology ; Panniculitis, Nodular Nonsuppurative ; pathology ; Prednisone ; administration & dosage ; Vincristine ; administration & dosage

Objective To explore the signification and method of Cut-off verification and gray zone setting in chemiluminescent assay.Methods NCCLS EP-12 A2 document defines that C50 is the analyte concentration of cut off value for immunology qualitative test and C5-C95 interval is the range of analyte concentration that yields 5％ positive results to 95％ positive results for immunology qualitativc test.The C50 and C5-C95 interval of HBeAg in ARCHITECT i2000 were worked out according to the cut off value provided by HBeAg reagent calibrated in ARCHITECT i2000,which were verified to approve the character declaimed by manufactory or not.Gray zone was set and the procedure of cut off verification and gray zone set in chemiluminescent were built; A set of quality control was detected 20 times with two different lot HBeAg reagent kits,S/CO was caculated and compared with t test.Results C50 and C5-C95 interval of reagent (lot 06087L100,96378HN00) were 0.171 PEI U/ml,0.125 PEI U/ml; ＞0.154 PEI U/ml to 0.188 PEI U/ml,0.119 PEI U/ml to ＜0.150 PEI U/ml,respectively.S/CO of negative quality control and positive quality control were (0.550 ±0.038),(2.422 ±0.084) and(0.334 ±0.063),(3.587 ±0.321),respectively.They all approved the character (the sensitivity at cut off was less than 0.5 PEI U/ml)declaimed by manufactory,and the results of S/CO between two lot kits were obvious difference (t =9.944,15.499,P ＜0.01).Conclusion C50 and C5-95 interval can be used to verify cut off value and set gray zone in chemiluminescent assay;They may vary in different lot reagents and they must be verified to approve the character declaimed by manufactory.

OBJECTIVE To investigate the role of cinnabar and realgar in Angong Niuhuang Wan (AGNH) -produced neuroprotection against lipopolysaccharide ( LPS) -mediated neuronal damage and further explore the corresponding mechanisms. METHODS Primary rat midbrain neuron-glia cultures were used as an in vitro model to investigate effects of AGNH on LPS-mediated degeneration of dopamine (DA) neurons. The experiment was divided into normal control group, LPS model group, LPS + cinnabar (4 and 40 mg·L-1) groups, LPS + realgar (4 and 40 mg·L-1 ) groups and LPS + AGNH (40 and 400 mg·L-1 ) group. Drugs were added 30 min before LPS treatment. After 7 d, dopaminergic neurotoxicity was assessed through the quantification of tyrosine hydroxylase (TH)-positive neurons and morphological analysis of TH-positive neurons; the activation of microglia was evaluated using OX-42 antibody; the gene expression of tumor necrosis factor-α (TNF-α) and induced nitric oxide synthase (iNOS) mRNA in microglia was performed by real-time RT-PCR analysis, and the release of TNF-α and nitric oxide (NO) in the supernatant of neuron-glia cultures was determined respectively by the ELISA and Griess reagent. RESULTS Compared with normal control group, DA neurons in LPS model group decreased by 40% (P <0.05) , microglial activation was induced, the expression of TNF-α mRNA and iNOS mRNA in microglia increased 9 and 2 times, respectively ( P < 0. 05 ) , and subsequent production of TNF-α and NO in the supernatant of neuron-glia cultures increased 20 and 30 times, respectively (P<0.05). Compared with LPS model group, AGNH 400 mg·L-1 and realgar 40 mg·L-1 significantly attenuated LPS-mediated DA neuronal loss by 40% and 30% , respectively (P<0.05) and inhibited activation of microglia and expression of TNF-α mRNA by 61% and 52% (P <0.05). iNOS mRNA was reduced by 58% and 51% (P <0.05 ) in microglia. The subsequent release of TNF-α was reduced by 55% and 43% (P<0.05) and NO reduced by 53% and 34% (P<0.05) in the supernatant of neuron-glia cultures. Cinnabar had no inhibitory effect on LPS-induced changes. CONCLUSION AGNH protects LPS-induced neurotoxicity through its anti-inflammatory properties and realgar might be the key contributor to the neuroprotective action of AGNH, while cinnabar fails to show any neuroprotection.

Objective To analyze the risk factors of refractory postoperative stenosis after large-scale endoscopic submucosal dissection (ESD) for patients with early esophageal cancer.Methods The data of 35 postoperative stenosis patients previously treated by ESD (dissection ≥3/4 circumferential) for early esophageal cancer from January 2011 to September 2016 in Digestive Endoscopy Center, Changhai Hospital were reviewed.According to the number of endoscopic dilation, 35 patients were divided into two groups: refractory stenosis (≥6 endoscopic dilations, n=21) and non-refractory stenosis (≤5 endoscopic dilations, n=14), comparison between the two groups was performed using t test or Fisher exact probability method.Results Muscle layer damage (P=0.018), longitudinal mucosal defect length (P=0.013), tumor infiltrating depth (P=0.031), and the number of hemostatic clips (P=0.031) were significantly different between the two groups.The history of chemotherapy and radiotherapy, the location of tumor, the macroscopic type, and the postoperative administration of oral prednisolone were not significant differences between the two groups (P>0.05).Conclusion Refractory esophageal stenosis commonly occurs in patients undergoing large-scale ESD with tumor depth >M2, muscle layer damage, longitudinal mucosal defect length ≥50 mm and the number of hemostatic clips ≥6.

Objective:To evaluate the effect of Nutlin-3,a MDM2 antagonist,on the pyroptosis in SMMC-7721 cells.Methods: The expression of actived caspase-1(p20) and IL-1β was detected using Western blot analysis.Pyroptosis was investigated by a standard lactate dehydrogenase release assay(LDH).IL-1β content in the cell culture supernatant was quantified by ELISA.Results: Nutlin-3 up-regulated the expression level of actived caspase-1 and IL-1β in SMMC-7721 cells.Meanwhile,Nutlin-3 increased significantly the content of LDH and IL-1β in the cell culture supernatant(P<0.05).Conclusion: Nutlin-3 activated pro-caspase-1,promoted pyroptosis and IL-1β release in SMMC-7721 cells.

Objective To evaluate the combined impacts of blood glucose and its related metabolic factors on 18F-FDG uptake by liver.Methods A total of 544 subjects (384 males and 160 females, age range 24-73 years) undergoing 18F-FDG PET/CT were recruited in this retrospective study.SUVmean of the right lobe of liver was calculated.Two-sample t test and one-way analysis of variance were performed to compare SUVmean between patients with different genders and BMI levels.Linear correlation analysis, partial correlation analysis and multiple linear regression analysis were conducted to evaluate the relationship between age, injected 18F-FDG dose, blood glucose, serum T3, T4, FT3, FT4, BMR, BMI and liver SUVmean.Results The SUVmean of the liver in males and females were 1.89±0.42 and 1.92±0.38 (t=0.693, P>0.05), but it was significantly different among BMI groups (F=3.056, P<0.05).Age, blood glucose and FT3 were significantly associated with liver SUVmean (r′ values: 0.108, 0.140 and 0.105, all P<0.05) and were independent factors that indicated variation of liver SUVmean (β values: 0.006, 0.070 and 0.088, all P<0.05).Blood glucose was the strongest powerful predicting variable of liver SUVmean (β′=0.154, P<0.001).Conclusions Blood glucose and its related metabolic factors can affect the liver 18F-FDG uptake.Age, FT3, blood glucose are independent factors predicting variation of liver SUVmean.The impact of glucose metabolism status should be considered when assessing liver 18F-FDG uptake.

Objective To investigate the clinical features of patients with hypertriglyceridemia-induced acute pancreatitis (HTGP) and the influence of hypertriglyceridemia on severity or progress of acute pancreatitis.Methods By retrospective analysis,45 patients with HTGP and 184 patients with acute biliary pancreatitis (ABP) were studied.Age,gender,medical history,severity and complications were recorded and analyzed.Results Compared to ABP group,HTGP patients were significantly younger,more patients were observed in the diabetes,obesity and pregnancy.The hospitalization days in the HTGP group were much longer than that in the ABP group.The number of patients with severe acute pancreatitis (SAP) in the HTGP group were significantly higher than that in the ABP group (11/45 vs 20/184).The Ranson scores in the HTGP group were significantly higher than ABP group (2.58 ± 1.78 vs 1.98 ± 1.26).The number of HTGP patients with respiratory failure,renal failure,circulatory failure and systemic inflammatory response syndrome (SIRS) were higher than that in ABP patients.More HTGP patients had acute peripancreatic fluid collection (APFC),pancreatic pseudocysts and pancreatic necrosis than ABP patients.The mortality in IITGP group was higher than that in ABP group.Conclusions HTGP patients are younger,have more comorbidities and complications,with a trend towards more severe disease.To improve the prognosis are crucial in treatment of HTGP.

Objective: Chlamydia pneumoniae is a kind of common pathogenic bacteria in respiratory passage which cause persistent and chronic infection cell mediated immunity results mainly followiny the infection.The infection kinetics and local in vitro-restimulated cell mediated immunity(CMI) responses in the lungs and spleens of Icr mice during Chlamydia pneumoniae(Cpn) primary infection and reinfection will be analyzed in this article.Methods: Icr mice were inoculated intranasally with 105 IFU of Cpn(PT group).The same dose was given in the same way as rechallenge 4 weeks after the primary challenge(ST group).Control groups were inoculated with 0.05 ml PBS.The mice were sacrificed at predetermined days,and the pulmonary mononuclear cells and splenic lymphocytes were isolated and stimulated with Cpn in vitro for 3 days.The proliferative response was measured by MTT;IL-4,IL-10 and IFN-? were detected by ELISA.Results: The PT group showed a weak proliferative response and no secretion of IFN-? in the lungs after Cpn stimulation,while the ST group presented a reinfection characterized by IFN-? production both in the lungs and in the spleens(P

Objective To evaluate the efficacy and safety of endoscopic submucosal excavation (ESE) and submucosal tunneling endoscopic resection (STER) for gastroesophageal junction (GEJ)submucosal tumors (SMTs) originating from the muscularis propria(MP) layer.Methods Clinical data of sixty-one patients with GEJ SMTs originating from the MP layer who were treated with ESE(ESE group,n=39) or STER(STER group,n=22) between January 2013 and December 2015 in Changhai Hospital were retrospectively analyzed.Outcomes and complications in the two groups were compared.Results Single lesion in 61 patients were all resected by therapeutic endoscopy successfully.Operation time in the STER group was shorter than that of the ESE group(47.27±20.89 min VS 66.56±40.07 min,P＜0.05).There was no significant difference in number of hemostatic clips between the two groups[7.10±5.57 VS 8.00± 1.88,P＞0.05].Hospitalization time of STER group was shorter than that of the ESE group [3.0(1.25) d VS 4.0 (1.00) d,P＜0.05].One patient developed delayed hemorrhage in ESE group,while no other complications occurred in either group.The wound healed in both groups under gastroscopy,and no residual or recurrent tumors were detected during the follow-up period.Conclusion Both STER and ESE can be used for GEJ SMTs originating from the MP layer,but STER is more safe and efficient.