Objective To make a further understanding of mammographic features of simple cyst of the breast (SCB).Methods Molybdenum target radiographic signs in 39 cases with SCB proved pathologically and were retrospectively analyzed. Results Of the 56 SCB in 39 cases, 23 were diagnosed rightly as SCB, 10 as fibroadenoma, 2 as cancer and the remaining 4 were undefined. The diagnostic accuracy and misdiagnosis were 59.0% and 41.0% respectively. Radiograph showed round in 12, ovoid in 38, mild lobed in 4 and comet tail form in 2. The borders of cyst were distinct and sharp in 26, distinct partly and indistinct partly in 27,indistinct completely in 3. The density was homogeneous in 54 with calcifications in 2. Of the 56 SCB, the length axes of cyst were upright to chest wall in 20 and towards nipple in 18. The cysts could be transformed with pressure in 4.Conclusion Careful analysis of radiographic features of SCB is helpful for diagnosing accurately this disease.

Ovarian endometrioma is a common form of endometriosis, which may cause infertility, dysmenorrhea and pelvic pain in women of reproductive age. Although surgery is the treatment of choice for endometriomas, recurrence poses a formidable frustration. This study investigated potential risk factors of endometriomas recurrence, aiming to better understand its pathogenesis. A total of 307 patients with endometriomas were followed up for an average of 28.6 months and the 1-, 2- and 3-year cumulative recurrence rate was 9.5%, 21.9%, and 29.2%, respectively. Twenty-one potential risk factors for endometriomas recurrence were evaluated using Cox's proportional hazards models. Total revised American Fertility Society (rAFS) score was significantly associated with higher recurrence (OR=1.858, 95% CI=1.122-3.075, P=0.016), as well as younger age at surgery (OR=0.953, 95% CI=0.915-0.992, P=0.020). Semiradical surgical treatment was defined as surgical removal of cyst plus hysterectomy with preservation of bilateral or unilateral ovary, and was a significant factor that was associated with lower recurrence than the conservative surgery (OR=0.318, 95% CI=0.107-0.951, P=0.040). Postoperative pregnancy was favorable factors for disease recurrence (OR=0.217, 95% CI=0.102-0.460, P=0.000). The results suggest that endometrioma recurrence is inversely associated with age at surgery and postoperative pregnancy, and may correlate with total rAFS score and conservative surgery method.

Objective To investigate the incidence of Keshan disease(KSD) in Shandong province and to supply evidence for scientific control of the disease.Methods According to the scheme of KSD monitoring in Shandong province,the KSD cases were searched in 7 counties,and representative 3 counties and 6 villages were selected as key monitoring sites.In each site,about 420 residents were checked by asking detailed disease history,physical examination,and electrocardiography (ECG) tracings.Suspected cardiac abnormalities were taken chest posteroanterior X-ray film.At the same time,residents hair and food samples were collected to detect selenium levels in internal and external environments,and residents' income and per capita share of grain and other basic information were collected.Results ①Two hundred and fifty-nine medical units were searched,1132 cases of myocardial disease were found out and 638 suspected cases were identified and 142 chronic KSD cases were diagnosed.②In the 6 monitoring sites,2538 residents were surveyed and 91 cases of KSD were detected(of which 77 cases of potential,14 cases of chronic),the detection rate was 3.58％.A total of 2127 residents were traced ECG and the incidence of abnormal ECG was 24.5％ (521/2127),of which ST-T changes,T-wave changes,sinus bradycardia,sinus arrhymia,sinus tachycardia,and atrial premature beats et al were more common.Of the 75 X-ray films,39 cases had enlarged heart(in which 21 of mild,13 of moderate,5 of severe).③A total of 406 hair and grain samples were collected,respectively,and the selenium content of hair was approaching the level of appropriate,and the selenium content of food was still low.The annual per capita incomes of each site were between 3000 - 5900 Yuan,and residents main staple food was flour.Conclusions KSD in Shandong province is in a relatively stable situation.But latent and chronic KSD cases can still be detected.The internal environment selenium levels are elevated since the local living standards and dietary nutrition are improved.

Adenocarcinoma ; metabolism ; pathology ; Aged ; Ampulla of Vater ; pathology ; Carcinoid Tumor ; pathology ; Carcinoma, Hepatocellular ; metabolism ; pathology ; Diagnosis, Differential ; Duodenal Neoplasms ; metabolism ; pathology ; Endodermal Sinus Tumor ; pathology ; Humans ; Male ; alpha-Fetoproteins ; metabolism

Objective To study the survival,migration and differentiation of the neural stem cells which transplanted into ventral horn of spinal cord after brachial plexus avulsion.Methods Neural stem ceils isolated from spinal cord of neogenetic rats and cultured,expanded,labeled by BrdU before transplanted. Twenty adult healthy SD rats preformed as the model of brochial plexus avulsion(Roots C_(5～7)),then transplan- rod stem ceils into the C_6 ventral horn of spinal cord.On 1,2,4,8,12 weeks postoperatively,immunohisto- chemistry assay were carried out in the spinal cord.Results Transplanted into ventral horn of spinal cord after brachial plexus avulsion.Neural stem cells can survive,migrate for at least one segment of spinal cord and differentiate to neurons and astrocytes.The differentiation of stem cells were time-depends.Conclusion Neural stem cells can survive,migrate and differentiate after transplanted into ventral horn of spinal cord in the rats which suffered from brachial plexus avulsion.

Objective To evaluate the clinical efficacy of multiple stents placement in the management of hilar cholangiocarcinoma,especially in the complex cases of which the hepatic ducts are invaded.Methods Forty-five consecutive patients with hilar cholangiocarcinoma were treated with percutaneous transhepatic placement of two or three self-expandable metallic endoprostheses.The cause of hilar obstructions in these patients were all cholangiocarcinoma,including Bismuth classification type Ⅱ(n 12 ),Ⅲa(n 17),Ⅲb(n 10),and Ⅳ(n 6).Two or 3 stents were placed in the configuration of T,Y or X over the strictures.Results Stent placement with 2 or 3 endoprostheses was successful in all patients.All patients showed significant decrease in serum bilirubin level.The mortality rate within 30 days of stent placement was 2.2%(1/45).The mean survival and stent patency times were 215.3 d(26— 516 d)and 181.5 d(26—473 d),respectively.Conclusion Deploying of multiple metallic stents is an effective method to treat complex hilar cholangiocarcinoma,especially for the cases of which hepatic ducts are invaded:the henatic ducts should be drained as much as nossible.

Objective To compare the differences of clinical characteristics between genotype B and C chronic hepatitis B(CHB)patients and to summarize clinical factors related to genotype C hepa- titis B virus(HBV)infection.Methods Seventy eight CHB patients who were diagnosed with genotype B or C infection by liver puncture biopsy and genotyping were enrolled.Their serum HBV DNA levels were detected.Severe hepatitis,liver cirrhosis,hepatocellular carcinoma and HBeAg positive rate were analyzed to determine the pathologic inflammation and fibrosis degree of liver tissue.Chi square test and Logistic multiple regression analysis were employed for the statistical analysis.Results The serum albumin and pre-protein were lower in genotype C CHB patients than that in genotype B.The alanine aminotrans- ferase,total bilirubin and prothrombin time were higher in genotype C CHB patients than that in genotype B.The rates of genotype C patients increased significantly with the grade of liver necroin- flammation progressing from GO to G4(1.8%,11.1%,20.4%,33.3%,33.3%) and the stage of liver fibrosis progressing from SO to S4(5.6%,5.6%,14.8%,33.3%,40.7%),but the rates of genotype B patients did not change significantly with the grade of liver necroinflammation(16.7%, 25.0%,25.0%,20.8%,12.5%)and stage of liver fibrosis progressing(16.7%,29.2%%,20.8%, 16.7%,16.7%).There was statistical significance in grades of liver necroinflammation(X~2= 11.49,P=0.022)and stages of liver fibrosis(X~2=13.56,P=0.006)between genotype B and gen- otype C patients.The rates of genotype C CHB patients were higher than,similar with and lower than the rates of genotype B patients of HBV DNA level above 1.0?10~6 copy/mL,between 5.0?10~2-1.0?10~6 copy/mL and under 5.0?10~2 copy/mL,respectively(51.8% vs 12.5%,35.2% vs 45.8% and 13.0% vs 41.7%).There was statistical significance of HBV loads between genotype B and genotype C patients(X~2=13.25,P=0.001).HBeAg positive rate in genotype C patients was significantly higher than that in genotype B patients(61.1% vs 25.0%,X~2=8.67,P=0.003).The rates of decompensated cirrhosis,compensated cirrhosis and no-cirrhosis in genotype C patients were higher than,similiar with and lower than the rates in genotype B patients,respectively(40.7% vs 4.2%,22.2% vs 20.8% and 37.0% vs 75.0%).There was statistical significance of the rate of cirrhosis between genotype B and genotype C patients (X~2=12.47,P=0.002).Conclusions The degree of liver necroinflammation and fibrosis,the HBeAg positive rate and the incidence of cirrhosis are all related with genotype C HBV infection.

Objective To investigate the clinical characteristics in chronic severe hepatitis B patients with HbeAg-positive and HbeAs-negative.Methods A total of 95 chronic severe hepatitis B cases were retrospectively analyzed.The clinical information,hepatic function,hepatic fibrosis and HBV DNA in HBeAg-negative and HBeAgpositive groups were analyzed.Results of the 95 cases,54(57% ) were HBeAg-negative and 41(43% ) were HBeAg-positive.No significant differences were found on age,ALB,TB,CHE,indexes of hepatic fibrosis and the ratio of complications between HBeAg-negative group and HBeAg-positive group.Compared with HBeAg-positive group,there were significantly higher levels of ALT(198.25±215.37)U/L vs(400.37±413.59)U/L],AST[(254.78±269.16)U/L vs(578.14±600.23)U/L] and lower level of HBV DNA[(6.17×10~6±8.24×10~1)copies/ml vs (2.39×10~5±6.75×10~1) copies/ml] in HBeAg-negative group(P<0.05).The anteroposterior diameter of the left liver and the thickness of right liver were(65.12±12.43)mm and(95.37.±12.69)mm in the HBeAg positive fatal chronic severe hepatitis B before the terminal phase,vs(56.78±11.04)mm and(89.34.±9.23)mm in the HBeAg negative group,and the former is longer than the later(P<0.05).Conclusion Tissue injury is more serious and the level of HBV DNA is lower in HBeAg-negative patients than HBeAg-positive patients.Liver size of HBeAg negative group reduces more significantly than HBeAg positive group before terminal phase.

Objective: To study the effects of TNFα on wound healing. Methods: The skin lesion and incisions were made on mice and rhTNFα was applied in both skin lesion and incision. Tissue strips were evaluated for tensiometry and histologic features after healing. Results: It was found that rhTNFα markedly improved wound healing both in skin lesion and incision wound model, it also markedly enhanced the breaking strength of treated incision and increased wound cellularity in rh TNF α treated groups. Conclusion: The results suggest that TNFα play an important role in regulating inflammatory reactions of local injured tissues and it may improve the functions of fibroblasts, mononuclear phagocytes and endothelial cells. rhTNFα of suitable doses can promote wound healing. This shows that TNFα, as a wound healing promoter, has the potentials for clinical application.

Objective To explore the status of iodine nutrition in 8～10 years children after universal salt iodization(USI)in the iodine deficiency area.Methods Probability proportion to size method(PPS)or simple random sampling methods were used to sample children aged 8～10 years in iodine deficiency area in the vear 1995,1997,1999,2002 and 2005, respectively.Goiter were detected by palpation and B-ultrasound, iodine concentration in salt was detected by direct titration method and that in urine by the method of As3+-Ce4+catalytic spectrophotometry.Results After USI has been implemented,the median of salt and urinary iodine tended to mcreaseand the goiter rate tended to decrease year by year.In 2005,the coverage rate of iodinated salt was elevated to 97.2%,qualified iodize salt rate was 97.1%and edible qualified iodinated salt rate was 94.3%in the whole iodine deficiency areas.The median of urinary iodine Was 227.7 μg/L 89.7%(323/360)of the population had a level of the urinary iodine over 100μg/L Goiter rate of 8～10 years children Wag decreased from 22.3%(282/1267)to 4.4%(53/1200) from 1995 to 2005.Conclusion After 10-year USI,the status of iodine nutrition in ShaJldong Province has been promoted obviously and it is in a suitable iodine nutritional status.