Objective The purpose of this study was to evaluate the value of contrast-enhanced ultrasound in diagnosis of renal cell carcinoma subtyping.Methods 206 cases with renal tumors were confirmed by pathology and surgery from June 2012 to June 2014,including 113 male cases and 93 female cases.The mean age was 54 years (range 23-80 years).The subtype of renal tumor included clear cell carcinoma in 147 cases,papillary cell carcinoma in 32 cases,chromophobe cell carcinoma in 27 cases.All patients were received the CEUS before operation.The enhancement patterns,degree of enhancement,the appearance of necrosis and the time-intensity curve by contrast-enhanced ultrasound were analyzed.Results Enhancement patterns of CEUS were showed by fast in and fast out in 63.9％ (94/147)cases with clear cell carcinoma,59.4％ (19/32) cases with papillary cell carcinoma,51.9％ (14/27) cases with chromophobe cell carcinoma.Statistical significant diference was shown among those subtype groups (P ＜ 0.05).Most of the clear cell carcinomas (127/147,86.4％) showed hyperenhancing.While,the papillary renal cell carcinoma (22/32,68.8％) and chromophobe cell carcinoma (15/27,55.6％) showed hypoenhancing (P ＜ 0.05).The rate of necrosis in clear renal cell carcinoma was 62.6％ (92/147),and 59.4％ (19/32) in papillary cell carcinoma.necrosis area accounted for only 18.5％ (5/27)in chromophobe cell carcinoma (P ＜ 0.05).In the time-intensity curve analysis,the initial time,the average arrival time,the time to peak and area under the curve in renal cortex was (11.06 ± 2.75) s,(23.42 ± 2.79) s,(27.47 ± 3.02) dB,(35.01 ± 2.94)dB,respectively.Significant differences in those items were found in clear cell carcinoma,which was(8.01 ± 1.89) s,(20.05 ± 3.01) s,(30.03 ± 2.98) dB,(37.64 ± 4.01) dB respectively,compared with those in cortex (P ＜ 0.05).The arrival time,time to peak,peak intensity and area under the curve in papillary cell carcinoma were (1 1.12 ± 2.43) s,(27.29 ± 3.54) s,(20.13 ± 2.67) dB,(34.67 ±3.24) dB,respectively.The curve showed the time to peak was higher and the peak intensity were lower than those of renal cortex (P ＜0.05).The arrival time,time to peak,peak intensity and area under the curve in chromophobe cell carcinoma were (11.32 ± 2.90) s,(22.21 ± 3.62) s,(22.02 ± 2.52) dB,(28.67 ± 3.65) dB,respectively.The curve demonstrated peak intensity and area under the curve were lower than those of surrounding renal cortex (P ＜ 0.05).The increase of tumor diameter after contrast-enhanced ultrasound in clear cell carcinoma was about (0.35 ± 0.11)cm and in nonclear cell carcinoma was about (0.23 ± 0.10) cm (P ＜ 0.05).Conclusion The contrast-enhanced ultrasound played an important role in diagnosis and subtype renal cell carcinoma.

Humans ; Ligands ; Neoplasm Invasiveness ; physiopathology ; Neoplasm Metastasis ; physiopathology ; Neoplasms ; metabolism ; Receptors, CCR7 ; metabolism

OBJECTIVETo investigate the factors influencing the pregnancy outcomes of artificial insemination with donor sperm (AID), improve the pregnancy rate, and evaluate the safety of the offspring.

METHODSWe retrospectively analyzed 7,761 cycles of AID for 5,109 infertile couples performed between July 1, 2005 and June 30, 2013 in the Center of Reproductive Medicine of Shenyang No 204 Hospital, the outcomes of pregnancy, and the incidence of birth defects.

RESULTSTotally, 2 252 clinical pregnancies were achieved by AID, in which the pregnancy rate per cycle was 29. 02% and the cumulative pregnancy rate was 44. 08%. The clinical pregnancy rate was remarkably higher in the females of ≤ 35 years than in those of > 35 years old (30.31% vs 20.18%, P < 0.01), in the women with < 5-year infertility than in those with > 5-year infertility (30.83% vs 28.16%, P < 0.01), and in the patients of the ovarian stimulation group than in those of the natural cycle group (33.22% vs 28.68%, P < 0.01) The clinical pregnancy rate was the highest in the first treatment cycle (29.87%), with statistically significant difference from the fourth cycle (23.61%) (P < 0.05), but not between the other cycles (P > 0.05). There were 28 cases of birth defects in the offspring (1.40%), including 6 cases (21.43%) involving the cardiovascular system, 4 (14.29%) involving the musculoskeletal system, 3 (10.71%) involving the urogenital system, 3 (10.71%) involving the central nervous system, 2 cases (7.14%) of cleft lip and palate, 2 (7.14%) involving the respiratory system, 2 (7.14%) involving the gastrointestinal digestive system, and other anomalies.

CONCLUSIONFemale age, infertility duration, and ovarian stimulation treatment are important factors influencing the clinical pregnancy rate of AID. Artificial insemination with cryopreserved donor sperm does not increase the incidence of birth defects, which is considered as a relatively safe technique of assisted reproduction.

Adult ; Cryopreservation ; Female ; Humans ; Infertility ; Insemination, Artificial, Heterologous ; methods ; Male ; Maternal Age ; Ovulation Induction ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Retrospective Studies ; Semen Preservation ; methods ; Spermatozoa ; Time Factors

Background Excimer laser corneal refractive surgery is widely used because it reduces the dependency of refractive error eye to glasses.However,the adverse effects of anti-inflammatory drugs is a problem after operation.Lotemax eyedrops is a kind of steroidal anti-inflammatory drug,with a good effect on the operative eye.But its influence on intraocular pressure(IOP) after long-term topical administration is less studied.Objective This study was to investigate the influence of lotemax eyedrops on IOP after long-term topical administration in myopic eyes received excimer laser corneal refractive surgery.Methods An one-month retrospective case serial study was adopted.The case history data of 1552 eyes from 1552 Patients who received excimer laser corneal refractive surgery were collected in Tangshan Eye Hospital from 2011 January to 2012 January,including 321 eyes with laser in situ keratomileusis(LASIK),608 eyes with sub-Bowman keratomileusis (SBK) and 623 eyes with femtosecond laser for flap excimer laser in situ keratomileusis(FS-LASIK).Lotemax eyedrops was topically administered after operation 4 times per day initial and then decreased 1 time weekly for 1 month.IOP was measured in before,1 week,2 weeks,3 weeks,4 weeks after operation with non-contact tonometer.The increasing range of IOP was divided into ＜5 mmHg,5-15 mmHg and ＞ 15 mmHg after operation.Optical head parameters were measured by Heidelberg retina tomography when IOP increasing after operation.Results Within 1 month,elevated IOP was found in 47 of 1552 eyes after administration of lotemax eyedrops,including 3.12％ (10/321) in the LASIK group,3.29％ (20/608) in the SBK group and 2.73％ (17/623) in the FS-LASIK group,without significant difference among them(x2 =1.95,P＞0.05).The IOP elevated 1 week after operation and remained normal after that till drug withdrawal in all eyes.There were no significant differences in the disk area (1.65 ±0.44) mm2 vs.(1.66 ±0.44) mm2,disk volume (0.40 ±0.09)mm3 vs.(0.39±0.08) mm3 and mean nerve fiber layer thickness (0.28 ± 0.08) mm vs.(0.29 ± 0.07) mm in IOP elevation duration compared with 1 month after IOP recovery(t =0.34,0.81,0.48,P＞0.05).Conclusions Topical administration of 0.5％ lotemax eyedrops after excimer laser corneal refractive surgery leads to reversible high IOP.It is very important to monitor the IOP during use of the drug.

OBJECTIVEThe clinical effect of the Shi's cervical reduction technique for cervical spondylosis and related disorders has confirmed, however, there were few studies on the body motion during manipulation in vivo study. This study is to summary the law of motion and the motion characteristics of the right operation shoulder, elbow, knee and ankle joints by data acquisition and analysis with the 3D motion capture system.

METHODSThe markers were pasted on the head, trunk, left and right acromion, elbow joint, wrist joint inner side and the outer side of the inner and the outer side and the lateral upper arm, forearm lateral, anterior superior iliac spine, posterior superior iliac spine, trochanter, femoral and tibial tubercle, inner and outer side of knee, ankle, fibular head, medial and lateral in first, 2,5 metatarsal head, heel and dual lateral thigh the calf, lateral tibia of one manipulation practioner, and the subject accepted a complete cycle of cervical "Jin Chu Cao and Gu Cuo Feng" manipulation which was repeated five times. The movement trajectory of the practioner's four markers of operation joints were captured, recorded, calculated and analyzed.

RESULTSThe movement trajectories of four joints were consistent, while the elbow joint had the biggest discrete degree. The 3D activities of the shoulder and elbow were more obvious than other two joints, but the degree of flexion and extension in the knee was significantly greater than the rotation and lateral bending.

CONCLUSIONThe flexibility of upper limb joint and stability of lower limb joint are the important guarantees for the Shi's cervical reduction technique, and the right knee facilitated the exerting force of upper limb by the flexion and extension activities. The 3D model built by the motion capture system would provide a new idea for manipulation teaching and further basic biomechanical research.

Adult ; Biomechanical Phenomena ; Cervical Vertebrae ; surgery ; Humans ; Male ; Manipulation, Orthopedic ; methods ; Movement

OBJECTIVETo study the effect of electro-acupuncture (EA) in regulating calcium (Ca2+) content in brain neurocytes of rats with focal cerebral ischemia.

METHODSThe changes of Ca2+ content in ischemic neurocytes were observed by using laser confocal scanning microscope.

RESULTSCa2+ content did not change significantly in cerebral cortex when the brain ischemia occurred for 1 hr, but it raised significantly in striatum neurocytes. Both the Ca2+ contents in striatum and cortex area increased significantly 3 hrs after ischemia occurrence and the content in striatum was higher than that in cortex significantly. Brain Ca2+ content could be reduced significantly after the 3 hrs ischemic brain were treated by EA for 30 min.

CONCLUSIONEA could regulate the content of Ca2+ in the ischemic area of brain, inhibit Ca2+ overload, so as to protect neurons from ischemic injury.

Animals ; Biological Transport, Active ; Brain ; metabolism ; pathology ; Calcium ; metabolism ; Electroacupuncture ; Infarction, Middle Cerebral Artery ; metabolism ; pathology ; Male ; Microscopy, Confocal ; Neurons ; metabolism ; Random Allocation ; Rats ; Rats, Wistar

The definition of critical quality attributes of Chinese materia medica ( CMM) was put forward based on the top-level design concept. Nowadays, coupled with the development of rapid analytical science, rapid assessment of critical quality attributes of CMM was firstly carried out, which was the secondary discipline branch of CMM. Taking near infrared (NIR) spectroscopy as an example, which is a rapid analytical technology in pharmaceutical process over the past decade, systematic review is the chemometric parameters in NIR model evaluation. According to the characteristics of complexity of CMM and trace components analysis, a multi-source information fusion strategy of NIR model was developed for assessment of critical quality attributes of CMM. The strategy has provided guideline for NIR reliable analysis in critical quality attributes of CMM.
Materia Medica ; standards ; Medicine, Chinese Traditional ; standards ; Spectroscopy, Near-Infrared ; methods

Astragalus membranaceus ; chemistry ; Cell Line ; Cytokines ; metabolism ; Humans ; Inflammation ; Macrophages ; drug effects ; metabolism ; Monocytes ; drug effects ; metabolism ; Polysaccharides ; pharmacology

Objective To explore the effect of Bailing capsule on epithelial-mesenchymal transition( EMT) in rats with adenine-in-duced tubulointerstitial fibrosis. Methods Tubulointerstitial fibrosis animal models were established and SD rats were divided into mo-del group ( n = 30), treatment group ( n = 30) and control group( n = 30), randomly. Experimental rats were harvested at 7 w, 12 w,17 w after onset of experiment and functional evaluations were performed. Histology, immunohistology were examined to investigateboth histolopathology changes and the expression of bone morphogenic protein-7 (BMP-7), transforming growth factor-β1 (TGF-β1 )and a-smooth muscle actin (α-SMA) in kidneys at three time points mentioned above, respectively. Results Compared with controlgroup, 24 h urinary protein in model group lost increasingly and significantly difference appeared at three time points relative to controlgroup ( P ＜ 0.01 ). Urinary NAG in model group was markedly higher than that in control group from 7 w after onset (P ＜ 0.01 ) andwas increasingly raised at 12 w and 17 w (P＜0.01). The value of blood BUN and Cr in model group increased at 7 w (P＞0.05) rel-ative to control group. There was significant difference at 12 w and 17.w (P ＜ 0.01 ). Histologically, kidneys in model group, at 7 w,exhibited tubular casts and gently tubular dilation, granuloma in cortex, mononuclear cells infiltration in tubulointerstitial areas, andmild interstitial fibrosis. At 12 w, the degree of tubular injury and tubulointerstitial fibrosis gradually aggravated. Up to 17 w, diffusetubular dilation or atrophy was observed and focal tubules disappear. Diffuse interstitial fibrosis was exhibited. In normal kidneys, im-munohistochemistry suggested that the light expression of BMP-7 was detected in proximal renal tubular epithelial cells and marked ex-pression was identified in distal tubule, collecting duct, and renal tubular epithelial in junction area between cortex and medulla. How-ever, the expression of BMP-7 in kidneys of model group significantly decreased with increasing tubulointerstitial fibrosis and was nega-tive correlation with the expression of TGF-β1(r = -0. 981 P＜0.01) and α-SMA (r= -0.975 P＜0.01). Bailing capsule ad-ministration protected the expression of BMP-7 and reduced TGF-β1 and α-SMA expression before 12 w(P＜ 0.01 ). Conclusions Ourstudy shows an anti-fibrotic reno-protective function of Bailing capsule in rats with tubulointerstitial fibrosis via prevention of epithelial-mesenchymal transition at early stage. However, the beneficial effect lost with increasing tubulointerstitial fibrosis.

Objective To explore the diagnostic value of ultrasound guided fine needle aspiration biopsy (US-FNAB) for thyroid imaging reported and data system (TI-RADS) 4 class ≤ 10 mm thyroid nodules.Methods The preoperative ultrasound features of patients with thyroid nodule who received USFNAB examination were retrospectively analyzed,the malignant risk of each nodule was evaluated and classified according to TI-RADS.TI-RADS 4a class thyroid nodules and diameter ≤ 10 mm of 365 patients were classified as suspicious nodules and received US-FNAB examination.The nodules were classified as ＜5 mm and 5-10 mm groups.The results of cytologic diagnosis were compared with the pathological diagnosis,and the differences for nodules with different size were analyzed.Results Among 365 TI-RADS 4 class thyroid nodules diagnosed by the cytology,68 nodules were malignant;81 nodules were suspicious of malignancy;193 nodules were benign;6 nodules were unsatisfactory;and 17 nodules were undetermined.According to postoperative pathology or follow-ups,153 nodules were malignant and 212 nodules were benign.The difference between US-FNAB results and pathology was not significant (P ＞ 0.05).Cytologic positive rate and actually malignant rate of the nodules in 5-10 mm group were higher than ＜ 5 mm groups (P ＜ 0.05).The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of US-FNAB cytological diagnosis of TI-RADS 4 class thyroid nodule were 92.2％,96.2％,94.6％,94.4％and 94.5％,respectively.Conclusion US-FNAB examination is valuable for the diagnosis of TI-RADS 4a class thyroid nodules and improves the preoperative diagnosis.