Objective To evaluate the clinical value of 99Tcm-MIBI SPECT for the differential diagnosis of parotid tumors before treatment.Methods 99Tcm-MIBI SPECT imaging of the parotid region was obtained in 32 patients with parotid tumors before surgery.Early and delayed 99Tcm-MIBI imaging were performed in all patients and the diagnosis was confirmed by pathological results after surgery.The ratio of radioactivity between the tumor and opposite side of normal parotid tissue (T/N) was measured.Fisher exact probability test and t test were used for statistical analysis.Results The sensitivity,specificity and accuracy of 99Tcm-MIBI SPECT imaging for the differential diagnosis of parotid tumor were 90.00％ (9/10),86.36％ (19/22) and 87.50％ (28/32),respectively.Among 22 patients who had benign tumors,19(86.36％) showed negative findings,and the other 3 ( 13.64％ ) patients showed false positive results.In 10 patients with malignant tumors,1 ( 10.00％ ) had false negative findings,and all the other 9 (90.00％)patients showed positive results.The difference between the benign and malignant groups was statistically significant (P =0.00018 ).In the early images,the T/N ratios of benign and malignant parotid tumors were 1.45 ±0.38 and 1.65 ±0.63 (t =20.4,P＜0.01),respectively; and in the delayed images,the ratios were 1.43 ± 0.56 and 1.77 ± 0.59 ( t =2.4,P ＜ 0.05 ),respectively.Conclusion 99Tcm-MIBI SPECT imaging might be useful for the differential diagnosis of parotid tumors before surgery.

Objective To identify the key factors triggering medical disputes induced by differences in cognition between doctors and patients in order to control the occurrence and development of medical disputes. Methods From 2002 to 2006,the outpatients,inpatients and medical staff of 3 hospitals in Shanghai(class 3 first level general hospital,n=2;class 3 first level special hospital,n=1) were investigated,and random sampling method was employed for the research analysis. Results There were significant differences between doctors and patients in cognition of influential factors triggering medical disputes such as health law,medical services,rights and obligations. Conclusion The differences in cognition between doctors and patients are important causes for medical disputes,and effective prevention and intervention measures must be taken.

Child ; Humans ; Male ; Niemann-Pick Disease, Type C ; diagnosis ; genetics

AIM:To establish a new method of rapid analysis of puerarin in Xintong Oral Liquid by acousto-optic tunable filter-nearinfrared spectroscopy. METHODS: HPLC was used as a reference method to determine puerarin content in Xintong Oral Liquid. Calibration model based on partial least squares(PLS1) algorithm was developed to correlate the spectra and the corresponding values determined by the reference methods. RESULTS: The root mean square error of prediction(RMSEP) of the model for puerarin was 0.137 1. The determination coefficient was R～2=0.984 5. The correlation coefficient of the true value and predication value from validation was r～2=0.996 4. CONCLUSION: The method is a quick, simple and low cost assay and able to be used in quantitative analysis of Xintong Oral Liquid.

Objective To identify novel mutations in the GATA6 gene associated with congenital atrial septal defects (ASD).Methods This was a case-control study.A cohort of 220 unrelated Han-race patients with congenital ASD and 200 unrelated ethnically matched healthy individuals used as controls,who were admitted to Tongji University Affiliated Tongji Hospital from January,2007 to October,2011,were recruited.The peripheral venous blood samples from the participants were prepared.All the coding exons and their flanking sequences of the GATA6 gene were amplified by polymerase chain reaction and sequenced using the di-deoxynucleotide chain termination technique.The acquired sequences were aligned with the sequences derived from GenBank by BLAST to identify the sequence variations.The software ClustalW was used to analyze the conservation of the altered amino acids.Results Three novel heterozygous missense GATA6 mutations,c.250G ＞A (p.A84T),c.649G ＞C (p.G217R) and c.1270A ＞C (p.S424R),were identified in 3 of 220 ASD patients,respectively.None of the three mutations was detected in 200 healthy control individuals.A cross-species alignment of GATA6 encoded protein sequences showed that the mutated amino acids were relatively conserved evolutionarily.Conclusion The identification of novel GATA6 mutations associated with ASD contributes to the reveal of the mechanism involved in the pathogenesis of ASD.

OBJECTIVETo study the effect of coixenolide on Foxp3+ CD4+ CD25+ regulatory T cells (Treg) in collagen induced arthritis (CIA) mice, and to explore its possible mechanism for treating rheumatiol arthritis.

METHODSFive mice were recruited as a normal control group from 25 mice, and the rest 20 were used in CIA modeling. After successful modeling they were randomly divided in the model control group and the coixenolide group, 10 in each group. Coixenolide injection at 25 mL/kg was intraperitoneally injected to mice in the coixenolide group, while normal saline at 25 mL/kg was intraperitoneally injected to mice in the normal control group and the model control group. The injection lasted for 21 days. Scoring for CIA was performed after injection and arthritis index was calculated. The peripheral blood Foxp3+ CD4+ CD25+ Treg ratio was determined by flow cytometry (FCM).

RESULTSCompared with the normal control group, the arthritis index obviously increased in the model control group (P < 0.01). The arthritis index obviously decreased more in the coixenolide group than in the model control group (P < 0.01). Foxp3+ CD4+ CD25+ Treg levels obviously decreased more in the model control group than in the normal control group (P < 0.01 ). Foxp3+ CD4+ CD25+ Treg levels obviously increased more in the coixenolide control group than in the model control group (P < 0.01).

CONCLUSIONCoixenolide could up-regulate Foxp3+ CD4+ CD25+ Treg ratios in CIA mice, which might play certain immunoregulation roles in the incidence of CIA.

Objective To compare the effect of continuous femoral nerve block (CFNB) with patient controlled intravenous analgesia (PCIA) on pain relief,rehabilitation efficacy,satisfaction degree following total knee arthroplasty (TKA) in an attempt to find a safe and effective analgesia at the stage of rehabilitation.Methods The records of 116 patients undergone unilateral TKA for osteoarthritis or rheumatoid arthritis of the knee were evaluated.The patients with preoperative American Society of Anesthesiology (ASA) score of 1 to 3 were randomized into CFNB group (58 cases) and PCIA group (58 cases) according to the random number table.Both operations were performed under ultrasound guidance.Postoperative visual analogue score (VAS),knee function,incidence of adverse reaction,and satisfaction degree were compared between the two groups.Results Regardless of the score at postoperative 4 and 12 hours,VAS between CFNB and PCIA groups revealed significant differences at postoperative 24 [(3.2±1.1)pointsvs (4.1 ±1.5)points],48 [(3.4±1.2)pointsvs (4.1 ±1.0) points] and 72 hours [(3.3 ± 1.2) points vs (4.0 ± 1.1) points] (all P ＜ 0.05).Time to achieve knee rehabilitation training objectives like straight leg raise,walking with crutches,and passive bending to 90° were similar between the two groups.Both groups achieved comparable knee function status with respect to Hospital for Special Surgery (HSS) score,Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score,and maximal knee flexion angle at postoperative 3 months.Postoperative nausea and vomit were significantly more frequent in PCIA group (24％) than in CFNB group (14％) (all P ＜O.05),but patients in both groups were satisfactory.Conclusion Ultrasound guided CFNB is an effective analgesic method during the early stage of TKA,for it can control pain,accelerate rehabilitation training and function recovery,reduce adverse reaction as well as improve patients' satisfaction.

Objective To assess the factors which affect the activity of isolated islets,and to construct a steady and effective isolation method of rat pancreatic islets.Methods Pancreatic islets were isolated by collagenase method.The glucose-stimulation of insulin secretion(GSIS) in different conditions was performed by batch incubation method and measured by RIA.Results GSIS was improved by BSA;There was a evident decrease of insulin secretion in cultured islets of 7 days,however,no difference was observed between the freshly isolated islets group and the 1～5days cultured islets groups.Compared to the groups of(5.5 mmol/L) and(25 mmol/L) glucose in the culture medium,(11.1 mmol/L) glucose group stimulated higher insulin release.Conclusion BSA,glucose concentration of RPMI1640 medium and the culture period are related to the activity of isolated islets.

Objective To study radiographic features of atypical adenomatous hyperplasia(AAH) of lung and correlate them with their pathologic findings,so as to improve the imaging diagnose.Methods The imaging features of 8 patients with pathology-proved AAH were reviewed.All patients were women with age ranging from 35 to 74 years.All cases had chest radiography and HRCT.The radiographic findings were studied retrospectively and correlated with those of pat hology.Results On chest X-ray,the foci in five patients presented as nodule-like area of a bit high attenuation,while the chest radiograph in the other three patients were negative.On HRCT,all 8 patients presented as non-solid nodules.All lesions were round or oval shaped with well-defined margin(n=4)or poor-defined margin(n=3).The greatest dimension of the lesions ranged from 5.0 mm to 20.0 mm.Their CT value ranged from-362.7 HU to-485.6 HU,the mean CT value was(-423.0?47.0)HU.Air bronchograms and/or bubbles were seen in 5 lesions.Coarse spiculation and pleural tag was not seen in any lesion.Before operation,all the nodules did not change in size over a follow-up period from one month to six months.Pathologic findings showed atypical epithelial cell proliferation along thickened alveolar septa without alveolar collapse.Conclusion AAH should be considered in cases with the following features:(1)nodules are found in lung cancer screening or incidentally detected;(2)the diameter of the nodule is usually less than 10 mm;(3)the lesion presented as non-solid nodule on HRCT,air bronchogram and/or bubble sign can be seen;(4)no coarse spiculation and plural tag was seen.

Catheter Ablation ; Child ; Child, Preschool ; Female ; Humans ; Hypertrophy ; Male ; Palatine Tonsil ; pathology ; surgery ; Snoring ; surgery ; Turbinates ; pathology ; surgery