OBJECTIVE: To investigate the cause, genetics, clinical features, pathological mechanism, diagonosis and treatment of the Giant pleomorphic adenoma of the parotid gland (GPA). METHOD: A case of GPA was reported and relevant literatures were reviewed. RESULT: GPAs were more commonly found in elderly patients, duration of more than 10 years, with a possible malignant degeneration. CT scan shows uneven density, different degrees of enhancement and clear boundary. Pathological examination shows that the composition of tumor tissue are epitheli al cells, myoepithelial cells and mucus. CONCLUSION GPA is an uncommon disease and is associated with human factors. The diagnosis of GPA is oriented by medical history, physical examination and imaging tests. The total resection of the tumor and preservation of the facial nerve is an effective way for the treatment of GPA.
Adenoma, Pleomorphic ; pathology ; Female ; Humans ; Middle Aged ; Parotid Neoplasms ; pathology

Objective:To study the incidence rates of cancer in the urban area of Shijiazhuang city, China in 2012 based on the data of 2,374,827 registered residents. Methods: The incidence of diagnosed cancer cases in 2012 was obtained from the hospital reimbursement database of the medical insurance center of the city by retrieving the records on first-time reimbursement applications for the hospitalization of tumor patients from January 1 to December 31 in 2012. Population census data was obtained from the Population Department of the Shijiazhuang Public Security Bureau. The site-specific and sex-specific age-adjusted incidence rates were calculated. Results:The overall incidence rate, the age-adjusted rate of the Chinese population (ASRC), and the age-adjusted rate of the world population (ASRW) for both men and women were 237.53, 129.86, and 167.71 per 100,000 individuals, respectively. The incidence rate increased with age and peaked in the 75-79 years age groups of men and women at 1,729.42 and 867.35 per 100,000 individuals, respectively. The top ten most frequently diagnosed cancers in males were lung, stomach, colorectal, liver, esophagus, kidney, prostate, leukemia, bladder, as well as lymphoma, whereas those in females were the breast, lung, colorectal, stomach, cervical, uterine body, ovary, lymphoma, esophageal, and liver cancers. The incidence rate and ASRW of all cancers combined in men were 269.05 and 187.52 per 100,000 individuals, whereas those for women were 207.57 and 150.44 per 100 000 individuals, respectively. Compared with the average incidence rates of 31 Chinese cities in 2009, the ASRW of lung, stomach, and colorectal cancers in males from Shijiazhuang was nearly equal to the national level;however, the ASRW of breast cancer in females from Shijiazhuang was higher than the national level. When the incidence rates of Shijiazhuang in 2012 were compared with those of Beijing in 2009, the ASRW of stomach and esophageal cancers in men of Shijiazhuang was twice that of the same cancers in Beijing. However, the same parameters for the pancreatic and prostate cancers in men, as well as the thyroid and uterine body cancers in women of Beijing, were twice the values for Shijiazhuang. Conclusion: The ASRWs of the major types of cancer, such as the lung, stomach, colorectal, and breast cancers, in urban Shijiazhuang in 2012 were identical to those of the 31 Chinese cities in 2009. Compared with Beijing, the incidence rates of pancreatic, prostate, and thyroid cancers were significantly higher in Shijiazhuang, whereas those of esophageal and stomach cancers were significantly lower.

Objective To prepare a radiofrequency (RF) ablation probe guided by endoscopic ultrasonography (EUS) and to evaluate its efficacy and safety. Methods A modified 19-gauge needle ( Olympus) was used, which was electrically insulated with shrink tubing, with the tip of lcm naked. The insulation was tested, and the current signal was stable. Three rabbits were anesthetized with 8% chloral hydrate ( 3 ml/kg) intraperitoneally, fixed on the dissecting table. A standard neutral pad was applied to the thigh of the rabbit to complete the electrical circuit, both the pad and the needle electrode connected with RF generator. After anesthesia was ready, the needle was advanced through the gastric wall into the liver. Ablations were performed three times in the same zone. Extent and tissue lesion were measured after ablation. Results Ablation could be successfully performed by the needle electrode, with brown lesions surrounded by normal hepatic tissue. The mean diameter of the ablated zone in the liver was 1.0 cm× 1.2 cm. After ablation,specimens along the passage were subjected to NADH staining, and no lesions were found. HE and NADH staining showed no viable cells in the central ablation area. Conclusion With the advance of the technology and selection of materials, an EUS-guided needle electrode can be made. This preliminary animal trial demonstrates that radiofrequency ablation can be performed effectively and safely by using this EUS-guided needle electrode.

Objective To evaluate the therapeutic effect of oral and external application of Chinese medicine combined with Ilizarov external fixator and the accordion technique for severe chronic osteomyelitis of the tibia.Methods A total of 78 patients with severe chronic osteomyelitis of the tibia were randomized into a routine treatment group and a combined treatment group, 39 in each group. All the patients in the two groups received external fixation by use of Ilizarov external fixator and the accordion technique. All the patients in the combined treatment group received oralGuyu decoction. The patients who had large wound received vacuum-sealing drainage in the routine treatment group, and vacuum-sealing drainage combined with external application ofShengji-Yuhong plaster in the combined treatment group. All the patients were treated for 8 weeks and followed up for 2 years. The time to wound healing and fracture healing, and the drainage time were compared between the two groups. Functional and radiologic findings were evaluated according to Paley's criteria. The functions of the knee joint and ankle joint were evaluated using the Hospital for Special Surgery (HSS) knee score and the scoring system of Baird and Jackson, respectively.Results The time to wound healing (17.33 ± 6.21 dvs. 22.27 ± 8.12 d;t=3.018,P=0.004) and the time to fracture healing (32.25 ± 6.02 weeks vs. 36.37 ± 7.75 weeks;t=2.623,P=0.011), and the drainage time (17.01 ± 4.66 dvs. 21.51 ± 5.23 d;t=4.012, P<0.001) in the combined treatment group were significantly shorter than those in the routine treatment group. According to Paley's criteria, the patients who achieved a score of excellent or good for fracture healing (84.6%vs. 53.8%;χ2=7.282,P=0.007) and function (92.3%vs. 66.7%;χ2=6.369,P=0.012) in the combined treatment group were significantly more than those in the routine treatment group. The scores of the HSS knee score (84.56 ± 7.42vs. 78.81 ± 5.33;t=3.391,P=0.002) and the scoring system of Baird and Jackson (85.01 ± 8.21vs. 79.21 ± 6.78;t=3.402,P=0.024) in the combined treatment group were significantly higher than those in the routine treatment group.Conclusion OralGuyu decoction and external application ofShengji-Yuhong plaster combined with Ilizarov external fixator and the accordion technique can promote recovery of the joint function, fracture healing and wound healing.

Objective Influence of cover statement and clarity of the messages upon risk decision making about thrombolysis therapy in patients with cerebral infarction was discussed in the Scenarios of thrombolytic therapy for acute cerebral infarction.Methods Inpatients and outpatients with cerebral infarction were randomly divided into two groups:detailed / simple cover statement group.Every participant underwent obscure messages and clear messages with only one frame:positive or negative frame.Results In the simple cover statement group,both obscure messages subgroup and clear messages subgroup were not influenced by the framing effect with preference to the risk seeking.In the detailed cover statement group,participants in the clear messages group were not influenced by the framing effect(x 2 =0.19,P＞0.05),while the subjects in the obscure messages group were actually affected by the framing effect,with the preference to risk seeking in the positive framework (x 2=7.90,P＜0.01).Conclusion The risk decision making about thrombolysis therapy in patients with cerebral infarction is influenced by cover statements and clarity of the messages.To improve the rate of thrombolysis therapy,the patients should be exposed to the obscure messages in the positive framing information under the detailed cover statement.

Objective To report our surgical experience in treating 19 cases of solitary iliac aneurysms (SIA). Methods The clinical data of 19 consecutive patients with SIA between January 1985 and January 2008 were retrospectively reviewed. There were 18 men and 1 woman, aging from 39 to 77 years ( mean 62 ± 7 years). Results There were 30 SIAs in the 19 patients, including 25 ( 83.3% ) common iliac aneurysms, 4 (13.3%) internal ihac aneurysms and 1 (3. 3% ) external iliac aneurysm. Eleven patients ( 57.9% ) had multiple ancurysms, with 9 patients ( 47.4% ) having bilateral SIA. Two patients had coexistent peripheral vascular occlusive disease. There were 2 patients suffering form ruptured SIA, one was saved by emergency operation and one died before an surgery could be attempted. Seventeen patients underwent successful open aneurysmectomy and artificial graft implantation leaving no ischemic complications of the pelvic organs. One patient with right common iliac aneurysm underwent endovascular repair without endoleak. There was no operative death during porioperative period. The surviving patients remained stable and had good patency of grafts during the follow-up period. Conclusions Early management of SIA is important, CT angiogarphy (CTA) is necessary not only to evaluate the SIAs, but also to detect multiple aneurysms or arterial occlusive disease. Close and long-term follow-up is mandatory for the early detection of the formation of new anearysms.

BACKGROUND:Human amniotic epithelial cells are an important source of cells in regenerative medicine as its multipotentation, but new studies mainly focused on differentiation features and there were little research oneffect of culture in vitro on biological property of amniotic epithelial cells.
OBJECTIVE:To analyze the effects of in vitro culture on growth, cellphenotype and differentiation capacity of human amniotic epithelial cells into cardiomyocyte-like cells, and explore the correlation of primarily cultured human amniotic epithelial cells marker SSEA-4 expression level and the change of biological characteristics of human amniotic epithelial cells.
METHODS:Primarily cultured human amniotic epithelial cells were obtained from amniotic tissues by using the same separation protocol. Human amniotic epithelial cells were cultured in vitro. The proliferation, cellphenotype and the differentiation capacity of human amniotic epithelial cells into cardiomyocyte-like cells were evaluated by means of cellcounting kit-8, flow cytometry and real-time PCR.
RESULTS AND CONCLUSION:The SSEA-4 positive cells in primarily cultured human amniotic epithelial cells from different fetal tissues were between 26.7%-97%, which indicated that there was great individual difference among amniotic tissue samples. Moreover, with passage, the SSEA-4 expression in human amniotic epithelial cells decreased significantly, which did not correlate with the SSEA-4 expression in primarily cultured human amniotic epithelial cells. Results indicated that there was great individual difference in SSEA-4 expression level in primarily cultured human amniotic epithelial cells from different amniotic tissue samples. Thus, it is necessary to set up clinical screening indexes to get samples with higher SSEA-4 expression stably and to control the quality of human amniotic epithelial cells. In addition, during culture period, SSEA-4 expression level was affected by culture conditions. The culture conditions of human amniotic epithelial cells should be optimized to maintain SSEA-4 expression at a high level. In addition, the differentiation capacity of human amniotic epithelial cells into cardiomyocyte-like cells was also affected by individual difference among different samples and culture conditions, which wil be further studied in the future.

Objective To compare the therapeutic efficiency of laparoscopic and open radical colorectal surgery in the treatment of colorectal carcinoma. Methods Clinical data of 77 cases undergoing laparoscopic colorectal surgery from September 2004 to October 2007 were compared with 90 patients treated by open surgery. Results Mean operating time was longer in the laparoseopic group than that in the open group [248 minutes vs. 225 minutes (t = -2. 11 ,P =0. 036)], blood loss was less in laparoscopic group [210 ml vs. 315 ml (t = 2. 82, P = 0. 005)]. Laparoscopic surgery was associated with lower rate of analgesia use [48% vs. 80% (x2 = 18. 69 ,P < 0. 01)], earlier recovery of bowel function [2. 9 days vs. 4. 3 days(t =5.59,P <0. 01)]and shorter hospital stay [12. 5 days vs. 15.5 days (t =2. 32,P=0. 039)]compared with open surgery. The number of removed lymph nodes [14. 2 vs. 15.3 (t = 1.04, P = 0. 3)]and length of reseeted bowel [18. 9 cm vs. 20. 0 cm, (t = 0. 88,P = 0. 383)]were not different between the two groups. The mean follow-up time of the two groups were 28 months, local recurrence rate, metachronous metastases rate and 3-year cumulative survival rate were not statistically different between the two groups. Conclusion Laparoscopic surgery is as effective as conventional open surgery in the treatment of colorectal carcinoma.

Objective To discuss the effects and the possible mechanismof curcumin on pulmonary functions and expression of TGF-β1 and NF-κB in paraquat-induced pulmonary fibrosis of rats.Methods SPF Wistar rats were randomly (random number) divided into three groups:paraquat-poisoned group (PQ group,with PQ 50 mg/kg by gavage),Curcumin-treatment group (PC group after 30,with curcumin (200 mg/kg) by intraperitoneal injection),and Blank group (B group,with same volume of sterile saline at the same time).After 14 d,the lung function of rats was observed,and the expression of TGF-β1 and NF-κB protein were detected by immunohistochemistry.Results The survival rates of mice significant difference in the PC and PQ groups with (70.83％ vs.41.67％,P ＜0.05).Compared with the B group,lung function index (Te,PIF,PEF,EF50,TV,F) of PQ group significantly decreased (P ＜ 0.05,P ＜ 0.01).Compared with the PQ group,lung function index (Te,PEF,TV,F) of PC group significantly increased (P ＜ 0.05 or P ＜ 0.01).There are some expression of lung tissues of rats with TGF-β1,NF-κB in B group.Compared with B group,PQ group significantly enhanced (P ＜0.01or P ＜0.05).Compared with the PQ,PC group significantly decreased (P ＜ 0.01 or P ＜ 0.05).Conclusions Curcumin can relieve paraquat-induced pulmonary fibrosis by inhibiting the over expression of TGF-β1,NF-κB in lung tissue of rats.

Objective To observe the effects of curcumin on pulmonary fibrosis and functions on paraquat (PQ)-challenged rats, and investigate the possible mechanism. Methods 108 SPF Wistar rats were divided into three groups according to random number sheet: normal saline (NS) control group, PQ model group and curcumin-treatment group. The rats in each group were subdivided into three subgroups according to different time points (3, 7, 14 days), with 12 rats in each subgroup. PQ-challenged models were reproduced by intragastrical administration of PQ solution 50 mg/kg, and those in NS control group were given the equal volume of NS. After 30 minutes, the rats in curcumin-treatment group were given 200 mg/kg of curcumin by intraperitoneal injection, and those in NS control group and PQ model group were given the equal volume of NS. At 3, 7, 14 days, the tidal volume (VT) was examined, and the blood was drawn from femoral artery for blood gas analysis. Then the rats were sacrificed and the lung tissues were harvested, the hydroxyproline (Hyp) content was measured by alkaline hydrolysis; the expression of transforming growth factor-β1 (TGF-β1) was determined by immuno-histochemistry; the distribution and the change of the pulmonary collagen fiber were observed after Masson staining. Results After exposure to PQ, the VT and arterial partial pressure of oxygen (PaO2) were decreased gradually, and the levels of Hyp and TGF-β1 were increased gradually, reaching the trough or the peak at 14 days, which were significantly lower or higher than those in NS control group [14-day VT (mL):1.52±0.33 vs. 2.81±0.47, 14-day PaO2(kPa): 5.87±0.95 vs. 14.15±1.02, 14-day Hyp (μg/mg): 3.12±0.06 vs. 1.14±0.05, 14-day TGF-β1 (integral A value): 29.72±4.27 vs. 4.15±0.52, all P < 0.01]. After intervene of curcumin, the parameters were significantly improved as compared with those of PQ model group [14-day VT (mL): 2.34±0.19 vs. 1.52±0.33, 14-day PaO2(kPa): 10.23±1.01 vs. 5.87±0.95, 14-day Hyp (μg/mg): 2.31±0.04 vs. 3.12±0.06, 14-day TGF-β1 (integral A value): 15.46±2.89 vs. 29.72±4.27, all P < 0.01]. It was shown by Masson staining that in PQ model group, with the PQ-poisoned time prolonging, diffused pulmonary fibrosis and a large number of collagen deposition were observed gradually, and the most serious collagen deposition was observed at 14 days; after intervene of curcumin, pulmonary fibrosis was alleviated significantly at different time points as compared with the PQ model group. Conclusion Curcumin can enhance the pulmonary function by reducing the deposition of collagen fiber and inhabiting pulmonary fibrosis of PQ-poisoned rats.