Ovarian neoplasms,composed predominantly or exclusively of small round cells with scant cytoplasm,is relatively rare.However,there is a wide range of differentiation,and pathologists often struggle to make a correct diagnosis because of its overlapping histological features.Perhaps the best known neoplasm of this kind is ovarian small cell carcinoma of the hypercalcemic type,which may be confused with a wide range of neoplasm from sex cord-stromal tumor to neoplasm in the family of small round blue cell tumor to various undifferentiated malignancies.Small cell carcinoma of the pulmonary type may also arise from the ovary,and this may be a component of a typical ovarian surface epithelial-stromal tumor.Other small cell neoplasm that may arise within the ovary or involve the ovary includes intra-abdominal desmoplastic small round cell tumor,metastatic small cell carcinoma,peripheral primitive neuroectodermal tumor,and endometrial stromal sarcoma.In this review,the morphologic features of some of these neoplasms are described,as well the value of immunohistochemistry and other ancillary techniques in establishing a diagnosis.

Objective To summarize the experiences got from perioperative management for intravital liver transplantation. Methods Of 30 cases of intravital liver transplantation, executed from June 2006 to December 2007 in the General Hospital of PLA, the data of perioperative management were retrospectively analyzed. Among the recipients, 26 received right hepatic lobe including middle hepatic vein (MHV), 2 received right hepatic lobe without MHV, 1 received complementary liver transplantation with MHV in left half liver, and the remained one received right hepatic lobe plus left external lobe including MHV. The primary diseases in the recipients included serious chronic hepatitis (8 cases), primary hepatocarcinoma (9 cases), fulminant hepatic failure (5 cases), final-stage cirrhosis (5 cases), and one each of liver purpura, liver angiosarcoma and Kinnier-Wilson syndrome. On Child-Pugh status, 5 cases in grade A, 9 in grade B and 16 in grade C. The score on the model for end-stage of liver disease (MEHD) was 27.7 (6.8-45.6). The total and right half liver volumes of donors were evaluated by conventional 3-D CT, and well-provided preoperative evaluation was done to both donors and recipients. Results For donors the average length of stay was 11 days (9-15) and average blood loss was 341 ml (160-1200ml), only one donor suffered from intra-operative blood loss of 1200 ml and then received 600 ml of concentrated erythrocytes. No severe complications were found in donors, and all of them recovered finally. The complications occurred in 5 recipients (16.7%), including bile leakage (2 cases), pulmonary infection (2 cases) and one case of diffusive Aspergillus infection. The survival rate of recipients was 90% (27/30), 2 recipients died from severe pulmonary infection and 1 from diffusive Aspergillus infection. Conclusion Sufficient pre-operative assessment for both donors and recipients and exquisite technology are the keys for a successful liver transplantation, and well-provided perioperative managements are also requirements.

Objective To explore the etiology and clinical prevention regime for hepatitis B virus reinfection in patients after orthotopic liver transplantation. Methods One hundred and twenty eight orthotopic liver transplantation recipients with hepatitis B virus related end-stage liver diseases were analyzed retrospectively. The patients' primary diseases included chronic fulminant hepatitis B, end-stage liver cirrhosis and liver carcinoma. All the patients were given lamivudine pre-transplantation to prevent hepatitis B virus reinfection. Single lamivudine was administered post-transplantation in 3 cases; lamivudine combined with hepatitis B immunoglobulin were given in 125 cases. Adefovir dipivoxil was administered to the patients with hepatitis B virus reinfection. All the patients were followed-up for 3～48 months. Results Two out of the three patients who received single lamivudine developed hepatitis B virus reinfection. The reinfection occurred in one patient 6 months after orthotopic liver transplantation, and the other patient was found to be reinfected 9 months after transplantation. Five out of the 125 patients who received lamivudine and hepatitis B immunoglobulin (small dosage) developed hepatitis B virus reinfection. To 3 patients with hepatitis B virus reinfection adefovir dipivoxil was given, and hepatitis B virus-DNA negative conversion was observed after three months of treatment. Conclusions Treatment with lamivudine and low dose of hepatitis B immunoglobulin post-transplantation may offer an effective prevention against hepatitis B virus reinfection. Adefovir dipivoxil is effective for patients with reinfection of hepatitis B virus by suppressing its variant replication.

Objective To study the relationship between lymph node micrometastasis and clinicopathological parameters. Methods Immunohistochemical method was adopted to detect CK19,CK20 and CD44v6 in 509 lymph nodes from 53 cases of gastric cancer, in which, conventional pathological diagnosis showed no lymph node metastasis. Results Micrometastasis was found in 47 lymph nodes (9.2%) of 21cases ( 39.6 %). The incidence of micrometastasis was correlated with the depth of invasion, and the incidence of micrometastasis in PT 3 and PT 4 patients was more than that in PT 1 and PT 2 patients(P

BACKGROUND:There are many researches on the finite element analysis of total hip arthroplasty, but the biomechanical distribution after hip surface replacement is little reported.OBJECTIVE: To analyze the biomechanical characteristics after hip surface replacement based on three- dimensional finite element analysis.METHODS: The three-dimensional finite element model after metal-to-metal hip surface replacement was established.The load of 350 N paralleling to the gravity line was loaded on the acetabulum. The stress distribution of the prosthesis and femur and the stress of the different regions of the femoral head were observed.RESULTS AND CONCLUSION: (1) The stress value of the acetabular cup was significantly higher than that of the acetabular body ((0.63± 0.34) vs. (1.89±0.67) MPa, P < 0.05). (2) The stress was concentrated on the femoral neck. The femoral head and femoral neck junction appeared with stress occlusion. The stress around the femoral prosthesis stem was (158.24±28.79) MPa, and the stress value of the femoral prosthesis stem was (186.46±22.37) MPa, showing no significant difference (P > 0.05). (3) The stress value showed significant difference among femoral head regions (P <0.05), and the stress of the regions 6 and 8 was significantly higher than that of the other regions (P < 0.05). (4) These results show that after metal-to-metal hip surface replacement, femoral neck stress is concentrated, the stress of the femoral prosthesis is occluded, and the stress at the medial femoral neck as well as the junction of femoral neck prosthesis and bone is larger.

Objective To investigate the effects of prostaglandin E1 (PGE1) on the levels of myocardium nuclear factor‐κB (NF‐κB) and plasma tumor necrosis factor‐α (TNF‐α) in patients underwent heart valve replacement .Methods Forty ASA Ⅱ orⅢ degree patients (NYHA Ⅱ or Ⅲ degree) ,aged 32 to 67 years with body mass index of 17 to 28 kg/m2 ,underwent heart valve replacement ,were randomly divided into 2 groups (n=20):control group (group C) and PGE1 group (group P) .After induction of anesthesia ,PGE1 20 ng · kg -1 · min-1 was infused intravenously in group P ,while the equivalent volume of normal saline was giv‐en in group C ,and the infusion was completed at the end of operation .Arterial blood samples were collected at the time of before cardiopulmonary bypass (T0 ,baseline) ,30 min after the begin of cardiopulmonary bypass (T1 ) ,the end of cardiopulmonary bypass (T2 ) ,and 12 h(T3 ) ,24 h(T4 ) after the end of cardiopulmonary bypass .Myocardial specimens were obtained from right auricular appendage at T0 and T2 for microscopic examination and determination the activity of NF‐κB .Results The plasma mass concentra‐tions of TNF‐αwas significantly lower (P<0 .05) at T1 to T4 ,while the myocardial histopathological damage was lighter and the activity of NF‐κb significantly attenuated (P<0 .05) at T2 in group P than that in group C .Conclusion PGE1 can attenuate myo‐cardial injury in patients underwent heart valve replacement ,the mechanism is related to inhibit the activity of myocardium NF‐κB and decrease the plasma mass concentrations of TNF‐α.

BACKGROUND: Previous studies have confirmed that atrial natriuretic peptide (ANP) exists in different regions of rat gastric mucosa in different densities, and ANP can inhibit the spontaneous contraction of gastric smooth muscles in rat, guinea pig and human.OBJECTIVE: To investigate the ultrastructural localization of ANP-synthesizing cells and the correlation between ANP-synthesizing cells and microvessel density in rat gastric mucosa.DESIGN: Single sampling study.SETTING: Affiliated Hospital of Chengde Medical College. MATERIALS: Eighteen adult male Wistar rats of clean grade, weighing 300-350 g, were used in this study.METHODS: This study was conducted in the Laboratory of Chinese Materia Medica Immunology, Chengde Medical College from October 2004 to July 2007. The ultrastructural localization of ANP-synthesizing cells in rat gastric mucosa was performed by postembedding immunoelectron microscopy technique. The area density of ANP-synthesizing cell distribution was calculated by histochemical technique (saffron solution and toluidine solution staining included). Microvessels of rat gastric mucosa were revealed distinctively by tannic acid-ferric chloride staining method and scanning electron microscope technique.MAIN OUTCOME MEASURES:①The ultrastructural localization of ANP-synthesizing cells in rat gastric mucosa.②The distribution characteristics of gastric microvessels in different regions of rat gastric mucosa.③The distribution characteristics of ANP-synthesizing cells in rat gastric mucosa.④Correlation between ANP-synthesizing cell distribution and microvessel density.RESULTS: ① Ultrastructural localization of ANP-synthesizing cells: It was confirmed that ANP-cells were the enterochrochromaffin (EC) cells. ② Observation of microvessels: The microvessels were stained successfully by tannic acid-ferric chloride and scanning electron microscope technology. Microvessels of gastric mucous were in wriggled way and cut in different cross-sections. They could be clearly observed in distinct three-dimensions. The microvessel density was the largest in the basal glands of rat gastric mucous. ③ Distribution of ANP-synthesizing cells: It was identified that EC cell was only a chromaffin cell in the rat gastric mucosa. The chromaffin granules (brown granules) were localized in the cytoplasm of EC cells. Negative staining for chromaffin granules was detected in the submucosa and smooth muscle. EC cells had different distribution densities in different regions. The density order of EC cells was gastric cardiac region ＞ gastric pyloric region ＞ gastric fundic region in mucosal layer. ④ Correlation between ANP-synthesizing cells and microvessel density: Correlation analysis showed that there was a positive correlation between ANP-synthesizing cells and microvessel density in the gastric cardiac region(r = 0.53, P ＜ 0.05, n=18), and there was a negative correlation between above-mentioned two indices in the gastric pyloric region(r = 0.38, P ＞ 0.05 , n=18)and in the gastric fundic region(r = -0.29, P ＞ 0.05, n=18).CONCLUSION: ANP-synthesizing cells are the EC cells of gastric mucosa. There is a positive correlation between ANP-synthesizing cells and microvessels in the rat gastric cardiac region, while there is a negative correlation between ANP-synthesizing cells and microvessels in the rat gastric pyloric region and in the gastric fundic region.

Objective To observe the protection of aprotinin, ulinastatin and aminomethylbenzoic acid, aminomethylbenzoie acid on blood fibrinolytie system during cardiopulmonary bypass(CPB). Methods Thirty-six patients with rheumatic heart disease who were treated by valve replacement were randomly divided into three groups: aprotinin group (group A, 12 cases): aprotinin 2000 kU was added into the priming solution; ulinastatin and aminomethylbenzoic acid group (group UP, 12 cases): ulinastatin 12 000 U/kg and aminomethylbenzoic acid 10 mg/kg was added into the priming solution; aminomethylbenzoie acid group (group P, 12 cases): aminomethylbenzoic acid 10 mg/kg was added into the priming solution. Results There was no significant difference in CPB time and blood transfusion among three groups; the postoperative 24 h chest tube drainage in group UP was (443.3 ± 150.8) ml, in group P was (430.0 ± 178.3) ml and in group A was (290.0 ± 98.0) ml, there were significant differences between group UP, group P and group A (P < 0.05). There was 1 case of severe allergic reaction in group A. Conclusion Aprotinin, ulinastatin and aminomethylbenzoic acid, aminomethylbenzoic acid are effective in stabilizing blood fibrinolytic system and preserving platelet function during CPB, leading to less postoperative blood loss.

OBJECTIVE: To study the effects of Wenyang Chubi Decoction (WYCBD), a compound traditional Chinese herbal medicine, on connective tissue growth factor (CTGF) and collagen-I (COL-I) in a mouse model of scleroderma. METHODS: Scleroderma was induced in BALB/c mice by daily local injection of bleomycin for three weeks and the mice were randomly divided into untreated, WYCBD-treated and normal saline (NS) treated groups, with another group of BALB/c mice as normal control. WYCBD and NS were given orally for one month respectively. Histopathology in the skin and lungs of the mice were examined. The CTGF and COL-I expressions in the skin or skin lesions were detected by immunohistochemical Elivision assay. RESULTS: The expression levels of CTGF and COL-I in the untreated group were significantly higher than those in the normal control group (P<0.05). Compared with the NS-treated group, the WYCBD-treated group had significant improvement in the skin and lung histopathology and remarkably decreased expression levels of CTGF and COL-I (P<0.05). CONCLUSION: Scleroderma mice showed high expressions of CTGF and COL-I in the skin. WYCBD had the effects of decreasing the CTGF and COL-I expressions and improving the skin fibrosis.

Background Previous retinal vascular mounting only obtained part of retinal vessels for the study of retinal diseases,and thus it is difficult to comprehensively assess these diseases.So optimizing the trypsin digestion method to show the complete retinal capillary network is very important for the study of retinal diseases.Objective This study was to modify the preparing way of trypsin digested whole retinal capillary network and offer a basis for a quantitative analysis of cells and capillaries.Methods Thirty Wistar rats were divided into model group (20 rats) and control group (10 rats).Streptozotocinum(STZ) of 1.25％ dissolved in 0.05 mmol/L sodium citratehydrochloric acid buffer was intraperitoneally injected to establish diabetes models in the model group,and the equal volume of solvent was used in the same way in the control group.Eight months after injection,100 ml PBS was injected via ventriculus sinister and released via cut right atrium,and then 100 ml 4％ paraformaldehyde was injected into the ventriculus sinister.The rat retinas containing part of the optic nerve were entirely isolated,and digested by trypsin,and vitreous,inner limiting membrane and neural retinal tissue were removed.The whole retinal capillaries network was mounted on the slide.The ghost pericytes and acellular capillaries in the middle retinal area were identified and counted under the optical microscope.Results The retinal mount exhibited that the retinal vessels were stained by hematoxylin and periodic acid schiff.The vessels network presented with the entire type in shape with the radical central retinal arteries and veins and their branches.The capillary showed the shallow-and deep-layer networks between the small arteries and veins.Pericytes distributed and protruded vessel wall and formed the ghost cells without nuclei.The diameter of acellular capillaries was 20％ or more than that of near capillaries,and no cellular nuclei or ghost cell was found through the vessel.Conclusions The experimental technique for setting-up of cleaned vasculature and mounting vessels on glass microscopic slide provides intact vessels,which is helpful for the evaluation of retinal vascular morphology and quantitative analysis.