Animals ; Evidence-Based Medicine ; Health Knowledge, Attitudes, Practice ; Humans ; Infant ; Meta-Analysis as Topic ; Milk Hypersensitivity ; diagnosis ; prevention & control ; Milk Proteins ; adverse effects ; Practice Guidelines as Topic ; standards ; Professional Staff Committees ; organization & administration

Actins ; metabolism ; Carcinosarcoma ; metabolism ; pathology ; Craniopharyngioma ; pathology ; Diagnosis, Differential ; Esthesioneuroblastoma, Olfactory ; pathology ; Humans ; Immunohistochemistry ; Keratins ; metabolism ; Male ; Middle Aged ; Mucin-1 ; metabolism ; Nasal Cavity ; Nose Neoplasms ; metabolism ; pathology ; Paranasal Sinus Neoplasms ; metabolism ; pathology ; Pituitary Neoplasms ; pathology ; Teratoma ; metabolism ; pathology ; Vimentin ; metabolism

Background and Objective:Metastatic alveolar soft tissue sarcoma (ASTS)of the central nervous system is rare and is easy to be misdiagnosed as other primary tumors of central nervous system. This study was to analyze the clinical and pathological features of four patients with ASTS of the central nervous system and to clarify their differential diagnosis as well as prognosis. Methods:HE slices and clinical data of the four cases were reviewed and immunohistochemical staining was performed. Antibodies included Vimentin,Myosin,Myoglobin,S-100,Actin,Desmin,CgA,Syn,NSE,and CK.Results:All four patients had a skin nodule of the extremities removed previously.Clinical symptoms included headache and sight blurring.The metastatic lesions were located in the posterior cranial fossa,closely associated with the meninges.The tumor cells had clear or eosinophilic cytoplasm and prominent nucleoli,arranged in alveolar structures,which were surrounded by delicate blood sinuses.The immunohistochemical staining results showed that the positive stainings of Actin,Desmin and S-100 were in 2 cases;the weakly positive stainings of NSE and Vimentin were in 1 case;the positive staining of PAS was in all four cases. The follow-up data showed that one case died during one year after surgery,two cases died during three years.The fourth case had half year after operation and had been alive without tumour.Conclusion:ASTS of the central nervous system was mostly metastatic and should be differentiated from other CNS tumors such as meningioma, melonocytic tumor,rhabdomyosarcoma and paraganglioma.Metastatic ASTS of the central nervous system had poor prognosis and the five-year survival rate was low.

Background Preferred practice pattern (PPP) is an evidence-based documents which can be used for reference to standardize medical practice by ophthalmologists.So far it has been promoted for more than 10 years in China.However,there is no report about the popularization and application of PPP in China.Objective This study was to investigate the cognitions of ophthalmologists to PPP from the view of clinical questions.Methods A questionnaire-based study was conducted.Questionnaires were dispensed during September 17 to 21,2014 to inquiry into the cognitions of ophthalmologists to PPP in the 19th Congress of Chinese Ophthalmological Society.A selfadministered questionnaire was designed and discussed according to the article published in the past by our research group.It included personal basic information and cognitions to PPP,and the latter consisted of self-assessment and cognition scoring.The constituent ratios of aware,quite aware,unaware and fully unaware ophthalmologists were counted.The cognitions were divided into low level (0-4 scores),moderate level (5-8 scores) and high level (9-12 scores) based on the effective answer sheets.The questionnaires were filled out anonymously and incomplete questionnaires were excluded.Results Among the 300 distributed questionnaires,282 were retrieved and 209 were valid,with the effective rate 74.1％.The ophthalmologists of awareness to PPP were 46.4％ (97/209),and 53.6％ (112/209) of respondents did not know PPP very well.A positive correlation was found between the awareness to PPP and the cognition scores to clinical issues (r,=0.143,P ＜ 0.05).The cognition scores to clinical issues were significantly different among different educational backgrounds (F =12.26,P ＜ 0.05),and cognition scores were significantly reduced in the ophthalmologists with lower master degree in comparison with the ophthalmologists with doctoral degree (all at P＜0.05).The coincide ratio between cognitions of ophthalmologists to different clinical issues and suggestions in PPP were evidently different in the ophthalmologists,with the highest coincide ratio 83％ and the lowest coincide ratio 1％.Conclusions The awareness to PPP is not adequate in Chinese eye doctors,which reduces the cognition level to clinical issues.There is a poor coincide ratio between cognitions of Chinese ophthalmologists to clinical issues and suggestions in PPP.This study emphasizes the need for effective awareness programs towards clinical issues based on PPP.

OBJECTIVETo investigate the clinicopathological characteristics, differential diagnosis, and prognosis of primary hepatic angiosarcoma, and to review the literature.

METHODSTwenty cases of primary hepatic angiosarcoma were analyzed by gross examination and light microscopy. Immunostaining was performed to detect the expression of CD34, CD31, FVIIIRAg, CK, GPC-3, Hepatocyte,vimentin, PTEN, desmin, and CD117.

RESULTSThe age of the patients ranged from 7 to 86 years. Eleven cases were male, and 9 were female. All cases showed no specific clinical manifestations and imaging results. Macroscopically, the tumors showed diffuse multi-nodular or single nodular patterns with hemorrhage. Microscopically, there were various patterns such as cavernous vascular space and epithelioid hemangioendothelioma-like appearances; however, specific pathological diagnostic features of angiosarcoma still existed in all cases. All of the cases expressed at least one of the three immunohistochemical markers: CD31, CD34 and/or FVIIIRag. Ten cases had PTEN low expression. Ki-67 proliferative index was more than 10% in all cases. None of cases expressed desmin, CD117, GPC-3 or Hepatocyte.

CONCLUSIONSPrimary hepatic angiosarcoma is a rare malignant tumor. Detailed morphological observation and using various vascular endothelial immunohistochemical markers can help to establish the diagnosis accurately.

Adult ; Aged ; Aged, 80 and over ; Antigens, CD34 ; metabolism ; Biomarkers, Tumor ; metabolism ; Child ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Hemangioendothelioma, Epithelioid ; pathology ; Hemangiosarcoma ; diagnosis ; metabolism ; pathology ; surgery ; Humans ; Ki-67 Antigen ; metabolism ; Liver Neoplasms ; diagnosis ; metabolism ; pathology ; surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; PTEN Phosphohydrolase ; metabolism ; Peliosis Hepatis ; pathology ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Survival Rate ; von Willebrand Factor ; metabolism

A comprehensive, geometrically accurate, nonlinear C0-T1 three-dimensional finite element (FE) model was developed for the biomechanical study of human cervical spine and related disorders. The model was developed with anatomic detail from the computed tomography (CT) images of a 46-year-old female healthy volunteer, and applied the finite element model processing softwares such as MIMICS13.1, Hypermesh11.0, Abaqus 6.12-1, etc., for developing, preprocessing, calculating and analysing sequentially. The stress concentration region and the range of motion (ROM) of each vertebral level under axial rotation, flexion, extension, and lateral bending under physiologic static loadings were observed and recorded. The model was proven reliable, which was validated with the range of motion in previous published literatures. The model predicted the front and side parts of the foramen magnum and contralateral pedicle and facet was the stress concentration region under physiological loads of the upper spine and the lower spine, respectively. The development of this comprehensive, geometrically accurate, nonlinear cervical spine FE model could provide an ideal platform for theoretical biomechanical study of human cervical spine and related disorders.
Biomechanical Phenomena ; Cervical Vertebrae ; Female ; Finite Element Analysis ; Humans ; Middle Aged ; Models, Biological ; Range of Motion, Articular ; Rotation

Objective: To explore the impact of body mass index (BMI) on long-term prognosis in patients of acute ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI). Methods: A total of 1435 consecutive STEMI patients received PCI in our hospital from 2013-01 to 2013-12 were enrolled. Based BMI (kg/m2), the patients were divided into 3 groups: Normal weight group, the patients with 18.5≤BMI<24.0, n=365, Overweight group, 24.0≤BMI<28.0, n=718 and Obese group, BMI≥28.0, n=352. The impact of BMI on major adverse cardiovascular and cerebral events (MACCE) was observed; weather BMI had predictive value for all-cause mortality and cardiac death was analyzed. Results: All-cause mortality in Obese group was lower than Normal weight group (0.6% vs 3.0%), P=0.027; while the incidences of bleeding, stroke, in-stent thrombosis, blood revascularization, re-myocardial infarction and cardiac death were similar among 3 groups. Multivariate analysis revealed that obesity was an independent predictor for all-cause death (HR=0.201, 95% CI 0.043-0.943, P=0.042), BMI was not the independent predictor for cardiac death. Conclusion: For STEMI patients after PCI treatment, the individuals with obesity had the better prognosis than those with normal weight and overweight. Obesity was an independent predictor for all-cause death and obesity paradox was applicable in such population.

Objective To investigate the efficiency of target gene transfection of the heart and liver after tail vein or intramyocardial injection of adenovirus vector (GFP-Ad).Methods GFP-AD was constructed at first.A total of 20 male 8-week old C57BL/6 mice were randomly and equally divided into tail vein injection of GFP-AD group and intramyocardial injection of GFP-AD group.The mRNA levels of GFP in the heart and liver tissues were detected by Q-PCR at different time points.Fluorescence microscopy was performed to visualize the expression of GFP fluorescence.Results Compared with the tail vein injection group, the GFP mRNA level in mouse heart tissue was apparently higher in the intramyocardial injection group.In both groups, the GFP mRNA levels in liver tissue were significantly increased compared with that in the heart tissue.In the tail vein injection group, the GFP mRNA level in liver tissue reached a peak on day 7;but in the intramyocardial injection group, the mRNA level of GFP in liver tissue reached apeak on day 3.We also observed the same trend of GFP fluorescence expression in the tail vein injection group compared with that in the intramyocardial injection group.Conclusions Intramyocardial injection of adenovirus vector is suitable to achieve a higher transfection efficiency in mouse heart tissue compared with the tail vein injection method.Although both injection methods are suitable for transfection of mouse liver, the tail vein injection method is preferential for it is simple and less invasive.

Objective To summarize the extra-bone joint characteristics of 18F-FDG PET/CT images in patients with adult-onset Still's disease. Methods Twelve patients with adult-onset Still's disease as confirmed by clinical and laboratory tests were enrolled in this study. The characteristics of 18F-FDG PET/CT images were retrospectively analyzed. Results Among the 12 patients, no patients were found with solid malignant tumors. Various degrees of high uptake were found in liver, spleen, bone marrow or lymph node. The hepatic SUV was 2.74 ± 0.89, the spleen SUV was 3.68 ± 1.24, and the SUV of thoracic spine was 4.36 ± 1.35. For the lumbar vertebral, the value of SUV was 4.26 ± 1.25. Lymph node high uptakes were found in 8 patients at different sites , including retroperitoneal , pelvic cavity and pelvic wall , inguinal bilateral neck , hepatic portal , axillary lymph nodes. The value of SUV was 3.76 ± 1.41. Conclusions 18F-FDG of AOSD has certain characteristics, such as diffusely uptake of liver, spleen, bone marrow, or lymph node, with or without pleural effusion.