Sclerosing angiomatoid nodular transformation (SANT) is a rarely encountered benign spleen lesion which has recently been gaining recognition. However,the actual pathogenesis of this disease remains unclear.SANT's remarkably characteristic appearance consists grossly of multiple well-circumscribed vascular/angiomatoid nodules of various sizes in a fibrosclerotic stroma. Immunohistochemical studies display a heterogeneous staining pattern of endothelial phenotypes in the angiomatoid nodules,with some cells resembling splenic sinusoids (CD34 -/CD31 +/CD8 + ),capillaries (CD34 +/CD31 +/CD8 - ) and small veins (CD34 -/CD31+/CD8-).Due to the rarity of this disease,it is often mistaken for splenic hamartoma,inflammatory pseudotumor,littoral cell angima or hemangioendothelioma. So far,SANT exhibits a benign clinical course because splenectomy can be curative.In this review,we outline the clinical and pathologic features of SANT and discuss its probable disease mechanism to provide a holistic overview of the disease at this time.

Objective To explore clinical effect of modified postural drainage for treating pulmonary infection of senile patients with gastric cancer.Methods 107 cases of patients with gastric cancer were randomly divided into two groups:control group (n =53) and treatment group (n =54),which were respectively treated by routine postoperative therapy and nursing measures and modified postural drainage based on these routine measures,and compared daily amount of expectoration sputum,positive cases of sputum culture,restore time of postoperative blood test,postoperative fever time,cases of pulmonary infection on the postoperative tenth day and length of stay.Results Daily amount of expectoration sputum of patients in treatment group was significantly higher than that of control group [(185.7 ± 23.7) ml vs.(99.7 ± 17.6) ml] (P ＜ 0.05).However,restore time of postoperative characters of blood test [white blood cell count (2.9±0.9) d vs (5.0±0.7)d,C-reaction protein (35±0.7)d vs.(7.4±0.6) d],postoperative fever time [(1.9±0.5) d vs.(3.6±1.4) d],cases of atelectasis (5 cases vs.19 cases) and length of stay [(1.9±0.5) d vs.(3.6±1.4) d] were respectively significantly less than those of control group (P ＜ 0.05).Conclusions Modified postural drainage could effectively prevent postoperative atelectasis and pulmonary infection,significantly reduced incidence of postoperative atelectasis of senile patients with gastric cancer operation,and so it was worthy of clinical application.

AlM: To observe the influence on the incidence of diffuse lamellar keratitis ( DLK ) after laser in situ keratomileusis ( LASlK ) whether or not wearing sterile gloves with talc during operation, and to confirm the role of residual talc in the occurrence of DLK.
METHODS: Totally 563 patients ( 1 126 eyes ) accepted operation with the method of surgical hand antisepsis only were set as the experimental group, while 592 patients ( 1 184 eyes ) with the method of surgical hand antisepsis and sterile gloves as the control group. Each patient was rechecked to observe the occurrence of DLK on the first day and the seventh day after the operation. Then the data of DLK were statistically analyzed byχ2 test and rank sum test.
RESULTS:On the first postoperative day, the incidence of DLK was 7. 4% (83 eyes) in experimental group and 12. 2% (144 eyes) in control group. ln the former group, stage Ⅰ of DLK accounted for 4. 6% (52 eyes) and stageⅡ for 2. 8% (31 eyes);while in the latter, stage l did for 7. 7% (91 eyes) and stageⅡfor 4. 5% (53 eyes). On the seventh day, all DLK were cured. The other 2 cases ( 3 eyes) occurred in stage Ⅳ DLK ( the first time recheck was on the eighth day after operation and fluorometholone ophthalmic solution was not used on time ) . The incidence and the severity were both significant lower in the experimental group than in the control (both P<0. 01).
CONCLUSlON: Talc is one of the most important factors resulting in DLK after LASlK. The method of surgical hand antisepsis without wearing gloves could avoid the stimulation of talc and reduce the incidence of DLK obviously.

Objective To explore the clinical diagnostic value of narrow-band imaging combined with magnification chromoendoscopy for suspicious neoplasia lesions of early gastric cancer.Methods A total of 115 patients which had been diagnosed as having suspicious lesions byconventional endoscopy were enrolled from Jan.2010 to Dec.2012.They were observed by magnifying endoscopy(C-WLI), magnifying endoscopy combined with narrow-band imaging (ME-NBI), magnification chromoendoscopy and magnification chromoendoscopy combined with narrow-band imaging, respectively.The lesion outline sharpness, opening of the gland sharpness and microvascular morphology sharpness were recorded and the subtypes of opening of the gland and microvascular morphology were compared.The histological examination was performed on the most significant changes in lesion site and the accuracy, sensitivity and specificity of the four procedures were calculated.Results The score of outline sharpness was 377 and the score of pit sharpness was 458 by magnification chromoendoscopy combined with narrow-band imaging, higher than those of ME-NBI (340 and 408 respectively) and magnification chromoendoscopy (354 and 386 respectively) (P ＜ 0.05), significantly higher than those of C-WLI (276 and 280 respectively) (P ＜ 0.01).The score of microvascular morphology sharpness was 380 by magnification chromoendoscopy combined with narrow-band imaging,higher than that of ME-NBI (348, P ＜ 0.05), C-WLI (267, P ＜ 0.01) and magnification chromoendoscopy (280, P ＜ 0.01).The detection rate of C type by magnification chromoendoscopy combined with narrow-band imaging was higher than that by magnification chromoendoscopy (93.0％ VS 79.7％, P ＜ 0.05).The accuracy, sensitivity and specificity of magnification chromoendoscopy combined with narrow-band imaging was 92.17％, 88.33％ ,96.36％ respectively.Conclusion Narrow-band imaging endoscopy combined with pigment amplification can yield more clear image of the microvascular morphology and opening of the gland, significantly improve the lesion detection rate, reduce the missing rate, and is worthy of further clinical observation and promotion.

Objective To study appliction value of quantitative dynamic contrast enhanced MRI(T1-DCE MRI)in preoperative grading of brain glioma.Methods 80 patients who were pathologically confirmed with a tumor grade (WHO grade Ⅰ 20 cases, grade Ⅱ 20 cases,grade Ⅲ 20 cases and grade Ⅳ 20 cases).All patients were examined with MR enhancements and T1-DCE MRI. The original perfusions imaging datas were analyzed using the GE Omni Kinetic software,which produced the transfer constant (Ktrans )map,the rate constant (Kep )map and fractional volume (Ve )map.Choose ROI and get values of Ktrans ,Kep and Ve .Pearson correlation was carried out to analyze the correlation between values of Ktrans ,Kep ,Ve of different grades of gliomas and pathology classifications.The Ktrans ,Kep and Ve values of the different grade gliomas were statistically analyzed using an ANOVA .Receiver operator characteristics (ROC)curve was used to analyze sensitivity and specificity of permeability parameters.Results The Ktrans ,Kep and Ve values of each levels has a strong correlation with pathological grading (r=0.95 1,0.804,0.766).There was obviously statistically significant difference between different grade groups(P < 0.01 )by Ktrans .Kep values have statistically difference between different grades except grade Ⅱ and Ⅲ.Ve values were different between different grades except grade I andⅡand grade Ⅲ and IV.Accord-ing to ROC curve,Ktrans seemed to be a better parameter for evaluating the tumor grade with the highest sensitivity and specificity. With the cutoff thresholds of Ktrans of 0.1 60,0.420 and 0.935,different grades of glioma can be differentiated with sensitivities of 90%,95%,95% and specificities of 95%,95%,85% respectively.Conclusion Quantitative analysis of microcirculation perfusion status of different grade gliomas by Ktrans values obtained from T1-DCE MRI can assessment the degree of the destruction of the blood brain barrier and evaluate the grade of gliomas more accurately before operation.

OBJECTIVETo investigate effectiveness of internal-fixation in mandibular fracture through endoscope.

METHODSUse puncture internal-fixation under endoscope to treat 28 patients of fracture of mandibular angle, ramus and condyle.

RESULTSThe 28 patients were restorated with occluding relation in good apposition. The healing of mandibular fracture was very good.

CONCLUSIONSThe interal-fixation under endoscope is an effective way of treating fracture of mandibular angle, ramus and condyle, without facial scar and complication of facial nerve injury.

Adolescent ; Adult ; Child ; Endoscopes ; Female ; Fracture Fixation, Internal ; methods ; Fracture Healing ; Humans ; Male ; Mandibular Fractures ; surgery ; Middle Aged ; Young Adult

Objective To explore the dynamic changes of the cellular immune function in severe infection after liver transplantation, and to guide the individualized immunology adjustment. Methods 378 cases of livertransplantation were analyzed retrospectively. Seventy-four cases (infection group) suffered serious infection, including 54 cases cured (cure group), 20 cases died (death group). Fifty cases without infection and rejection were randomly selected as control group (stable group). According to the individualized adjusting proposal of immunosuppressants, 74 patients with severe infection were divided into two groups: traditional (T) group and individualized (Ⅰ) group. The general condition, recovery rate and change of cellular immune function pre- and post-treatment were analyzed. Results The preoperative MELD score and the intraoperative blood loss in infection group were significantly higher than stable group, and those in death group were higher than in cure group. CD4+ T lymphocyte counts and lymphocyte counts in stable group were increased significantly from first week post-operation to discharge. The two indicators in infection group at first week postoperation and the onset of infection were lower than in stable group (P<0. 01). In cure group after infection was controlled the two indicators were higher than at first week post-operation and the onset of infection (P<0. 01), while in death group they were reduced up to death (P<0. 05). There was no significant difference in age, preoperative MELD score and the immune function indicators both at first week post-operation and the onset of infection between T group and Ⅰ group, except the intraoperative blood loss in Ⅰ group was greater than in T group. The recovery rate in Ⅰ group (90. 5 %)was higher than in T group (66.0 %). Conclusion Individualized adjustments of immunosuppressants guided according to the dynamic changes of cellular immune function helped to improve the prognosis of severe infection after liver transplantation.

BACKGROUND: To repair bone defect, histocompatibility, growing characteristics, biodegradation and repairing mechanism of nanometer need to be further studied in clinic. OBJECTIVE: To observe the growing characteristics and histocompatibility of nano-hydroxyapatite (Nano-HA) for repairing jaw defect of rabbits.DESIGN: Randomized grouping animal study.SETTING: Beijing Jishuitan Hospital and Stomatology College of Jiamusi University.MATERIALS: A total of 24 New Zealand rabbits, either gender, weighing 2.5-3.5 kg, were provided by Animal Experimental Center of Jiamusi University. The animal experiment had got confirmed consent from local ethic committee. Nano-HA was provided by Material Engineering College of Jiamusi University and dealt with routine hyperthermia/hypertension sterilization. In addition, hydroxyapatite was provided by Wuhan Industry University, and the diameter was 1.0-2.0 μm.METHODS: The experiment was carried out in the Experimental Animal Center of Jiamusi University from November 2001 to May 2006. All rabbits were randomly divided into experimental group and control group with 12 in each group. Bone defect in the diameter of 1.0 cm was produced on body of mandible. Nano-HA was used to repair the bone defect of rabbits in the experimental group, while hydroxyapatite was used to repair the bone defect of rabbits in the control group. At 1, 4, 8 and 12 weeks after operation, all rabbits were sacrificed. In addition, medical imaging analysis system was used to analyze generative quantity of tissue in the two groups; meanwhile, histological quality and quantity were also analyzed so as to observe histocompatibility and newborn osteogenesis. MAIN OUTCOME MEASURES: Histocompatibility and newborn osteogenesis.RESULTS: With the time passing by, the amount of repairing materials was decreased because of the combination with newborn tissue into bone in bone defect-repaired region in the experimental group. When it was closed to normal bone, the amount was stable. However, bony callus was not able to grow in materials in the control group. Results of correlation analysis demonstrated that materials were negatively straight-line correlation with newborn bone (r = -0.912 0, P < 0.01). During the repairing procedure of bone defect, newborn bone was closely correlative with Nano-HA; while, with the increase of newborn bone, the amount of repairing materials was decreased because of the combination with newborn tissue into bone.CONCLUSION: Nano-HA can combine with newborn bone tissue so as to rapidly generate bone, while it has an excellent biocompatibility.

Objective To report the results of a single-center, retrospective study on the effect of calcineurin inhibitors (CNI) withdraw for controlling infections and conversion to sirolimus (SRL)for ameliorating renal dysfunction. Methods A total of 947 liver transplant cases from 2002 to 2010were divided into two eras (Jan. 2002 to Dec. 2007 and Jan. 2008 to Dec. 2010). There were 234cases of infections after liver transplantation (LT) in the first era and 101 cases in the second era. And of 329 cases of CNI-related renal dysfunction after LT in two eras, 40 cases (converting group) had converted CNI to SRL, while 289 cases (reducing group) adopted protocol of CNI reducing and mycophenolate mofetil (MMF) raising. Results CNI-based IS took up 95.8 %, 95. 3 %, 97. 5 % of the IS protocols with recipient survival time longer than 1, 3, and 5 years. The primary cause for CNI withdraw was infection (88. 2 %, 15/17) in the second era, and renal dysfunction for conversion to SRL in the two eras (83. 3 %, 40/48). In the second era, 14. 9% (15/101) of the cases of infections after LT experienced CNI withdraw. Of the 15 patients, 11 had effectively controlled the infection (77. 3 %) while rejection rate was 6. 7 % (1/15). The cumulative survival rate of the second era was significantly higher than the first era (P＜0. 05). The glomerular filtration rate (GFR) of converting group at 6th week and 6th month was statistically elevated as compared with that before conversion,respectively (1.28 ± 0. 31, 1.36 ± 0. 32 mL/s vs. 0. 82 ± 0. 24 mL/s, P＜0. 05). Six months after CNI adjustments, survival rate of converting group and reducing group was 85. 0% and 83. 7 %,respectively (P＞0. 05). Conclusion Reducing or even short-term withdraw of CNI may allow the better control of infections after LT, and the conversion from CNI to SRL can ameliorate the CNIrelated nephrotoxicity. These individually tailored IS protocols will benefit the long term survival for LT.

Double cannulation model of conscious rat allowing simultaneous collection of mesenteric lymph and jugular venous blood was established to investigate the intestinal lymphatic transport of breviscapine orally administered in rat. The concentrations of breviscapine in plasma and lymph were determined by HPLC. The pharmacokinetics of breviscapine after oral and intravenous administration was evaluated in the conscious rat model. It was observed that scutellarin distributed from blood circulation to lymphatic system after intravenous injection. The cumulative lymphatic transport amount within 12 h was (2.78 +/- 0.25) microg, equivalent to 0.0792% of intravenous dose. After oral administration of scutellarin to double-cannulation rats, the cumulative lymphatic transport amount within 12 h was (0.92 +/- 0.08) microg, equal to 0.0083% of oral dose. The absolute bioavailability of breviscapine orally administered to double-cannulation rats was 4.91%, indicating that scutellarin was mainly absorbed into the bloodstream through the portal vein. Lymphatic transport of scutellarin appears to reflect high affinity for the lymph lipoproteins to chylomicron. This study provided a biopharmaceutics basis for developing oral lipid delivery system for the promotion of intestinal lymphatic transport to improve oral bioavailability of breviscapine.