Purpose To study the clinicopathological features, immunophenotype and differential diagnosis of spindle cell rhabdomyosarcoma in adults (SRMS).Methods The clinical,pathologic and immunohistochemical features were evaluated in 9 cases of SRMS in adults.Results Nine cases of SRMS in adults were retrieved from the pathological archive of this hospital. 7 cases were male and 2 were female. Patients age ranged from 20 to 80 years (median,45 years). The head and neck region,including the right mandible, pharyngeal portion, nasopharynx, and left maxillary,was the most commonly affected area, accounting for 44% of the cases, followed by forearm, waist, thigh, leg and testis(1 case each). Tumor size varied from 2 to 14 cm (median 5.9 cm).Histologically, all the tumors were mainly composed of cellular bands and fascicles of atypical spindlE-shaped tumor cells with a variable number of spindled or polygonal rhabdomyoblasts.In addition, focal areas reminiscent of interstitial sclerosing were presented in 2 cases, and pseudovascular structures were noted in 2 cases, loosely myxoid stroma were detected in 1 case and small solid areas with mild pleomorphic tumor cells were present, but lacking bizarre pleomorphic rhabdomyoblasts. Immunohistochemically, the tumor cells were positive for vimentin, desmin, CD99 and MyoD1; Myogenin and MSA were positive in most of the cases (6/9 and 7/9 each); The remaining antibodies(S-100, CD34,CK and HMB-45) were all negative. Follow-up information was available in all the cases, ranged from 6 months to 4 years, revealed paravenous metastases of the peritoneal cavity in one patient with testis tumor and liver metastases in one patient with leg tumour. 4 patients developed local recurrences and 2 patients died of the disease.Conclusions SRMS is a rare neoplasm in adults,and most commonly occurs in male with preferential involvement in the head and neck region. It appears a more aggressive clinical course in adults. Morphologically, SRMS in adults should be differentiated from other spindle cell tumors.

Objective:To explore the value of preoperative 18F-fluorodeoxyglucose(FDG) PET/CT parameters combined with coagulation parameters in predicting the recurrence after surgery in patients with early cervical cancer. Methods:A total of 120 patients(age range: 25-70 (47.9±8.5) years) with cervical cancer who underwent preoperative 18F-FDG PET/CT examination and blood coagulation index test in Shengjing Hospital of China Medical University between January 2012 and December 2014 were retrospectively analyzed. Patients were divided into recurrent group and non-recurrent group according to the follow-up results. Independent-sample t test or Mann-Whitney U test was used to compare the differences of related parameters between the recurrent and non-recurrent patients. Then the receiver operating characteristic (ROC) curve analysis was performed, and univariate and multivariate Cox analyses were used to evaluate the predictive value of parameters. Results:The follow-up time was 2-60 months. There were 36 recurrent cases, accounting for 30.0% (36/120) of all patients. The mean standardized uptake value (SUV mean), peak of standardized uptake value (SUV peak) and total lesion glycosis (TLG) were significantly different between recurrent ( n=27) and non-recurrent ( n=62) subgroups of moderately differentiated patiens (8.90±3.00 vs 7.50±2.90, 12.00±3.70 vs 10.20±4.50, 144.48(43.79, 366.46) vs 60.23(28.46, 113.15) g; t values: 1.968, 2.063, U=547.000, all P<0.05); the maximum standardized uptake value (SUV max), SUV mean, SUV peak, TLG were significantly different between recurrent ( n=7) and non-recurrent ( n=12) subgroups of poorly differentiated patiens (16.10±4.70 vs 7.60±2.33, 8.70±2.10 vs 4.40±1.50, 13.30±4.40 vs 5.60±1.80, 140.37(131.44, 143.94) vs 31.64(15.84, 92.14) g; t values: 5.363, 4.829, 5.429, U=3.000, all P<0.05); D-dimer and fibrinogen (FIB) of recurrent and non-recurrent patients were also different (175.00(100.00, 256.00) vs 86.00(51.25, 115.25) mg/L, (3.10±0.50) vs (2.80±0.50) mg/L; U=619.500, t=2.962, both P<0.05). The ROC curve indicated that SUV max (area under curve (AUC)=0.651), SUV mean (AUC=0.650), SUV peak (AUC=0.675), TLG (AUC=0.703), D-dimer (AUC=0.795) and FIB (AUC=0.672) could predict the recurrence of the disease(all P<0.01). Univariate Cox analysis revealed that the International Federation of Gynecology and Obstetrics (FIGO) staging (hazard ratio ( HR)=2.363, 95% CI: 1.217-4.590), SUV max ( HR=4.855, 95% CI: 1.488-15.841), SUV mean ( HR=4.451, 95% CI: 1.573-12.597), SUV peak ( HR=7.190, 95% CI: 2.203-23.469), TLG ( HR=4.396, 95% CI: 2.238-8.633), D-dimer ( HR=4.761, 95% CI: 2.470-9.253) and FIB ( HR=3.196, 95% CI: 1.596-6.400) were predictive factors of recurrence (all P<0.05). Multivariate Cox analysis showed that D-dimer ( HR=2.974, 95% CI: 1.476-5.990) and SUV peak ( HR=3.826, 95% CI: 1.063-13.778) were the main predictors (both P<0.05). ROC curve of SUV peak combined with D-dimer showed the AUC of 0.841( P<0.01). Conclusions:SUV peak and D-dimer are main indexes to evaluate the recurrence after surgery in patients with cervical cancer. SUV peak combined with D-dimer have good predictive value for the recurrence of cervical cancer.

Objective: To assess the autonomic nervous impairm ent in chronic renal failure and its related factors. Methods: F orty adults were randomly selected including in-patients in the nephrology ward and healthy subjects for routine medical examination. The subjects were classifi ed into 4 groups: normal subjects(NS)，normal renal function，nitremia， uremic patients. The time domain measurements of heart rate variability(HRV) and ambula tory blood pressure were analyzed simultaneously . Results: (1) There were significant differences as compared with normal subjects in the time domain measurements of HRV in uremic group. It decreased significantly when the patient was defined as end stage chronic renal failure. There were no significan t differences between NS，normal renal function group and nitremic group. (2) Ti me domain measurements of HRV was significantly lower(P<0.05) in uremia with renal hypertension than in uremia with normal blood pressure. Conclusio n: (1) Patients with chronic renal failure(HRV) have their cardiac auton omic nervous system impaired conspicuously in the course of uremia. (2) There is a positive correlation between cardiac autonomic nervous system impairment in p atients with CRF and renal function levels. Uremia itself is an independent fact or for the impairment of cardiac autonomic nervous system. (3) Renal hypertensio n with uremia may intensify the impairment of cardiac autonomic nervous system of the patients.

Objective To Analysis the physical fitness participation of 1243 community residents and to provide the scientific basis for developing intervention strategies. Methods The study was based on data of Physical Activity Questionnaire collected in Nutrition and Health Survey 2006 in Putuo, Shanghai. 1 243 subjects aged 6 years and above were involved. Results 43.8% of community residents had participated in physical exercise. Participation ratio was 41.4% in male, lower than that in female (45.8%). Participation ratios among aged 6yr～, 18yr～, 45yr～, 60yr～ were 48.1%, 25.2%, 22.0%, 64.9% in male and 40.8%, 22.5%, 40.1%, 67.1% in female. Participation ratios among age groups were significantly different (P=0.000). Proportion for frequent exercise of all age groups were 25.0%, 11.9%, 19.7%, 64.9% for male and 21.1%, 15.0%, 37.4%, 66.3% for female. There were difference among age groups (P= 0.000). Conclusion Specific intervention measures should be developed for different kind of people.

Objective To evaluate the efficacy and feasibility of percutaneous microwave coagulation therapy(PMCT) combined with 125I seeds implantation for the treatment of advanced lung cancer.Methods CT-guided PMCT and implantation of 125I seeds were applied to 22 cases of NSCLC,including 15 cases of squamous carcinoma and 7 cases of adenocarcinoma.The maximum diameter of the lesions ranged from 5-12 cm.The part of focuses situated at thoracic wall or surrounding the large vessels and airways was treated with 125I seed implantation,and the other parts were treated with PMCT. Results In all the patients,PMCT was done in one session with multipoint ablation,and an average of 32.4 particles of 125I seeds were implanted for each of the focuses(712 particles in total).The main postoperative complications included slight hemoptysis(7 cases),pneumothorax(4 cases),fever(17) and lung inflammation(11) after PMCT,chest fluid(6),and dislocation of the particles(2).15 cases achieved PR,5 cases were SD,and 2 cases were PD in 2 months after the operation shown by CT.The effective rate(CR + PR) was 68.2%(15/22).The chest pain was relieved in 15 patients,and improved in 4.22 of the cases were followed up for 4 to 18 months(mean 7 months).No enlargement of the chest lesion was detected during the period. Conclusions For the advanced NSCLC sized ≥ 5 cm in diameter,PMCT combined with 125I seeds implantation is safe,minimally invasive,and effective.

Objective: To assess the autonomic nervous impairment in chronic renal failure and its related factors. Methods: Forty adults were randomly selected including in patients in the nephrology ward and healthy subjects for routine medical examination. The subjects were classified into 4 groups: normal subjects(NS),normal renal function,nitremia, uremic patients. The time domain measurements of heart rate variability(HRV) and ambulatory blood pressure were analyzed simultaneously . Results: (1) There were significant differences as compared with normal subjects in the time domain measurements of HRV in uremic group. It decreased significantly when the patient was defined as end stage chronic renal failure. There were no significant differences between NS,normal renal function group and nitremic group. (2) Time domain measurements of HRV was significantly lower( P

Objective To study the incidence rate and correlation of anomalous pancreaticobiliary ductal junction( APBDJ) for patients with biliogenic chronic pancreatitis (BCP). Methods From January 2000 to January 2012,the data of 1 373 patients who underwent ER-CP,MRCP or T-Tube cholangiography in which both biliary and pancreatic ducts in our hospital were analyzed retrospectively. Results Bil-iogenic chronic pancreatitis was found in 47 patients,of which 17 patients with APBDJ. The mean (SD) common channel was (19. 3±7. 2) mm in length ( range 11~40 mm) . Conclusion APBDJ may be the important reason of BCP among Chinese patients.

Objective To analyze the effect of different postoperative nutrition:enteral nutrition( EN) and parenteral nutrition( PN) in patients with colorectal cancer. Methods 84 patients with colorectal cancer were collected in this study from Jan. 2012 to Jan. 2014, and they were divided into the EN group (43 cases) and the PN group (41 cases). They were given EN or PN after operation. The nutritional parameters such as ALB, TF and PA were detected before surgery and 7 days after operation, Observe the adverse reaction, time of gastroin-testinal function recovery, infection and costs after operation. Results There was no statistical difference (P>0. 05) in the nutritional pa-rameters and rate of adverse reaction between the two groups. The rate of infection in EN group was lower than that in PN group(P<0. 01), and the time of gastrointestinal function recovery was shorter in EN group compared with that in PN group (P<0. 01). Conclusion EN is better in recovery of gastrointestinal function, and there is less complication compared to PN. EN have clinical application value for patients with gastrointestinal cancer.

Objective To evaluate the association between isotretinoin pharmacokinetic parameters and CYP2B6 (cytochrome p-450) gene polymorphisms. Methods Blood samples were collected at different time points from 21 healthy male volunteers who received a single 40-rng oral dose of isotretinoin. High performance liquid chromatography-electrospray ionization mass spectrometry (LC-MS) was used for the quantification of isotretinoin in plasma samples which were standardized by dosage and body weight. PCR and restriction fragment length polymorphism (RFLP) analysis were performed to detect the G516T mutation in exon 4 as well as A785G mutation in exon 5 of CYP2B6 gene in these subjects. Results There was an obvious genetic linkage imbalance in exon 4 and 5 of CYP2B6 gene among these volunteers. In the case of CYP2B6*4 allele,3 (14.29%) people were CYP2B6*4/*4 homozygotes, 6 (28.57%) CYP2B6*1/*4 heterozygotes, and 12 (57.14%) CYP2B6*1/*1 wild-type homogygotes, while as far as CYP2B6*6 allele was concerned, 3 (14.29%)people were CYP2B6*6/*6 homozygotes, 5 (23.81%) CYP2B6*1/*6 heterozygotes, and 13 (61.90%)CYP2B6*1/*1 wild-type homozygotes. The reaction half-time (t1/2) and mean residence time (MRT) of isotretinoin were longer in volunteers carrying wild-type CYP2B6*4 allele than those of CYP2B6*4/*4 homozygotes (both P ＜ 0.05 ), while no significant difference was observed in maximum concentration (Cmax), peak time (Tmax) or area under the plasma concentration time (AUC) between the two groups of volunteers. There was no statistical difference in any of the above parameters between subjects carrying wild type CYP2B6*6 allele and those of CYP2B6 *6/*6 homozygotes (all P ＞ 0.05 ). Conclusions The mutation of CYP2B6*4 allele ia relevant to the metabolism of isotretinoin, which seems to be more rapid in CYP2B6*4/*4 homozygotes.

Antihypertensive Agents ; therapeutic use ; Humans ; Hypertension ; therapy ; Practice Guidelines as Topic