Objective To study the histological and immunohistochemical features of primary and metastatic ovarian mucinous adenocarcinoma. Methods 24 cases of primary ovarian mucinous adenocarcinoma and 16 cases of metastatic mucinous adenocarcinoma (5 gastric, 5 appendix, 6 colorectal) with definite diagnosis were included in this study. All the tissue sections with either HE staining or immunohistochemical staining with CK7 and CK20 monoclonal antibodies were studied. Results All the 24 primary mucinous adenocarcinoma were positive for CK7 and only 3 cases showed focal positive for CK20. Among the 16 secondary mucinous adenocarcinoma, 6 colorectal and 5 appendiceal metastatic adenocarcinoma were positive for CK20 and only one metastasis showed focal positiveness for CK7. The five gastric metastatic mucinous adenocarcinoma showed strong CK7 expression and four of them were CK20 positive. Conclusions The primary and secondary mucinous adenocarcinoma of the ovary had different immunohistochemical features. CK7 and CK20 were valuable markers in the differentiation of these two entities.

Objective To find out the clinical effects of mifepristone in the treatment of perimenopausal dysfunctional uterine bleeding.Methods 87 patients with perimenopausal dysfunctional uterine bleeding were received mifepristone treatment.The thickness of the endometrium and sex hormones indicators,including progesterone(P),estrogen (E2),the corpus luteum generated hormone (LH),follicle hormone (FSH),prolactin (PRL) and testosterone (T),were checked before and after treatment.Results The treatment efficiency was 90.8％.Endometrial thickness before treatment (10.9 ± 1.9) mm,endometrial thickness after treatment (5.4 ± 1.1) mm,with significant differences between them(t =0.684,P ＜ 0.01).After treatment,patients with hemoglobin (102.5 ± 7.1) g/L,significantly increased compared with before treatment (t =0.539,P ＜ 0.01).After treatment,the P,E2,LH,FSH levels were significantly lower than those of before treatment (t =0.690,0.552,0.513,0.376,all P ＜ 0.05) ; PRL,T levels after treatment compared with before treatment,there were no significant differences (all P ＞ 0.05).Conclusion The mifepristone treatment for perimenopausal uterine bleeding has high effective rate,less adverse reactions,and high clinical value.

OBJECTIVE:To calculate pharmacokinetic parameters and compartment model's parameters by extravascular administration based on Excel function.METHODS:The parameters of pharmacokinetics and compartment model were calculated using residual method and Excel function.RESULTS:Excel can be used to directly demonstrate calculation process of parameters of pharmacokinetics and compartment model,with calculation results in line with those stated in textbooks.CONC-LUSION:The established method is simple,direct-viewing,reliable and easy to be extended,and it can be used to calculate pharmacokinetic parameters in clinical teaching or experiments.

Leukoencephalopathy with ataxia (LKPAT) is a rare autosomal recessive disorder caused by mutations of CLCN2 gene. LKPAT is clinically characterized by cerebellar ataxia, headache and cognition impairment. Brain magnetic resonance imaging showed characteristic hyperintensities along the pyramidal fiber tracts. Few cases have been reported so far. This article reported the clinical data of a 48 years old female patient with LKPAT for clinical reference.

Objective:To investigate the efficacy of three different methods of digestive tract reconstruction after total gastrectomy.Methods:A total of 106 cases underwent the uncutted Roux-en-Y esophagojejunostomy with a jejunal pouch(group A,n=38) ,Roux-en-Y esophagojejunostomy with the J-type jejunal pouch(group B,n=31) ,and Roux-en-Y esophagojejunostomy with the Orr-type jejunal pouch(group C,n=37) respectively.The clinical data were retrospectively studied.The digestive tract reconstruction time,the post-operative complication incidence rate,postprandial symptoms,food-intake quantity,weight,serum nutritional parameters and emptying time of the gastricsubstitute were compared respectively.Results:The reconstruction time was the shortest in group A,which was significantly shorter than that in group B(P0.05) ,Group A was significantly lower than group B and C in the incidence of roux stasis syndrome.The Visick score of group A were superior to those of group B and C in 6 and 12 months after operation.The food intake gain of group A and B were superior to that of group C 6 and 12 months after operation.There were no significant differences among 3 groups in the term of weight,Hb and ALB loss and prognosis nutritional index(PNI) 6 months postoperatively.Weight and ALB loss in group A and B were lower than those in group C 12 months postoperatively,but PNI was higher in group A and B than those in group C.Emptying time of the gastric substitute was prolonged both in group A and B 12 months postoperatively.Conclusion:The uncutted Roux-en-Y esophagojejunostomy may act as an adoptable method of digestive tract reconstruction after total gastrectomy for gastric cancer.

OBJECTIVE: To conduct a quantitative evaluation on pharmaceutical research performance in our department. METHODS: Our department's annual research performance during 2001～2005 was scored by integrated weighting method. RESULTS: The research performance in our department over the five years achieved overall high scoring, especially in 2003 and 2004. CONCLUSION: Integrated weighting method can be used to evaluate pharmaceutical research performance.

Objective To evaluate the diagnostic accuracy of contrast-enhanced MR angiography (CE MRA) in infrapopliteal occlusive diseases of diabetic patients.Methods A total of 105 patients with known diabetes and peripheral vascular occlusive disease who underwent both CE MRA and DSA examnations were included in this study.They had no obvious stenosis or with stenosis of less than 75％ in iliac,femoral,and popliteal arteries.Every infra-popliteal artery was anatomically divided into 9 vascular segments as tibiofibular trunk artery,proximal and distal anterior tibial artery,proximal and distal posterior tibial artery,proximal and distal peroneal artery,plantar and dorsalis pedis artery.There were 945 segments.The arterial stenosis was accessed with CE MRA and DSA respectively.The segments were scored in 5 categories as＜30％,≥30％ and＜50％,≥50％ and＜75％,≥75％ and＜100％,and 100％ according to stenostic degrees.The Kappa test was used to compare the diagnostic consistency of CE MRA and DSA.Taken DSA as a gold standard for reference,ROC curve was drawn to calculate the diagnostic accuracy of CE MRA in diagnosis of lower limb arterial disease.Results The ratio of statistically valid segments for both CE MRA and DSA were 97.7％ (923/945) in 945 vessel segments of 105 patients,and 390 of 923 arterial segments were both indicated as occlusion by CE MRA and DSA.The diagnostic consistency for the segments was listed in the decreasing order as follows:proximal peroneal artery,proximal posterior tibial artery,distal posterior tibial artery,proximal anterior tibial artery,distal anterior tibial artery,tibiofibular trunk artery,dorsalis pedis artery,plantar artery,distal peroneal artery,and corresponding Kappa values were 0.88,0.86,0.84,0.84,0.81,0.77,0.75,0.75 and 0.73,P＜ 0.05.The AUC(area under ROC curve) of CE MRA was 0.893 with 95％ confidence interval of 0.882 to 0.904.Conclusion CE MRA is an accurate imaging modality in the diagnosis of infrapopliteal occlusive disease s for diabetes.

Objective To compare the difference in pharmacokinetics characteristics of vancomycin in cerebrospinal fluid between administration by continuous infusion and interim infusion.Methods Twenty postoperative patients in the Department of Neurosurgery of Beijing Tiantan Hospital, Capital Medical University admitted into intensive care unit (ICU) to receive vancomycin for prophylaxis of intracranial infection were enrolled, and they were randomly distributed to a continuous intravenous infusion group and a interim intravenous infusion group, each group 10 cases. In continuous intravenous infusion group, the patients received a loading dose of vancomycin (15 mg/kg) by continuous intravenous pump infusion for 1 - 2 hours followed by 30 mg/kg vancomycin in a constant pump infusion rate for 24 hours; while in interim intravenous infusion group, the patients received 15 mg/kg vancomycin administered by intravenous pump infusion for 1 - 2 hours, once every 12 hours. The concentration of vancomycin in the cerebrospinal fluid at different time points was measured by two-dimensional liquid chromatography (2D-LC) method, the parameters of pharmacokinetics were calculated in the two groups, and the adverse reaction was observed.Results The comparison between the ratio of areas under the concentration-time curves (AUC) and minimum inhibitory concentration (MIC) of the continuous and interim groups showed no significant difference (19.7±14.0 vs. 16.1±6.4,P > 0.05). However, in the continuous intravenous infusion group, the drug concentration reached the peak value (0.96± 0.77)μg/mL at 12 hours, and later revealed a plateau concentration 0.91-0.93μg/mL for 12 hours; while in the intravenous infusion interim group, the drug concentration reached the peak value (0.92±0.47)μg/mL at 16 hours, in the later 2 hours declined to (0.84±0.45)μg/mL, and afterwards still had a tendency of persistent declination. In all the patients, no any adverse reaction related to the drug occurred.Conclusion Continuous intravenous infusion and interim intravenous infusion of vancomycin for the postoperative neurosurgical patients without intracranial infection have the similar efficacy of medication, but the former can achieve the peak concentration faster and later the fluctuation of drug concentration in cerebrospinal fluid is smaller than those in the latter.

Small intestinal neuroendocrine carcinoma is poorly differentiated,highly malignant,and originated from the diffuse neuroendocrine system.It diffusely expresses the general neuroendocrine differentiation markers.The disease can be manifested as carcinoid syndrome,but most of the patients were with occult onset and absence of specific clinical symptoms,which led to difficult diagnosis before operation.On June 18,2012,a patient with manifestation of recurrent vague abdominal pain received capsule endoscopy at the Northern Jiangsu People's Hospital.The capsule endoscope was retained in the distal small intestine,and malignant ileum lesion was revealed during the surgical exploration.Finally,poorly differentiated neuroendocrine carcinoma with abdominal wall metastases was identified by pathological examination.