Purpose To explore the diagnostic value of dynamic contrast-enhanced CT (DCE-CT) in the differential diagnosis of chromophobic renal cell carcinoma (CRCC) and renal oncocytoma (RO). Materials and Methods A retrospective study was carried out on the DCE-CT findings of 24 patients with pathologically-proved CRCCs and 17 patients with pathologically-confirmed ROs. The enhancement percentage (EP) and the enhancement index (EI) of both types of lesions were compared on corticomedullary phase and nephrographic phase. Results CRCCs on corticomedullary phase and nephrographic phase:EP (132.8±39.8)%and (99.2±32.5)%, respectively;EI 0.31±0.11 and 0.30±0.12, respectively. ROs on corticomedullary phase and nephrographic phase:EP (234.1±129.1)%and (195.4±87.1)%, respectively;EI 0.66±0.33 and 0.68±0.28, respectively. Both EP and EI of CRCCs and ROs showed statistical difference (P<0.05). As the threshold value of EI on nephrograhic phase was 0.44, the sensitivity was 82.4%, specificity was 91.7% and Youden index was 0.74. Conclusion Imaging features of DCE-CT, especially EI on nephrographic phase, are helpful in the differential diagnosis of CRCC and RO.

Objective To study the relationship between the bacterial vaginosis (BV) and the preterm premature rupture of membranes and premature labor. Methods Qualitative and colorimetric test was used to detect the presence of bacterial sialidase level in 104 pregnant women with preterm premature rupture of membranes and 80 women with normal full term pregnancy. Results 38 cases were positive of BV in patients with premature rupture of membranes (36.54%) and nine cases were positive in normal full term pregnancy (11.25%) ( P

Aim To explore the mechanism of tetram-ethypyrazine ( TMP) in the inhibition of cancer cell in-vasion and metastasis, by investigating the effect of TMP on cell migration, cell invasion and cytoskeleton of HepG2 cells. Methods Using HepG2 cells as tar-get cells, cell migration of different concentrations of TMP on HepG2 cells was assayed by the scratch wound healing assay. Matrigel cell invasion assay was used to detect the effect of TMP on the invasion of HepG2 cells. The effect of TMP on cytoskeleton of HepG2 cells was detected by high content screening ( HCS ) . Results TMP inhibited the migration of HepG2 cells, and showed a time-dependent and dose-dependent manner. Moreover, TMP significantly inhibited the in-vasion of HepG2 cells ( P<0. 01 ) , and showed a cer-tain time-dependence. Furthermore, compared with control group, a significant decrease in HepG2 cy-toskeleton area was found in a dose-dependent manner ( P<0. 01 ) . Conclusion TMP can inhibit the migra-tion and invasion of HepG2 cells, and it has the poten-tial to resist tumor metastasis, and the mechanism may be associated with TMP significantly decreasing the number and area of cytoskeleton, and inhibiting the re-arrangement of cytoskeleton.

Objective To compare the diagnostic performances of strain elastography (SE) and shear-wave elastography (SWE) in differentiating benign and malignant solid breast lesions. Methods From January 2015 to December 2015, 150 patients with 155 lesions were examined with SE and SWE respectively in the First Affiliated Hospital with Nanjing Medical University. Elasticity scores on a improved 5-point scale,strain ratio (SR), maximum elasticity (Emax), mean elasticity (Emean), standard deviation of the elasticity (Esd) and the lesion-to-fat elasticity ratio (Eratio) were assessed. The receiver operating characteristic (ROC) curve of SE and SWE parameters were plotted to assess the value in distinguishing benign and malignant breast lesions. The results were compared using the area under the ROC curve (AUC). The accuracy of the parameters with the largest AUC were compared between SE and SWE by McNemar test in different breast imaging reporting and data system (BI-RADS) categories. Results The AUC of elasticity scores, SR, Emax,Emean, Esd and Eratio were 0.823, 0.810, 0.877, 0.835, 0.881 and 0.853, respectively. The SE and SWE parameter with the largest AUC were elasticity scores and Esd respectively. The accuracy of Esd was higher than that of elasticity scores(86.3% vs 64.7%)in 4A lesions (2=4.639, P < 0.05). There were no significant differences in accuracy in other BI-RADS categories. Conclusions Both SE and SWE were helpful for the differentiation of benign and malignant solid breast lesions, and the diagnostic performance of SE and SWE was similar. The optimization of elastography can be achieved by combination with BI-RADS.

Objective To upgrade No.1 Military Medical Project from single operation to Oracle RAC to eliminate single failure of the operation system, protect medical data and lay a foundation for the following upgrade and deployment.Methods RAC software and hardware environment was constructed for database upgrade and deployment of Data Guard.Results The database was gifted with high availability and high performances, and database maintenance and upgrade could be carried out with the operation system less ceased than before.Conclusion The database is upgraded from a single-mode rigid architecture to a multi-mode elastic one, with the performances, safety and extendibility enhanced greatly.

Objective To study the efficiency of the first time platelet transfusion in patients with blood diseases.Methods Investigate the effect of platelet transfusion in 87 patients with blood diseases.All the patients were transfused 10U platelet (platelet≥2.5×1011 ).Observe CCI after platelet transfusion and analyse the influence factors to the efficiency of the first time platelet transfusion such as the kind of diseases,splenomegaly,fever,age and sex.Results After platelet transfusion,66 patients (75.9 ％) were effective.The efficancy rates were 80.0 ％,78.1％,65.2 ％,82.3 ％ in AA,ITP,AL,MDS (x2=2.88,P＞0.05).In 31 patients with a fever and infaction the efficancy rate was 58.1％,but it was 85.7％ in 56 patients without a fever and infaction (x2=8.3308,P＜0.01).The efficancy rate in 59 patients with non-splenomegaly was 86.4 ％.It was higher than that in 28 patients with splenomegaly which was 53.6％(x2=11.2033,P＜0.01).The efficancy rate was 76.0％ in male patients and it was 75.7 ％ in female patients (x2=- 0.0012,P＞0.05).The efficancy rate was 74.5 ％ in young group (＜60 years old)and 77.8 ％ in old group (≥60 years old)(x2=0.1231,P＞0.05).Conclusion Fever and splenomegaly are the influence factors to the efficiency of the first time platelet transfusion.

Objective·To investigate factors affecting the prognosis of aged esophageal cancer patients after esophagectomy.Methods·Clinical data of 103 aged patients (≥ 80 years old) undergoing esophageetomy were collected.Effects of age,sex,clinical manifestations,pre-operative diseases,post-operative complications,T stage,lymph node metastasis,maximum diameter and location of the tumor,and surgical methods on the post-operative survival were analyzed.Results·1,3,and 5 years survival rates of 103 patients were 63.2％,15.9％,and 2.7％,respectively.Kaplan-Meier survival curve analysis indicated that the post-operative survival was significantly higher in patients with T1 and T2 stages than in patients with T3 stage.The 3 and 5 y survival rates of patients with T 1 stage were 50％ and 25％,respectively.Results of Cox regression multivariate analysis showed that T stage,maximum diameter of tumor,postoperative complications,and lymph node metastasis were independent factors affecting the post-operative survival.Conclusion·Esophageal cancer patients aged over 80 years with smaller tumor diameters,less postoperative complications,and negative lymph node metastasis have a longer post-operative survival period.Esophagectomy for patients with earlier stages (T1 and T2) can achieve an ideal post-operative survival period.

Objective To discuss the effect of H2 on osteoclast differentiation of RAW264.7 cells induced by RANKL and RANKL/TNF-α.MethodsRAW264.7 cells were treated with H2 in the presence of RANKL and RANKL/TNF-α.RAW264.7 cells viability was assessed by CCK-8.Test the Oxidative Stress of the induced RAW264.7.The number of TRAP-positive cells were counted under light microscopy.The levels of cathepsin K (CTK) and matrix metalloprotein-9(MMP-9) mRNA were analyzed by real-time PCR.ResultsH2 can not influence the RAW264.7 cell viability but can lower oxidative stress.The significant difference(P<0.05) indicated that H2 could significantly decrease the number of TRAP-positive MNCs.The significant difference among the 4 groups in CTK and MMP-9 genes (P<0.05) indicated that H2 could down-regulate their mRNA expression.ConclusionH2 can reduce the oxidative stress and inhibit differentiation of RAW264.7 cells into osteoclasts.

Objective To evaluate the effect of problem-based learning (PBL)versus tradi-tional methods in medical statistics. Methods Computer retrieval was conducted to search for con-trolled studies comparing PBL and traditional methods. The quality of included studies was critically evaluated and data were analyzed by using the Cochrane Collaboration's RevMan 5.0 software. Results A total of 21 articles were retrieved,but only 7 were included. The results of Meta analysis showed that there was no significant difference between PBL and traditional methods in both the passing rate of student's score (RR=1.09,95%CI=0.98-1.23,P=0.12>0.05)and the exact score (WMD=0.30, 95%CI=-0.06 -0.67,P=0.10>0.05). Conclusion PBL showed no better learning results in medical statistics compared with traditional methods.

OBJECTIVETo investigate the clinical features and proline-rich transmembrane protein 2 (PRRT2) gene mutation in patients with paroxysmal kinesigenic dyskinesia (PKD).

METHODClinical information was collected at Peking University First Hospital from January 2004 to July 2014. In total, 10 patients with PKD were recruited, and all were males. Among them, four patients were the probands from four PKD families and the other six patients were sporadic cases. Clinical information was analyzed. Peripheral blood samples for DNA study were collected from PKD patients and their family members. Genomic DNA was extracted using standard procedures. Mutation analysis of PRRT2 was performed by Sanger sequencing after PCR.

RESULTOf the 10 patients, the median age of dyskinesias onset was 10 years, ranging from 4 to 13 years. The description of their attacks were abnormal involuntary movements provoked by sudden movements, without loss of consciousness. Five patients exhibited dystonia, two patients exhibited choreoathetosis, and three patients had mixed (dystonia and choreoathetosis) dyskinesias. The duration of the attacks lasted for 3 to 30 seconds. The frequency ranged from once per month to twenty times per day. PRRT2 mutations, c. 649_650insC (p. R217PfsX8), were found in all the four PKD families. Mutation c. 649_650insC was also detected in two of the six sporadic PKD cases, inheriting from their asymptomatic mother.

CONCLUSIONThe onset age of PKD could be in the early childhood. The clinical features of the familial cases and sporadic cases showed no difference. The attacks manifested as dystonia, choreathetosis, or mixed. PRR2 mutations could be identified in familial or sporadic cases with PKD. Mutation c. 649_650insC is the hotspot mutation of PRRT2 gene.

Adolescent ; Child ; Child, Preschool ; DNA Mutational Analysis ; Dystonia ; genetics ; Humans ; Male ; Membrane Proteins ; genetics ; Mutation ; Nerve Tissue Proteins ; genetics