?Objective:To study apoptosis and apoptotic mechanisms of buccal carcinoma cells(BCCs) induced by anticancer agents.Methods:34 cases of buccal carcinoma were treated with pinyangmycin or pinyangmycin combined with other anticancer agents.The samples of the lesions were examined by in situ terminal deoxynucleotidyl transferase (TDT) mediated dUTP nick end labeling (TUNEL) before and after chemotherapy.Apoptotic cells were detected in parraffin embedded buccal cancer specimens from the patients.Apoptotic index (AI) were respectively quantified in prechemotherapy and postchemotherapy specimens of each patient.Fas expression was examined by SP immunohistochemical staining in each specimen.Results:The mean of AI in the samples of prechemotherapy and in those of postchemotherapy were 0.38 and 0.91 ( P

Objective To analyze the image noise and artifact of low-dose chest CT scanning and the distribution pattern. Methods A chest phantom equivalent to human tissue was scanned by 64 slices spiral scanner at standard dose (250 mAs) and low-dose (50, 30,and 21 mAs) respectively, HU in sites of the phantom and SD of which was recorded. 200 patients with pulmonary nodules were scanned at 30 or 21 mAs for minimal length. The relationship between severity of noise and artifact in chest low-dose CT scanning and gender or body mass index (BMI) of the patients, as well as the distribution of noise and artifact was evaluated. Results There was no statistical difference between the HU in sites of the phantom: lung (-777.3-- -758.2 HU, F=0.992, P<0.01), chest wall (107.9--111.3 HU, F=2.044, P>0.05), vertebra (835.6--875.3 HU, F=1.453, P>0.05), while the SD of which was of statistical signification: lung (9.5--29.0 HU, F=108.7, P<0.01), chest wall (10.1--32.4 HU, F=84.3, P<0.01), vertebra (19.2--57.1 HU, F=30.6, P<0.01),tbe SD increased with the decrease of the tube current. There was no statistical difference between male (in which 74 cases no or mild, 17 cases severe)and female (81 cases no or mild, and 28 cases severe)in image noise and artifact in low-dose images (X~2=2.294, P>0.05), and significant difference between groups of different BMI(in BMI<18.5 group, 29 cases no or mild,2 cases severe, in group of 18.5≤BMI<24.0, 120 cases no or mild, 13 cases severe, and in group of BMI≥24.0, 6 cases no or mild, 30 cases severe, X~2=128.274, P<0.01). The noise andartifact was greater in the upper (80 cases no or mild, 38 cases severe, X~2=18.918, P<0.01) and dorsal field (89 cases no or mild, 33 cases severe, X~2=6.760, P<0.05). Conclusions The image noise and artifact was significant in low-dose CT, especially in the dorsal and upper field of the lung, which might be attributed to the distribution of skeleton in the chest. It was recommended that scanning protocol (mAs value) be individualized adjusted in according to the patients BMI.

Objective To evaluate the sensitivity and optimized scanning parameter of 64-slice spiral CT in detection of pulmonary nodules with different size and density. Methods Three groups of prosthesis nodules with diameter of 2.5～13 mm and different density (soft-tissue, low density, and ground glass opacity,GGO)were taken into the chest phantom equivalent to human tissue,then scanned with Philips Brilliance 64 scanner in standard dose(tube voltage:120 kV, tube current: 250 mAs)and low-dose(tube voltage:120 kV, tube current: 50, 30,and 21mAs) respectively. The radiation dose(CTDIw and DLP) of the scans, Hounsfield unit(HU) and standard deviation(SD) of CT values in different regions of the phantom, and visibility of the nodules was assessed and recorded.Results The radiation dose of 64-slices spiral CT scanning in low-dose(tube current 21～51 mAs) decreased to 8%～20% of which scanning in standard-dose(250 mAs). There was no statistical difference between the CT values in different regions of the phantom (P>0.05), while the SD of CT values was of statistical significantce (P<0.001) and SD increased with the increment of the density under different scanning parameters. None of the nodules besides of GGO nodules with 2.5 mm and 4 mm in size scanned at 21 mAs was invisible. Conclusion GGO nodules of 2.5 mm in diameter can be detected with 64-slice spiral CT using 30 mAs at experimental study, which might be the optimized dose for detecting pulmonary nodules.

Objective To discuss whether it is necessary to integrate metabolic indices into diagnosis of polycystic ovary syndrome(PCOS).Methods Taking ESHRE /ASRM diagnosis standard as gold standard,the case group composed of 51 women with PCOS and the control group composed of 47 women without PCOS were selected.By using classification tree C5.0,significant variables chosen by single factor analysis were used to establish a new diagnostic model which combined reproductive indices and metabolic indices.The validity and reliability of the new diagnostic model by using ROC curve analysis were evaluated.Finally,the consistence and difference between the new diagnostic model and the gold standard were analyzed.Results Single factor analysis chose 13 significant variables. ROC analysis showed an area under the curve of 0.930(P =0.000)and the optimal cut -off point was 0.190 with a sensitivity of 94.10%,a specificity of 91.50% and a consistency of 92.86%,which told us the new diagnostic model had superior validity and reliability.The two diagnostic methods had excellent consistence (Kappa =0.857,P =0.000)and there was no statistically significant difference (P =1.000).Conclusion Considering that whether metabolic indices are integrated into diagnosis of PCOS doesn′t change the diagnosis result,and it is unnecessary to integrate metabolic indices into diagnosis of PCOS.

Objective To study the effectiveness of the laboratory diagnosis of multiple myeloma(MM)patients with immun-ofixtion electrophoresis (IFE),protein electrophoresis (SPE)and immunoglobulins and light chain quantitative analysis. Methods Selected 192 MM patients and 30 healthy controls during June 2012 to December 2013 and analyzed the results of IFE,SPE and immunoglobulins,and light chain quantitative analysis in MM patients.Results M protein bands were seen in 120 cases (62.5%)by using SPE and M protein were positive in 174 cases (90.6%)among the 192 MM patients by using IFE.IFE showed that IgG were maximum type of the M protein (106 of 192,55.2%).There were IgG-λ type 66 cases (34.4%),IgA type 36 cases (18.8%)and free light chain type 24 cases (12.5%).Immunoglobulins of different immuno-phenotypes had higher than the nomal group with serum immunoglobulin and light chain quantitative analysis (P <0.05). The detection rate was 67.7% (130/192).Whateverκ-type M protein orλ-type M protein,the ratio ofκ/λwas significantly abnormal (P <0.05).The detection rate was 85.4% (164/192).Conclusion The better detection rate of immunological techniques such as immunofixtion electrophoresis and immunoglobulins quantitative analysis might provide valuable basis for the diagnosis and treatment of MM clinically and prevent misdiagnosis.

Objective To investigate the value of pathological examination in the diag-nosis of lethal cases due to acute poisoning.Methods The macroscopic and microscopic find-ings in 28 autopsy cases (10 cases of toxic gas,7 cases of pesticide,6 cases of drug,3 cases of alcohol and 2 cases of chinese herbal medicine) died of acute poisoning during the period from October,2001 to June,2012 were retrospectively reviewed.Results Gross Changes were found on gross examination in 22 of the 28 cases studied.Of them,7 cases died of acute carbon mono-xide poisoning had showed cherry red of Shiban,muscle,visceral organs and blood.In addition,11 and 8 cases had been found gastric mucosa hemorrhage and epicardium petechial hemorrhage respectively.Histologically,myocardial interstitial hemorrhage was observed in 9 cases,pulmonary hemorrhage in 18 cases,bronchospasm in 12 cases,cerebral hemorrhage in 4 cases,hepato-cyte necrosis in 11 cases,renal tubular necrosis in 7 cases and gastric mucosa hemorrhage in 11 cases.In 6 cases of oral pesticides poisoning,besides they had all gastric mucosa hemorrhage,the change of character of gastric contents was found in 3 cases and pesticide odor from stomach in 3 cases.In addition,acute inflammatory and necrosis of gastric wall in 6 cases of oral pesticides poisoning were observed under the light microscope.Drug addicts often suffered from chronic lesions in multiple organs,such as chronic liver disease,fatty infiltration of the myocardium with myocardial atrophy,interstitial lung disease and pulmonary foreign body granuloma.Conclusions Pathology examination is helpful in the diagnosis of some lethal cases due to acute ooisoning,and it can provide pathological basis to study on treatment of acute poisoning.

Objective To evaluate the efficacy of using dual laser system in off clamp nephronsparing surgery.Methods We used dual laser system in the patients who underwent off-clamp NSS between Jan 2016 and Apr 2016 in our institution.There were 16 males and 8 females with average age of 49 years.Mean tumor size was 1.9 cm (range 0.8-3.2 cm).The mean R.E.N.A.L.score was 3.8 (range 3-6).The mean Zhongshan score was 3.5(range 3-5).The mean ZⅡ(zero ischemia index)was 1.6(range 1-4).The Evolve Dual (980 nm/1 470 nm) laser system set at 60 W in continuous mode was used.Results Offclamp NSS was successfully performed in 22 patients except for renal artery occlusion in 2 case.Mean operative time was 74 min(range 50-100 min);The average estimated blood loss was 52.9 ml(range 10-200 ml);Mean postoperative drainage was 65.4 ml(range 20-150ml);Mean postoperative hospital stay was 5.2 days (range:4-7days).No severe post-operative complication was found.The mean pre-and postoperative serum creatinine levels were 76.2 μmol/L(range:48-112μ mol/L) and 81.5μ mol/L(range:54-122 μ mol/L) with no significant difference(P ＞0.05).The postoperative pathology indicated that 20 cases of clear cell carcinomas,3 cases of chromophobe renal cell carcinomas,one case of papillary carcinoma.Conclusions Dual laser system can be used in off clamp nephron-sparing surgery safely and effectively.

Objective To study X-ray, CT and MRI features of the spinal giant cell tumors (GCT)and to assess the clinical applied value.Methods Thirty cases of GCT of spine (13 males and 17 females with ages ranging from 17 to 69 years) were reviewed. Allcases underwent radiography,CT was done in 22 patients and MRI was performed in 16 cases.Results One lesion localized in cervical spine,10 in thoracic, 6 in lumbar and another 13 lesions in the sacrum.Osteolytic destruction and vertebral compression were seen on X-ray film. The main CT signs were expanding bone destruction and soft tissue mass. MRI showed low to intermediate signal intensity on T_1WI while high signal on T_2WI.Conclusion X-ray, CT and MRI are of significant value in diagnosis of the spinal GCT, and play an important role in surgical planning.

Objective To enhance the understanding of MR imaging in neurosyphilis Methods One case of syphilitic gumma with positive treponemal antibody test in the serum was confirmed pathologically after operation, and the other case with positive treponemal antibody test in the cerebrospinal fluid (CBF) was cured by medical therapy Both patients were examined by MRI Results Syphilitic gumma has some characteristic MRI findings The roundish areas of low signal or mixed low and iso signal intensity were revealed on T 1WI with the diameter ranged from 2 0 cm to 2 5 cm The lesions were located at the cortex or infra cortex surrounded by obvious edema The lesions showed high signal or mixed signal made up of iso , high, and low signals on T 2WI Gd DTPA enhanced T 1WI demonstrated irregular circular enhancement on the edge of the lesions and abnormal neighboring meningeal enhancement, and the border of the lesions was angulated with neighboring meninges by obtuse angle Conclusion The final diagnosis of neurosyphilis should depend on laboratory examination or histopathologic examination, but neuroimaging suspicion is paramount to early detection and diagnosis of neurosyphilis

Objective To discuss whether it is necessary to integrate metabolic indices into diagnosis of polycystic ovary syndrome (PCOS).Methods Taking ESHRE/ASRM diagnosis as the gold standard,51 women with PCOS and 47 women without PCOS were selected and divided into the intervention group and control group respectively from the Department of Gynecology in the Second Affiliated Hospital of Kunming Medical University between January 2013 and July 2014.Logistic regression based on principal component analysis and significant variables chosen through single factor analysis were used to establish the new diagnostic model which combined reproductive indices and metabolic indices.We evaluated the validity and reliability of the new diagnostic model by using ROC curve analysis.Finally,we analyzed the consistence and difference between the new diagnostic model and the gold standard.Results Thirteen significant variables were chosen using single factor analysis.ROC analysis showed that an area under the curve was 0.976 (P＜0.001) and the optimal cut-off point was 0.526 with a sensitivity of 96.08％,a specificity of 93.62％ and a consistency of93.88％.The new diagnostic model had superior validity and reliability.The two diagnostic methods had strong consistence (Kappa=0.877,P＜0.001) and no difference (x2=0.167,P=0.688).Conclusion Considering that the integration of metabolic indices does not change the diagnosis result,we come to a conclusion that it is unnecessary to integrate metabolic indices into diagnosis of PCOS.