Antifungal Agents ; therapeutic use ; Fever ; Histiocytosis ; drug therapy ; etiology ; Humans ; Infant ; Lung Diseases, Fungal ; complications ; diagnosis ; drug therapy ; Male

Objective To investigate the clinical values of extracapsular invasion at sentinel lymph nodes in patients with breast cancer.Methods From Jan,2010 to Jan,2013,80 patients underwent axillary lymph node dissection due to sentinel lymph nodes invasion were enrolled in this prospective study.Patients were signed to extracapsular at sentinel lymph nodes positive group (n =45)and control group (n =35)according to the intra -operative pathology.The primary outcome was rate of positive non -sentinel lymph nodes and the second outcomes were 3 -year recurrence -free survival,mortality and health -related quality of life.Results Compared with the control group,the patients in extracapsular at sentinel lymph nodes positive group got a significantly higher rate of positive non -sentinel lymph nodes (91.11% vs.28.57%,χ2 =33.321,P <0.001 );a significantly lower rate of 3 -year recurrence -free survival(57.78% vs.88.57%,χ2 =9.114,P =0.003);a significantly higher rate of mortality (17.78% vs.2.86%,χ2 =4.390,P =0.036);and a significantly lower level of health -related quality of life[(78.43 ±12.43)vs.(87.54 ±11.89),t =11.324,P =0.000].Conclusion Extracapsular invasion at sentinel lymph nodes was a reliable predictor for non -sentinel lymph nodes invasion and long -term clinical outcomes.

Arthropathy, Neurogenic ; Child ; Coxa Vara ; Hand Deformities, Congenital ; Humans ; Male ; Synovitis

Hepatoid adenocarcinoma of the stomach ( HAS) belongs to one of the rare cases in gastric cancer types ,which has extremely high malignant degree and poor prognosis .Lymph node metastasis and liver me-tastasis are common in HAS.In this article,we reported alpha-fetoprotein-high-producing hepatoid adenocar-cinoma of the stomach(HAS),and reviewed the related literature at home and abroad in order to improve clinical physicians understanding of these diseases and treatment experience .

Objective:To investigate the effect of NS-398,a selective cyclooxygenase-2(COX-2) inhibitor,on the proliferation and invasion of human colon carcinoma cells in vitro,so as to determine the possibility of COX-2 as a new target for treatment of colon carcinoma.Methods: The expression of COX-2 in colorectal cancer cells(CW-2,COLO-320) was detected by RT-PCR and Western blotting.COLO-320 cell proliferation was measured by MTT after treatment with NS-398.Cell invasion ability was measured using migration and invasion chamber systems.Western blotting assay was used to examine the influence of NS-398 on MMP-2 expression.Results: Our results showed that CW-2,COLO-320 cells expressed COX-2 mRNA and protein.NS-398 inhibited the proliferation of COLO-320 cells in a time-and concentration-dependent manner.Invasion test showed that NS-398 inhibited the migration and invasion of COLO-320 cells.Western blotting revealed that NS-398 inhibited the expression of MMP-2 in COLO-320 cells.Conclusion: The selective COX-2 inhibitor NS-398 can inhibit COLO-320 cell proliferation and invasion,indicating COX-2 may serve as a new target for colon carcinoma treatment.

Objective To study the result of total ankle replacement in treating ankle disorders. Methods Total ankle replacement was employed to treat 18 cases (18 ankles) with ankle disorders including ankle osteoarthritis in six, traumatic arthritis in nine, local necrosis of the talus in two and post ankle arthrodesis in one. Results The follow up averaged three years and nine months (1-5 years). The ankle functions were evaluated with Kofoed's system that showed excellent result in 16 cases and good in 2. The foot dorsiflexion was 6?-12? and plantoflexion 8?-16?. Movement range of the foot dorsiflexion and plantoflexion was 11?-23?. The implication was the skin necrosis of incise bordger. No foot inversion, eversion and radiographic loosen were seen. Conclusion Total ankle replacement is a good method for improvement of the ankle function.

Objective To explore the clinical effect of transplantation of autologous fat with stromal vascular fraction for breast augmentation.Methods From September 2012 to March 2014,15 people accepted breast augmentation by transplanting autologous fat with SVF under local anaesthesia.Three-dimensional computer tomography reconstruction (3D-CT reconstruction) was applied preoperatively and postoperatively,the data of the thickness of breast's subcutaneous tissue was compared to observe the breast contour improvement.Results Autologous fat was injected 2 times in 3 cases,and the rest were 1 time.6 months after operation,13 cases were satisfied with the results,and 2 cases were quite satisfied.3D-CT reconstruction was performed before operation and 6 months after operation;statistics showed that before operation the thickness of breast subcutaneous tissue of the right side was (11±4) mm,the left side was (11±6) mm;6 months after operation the right side was (14±3) mm,the left side was (16±3) mm (P＞0.05).The breast was soft,no major complication such as nodules,cysts or calcification were seen.Conclusions The transplantation of SVF with autologous fat is a safe,effective procedure for breast augmentation.3D-CT reconstruction can show more details of breast structures,which is a more effective method to guide and evaluate the lipotrans plantation.

Objective To evaluate the value of contrast-enhanced ultrasound (CEUS) in preoperative classification for hilar cholangiocarcinoma. Methods Forty-six patients with 46 hilar cholangiocarcinoma were diagnosed by surgical pathology in Zhongshan Hospital of Fudan University from January 2007 to April 2013. The echogenicity difference on conventinal ultrasound and CEUS were compared with chi-square test. The accuracy of conventinal ultrasound and CEUS for evaluating invaded bile duct, detective rates for portal vein invasion and displaying rate of metastatic hilar lymph nodes were compared with chi-square test or Fisher’s Exact test according to the golden standard of operative exploration. Results On CEUS, 82.6%(38/46) and 91.3%(42/46) hilar cholangiocarcinoma were hypoechoic in portal vein phase and delayed phase respectively, while 63.0%(29/46) hilar cholangiocarcinoma were isoechoic on conventinal ultrasound with vague margin. The clearly displaying rates were 37.0%(17/46), 84.8%(39/46) and 91.3%(42/46) in conventinal ultrasound, portal vein and delayed phase of CEUS and the echogenicity was signiifcantly different. The evaluation accuracy of hilar cholangiocarcinoma invading bile duct was improved from 80.4%(37/46, conventinal ultrasound) to 100%(46/46, CEUS) significantly (χ2=7.882,P=0.005). Portal vein invasion were found in 9 cases during operative exploration and the detective rates on conventinal ultrasound and CEUS were 78%(7/9) and 89%(8/9) without signiifcant difference (P=1.000). Metastatic hilar lymph nodes were found in 8 cases and the displaying rates on conventinal ultrasound and CEUS were the same (75%, 6/8) without signiifcant difference (P=1.000). Conclusions CEUS could signiifcantly improve the clearly displaying rate of hilar cholangiocarcinoma and improve the evaluation accuracy for invaded bile duct comparing with conventinal ultrasound.

Objective To investigate the significance of early diagnosis and intervention in cases with severe hand-foot-mouth disease. Methods Nine severe cases were chosen from 220 hospitalized children with hand-foot-mouth disease for retrospective analysis, including onset, disease progression, the blood and cerebrospinal fluid tests, electroencephalogram data, patients' treatment responses and prognosis. Pearson X2 test and t test were utilized for statistical analysis. Results All cases showed nervous systems involved symptom, including meningeal irritation sign and (or) other pathological signs of nervous system (9 cases), drowsy (7 cases), trembling (6 cases), voiding dysfunction (3 cases), hypersensitivity(3 cases), autonomic nervous system disorders (2 cases), ataxia (1 case), left leg mild paralysis (1 case) and early stage of pulmonary edema (1 case). Early intervention, such as high dose gamma globulin, methylprednisolone, mannitol treatment restriction of fluid input, started before the development of heart and lung failure. No case died but one patient with encephalomyelitis showed hobbling left leg, which didn't recover until 6 weeks later. One case with brainstem encephalitis still showed abnormal electroencephalogram after 8 weeks follow-up but without clinical symptom. Conclusions Enterovirus 71 can cause severe hand-foot-mouth disease complicated by encephalitis, meningitis and pulmonary edema. Early active intervention before the development of neurogenic pulmonary edema can improve the prognosis and reduce the mortality.