Objective To clarify diagnostic value of C-reactive protein (CRP) in the pathological types of acute appendicitis in children and the role of CRP as a surgical indication marker for appendicitis.Methods Two hundred and six patients who underwent appendectomies and had pathologically confirmed appendicitis were reviewed between January 2010 and February 2014,and they were divided into gangrenous appendicitis group(n =53) and non-gangrenous appendicitis group(n =153) by postoperative pathological type.The correlation between preoperative clinical factors and the actual histological severity,and identify surgical indication markers were assessed by multivariate analysis and ROC analysis.Results There were significant differences in white blood count(WBC),neutrophils percentage and CRP level between gangrenous appendicitis group and non-gangrenous appendicitis group(P ＜ 0.05).Multivariate analysis showed that the level of CRP should be a risk factor for judging gangrenous appendicitis.It showed that the role of CRP in judging gangrenous appendicitis was superior to the proportion of neutrophils and WBC in the ROC curve.The ROC curve showed that the area under the ROC curve for the CRP level,neutrophils percentage and WBC was 0.931,0.659 and 0.599 respectively,and the optimal cut off value of CRP for surgical indication for classifying cases was around 44.4 mg/L,and the sensitivity was 75.5 ％,specificity was 93.5 ％.Conclusion The level of CRP is useful in identifying the pathological types of acute appendicitis in children,and can be considered to be a surgical indication marker for acute appendicitis in children.

Objective To investigate the clinical and pathological features of microscopic thymoma(MT).Methods The histopathological features of 12 cases of MT were observed by histopathologic and immunohistochemical methods.The pathological morphology,diagnosis,and differential diagnosis were discussed combined with literature.Results 6 cases of MT were accompanied by myasthenia gravis(MG) symptoms.Focal hyperplastic thymic epithelial islands were accompanied by large tracts of mature adipose tissue in 12 cases of MTs,and immunohistochemistry showed CK positive.Cyst formation was found in 5 cases,lymphoid hyperplasia in 7 cases,and vascular proliferation in 5 cases.Conclusions MG may be the clinical manifestation of MT.MT can occur in thymic cortex,medulla and cortex and medulla junction.Since the tumor is small and the lesions are multiple,it can not be found by X-ray or CT examination.Diagnosis depends on histopathological examination.Correct understanding of the clinical and pathological features of MT has guiding significance on the treatment and prognosis judgment of MT.Thymic resection was recommended for MG patients either with or without thymoma.

It is an essential educational goal to strength experimental teaching and improving the practical skill of medical postgraduate students in medical colleges and universities.We made anexploration and practice on how to improve the practical skill and innovative ability of postgraduate students in medical immunology experimental teaching.The article points out that optimizing the design of experimental course,innovating the teaching methods,standard appraised of experiment and improving the quality of teacher are the efficient ways to enhance the practical skill of postgraduate students.

Humans ; Papilloma ; pathology ; Salivary Ducts ; pathology ; Salivary Gland Neoplasms ; pathology

Objective To probe into the color Doppler echocardiographic characteristics of bilocular heart (BH) and associated malformations. Methods Twenty patients of BH were examined with color Doppler echocardiography (CDE) and the characteristics were observed. All the CDE results were compared with angiocardiography and 14 were confirmed by operation. Results Nineteen cases were properly diagnosed based on the CDE characteristics,1 case were misdiagnosed as mitral atresia. CDE characteristics of BH were obvious:① Apical four-chamber view of two-dimensional echocardiography (2DE) showed total echo dropout in both the interatrial septum and the interventricular septum and disappearance of the intracardiac "cross". The common atrioventricular valve closed during systole and appeared as figure "8", named 2DE "8" sign. During diastole, the common atrioventricular valve opened to a common ventricle. ② Color Doppler flow imaging (CDFI) showed common intra-atrial flow signal entereda common ventricle through common atrioventricular valve during diastole in all patients and colorful reflux through common atrioventricular valve during systole in 15 cases. ③ Among the 20 eases, 16 of the common atria were situs solitus,4 were situs inversus; 10 of the common ventricles were type A,2 were type B and 8 were type C. According to the spatial relationship of the great arteries,there were 4 type Ⅰ ,7 type Ⅱ and 9 type Ⅲ.There were 18 pulmonary stenosis and 2 pulmonary hypertension. ④ In the presence of pulmonary stenosis, CDFI showed colorful shunt signals through pulmonary artery during systole. Conclusions BH and associated malformations have obvious echocardiographic characteristics. CDE has a specific value in diagnosing BH and associated malformations.

Objective:To explore the clinical outcome of measured resection combined with gap balancing technique in total knee arthroplasty (TKA).Methods:From January 2016 to October 2017, 61 cases of varus knee joint flexion deformity were applied the procedure of measured resection combined with gap balancing technique in primary total knee arthroplasty, including 24 male and 37 female; the average age was 66.80±8.2 years old (range from 60 to 78 years old). All patients underwent antero-medial incision of knee joint,medial parapatellar approach and posterior stabilized prosthesis. Measurement osteotomy technique was used to localize osteotomy. Gap balancing technique was vitrificated flexion and extension. Operation time, surgical blood loss and osteotomy volume were recorded. Radiographic evaluation included alignment of lower extremity, knee joint linedistance, tibiofemoral joint angle, rotation angle of femoral prothesis and posterior condylar offset (PCO). Joint functions were assessed including KSS scores, ROM and patient satisfaction.Results:The average operation time was 54±12 min (range from 45 to 65 min). The average postoperative drainage was 140±26 ml (range from 120 to 180 ml). The difference in hemoglobin values were 22±8.5 g/L(range from 20 to 30 g/L) between preoperative and postoperative 5 days. The lateral proximal tibial bone mass was 10.2±1.5 mm (range from 9.2 to 11.5 mm). The lateral distal femoral bone mass was 9.1±1.5 mm (range from 8.8 to 10 mm). The bone mass of posterior lateral condyle of femur was 8.6±1.5 mm (range from 7.8 to 10 mm). The bone mass of posterior medial condyle of femur was 9.2±1.2 mm (range from 8.6 to 10 mm), compared with the bone mass of posterior lateral condyle of femur, and the difference was statistically significant ( t=2.44, P=0.006). The intraoperative angle between osteotomy line of gap balanced osteotomy technique (line B) and connecting line of screw hole in measure osteotomy (line A) was 1.15°±0.47° (range from 1.02° to 2°). The external rotation angle was27.8%, the internal rotation angle was72.2%. There was no significant difference between preoperative knee joint line distance 40.55±4.32 mm and postoperative knee prosthesis joint line distance 40.99±3.86 mm. Postoperative knee straight and bent-knee 90° stress X-ray demonstrated that medial-lateral tibiofemoral joint angle showed no significant difference ( P >0.05). Cross-sectional CT of knee joint post operation, rotation angle of femoral prosthesis ≤±2°. Most of them were mainly concentrated in the internal rotation angle. There was no significant difference between preoperative PCO 31.55±3.18 mm and postoperative PCO 31.55±3.18 mm ( P>0.05). The KSS score and patient satisfaction score post operationwere significantly higher than those preoperation. The KSS score and patient satisfaction score at 3 months after operation were 89.2±9.4 points and 7.2±2.6 points, which were higher than that at 1 month after operation (78.0±3.5 points and 5.2±1.8 points), with statistically significant differences ( t=1.897, P=0.026; t=1.753, P=0.038). The KSS score was above 90 at 6 months after operation. The knee ROM after 1 month (94.7°±10.6°) had no statistical significance compared with that preoperation (91.9°±12.5°) ( t=1.286, P=0.245). The knee ROM at 3 months after surgery (105.8°±14.7°) was significantly higher than that before operation (91.9°±12.5°) ( t=1.924, P=0.041). There was no significant difference between the scores of the follow-up time points and those of 3 months after operation ( P >0.05). Conclusion:TKA were performed by using measured resection combined with gap balancing technique. Not only can good alignment of lower extremity be restored, but also flexion-extension gap balance can be obtained. Equal osteotomy with less soft tissue release. There are better ROM of knee and KSS functional scores in the early postoperative period. However, it is easy to cause femoral pseudointernal rotation.

Objective To obtain differentiated osteoblast-specific inactivation of fgfr1 mice Methods To obtain fgfr1△/+/OC-CreTG/+ mice,fgfr1flox/flox mice obtained from NIH were crossed with OC-Cre mice To obtain fgfr1△/△/OC-CreTG/+ mutant mice,fgfr1△/+/OC-CreTG/+ further crossed with themselves or fgfr1flox/flox mice After fgfr1△/△/OC-CreTG/+ crossed with fgfr1flox/flox mice,half of their offspring were mutant mice Results Differentiated osteoblast-specific fgfr1 knockout mice were obtained Conclusion fgfr1△/△/OC-CreTG/+ mice were obtained through proper crossing strategy,which provides a suitable platform for studying fgfr1 function in bone development and fracture healing

Objective To investigate the role of COOH-terminus tensin like molecule (CTEN) in epithelial-mesenchymal transformation of gastric cancer and its prognostic factors.Methods The expressions of CTEN,E-cadherin and Vimentin in 220 patients with gastric cancer were detected by immunohistochemical staining.Results The positive expression rate of CTEN was 61.8％ (136/220) in gastric cancer specimens,higher than 15％ (3/20) in adjacent tissues (x2 =16.488,P ＜0.01);the positive expression rate of E-cadherin in gastric cancer specimens was 25.5％ (56/220),lower than 85％ (17/20) in adjacent tissues (x2 =30.713,P ＜0.01);and the positive expression rate of Vimentin in gastric cancer specimens was 35.0％ (77/220),higher than 10％ (2/20) in adjacent tissues.There was no significant difference in the expression of CTEN between different genders,ages,size of tumors and histopathological types (P ＞ 0.05).In different infiltration depth,the CTEN expression difference were statistically significant (x2 =54.058,P ＜0.01),CTEN expression rate in lymph node metastasis group was obviously higher than without lymph node metastasis group (x2 =15.989,P ＜0.01),and CTEN expression rate in distant metastasis group was obviously higher than without distant metastasis group (x2 =4.143,P ＜0.01).CTEN and E-cadherin expression in gastric cancer tissue showed a negative correlation (r =0.357,P ＜ 0.01),while CTEN and Vimentin expression were positively correlated (r =0.498,P ＜0.01).220 cases of patients with gastric cancer received follow-up.Median survival time of CTEN negative express group was 48.2 months (95％ confidence interal,44.0-52.5 months),69.0％ for the 5-year cumulative survival rate.The survival analysis showed median survival time of CTEN positive expression group was 41.8 months (95％ confidence interal,38.3-45.3 months),48.5 ％ for the 5-year cumulative survival rate,which were lower than that in negative group (x2 =4.884,P ＜ 0.05).Multifactor analysis showed CTEN expression,lymph node metastasis and distant metastasis were independent risk factors for the prognosis of gastric cancer patients (P ＜ 0.05).Conclusions CTEN was positively correlated with gastric cancer invasion and metastasis,and played an important role in gastric cancer epithelial mesenchymal transformation.CTEN is independent risk factor for prognosis of gastric cancer,detection of CTEN gene mutation has important significance to evaluate the treatment and prognosis of gastric cancer.