Objective To explore the clinical and pathological characteristics of singularity uterine leiomyoma.Methods The cause of disease and the clinical features in 15 patients with singularity uterine leiomyoma were analyzed.The patients were examined by pathology and immunohistochemistry.Results The main clinical manifestations were irregular vaginal bleeding,pelvic tumor and anemia.3 patients combined with pregnancy,4 patients had the treatment history of exogenous progesterone.The tumor appeared grayish red,and with complete envelope by macroscopic examination;The multi-and mono-nucleated giant cells were seen under surgical microscopy,the mitosis count was 0～3/10HPF.The tumors showed weak positive staining for Ki-67 and p53,negative staining for ER in 8 cases and positive staining for PR in all cases.Conclusions Singularity uterine leiomyoma belongs to benign tumor,its clinical features and treatments are similar to common leiomyoma;It has certain relation with exogenous and endogenous progesterone.The differentiation of leiomyoma with leiomyosarcoma is basically depended on HE staining observation;The immunohistochemistry of leiomyoma has certain feature.

Literatures of study on acupoint functional effect of encephalic region with functional magnetic resonance imaging (fMRI) are collected from the database of China National Knowledge Information (CNKI) and Wan fang database. Analysis and comments are made respectively from the status quo of studies on combination of single acupoint, two acupoints and multiple acupoints under both physiological and pathological conditions. The results show that the corresponding encephalic regions can be specifically activated by acupuncture. And different regions can be activated by different acupoints. However, studies on single acupoint, two acupoints and three acupoints are the major researches carried out at present. It is still lack of observation on effect of commonly-used combinations in clinic. Moreover, the reliability of the research results are also affected by disunity of operations protocol, reinforcing or reducing manipulations, intensity or depth of stimulation and duration of needling retention. Therefore, it is necessary to establish a unified and standard operation protocol to strictly control the bias factors which may affect the result of research in the future, and take patients as the study target as much as possible, so as to further explore the central effect mechanism.
Acupuncture Points ; Acupuncture Therapy ; Brain ; diagnostic imaging ; physiology ; Humans ; Magnetic Resonance Imaging ; Radiography

Acute Disease ; Adolescent ; Adult ; Benzene ; poisoning ; Cough ; etiology ; Dexamethasone ; therapeutic use ; Fatigue ; etiology ; Female ; Glucocorticoids ; therapeutic use ; Glutathione ; therapeutic use ; Humans ; Length of Stay ; Male ; Middle Aged ; Occupational Diseases ; etiology ; therapy ; Occupational Exposure ; adverse effects ; Treatment Outcome

Objective To evaluate the performance of an improved skin prick test in the screening for allergens.Methods A total of 475 patients with chronic urticaria who aged from 3 to 81 years were enrolled in this study,and classified into the control group (n =235) and research group (n =240).Traditional and improved skin prick test were conducted in the control and research group respectively.The allergen detection rate was compared between the two test methods.Results The allergen detection rate was 65.4％ and 67.2％ respectively for the improved and traditional skin prick test,respectively (P ＞ 0.05).House dust mites were the most common sensitizing agent.Conclusion The improved skin prick test can offer reliable evidence for chnical diagnosis with a relatively convenient and safe procedure.

Acute Disease ; Autonomic Nervous System Diseases ; Child ; Humans ; Male

Objective To analyze the clinicopathologic characteristics and prognosis in multinodular and multicentric occurrence of hepatocellular carcinoma (HCC). Methods Study group (multinodular HCCs) involved 42 multinodular HCCs patients with a total of 112 HCC nodules. 16 patients with single HCC nodule, and 4 patients with portal vein tumor embolus, 5 normal livers served as controls. MtDNA D-Loop sequences were compared among multinodular lesions in the study group, between inconsecutive tumor tissues and between tumor and embolus tissues in the study group with regard to their clinicopathologic characteristics. Results In study group, for the multinodular HCCs 20 cases were categorized as multicentric occurrence (MO) based on their variant mtDNA D-Loop sequences in each nodule from the same patient. 22 cases were characterized as intrahepatic metastasis (IM) based on the identical sequences found in each nodule from the same patient. In all 20 cases for the rest of the study group (16 patients with single HCC nodule and 4 patients with portal vein tumor embolus), the inconsecutive tumor tissues or the portal vein tumor embolus and original tumors shared identical sequences. HBeAg (P =0. 008), tumor size ( sizes of all nodules) ( P = 0. 029), position of nodules (P = 0. 040), cirrhosis ( P =0. 011 ), portal vein and microscopic tumor embolus ( P = 0. 023 ) and differentiation ( Edmondson grade) of the main nodule (P = 0. 027 ) were significantly different between the IM and MO HCCs, thus were considered to be the important factors in determinning the clonal origin of multinodular HCC. Positive HBeAg, cumulative diameter of all nodules ≤7 cm, nodules located in different lobes, cirrhosis, negative for portal vein or microscope tumor embolus and/or well/moderate differentiation of main nodular histopathology were found in high rate in MO. Tumor-free survival of the MO subjects was significantly longer than that of the IM subjects (21.6 ±4. 2) months vs. (8.7 ±2. 5) months, P =0. 031 ). Similarly, overall survival of the MO subjects was longer than that of the IM subjects (29. 6±4. 7) months vs. ( 14. 6 ±2. 9) months, P = 0. 034). Multivariate analysis revealed that the IM/MO characteristic was an independent factor influencing both tumor-free survival ( P = 0.012 ) and overall survival ( P = 0.011 ).Conclusions HBeAg, tumor size ( sizes of all nodules), position of nodules, cirrhosis, portal vein and microscopic tumor embolus and differentiation of the main nodule are important factors in differentiating IM and MO. Positive HBeAg, cumulative diameter of all nodules ≤ 7 cm, nodules located in different lobes, cirrhosis, negative for portal vein or microscopic tumor embolus and/or well/moderate differentiation of main nodular histopathology are frequent phenomena in MO. MO HCC patients might have a favorable outcome compared with IM patients.

Aged ; Astragalus Plant ; Cerebral Infarction ; drug therapy ; Drug Combinations ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Plant Extracts ; Platelet Aggregation ; drug effects ; Salvia miltiorrhiza

Objective To investigate the effect of two chemotherapeutic regimens suitable for elderly ad -vanced non-small cell lung cancer(NSCLC).Methods A total of 58 elderly advance nonsmall cell lung cancer pa-tients randomized into two group:single-agent group and combined group .Single-agent group received gemcitabine 1 000mg/m2 at Days 1 and 8 for a 21 day cycle.Combined group received gemcitabine 1 000mg/m2 at Days 1 and 8 in combination earboplatin AUC 5 at Day 2 for a 21 day cycle .All patients in the two groups received 3 cycles of chemotherapeutic regimens.Results Of the single-agent group,complete remission (CR) in 1 cases,partial remis-sion (PR) in 12 cases, the effective rate was 46.4%,and of the combined group,CR in 1 cases,PR in 13 cases,the effective rate was 50.0%,there was no statistically significant difference between the two groups (P>0.05).Of the single-agent group,the median survival time was 9.7 months,1-and 2-year survival rates were 31.3%,12.5%,re-spectively,and of the combined group ,the median survival time was 10.1 months,1-and 2-year survival rates were 33.8%,15.6%,respectively,there were no statistically significant difference between the two groups (χ2 =1.743, 1.529,1.739,all P>0.05).The leutropenia and thrombocytopenia incidence of 3 to 4 grade in the combined group was 50.0%,46.4%,respectively,which were significantly higher than 28.6%and 18.0%in the single-agent group (χ2 =4.41,4.69,all P<0.05).Lung Cancer Symptom Scale scores showed:after the treatment,the anorexia,fatigue and pain scores of the single-agent group improved significantly compared with pre-treatment ( t =2.687,2.789, 2.603,all P<0.05),whereas no significant improvement in the combined group;After the treatment,three symptom scores of the single-agent group were significantly higher than those of the combined group (t=2.986,3.569,2.764, all P<0.05).Conclusion Single-agent gemeitabine regimen efficacy is comparable with that of combined regimen for elderly advanced NSCLC with less adverse effects .

Objective To evaluate the immune response triggered by an in-house constructed hu-man metapneumovirus multi-epitope antigen ( MEA) in a mouse model .Methods Female SPF BALB/c mice at age 4-6 weeks were used in the study and divided into 7 groups.Mice in the five groups including MEA+oligodeoxynucleotides containing CpG motifs ( CpG ODN) intraperitoneal injection ( i.p.) treatment group, MEA+Alum i.p.treatment group, MEA+Alum+CpG ODN i.p.treatment group, MEA+CpG ODN intranasal (i.n.) treatment group and MEA+Alum+CpG ODN i.n.treatment group were immunized three times on days 0, 14 and 21, and those in the other experimental group were immunized intramuscularly with MEA+Quickantibody5W on days 0 and 21.A control group without treatment was set up accordingly .All mice were sacrificed two weeks after the last immunization .Antibodies including IgG , IgG1, IgG2a and IgA in serum samples were detected by ELISA .MTS assay was performed to analyze the proliferation of lympho-cytes.The cytotoxicity of cytotoxic T lymphocytes (CTL) was measured by LDH assay.Flow cytometry was used to detect T lymphocyte subsets .The cytokines secreted by T helper cells ( Th1 and Th2) were analyzed with Bio-Rad Liquid Chips.Results High titers of IgG, IgG1 and IgG2a antibodies were produced in MEA treated mice except for those in intranasal treatment groups .Serum samples from three groups including the MEA+Alum i.p., MEA+Alum+CpG ODN i.p.and MEA+Quickantibody5W i.m.treatment groups were positive for IgA antibody .The highest titer of IgA antibody was detected in mice from the MEA+Alum+CpG ODN i.p.treatment group, which was 2.15×103.Compared with the control group, significantly enhanced proliferation of lymphocytes was observed in the MEA+Alum i.p., MEA+Alum+CpG ODN i.p.and MEA+Quickantibody5W i.m.treatment groups (P<0.05).Enhanced cytotoxic activities of CTL were observed in mice with ip.and i.m.treatments as compared with those in control group (P<0.05).The levels of CD4+/CD8+T cells were slightly increased in mice from the MEA+CpG ODN i.p., MEA+Alum+CpG ODN i.p. and MEA+Quickantibody5W i.m.treatment groups as compared with those in control group (P<0.05).In-creased secretion of IL-2, IFN-γand Th2-type cytokines including IL-4, IL-5 and IL-10 were detected in mice from the MEA+CpG ODN i.p.treatment group.The MEA+Alum i.p.treated mice showed a slightly increased secretion of IFN-γand significantly increased secretions of IL-4, IL-5 and IL-10.Significantly in-creased secretions of IFN-γ, IL-4, IL-5 and IL-10 were detected in mice from the MEA+Alum+CpG ODN i.p.treatment group.Significantly increased secretions of IFN-γ, IL-5, IL-10 and granulocyte-macrophage colony-stimulating factor (GM-CSF) were detected in mice from the MEA+Quickantibody5W i.m.treatment group.Conclusion MEA together with different adjuvants could stimulate high titers of specific antibodies , increase the proliferation of lymphocytes and enhance the cytotoxic activities of CTL .CpG ODN could bal-ance the Th1/Th2-mediated immune responses , and the balance could be enhanced when using CpG ODN in combination with Alum .A similar effect could be achieved by using the commercial adjuvant Quickanti -body5w.This study has paved the way for further investigation on the development of hMPV epitope vaccines and diagnostic reagents for hMPV as well as the epidemiological study of hMPV .

Objective To retrospectively analyze the prognostic factors of advanced esophageal carcinoma (EPC) with concurrent chemoradiotherapy.Methods A total of 200 advanced EPC patients between January 2008 and December 2011 were reviewed,and all of them received concurrent chemoradiotherapy,either IMRT or CRT.Among them,there were 92 and 108 patients in the IMRT and CRT group,respectively.The chemotherapy scheme was paclitaxel combined with different platinum drugs (cisplatin,nedaplatin,oxaliplatin or lobaplatin).The number of chemotherapy cycles was 2-4.Results Patients who received IMRT had a significant higher 3-year overall survival (OS) than that who received CRT (63.6 ％ vs 38.9 ％,x2 =12.102,P =0.001).Three-year OS differed no significantly between different chemotherapy regimens.There were 44.6 ％,57.5 ％,52.5 ％ and 52.5 ％ for those who received cisplatin,nedaplatin,oxaliplatin and lobaplatin,respectively (x2 =2.756,P =0.431).Patients received different cycles of chemotherapy had comparable treatment outcome,and the overall survival were 44.1％,51.6 ％ and 57.4 ％ for those who underwent 2,3 and 4 chemotherapy cycles at 3 years,without any statistical significance (x2 =2.497,P =0.287).Univariate analysis indicated that lesion length on X-ray,M stage,6th edition UICC staging and radiotherapy methods were the potential predictive factors.Multivariate analysis shown that gender,lesion length on X-ray and radiotherapy methods were the significant prognostic factors.Conclusion The significant prognostic factors for advanced EPC with concurrent chemoradiotherapy are mainly lesion length on X-ray and radiotherapy methods.