Carcinoma in Situ ; diagnosis ; pathology ; surgery ; Carcinoma, Transitional Cell ; diagnosis ; pathology ; surgery ; Cystectomy ; Humans ; Neoplasm Invasiveness ; Neoplasm Staging ; methods ; Urinary Bladder ; pathology ; surgery ; Urinary Bladder Neoplasms ; diagnosis ; pathology ; surgery

AIM: To investigate the effect of high concentration of chlorine gas(Cl 2) exposure on lung haemodynamic and respiratory function in intact and isolated perfused rabbit lungs (IPLs). METHODS: 8 intact and 10 IPLs were exposed to Cl 2 at high concentration(50?10 -4 )for 20 min, as measured group, 8 additional intact and 9 IPLs, which were similarly treated but not exposed to Cl 2, served as controls. The changes of lung weigh of IPL(△W)?pressure of pulmonary artery(Pa)and venous pressure(Pv)?airway pressure and tidal volume(TV) were continuously measured and recorded simultaneously. RESULTS: In IPL group: While the perfusing blood flow was kept constant (133.3 mL/min), and Pv did not change, following the exposure, the Pa increased slightly, then the lung weight were increased significantly and the TV decreased . Hematocrit of perfusate of EIPL and parameters of lung water increased also. In intact group : Pa increased slightly, respiratory rate accelerated immediately, and TV decreased. CONCLUSION:Although mean Pa increased continuously and slightly in both intact and IPL group following the exposure to high concentration of Cl 2, the primary cause of edema was most likely to alter pulmonary capillary permeability. The respiratory rate accelerated and TV decreased due to exposure to Cl 2 enhanced hypoxia of intact rabbits.

Objective To study correlation between MRI signal intensity of the lumbar intervertebral disc and collagen content in the nucleus pulposus.Methods Thirty-one cases with lumbar intervertebral disc herniation(male 21,female 10)received percutaneous lumbar disketetomy.Thirty-one specimens of nucleous pulposus were obtained from percutaneous lumbar disketctomy procedure and collagen content in them was measured with reformed hydroxyproline measurement method.The signal intensity(SI) of lumbar intervertebral disc and cerebrospinal fluid was measured in T_2 WI sagittal image and then ratio of disc SI to cerebrospinal fluid SI was calculated.The Pearson analysis was used to analyze the correlation between the collagen content and SI ratio and disc SI on T_2 WI.Results Collagen content and SI ratio were (231.0?63.5)mg/g and 0.19?0.07,respectively.There was negative correlation between them (r=-0.61,P

OBJECTIVETo study on the reliability of the Akagi line as a reference axis to guide for rotational alignment of the proximal tibial component in total knee arthroplasty (TKA) the rotational alignment reference bony landmarks of the proximal tibial component on magnetic resonance image (MRI) were measured.

METHODSFrom January 2010 to December 2013, 80 normal knees of Chinese volunteers including 35 males and 45 females with an average age of (35.4±6.1) years were reviewed. The images of the knees were obtained by MRI. The surgical epicondylar axis (STEA) was identified in the femoral transverse sections and then was projected to the side of tibia, forming the SETA'. A line connecting the medial border of the patellar tendon and the middle of the posterior cruciate ligament insertion (Akagi line) and its vertical line (AK), as well as a line connecting the medial 1/3 of the patellar tendon and the middle of the posterior cruciate ligament insertion and its vertical line (AP), were identified in the tibial transverse sections. The angles were measured between the AK, AP and STEA'.

RESULTSThe angle between AK and STEA' was (0.59±2.07)°, and there was no significant difference between the two lines (t=-2.54, P=0.13). The mean angle between AP and STEA' was (3.21±2.04)°, and there was a significant difference between the two lines (t=14.05, P<0.05). There was a significant difference between the AK and AP (t=-11.68, P<0.05).

CONCLUSIONThe reliability of the Akagi line as a reference axis to guide for rotational alignment of the proximal tibial component in TKA is good.

Adolescent ; Adult ; Arthroplasty, Replacement, Knee ; methods ; Female ; Humans ; Male ; Middle Aged ; Reproducibility of Results ; Rotation ; Tibia ; surgery

Objective To study the cellular immune function in children with kawasaki disease(KD).Methods T lymphocyte subcytes,levels of serum interleukin 2(IL-2) and soluble interleukin 2 receptor(sIL-2R) were determined by APAAP,ELISA met-hods,and a double-antibody “sandwich” enzyme-linked immunosorbent assay respectively in 60 cases.Results During the acute stage of KD,the percentage of CD4 +,the ratio of CD4 +/CD8 +,levels of IL-2 and sIL-2R increased markedly,while the percentage of CD3 + and CD8 + decreased significantly compared with the controls.These changes were more remarkable in patients subsequently developed coronary artery aneurysms than in those with normal appearing coronary artery.Conclusion Marked activation of cellular immune function and immune regulation disorders develop in acute stage of KD patients.

Objective To quantitatively evaluate the metabolic changes in posterior cingulated cortex and left basal ganglia in patients with liver cirrhosis before and after liver Transplantation (LT).Methods A total of 22 controls and 37 cirrhotic patients listed for LT were enrolled in the study. Brain MRS (PRESS sequence) and neuropsychological (NP) tests were performed in all subjects. Eighteen patients were followed up at 1 month and 3 month after LT. The NP parameters including number connection test-A ( NCT-A), digital symbol test (DST) and symbol digital test (SDT) were measured. MRS metabolic contents were measured automatically at posterior cingulate cortex (PCC) and left basal ganglia (LBG).Independent t-test was used to compare the parameters of NP test and MRS metabolites between the 2 groups. The changes of the parameters before and after LT were compared using analysis of variance.Pearson correlation test was also used to analysis the relationship between NP test parameters and MRS metabolites. Results ( 1 ) Before LT, significant difference of metabolites was found in the PCC between the two groups [ NAA/Cr(1.96 ±0.21, 1.73 ±0. 12), Cho/Cr(0. 65 ±0. 12,0. 83 ±0.09), mI/Cr (0.41 ±0.14,0.72±0.11), Glx/Cr(2. 37 ±0. 38,1. 92 ±0. 32) (t= -5.42,5.96,8.62,-4.72,P＜0.01)].And statistical significance also were found in LBG between the 2 groups [ Cho/Cr (0. 63 ± 0. 16,0. 77 ±0. 10), mI/Cr(0.38 ±0. 17,0.53 ±0.21), GIx/Cr(1.70 ±0.36,1.29 ±0.30), (t =3.64,3.07,-4.58 ,P ＜ 0. 01 )]. (2)Compared with controls, the patients before LT had longer NCT-A reaction time [ (58. 17 ±19. 12) s,(37.68 ±8.02) s,t =4. 14,P＜0.01], lower scores of DST (36.67 ±9.91,55.36 ±9.27,t = 4.60,P＜0.01) and SDT (31.67 ±9.49,50.73 ±8.34,t = 4.652,P＜0.01) before LT. All the scores of NP tests changed significantly at 1 and 3 month after LT compared with those before LT[ NCT-A (53.06±12.71) s,(35.72 ±5.20) s,F =33.554,P ＜0.01 ], DST(41.89 ±8. 17,54.39 ±5.69,F =85.772,P＜0.01),SDT(37.44±7.68,49.39±5.65,F=83.061,P＜0.01)]. (3) In the 18 patients who were followed, Cho/Cr [ PCC (0. 90 ± 0. 14,0. 92 ± 0. 08, F = 38. 178, P ＜ 0. 01 ); LBG (0. 81 ± 0. 08,0. 80 ±0.09,F =9.447,P ＜0.01)] and Glx/Cr [ PCC(1.86 ±0.32,1.75 ±0.25,F = 19.420, P ＜0. 01 ); LBG( 1.30 ±0. 20,1.23 ±0. 25 ,F = 17. 952,P ＜0. 01 ) ] recovered at 1 month after LT, while the mI/Cr [PCC (0.39±0.15,0.71 ±0. 10,F =75. 186,P＜0.01) ;LBG (0.47 ±0.25,0.61 ±0.27,F =8. 027, P ＜ 0. 01 ) ] recovered at 3 month after LT. (4)mI/Cr of cingulate cortex correlated significantly with NCT-A, DST and SDT (r= -0.743, 0.597, 0.615, P＜0.01 ) before LT. Conclusion Cerebral metabolic changes in patients with liver cirrhosis is reversible and MRS of the posterior cingulate cortex is a helpful method in following up the changes after LT. mI/Cr is a useful indicator to predict the brain changes of cirrhotic patients before and after LT.

Objective To delineate the speculation that triple combination of small doses of calcium antagonist (levoamlodipine),the ACEI(imidapril)and the ARB(candesartan)may exert more significantly effect on mi- croalbuminuria(MAU)in patients with type 2 diabetes mellitus and hypertension.Methods One hundred sixty ca- ses of consecutive patients with type 2 diabetes mellitus and hypertension were randomized to receive following vari- ous combinations:amlodipine 2.5 mg/candesartan 4 mg(n=40),candesartan 4 mg/imidapril 5 mg(n=40);imidapril 5 mg/amlodipine 2.5 mg(n=40),and amlodipine 2.5 mg/candesartan 4,mg plus imidapril 5 mg(n=40).The changes in blood pressure and MAU were determined before and after treatment.Results Four combinations of treatment all significantly lowered BP(P

OBJECTIVE: To investigate the clinical application and efficacy of ¹²⁵Ⅰ radioactive seeds implantation in the treatment of recurrent salivary gland carcinoma after external radiotherapy. METHODS: From July 2004 to July 2016, 43 cases of recurrent salivary gland carcinoma of the neck after external radiotherapy or surgery combined with external radiotherapy were treated. According to the conventional segmentation radiotherapy for head and neck cancer (once a day, 1.8-2.0 Gy each time, 5 days per week), the cumulative radiation dose of the patients in this group was calculated. In the study, 26 patients received 50-60 Gy, 7 patients received less than 50 Gy, 4 patients received 60-70 Gy, and 6 patients received more than 80 Gy (range: 80-120 Gy). The interval between the last external irradiation and local recurrence was 4-204 months, and the median interval was 48 months. Among them, 25 cases were treated with ¹²⁵Ⅰ radioactive seeds implantation only and 18 cases were treated with ¹²⁵Ⅰ radioactive seeds implantation after operation. The prescription dose was 100-140 Gy. The control rate, survival rate and disease-free survival rate were recorded to evaluate the side effects. RESULTS: The median follow-up time was 27 months (ranging from 2.5 to 149.0 months). Among them, the median follow-up time of adenoid cystic carcinoma patients was 31 months (range: 2.5-112.0 months), and the median follow-up time of mucoepidermoid carcinoma patients was 18 months (range: 5-149 months). The local control rates for 1, 3 and 5 years were 66.5%, 48.8% and 42.7%, respectively. The 1-, 3- and 5- year survival rates were 88.0%, 56.7% and 45.8%, respectively. The disease-free survival rates of 1, 3 and 5 years were 58.3%, 45.4% and 38.1%, respectively. There was no statistically significant difference in local control rate, survival rate, and disease-free survival between the radioactive seeds implantation group and the radioactive seeds implantation group after surgical resection. There were 2 cases of acute radiation reaction Ⅰ/Ⅱ and 3 cases of reaction Ⅲ or above. In the late stage of radiotherapy, there were 8 cases with Ⅰ/Ⅱ grade reaction and 3 cases with Ⅲ grade or above reaction. The incidence of radiation reactions of Grade Ⅲ and above was 7%. CONCLUSION ¹²⁵Ⅰ radioactive seeds implantation provides an alternative method for the treatment of recurrent salivary gland carcinoma after external radiotherapy. The local control rate and survival rate are improved on the premise of low incidence of side effects.
Brachytherapy/adverse effects* ; Humans ; Iodine Radioisotopes/therapeutic use* ; Neoplasm Recurrence, Local/radiotherapy* ; Salivary Gland Neoplasms/radiotherapy* ; Salivary Glands

Objective To evaluate the lymphoscintigraphic imaging characteristics for the patients with lower limb lymphedema and to establish a novel grading system for the injury to lower limb lymphatic system. Methods One hundred and sixty six consecutive patients (332 lower limbs) with lower limb lymphedema after surgical and(or) radiotherapy treatment for gynecological cancer were recruited into this retrospective study. The lymphoscintigraphy studies were performed after subcutaneous injection of 111～185 MBq (0. 1～0. 15 ml) of 99Tcm-DX into the webbed space between the first and second toes of both feet. Based on the integrity of lymphatic vessel and the extension of dermal diffusion on lymphoscintigram,the lymphatic injury to the lower limb was graded as 0, 1,2 and 3 respectively. The lymphedema of the limb was staged as 0, Ⅰ , Ⅱ a, Ⅱ b, Ⅲ by the standard of Consensus Document of the International Society of Lymphology (ISL). Chi square test was carried out to validate the established grading system for the assessment of the injury to the lower limb lymphatic system. Results The lymphoscintigraphic imaging characteristics included lymphatic blockage, dermal backflow, no visualization of lymphatic or lymph node, lymphocele and lymph fistula in the lower limb, pelvis and abdomen. There were 65 (19.6%), 71 (21.4%),131 (39.5%), 62 (18.7%) and 3 (0.9%) limbs staged as 0, Ⅰ , Ⅱa, Ⅱb, and Ⅲ for lymphedema while 36(10.8%), 79(23.8%), 116(34.9%) and 101 (30.4%) limbs graded as 0, 1, 2, and 3 for lymphatic injury. There was a statistically significant correlation between the grading methods (χ2 =313.483, P <0.001). The patients who underwent radiotherapy had a higher incidence rate of grade 2 and 3 (70.5%, 158/224) than those who underwent surgery (53.6%, 59/108) (χ2 = 9.662, P = 0.022).The patients with erysipelas had a higher incidence rate of grade 3(73.1%, 38/52) than those without erysipelas (43.9%, 50/114) (χ2= 12.238, P<0.001). The incidence rate of grade 3 increased with the duration of lymphedema after treatment: 36.6% (34/93) for less than 1.5 years, 72.3% (34/47) for between 1.5 to 5 years, and 76.9% (20/26) for more than 5 years (χ2 = 23.123, P<0.001). The grade of lymphatic injury showed no significant difference among 3 types of gynecological cancers (χ2 = 4.000, P =0.676), or between the patients with and without chemotherapy (χ2 =0.411, P=0.938). Conclusions Lymphoscintigraphy is a reliable modality to diagnose lower limb lymphedema after treatment for gynecological cancer. The injury grading system could provide objective assessment of the lymphatic damage.

Objective To investigate the clinical value of virtual touch tissues quantification in the evaluation of kidney stiffness in patients of diabetic nephropathy .Methods A total of 90 cases of diabetic nephropathy were divided into 3 groups:infinitesimal albuminuria ,microalbuminuria and massive proteinuria groups.And other 30 health subjects were taken as control group.The shears wave velocity ( Vs) which reflected the tissue elasticity was measured.The Vs values were compared among different groups.Results In all groups,the highest Vs was present in renal cortex .And compared with the renal cortex ,the Vs of the renal medulla and renal sinus have statistically significant differences [ the normal control group:( 3.65 ± 0.26)m/s,(2.72 ±0.35) m/s,(1.83 ±0.54) m/s,t =9.30,18.20,both P <0.05;Infinitesimal albuminuria group:(2.98 ±0.28)m/s,(2.47 ±0.33)m/s,(1.65 ±0.31)m/s,t=5.97,15.57,both P<0.05;microalbuminuria group:(2.55 ±0.22) m/s,(2.22 ±0.28) m/s,(1.54 ±0.21) m/s,t =3.86, 11.83,both P<0.05;massive proteinuria group:(1.99 ±0.28)m/s,(1.49 ±0.30)m/s,(1.01 ±0.39)m/s, t=5.85,11.48,both P<0.05].The renal cortex Vs of Infinitesimal albumonuria group ,microalbuminuria group and massive proteinuria group show a gradually decreasing trend .And the renal cortex Vs of microalbuminuria group and massive proteinuria group have statistically significant differences compared with the normal control group(t=11.79,17.79,both P<0.05).Conclusions Virtual touch tissues quantification technique can reflect the renal tissue elasticity .It will contribute to the assessment of renal function in patients with early diabetic nephropathy .