Objective To identify the value of multiparametric MR imaging features including diffusion weighted (DW) and dynamic contrast-enhanced (DCE) MR imaging features in differentiation between inverted papilloma and malignant transformation of inverted papilloma in the sinonasal region.Methods Seventy-seven patients were included in this study,including 12 malignant transformation of inverted papilloma and 65 inverted papillomas.Conventional MRI including nonenhanced and static contrast-enhanced imaging,DCE-and the DW-MRI were analyzed.Differences in conventional MRI features,ADCs and DCE-MRI parameters between the two entities were determined by Fisher exact test,independent samples t-test and Mann-Whitney U test,respectively.Results There were significant differences in convoluted cerebriform pattern (P=0.045),necrosis (P=0.003) and orbit involvement (P＜ 0.01) between inverted papilloma and malignant transformation of inverted papilloma in the sinonasal region.The ADCs of inverted papilloma were significantly lower than those of malignant transformation of inverted papilloma (P＜0.01).There were significant differences in time to peak enhancement (P＜0.01),maximum contrast index (P=0.004) and time intensity curve types (P＜0.01) between the two entities.Conclusions A multiparametric approach using conventional MR imaging with added ADCs and DCE-MRI parameters had the potential to improve the differentiation between inverted papilloma and malignant transformation of inverted papilloma in the sinonasal region.

Objective To assess the effect of a noninvasive equipment (the human biological stimulation feedback instrument) for the screening of metabolic syndrome (MS). Methods The samples were selected from the International Health Care Center of the Second Affiliated Hospital of Zhejiang University College of Medicine. From January to December 2012, according to the inclusion criteria, a total of 5674 consecutive participants (3 437 men, 2 237 women) without medical history of diabetes mellitus underwent general health screening in this hospital, which included questionnaire investigation, all MS components and the risk assessment of the human biological stimulation feedback instrument. MS was defined according to 2004 the Chinese Diabetes Society (CDS) criteria. Results The 5 674 subjects were divided into three groups in accordance with the human biological stimulation feedback instrument risk score: the normal group, metabolic abnormalities low risk group, metabolic abnormalities high risk group. The detection rate of MS corresponding to the three groups was 8.73% (251/2 876), 29.32% (612/2 087), 32.77% (233/711), respectively (trend χ2=372.14,P<0.001). With the increase of risk score, the detection rate of MS increased. A total of 1 096 (male 879, female 217) were diagnosed MS by CDS criteria. The area under the curve (AUC) of the test was 0.674 (95%CI 0.658-0.691, P<0.000 1)for predicting MS. The corresponding cutoff value was 25.00%, the sensitivity, specificity, positive predictive value and negative predictive value of diagnosis of MS was 77.80%, 56.00%, 30.20%and 91.30%, respectively;409 subjects who had no history of MS and diabetes mellitus follow up for two years, the AUC of the test was 0.719 (95%CI 0.644-0.794)for predicting MS. The corresponding cutoff value was 25.00%, too. And the sensitivity and specificity of diagnosis of MS was 78.00%and 59.80%, respectively. The detection rate of MS was positively correlated with the risk score. Conclusion We found that the human biological stimulation feedback instrument is a potential screening approach for early predicting MS in health checkup with simple and noninvasive procedure and high negative predictive value, although its diagnostic efficiency is not so good. And it might have a warning effect on the progress of MS.

Objeictivie To investigate the diagnostic value of anti-mutated citrullinated vimentin (anti-MCV) antibody, anti-cyclic citrullinated peptide (anti-CCP) antibodies and glucose-6-phospha-teisomerase (GP1) for rheumatoid arthritis (RA). Methods Anti-MCV antibody, GPI and anti-CCP antibody were detected in serum samples of 109 RA patients, 24 non-RA rheumatic diseases patients and 19 healthy blood donors. The sensitivity and specificity of these parameters for the diagnosis of RA were analyzed. Results Both the positive rate and average cut off concentration of anti-MCV and GPI in RA were higher than those of non-RA rheumatic diseases or healthy controls (P<0.05). A significant difference was found between anti-MCV and GPI in RA patients. The most sensitive and specific parameter in RA was anti-MCV (99.1%) and anti-CCP (90.7%) respectively, but, when anti-MCV combined with anti-CCP, or GPI or anti-CCP and GPI, the specificity could be up to 98.1%. Coniclusions Anti-MCV, anti-CCP and GPI alone or in combination may be valuable parameters for the diagnosis of RA.

BACKGROUND: What are the influencing factors of serum uric acid of inhabitants from coastal area? What is the critical concentration of serum uric acid to prevent and treat metabolic syndrome?OBJECTIVE: To probe into the relationship between serum uric acid and metabolic syndrome in female inhabitants aged more than 20 years from coastal area of Shandong province.DESIGN: A clusting stratified random sampling survey.SETTING: Department of Endocrinology, Affiliated Hospital of Medical College of Qingdao University.PARTICIPANTS: The survey was carried out in the female inhabitants of five cities from coastal area of Shandong province (Qingdao, Rizhao, Yantai, Weihai and Dongying) between May and October 2004. The inhabitants, aged 20 to 80 years, lived there for 5 or more than 5 years, and they were natural crowd taking family as unit.METHODS: Investigations in the manner of entering every family and being on the spot were combined. Questionnaires were filled in on the first day, and fasting blood was taken to perform serum uric acid examination on the morning of the second day. For those with serum uric acid higher than normal, they were given rechecking on the third day, and education about prevention and treatment of gout and hyperuricemia was conducted at the same time.MAIN OUTCOME MEASURES: ① Investigation on general condition:Including health status, diet, physical activity, labour intensity and economics. ② Investigation on nutrition: Consists of food intake frequency and dietary. ③ Body height, body mass, waistline, hip circum, blood pressure and body mass index. ④ Levels of fasting blood glucose(FBG), serum uric acid, total cholesterol (TC), triacylglycerol (TG), high-density lipoprotein cholesterol(HDL-C), urea nitrogen (UN) and creatinine(Cr).RESULTS: ① With the increase of concentration of serum uric acid, levels of systolic pressure (SP), diastolic pressure (DP), pulse pressure (PP),body mass index(BMI) , waistline, waist-to-hip ratio(WHR), UN, Cr, TG,TC were all gradually increased. Each index was significantly higher in the serum uric acid 280-319 μmol/L group, serum uric acid 320-349 μmol/L group and serum uric acid ＞ 350 μmol/L group (hyperuricemia group)than that in serum uric acid ＜ 280 μmol/L (P ＜ 0.05-0.01 ), While the concentration of HDL-C was decreased with the increase of concentration of serum uric acid (all P ＜ 0.01). ② The incidence of hypertension, lipid metabolic disorder, overweight and obesity, glycometabolism disorder as well as metabolic syndrome was increased with the increase of uric acid;Compared with serum uric acid ＜ 280 μmol/L group, OR value of metabolic syndrome was 2.29(95%CI: 1.81-2.89),4.15(95%CI:3.10-5.55),4.96 (95%CI:3.85-6.39) in the serum uric acid 280-319 μmol/L group,320-349 μmol/L group and hyperuricemia group , respectively. ③Noncondition Logistic multiple stepwise regression analysis showed that age,hypertension, shellfish intake volume, UN, Cr, TG and WHR and light physical activity were the independent risk factors for female patients with hyperuricemia and HDL-C was protective factor.CONCLUSION: The incidence of metabolic syndrome is increased with the increase of concentration of serum uric acid in female inhabitants from coastal area of Shandong province. 280 μmol/L should be as the critical concentration of serum uric acid to prevent and treat metabolic syndrome.Controlling metabolic syndrome and reducing intake of shellfish and other marine products which contain high level of purine is one of means to prevent hyperuricemia. Clinical physicians should paid more attention to the pathopoiesis of hyperuricemia.

Objective To analyze the miss rates of colorectal adenomas during colonoscopy as well as risk factors influencing the adenoma miss rates and to take corresponding measures. Methods A total of 432 patients who underwent index and follow-up colonoscopy in 18 months were randomized and investigated. The results of two colonoscopies were compared and the missed adenomas were defined as the adenomas de-tected only during the second colonoscopy. Miss rates were calculated according to patient-based methods. Chi-square test was used to analyze the relative factors influencing the adenoma miss rate of per-patient. Then the meaningful factors were chosen into the logistic regression model for multiple factors analysis. Results Of 432 patients,116(26. 9%)had missed adenomas on first colonoscopy. Single factor analysis found that the size of adenoma( χ2 = 89. 686,P = 0. 000),the shape of adenoma( χ2 = 68. 488,P = 0. 000),the location of adenoma(χ2 = 77. 055,P = 0. 000)and adenoma tissue types(χ2 = 417. 000,P = 0. 000)were the risk factors for miss rates of colorectal adenomas. Number of polyps(χ2 = 8. 450,P= 0. 038),the organi-zation type of polyp(χ2 = 10. 718,P= 0. 013)and proficiency of colonoscopists(χ2 = 56. 069,P= 0. 000), the quality of bowel preparation(χ2 = 39. 195,P = 0. 000),insertion time(χ2 = 13. 133,P = 0. 001)were also the risk factors for miss rates of colorectal adenomas. Logistic regression analysis showed that the bigger the adenoma size,the less missed adenomas(OR= 0. 341,95%CI:0. 173-0. 671). Also,the longer insertion time took,the lower the adenoma miss rate(OR = 0. 987,95% CI:0. 981-0. 994). Per-patient miss rates were lower for high-risk adenomas compared with low-risk adenomas(OR = 0. 324,95%CI:0. 154-0. 680). Adenomas happening in multiple parts of bowel easily leads to missing(OR= 3. 791,95%CI:1. 505-9. 546). Conclusion The missed diagnosis of adenomas is not only significantly associated with features of missed adenomas,but also with skills of colonoscopists,insertion time,and bowel preparation. The key is high-quality index colonoscopy to avoid adenomas missing.

Objective: To compare hemodynamic effects of infusion of diethylamine/nitric oxide (DEA/NO)and sodium nitroprusside(SNP)during controlled hypotension. Method: General anesthesia was induced in dogs. The twelve healthy adult dogs were randomly assigned into one of two groups. 0.00l％ DEA/NO or 0.01％ SNP was infused to induce mean arterial pressure(MAP) to decrease to 60％ of baseline and be maintained for 30 min. During hypotension, MAP,central venous pressure (CVP), mean pulmonary artery pressure (MPAP)and cardiac output (CO) were measured and recorded. Arterial blood gas, blood lactate and urine output were also measured. Result: HR,CVP and CO were unchanged during hypotension period in both groups, MPAP decreased correspondently with MAP. There were no significantly changes in arterial blood gas,blood lactate and urine output in both groups during hypotension. Conclusion: Controlled hypotension achieved with infusion of DEA/NO has a rapid onset and short duration of action.The hemodynamics were similar to those of SNP.

Objectives:To study the pathological behavior and the value of transforming growth factor β1(TGF-β1) in predicting prognosis in pulmonary hypertension associated with congenital heart disease.　Methods:Lung tissues from 29 patients with congenital heart diseases associated with pulmonary hypertension were examined by surgical biopsy of the lung. All samples were examined for the expression and localization of TGF-β1 by immunohistochemical technique with anti-TGF-β1 antibody.　Results:Twenty-six out of 29 showed positive staining of intracellular endotheliocyte TGF-β1(89.65%),16 samples showed extracellular matrix TGF-β1 staining(55.17%).Statistically, there was significant difference between Ⅰ～Ⅱ and Ⅲ～Ⅵ pathological degrees in extracellular matrix(P<0.05).　Conclusions: TGF-β1 plays an important biological role in the formation of pulmonary hypertension after congenital heart disease. It is conductive in predicting prognosis.

Objective To analyze the clinical features of differentiated thyroid cancer diagnosed during pregnancy or one year after delivery.MethodsA total of 234 women with differentiated thyroid cancer were treated from January 2001 to January 2011.Cases were divided into three groups according to the time of tumor diagnosis( group 1,no pregnancy history; group 2,during pregnancy or in the first year after delivery;group 3,longer than 1 year after the delivery).ResultsThe thyroid nodule was asymptomatic and discovered on routine examination more often in group 2(78.7％ ) than other two groups (P =0.02).There were no significant difference among three groups in age,hospitalization time,operation time,operation method,tumor type,primary tumor stage and mortality. But more patients in group 2 were suffering from extrathyroid invasion ( P =0.024 ),multi-focal cancer ( P =0.023 ),larger cervical lymph node ( P =0.021 ),later regional lymph node stage (P =0.020 ) and higher local recurrence (P =0.001 ).By stepwise logistic regression analysis,pregnancy is one of the factors impacting on local recurrence rate ( P =0.045 ).ConclusionsPregnancy does not affect the mortality of the differentiated thyroid cancer,but the incidence of extrathyroid invasion,multi-focal cancer,cervical lymph node metastasis,local recurrence is higher in patients with differentiated thyroid cancer diagnosed during pregnancy.

Female ; Glioma ; pathology ; Humans ; Neoplasms, Germ Cell and Embryonal ; pathology ; Ovarian Neoplasms ; pathology ; Peritoneal Neoplasms ; pathology ; Teratoma ; pathology

Objective To investigate the effects of high-fat diets and rosiglitazone treatment on the expressions of peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α) and mitofusin-2 (Mfn2) in skeletal muscle of aged rats. Methods Male wistar rats aged 21-23 months were randomly divided into old control group (OC; n=20), high-fat diets group (HF; n=20) and high-fat diets plus rosiglitazone treatment group (RSG; n=20). Male wistar rats aged 4-5 months were selected as young control group (YC; n=20). Insulin sensitivity was evaluated by hyperinsulinemic-euglycemic clamp technique at the end of the 4th and 8th week. The expressions at mRNA and protein levels of PGC-1α and Mfn2 in skeletal muscle were determined by polymerase chain reaction and Western blotting technique. Results (1)After 8 weeks, the levels of free fatty acid [(0. 68±0. 18)mmol/L, (0.82±0. 23) mmol/L and (1. 53±0.40) mmol/L], triglyceride [(0.53±0.13) mmol/L,(0. 63±0. 17) mmol/L and (1.08±0.30) mmol/L]and muscle triglyceride [(1.09±0.17) mmol/L,(1.34±0. 20) mmol/L and (2.07±0. 30) mmol/L]in YC group, OC group and HF group were significantly increased and glucose infusion rate [(30.4±4. 2) mg·kg~(-1)·min~(-1), (20.9±2.2) mg·kg~(-1)·min~(-1) and (12. 0±1.9) mg·kg~(-1)·min~(-1)]was significantly decreased as compared with pre-high fat diet, respectively. The levels of fasting free fatty acid [(0.93±0.29) mmol/L], triglyceride [(0.62±0.12) mmol/L]and music triglyceride [(1.68±0.28) mmol/L]in RSG group were significantly decreased and glucose infusion rate [(16.7±1.7) mg·kg~(-1)·min~(-1)]was significantly higher than in HF group. (2)In skeletal muscle, the expressions at mRNA and protein levels of PGC-1α and Mfn2 decreased in OC group compared with YC group (all P<0.01). The expressions of PGC-1α and Mfn2 were lower significantly in HF group than in OC group, and were higher significantly in RSG group than in HF group (all P<0.01). Conclusions The aged rats fed the high-fat diets develop insulin resistance with decreased expressions of PGC-1α and Mfn2 in skeletal muscle. Insulin sensitivity is improved with rosiglitazone treatment by increasing expressions of PGC-1α and Mfn2 in skeletal muscle.