Objective To explore the imaging features of pediatric splenic primary solitary tumor. Methods The medical imaging appearances of 6 children with splenic primary solitary tumor conifrmed by surgery and pathology from January 2010 to August 2015 were retrospectively studied. The related literatur were reviewed. Results In 6 children, 2 children of cystic lesions, ultrasound showed anechoic mass, CT scan showed low density mass, without change after contrast, pathologically conifrmed as congenital cyst;2 children’s ultrasound showed solid echo, color Doppler ultrasound explored the blood lfow signals, contrast CT showed the lower strength around the splenic parenchyma, pathologically conifrmed as splenic lymphangioma;one child’s unltrasound showed echo mass with rich signals of blood lfow, MRI scans showed T1WI, T2WI and other signals of lumps, with little homogenity after contrast, pathologically conifrmed as splenic hamartoma;one child’s ultrasound cannot distinguish tumor boundaries, contrast CT scan showed concentric filling reinforcement, pathologically confirmed as hemangioma. Conclusion Splenic primary solitary tumor in children is rare. There are no speciifc clinical characteristics. The image ifndings can deifne the locations and help the differential diagnosis. The ifnal diagnosis depends on pathology.

Objective To evaluate the sonography features of heptaobiliary involvement of pediatric Langerhans′cell histiocytosis ( LCH) . Methods Nine pediatric patients with LCH confirmed by the clinical presentation ,biochemical tests and pathologic results of our hospital were retrospectively analyzed . Results Eight patients were seen in multi‐system LCH ,while one patient only had liver involved . All patients showed varying hepatomegaly with multiple distributed lesions in ultrasound images . According the lesion distribution features ,they could be classified into three types:central type(6/9) ,peripheral type(1/9) and diffuse type(2/9) . In ultrasonography ,they manifested as linear lesions alongside the central portal veins , multi‐nodular and randomly distributed lesions in liver parenchyma ,or both of them . Eight bile‐duct involved patients behaved with unevenly thicked bile‐duct walls ,stenosis or dilated bile‐ducts ,and even sclerosing cholangitis , some of them with cholelithiasis . Conclusions Pediatric LCH patients with heptobiliary involved are seemed mainly in multi‐system LCH ,while it is rare but possible that pathological Langerhans′cell only infringe on liver and bile‐ducts . The ultrasound imaging findings of pediatric LCH liver infiltration are with characteristic and are helpful for the early diagnosis and clinical procedure .

Adenoma, Acidophil ; metabolism ; Adult ; Angiomyolipoma ; genetics ; metabolism ; pathology ; Carcinoma, Renal Cell ; metabolism ; Codon ; Diagnosis, Differential ; Exons ; Female ; Follow-Up Studies ; Gene Deletion ; Genes, p53 ; Humans ; Kidney Neoplasms ; genetics ; metabolism ; pathology ; Male ; Melanoma-Specific Antigens ; metabolism ; Middle Aged ; Retrospective Studies ; Tumor Suppressor Protein p53 ; genetics ; metabolism

With Minglou Community Children's Rehabilitation Base as a case,which was jointly founded by tertiary specialized hospital and community health service center,the paper introduced how to use SWOT model to systematically analyze the strengths and weaknesses of the internal environment,opportunities and threats of external condition.Based on the analysis,the solutions,suggestions and policy of children's rehabilitation were proposed,providing reference for decision making to promote the community children's rehabilitation.

Adenocarcinoma, Clear Cell ; pathology ; Adult ; Female ; Humans ; Thyroid Neoplasms ; pathology

Contraindications ; Humans ; Laryngeal Neoplasms ; classification ; pathology ; surgery ; Laryngectomy ; methods ; Neoplasm Staging

To investigate the correlation between cognitive function and the Chinese medicine syndrome characteristics of vascular cognitive impairment (VCI).

Objective To evaluate the short -term efficacy and adverse reactions of gemcitabin combined with nedaplatin to patients with metastatic triple -negative breast cancer after taxane and/or anthracycline treatment. Methods Thirty -three patients with anthracycline and/or taxane -resistant metastatic triple -negative breast cancer received gemcitabin and nedaplatin regimen:gemcitabin 1 000 mg/m2,d1,8 days,intravenous;nedaplatin 80mg/m2,d1,intravenous.Treatments were repeated every 21 days and response rate was evaluated every two cycles. Results Of 33 patients, complete remission ( CR) in 1 case ( 3.03%), partial remission ( PR) in 13 cases (39.39%),stable disease(SD) in 11 cases(33.33%),progressive disease(PD) in 8 cases(24.24%),objective response rate was 42.42%.The main adverse reaction was bone marrow suppression and gastrointestinal reaction. Conclusion Combination therapy of gemcitabin and nedaplatin is an effective and well tolerated rescue regimen in anthracycline and/or taxane -resistant metastatic triple -negative breast cancer patients.

Objectives To analyze the relationship between phosphorylation of serine-3 of cofilin1 and Taxol resistance of ovarian cancer and to evaluate the prognostic value of cofilin1 phosphorylation in estimating ovarian cancer survival using clinical samples.Methods Wild type (WT) plasmids with over-expression of wild cofilin1,S3L plasmids with over-expression of cofilin1 and inhibited phosphorylation at serine-3,and siRNA-C plasmids with down-regulation of cofilin1 were constructed using molecular biology techniques.After the SKOV3 and SK-TR30 cell-lines were transfected with these plasmids,changes in biological characteristics and drug resistance after instant transfection were compared.Fifty-one elderly female patients with microscopically confirmed ovarian cancer,who had received chemotherapy with Taxol and cis-platinum (TC)after surgery,including 30 chemo-sensitive and 21 chemo-resistant cases,were recruited in this study.Immunohistochemical methods were used to detect the expression of cofilinl and phosphorylated cofilin in tissue sections from the two groups.Progression free survival(PFS)was analyzed.Results Compared with the control group,the proportion of cells increased at the G0/G1 phase(P=0.034)and decreased at the S phase (P=0.031),and the apoptosis rate decreased(P=0.020),in SKOV3 cells with high expression of cofilin1.However,these characteristics disappeared when the wild type was replaced with the inactive mutant S3L.When cofilin1 expression was down-regulated in SK-TR30 cells,the proportion of cells at the G0/G1 phase decreased(P=0.020).The expression of cofilin1 was detected in 56.7 ％ (17/30)and 57.1％ (12/21),respectively,sections of ovarian tumor tissues of the chemo-sensitive and chemoresistant groups,and there was no statistic difference (x2=0.332,P =0.943)between the two groups.The expression of phosphorylated cofilin was much higher in the chemo-resistant group (85.7％ or 18/21)than in the chemo-sensitive group (53.3％ or 16/30),and the difference was statistically significant(x2=5.829,P=0.016).The higher expression of phosphorylated cofilin was also correlated with shorter PFS(x2 =21.440,P＜0.01,95％ CI:0.068-0.883),especially in the chemo-sensitive group.Conclusions Serine-3 phosphorylation status of cofilin 1 is associated with paclitaxel resistance in ovarian cancer,but the underlying mechanisms of regulation need further investigation.

Humanistic doctor-patient communication is an essential capability for medical workers and is as impor -tant as medical technology .Its education has been getting more and more attention in recent years .However , the training and evaluation of humanistic doctor-patient communication as a practical other than theoretical capability has been difficult .A new method , clinical scenery drama , based on psychodrama and role theory , is developed by Dept.of Psychological Medicine , Peking Union Medical College Hospital from recent 10 years of medical doctor and student training .In clinical scenery drama , medical students are thrown to different roles to empathize with their feelings and conflicts , try to resolve clinical dilemma with humanistic communication technique besides medi-cal technology .Then the sharing and comments from teachers and observers help students to understand the situa -tion from other perspectives and think about other possible solutions .