Objective To discuss the clinical value of the "three-step" diagnostic routine in the diagnosis of cervical high-grade lesions. Method The women with the abnormal thinprep cytology test (TCT) underwent colposcopy and biopsy,the pathobiology result was the diagnostic standard. The sensitivity and specificity of the cervical high-grade lesions was calculated. Results The identify rate of the cervical high-grade lesions from the abnormal TCT was 22.3% (340/1524), the sensitivity was 27.1% (92/340), the specificity was 97.5% (1154/1184). The sensitivity of colposcopy was 47.9% (163/340), the specificity of colposcopy was 96.4% (1141/1184). Conclusion TCT with high sensitivity is used for preliminary screening, the colposcopic examination is used to pinpoint and evaluate the lesions,the detection rate and accuracy of cervical high-grade lesions can be improved.

Objective To analyze the imaging performances and significance of Modic changes on X-ray,CT and MRI.Methods The imaging data (MR,CT and X-ray)of patients with low back pain were retrospectively analyzed.The selected patients’images were studied on the same work station by the two physician experts in muscle and bone imaging.A double-blind method was used. Firstly,MRI was used to sort the MC.Then,the alterations of the density in the lesions on X-ray plain film and CT image were measured.if the judgments of the two readers were inconsistent,another professor of radiology will join the discussion and consist-ent results will be got finally.The data were recorded using Excel 2010,and processed for statistical analysis using SPSS 1 6.0.Re-sults A total of 47 cases that met the requirements were collected which included 1 6 males and 31 females,aged from 32 to 76 years,with a median age of 56.0 years.A total of 93 on MRI endplate were changed.However,a part of lumbar endplates with MC on MRI images were displayed as higher density than normal vertebral body on the X-ray and CT reconstruction images (total of 36).The occurrence rates of Type Ⅰ,Type Ⅱ,Type Ⅰ/Ⅱ were 40.0%,14.8%,58.3%,respectively.But the occurrence rate of Type Ⅲ (100%)and hybrid Type which contained type Ⅲ were 100%.Conclusion Some Modic typeⅠ,Ⅱ,Ⅰ/Ⅱchanges in X-ray plain film, CT reconstruction images had a higher density,speculating that there is reactive new bone formation,which reflects the internal ver-tebral body bone mineralized rather than the change of the bone marrow.

Adult ; Aged ; Axilla ; innervation ; surgery ; Brachial Plexus ; surgery ; Breast Neoplasms ; physiopathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision ; methods ; Mastectomy, Radical ; adverse effects ; methods ; Middle Aged ; Pain, Postoperative ; etiology ; Somatosensory Disorders ; etiology

Objective To investigate the protective effects of recombinant human erythropoietin (rHuEPO) on acute lung injury (ALI) induced by lipopolysaccharide (LPS).Methods Fourty-five rats were randomly (random number) assigned to three groups,namely control group,model group,and rHuEPO group.ALI was induced by intravenous injection of LPS (6 mg/kg).The rHuEPO (5000 U/kg) was injected intravenously into rats 60 min before LPS challenge.The general status of rats was observed.Twelve hours after modeling,the rats were sacrificed and the tissue samples including lung tissue and blood were collected.PaO2,PaCO2,pH,the lung wet/dry weight ratio,plasma cytokines [interleukin (IL) IL-6 and tumor necrosis factor-alpha (TNF-α)],and inducible nitric oxide synthase (iNOS) were detected.Cytokines were assayed with ELISA method.Pathological changes of lung tissues were observed under light microscope and transmission electron microscopy.Results (1) Compared with the control group,PaO2,pH in the model group and in the rHuEPO group were significantly lower (P ＜ 0.05),and PaCO2 were significantly higher (P ＜ 0.05).Compared with the model group,PaO2,pH in the rHuEPO group were significantly higher (P ＜ 0.05),and PaCO2 were significantly lower (P ＜ 0.05).(2) Compared with the control group,the W/D weight ratio of lung tissues in the model group and the rHuEPO group was significantly higher (P ＜ 0.05).Compared with the model group,the W/D weight ratio of lung tissues in the rHuEPO group significantly lower (P ＜ 0.05).(3) The levels of TNF-o,IL-6 and iNOS in serum of rats in the control group were lower than those in the model group and the rHuEPO group (P ＜0.01).The serum levels of TNF-α,IL-6 and iNOS of rats in the rHuEPO group were significantly lower compared with the model group (P ＜ 0.01).(4) The light microscopy and the transmission electron microscopy showed the model group had histopathologic changes with acute diffuse lung injury manifested by intra-alveolar hemorrhage,exudate,inflammatory cells infiltration,Ⅰ type and Ⅱ type epithelial cell necrosis and detachment,and the pathological changes of lung tissue in the rHuEPO group were not as serious as those in the LPS group,showing only a little inflammatory cells infiltration of focal alveoli.Conclusions Recombinant human erythropoietin can inhibit the genesis of TNF-α,IL-6 and iNOS in serum,modifying the inflammatory response and providing protective effects against acute lung injury induced by sepsis.

Objective To observe endoplagmic reticulum stress in bone tissue of fluomsis rats and further explore the pathogenesis of skeletal fluorosis.Methods 48 Wistar rats were divided into 4 groups according to their body mass.The control and low.calcium group were fed with normal diet(0.79%calcium)and low-calcium diet(0.79%calcium)respectively,and both drank tap water(sodium fluoride concentrations＜1 mg/L).High fluoride and low.calcium plus high-fluoride groups were fed with normal diet(0.79%calcium)and low-calcium diet (0.79%calcium)respectively,and both drank tap water containing sodium fluoride(sodium fluoride concentrations 221 mg/L).During experimental period,rats were measured body mass once a week with a stand diet and water available ad libiturn.The experimental period was 3 months.The biochemical techniques were used to test the indicators of oxidative stress and ALP in seFum of fluorosis rats.The total RNA was extracted from the one side of the femur,and the transcription level of Bip,Xbp1,CHOP and PDI were investigated by reverse transcription polymerase chain reaction(RT-PCR).Results The level of MDA in serum of low-calcium plus high-fluoride group wag higher than that of the control[(14.74±3.11)μmol/L vs(10.15±1.96)μmol/L,P＜0.05];the activity of GPx was ma~edly higher in hish-fluoride group compared with the control[(3.87±0.41)×103 U/L vs(2.85± 0.55)×103 U/L,P＜0.05];the level of uric acid in sel'um was significantly lower both in high-fluoride group and low-calcium plus high-fluoride group compared with the respective control and the low-calcium group[(73.95± 9.52)μmol/L vs(110.43±25.48)μmol/L,(54.32±22.09)μmol/L vs(101.71±17.01)μmol/L,P＜0.05]. The activity of ALP wag obviously higher in low-calcium plus high-fluoride group compared with the control [(24.77±4.57)×103U/L vs (12.91±3.97)×103U/L,P＜0.01)].The mRNA expression of Bip/GAPDH in bone tissue was markedly higher in bone of high-fluoride group and low-calcium plus high-fluoride group compared with the control(1.38±0.24,1.35±0.12 vs 1.14±0.06,P ＜ 0.05). The expression of Xbp1/GAPDH in bone tissue significantly increased in low-calcium plus high-fluoride groups compared with the control and the low-calcium group (1.48±0.20 vs 1.02±0.25,1.07±0.25,P ＜ 0.05 or ＜ 0.01);and CHOP/GAPDH in bone tissue significantly increased in low-calcium plus high-fluoride groups compared with the control(0.84±0.18 vs 0.52±0.07,P ＜ 0.05 ). Conclusions Accelerated osteogenetic action is seen in fluorosis rats,accompanied by oxidative stress and bone endoplasmic reticulum stress,which is likely involved in the pathogenesis of skeletal fluorosis.

Objective To explore the clinical modalities and diagnosis of respiratory failure due to laryngotracheal disorders in children,in order to reduce the misdiagnosis.Methods Fifteen patients(11 cases were male,4 cases were female) with respiratory failure in Intensive Care Unit, Tianjin Children′s Hospital from Jul.2006 to Jul.2009 were selected.Data including history,characteristics and results of spiral computerized tomography(CT) and reconstruction and magnetic resonance imaging(MRI) were reviewed.Results The major clinical manifestations indicated that 7 cases had laryngeal stridor,6 cases had recurrent pneumonia,5 cases had cyanosis after crying,and 12 patients were complicated with respiratory failure in 12 hours.Nine cases were recovered,3 cases were given up,and 3 cases died.All patients were performed with CT about laryngohypopharynx,and the results were cyst of root of tongue in 3 cases,trachea pressed by cyst of parapharyngeal space in 1 case.There were 11 cases examined by spiral CT and reconstruction,in which 6 cases were confirmed as tracheal stenosis,2 cases were left bifid tracheostoma,2 cases were pulmonary artery sling,and 1 case was diagnosed as tracheomalacia.Chest X-ray radiograph indicated that bronchopneumonia in 8 cases,bronchitis in 3 cases and negative in 4 cases.Echocardiograph examination was performed among 11 cases,in which 2 cases were pulmonary artery sling,2 cases were atrial septal defect,1 case was patent ductus arteriosus, and 6 cases were negative.Conclusions There is high morbidity of respiratory failure caused by laryngotracheal disorders in infants,but misdiagnosis ccures usually because of non-specific symptoms.If the infant must depend on mechanic ventilation for a long time and has airway obstruction,he should be examined early by using spiral CT.

Objective To explore an approach to identifying the plant source of Flos Lonicerae and Lonicera confusa rapidly, precisely, and efficiently. Methods Using LM and SEM to observe and compare the characters of leaf epidermis of the five species of Lonicer L. including L. japonica, L. confuse, L. hypoglauca, L. dasystyla, and L. macrantha. Results There are obvious differences in leaf epidermis among the five species of Lonicera L. under LM and SEM. Conclusion The characteristics of leaf epidermis can be used to identify the plant source of Flos Lonicerae and L. confusa. According to their characteristics under LM and SEM, the retrieval keys to the five species of Lonicera L. have been compiled.

Objective To investigate the value of contrast enhanced ultrasonography in evaluating cystic renal mass. Methods According to the imaging diagnosing standard, 29 cystic renal mass lesions were studied with contrast enhanced ultrasonography(CEUS), unenhanced ultrasonography (US), contrast enhanced CT(CECT) and then correlated their results with final histopathological results. The data were tested by receiver operating characteristic(ROC) curve. Results The area under ROC curve of CEUS and US was 0. 721, 0. 997, respectively. There was significant difference between the 2 groups (P=0. 003). The area under ROC curve of CEUS and CECT was 0. 997, 0. 997,respectively. There was no significant difference between the 2 groups (P= 1. 000). Conclusions CEUS is better than US and similar to CECT in evaluating cystic renal mass. CEUS with the Bosniak classification is useful for evaluating cystic renal mass.

ObjectivesTo discuss the value of the three kinds of surgical management to treat high-grade cervical intraepithelial neoplasia. MethodsThe study was conducted on 136 patients who underwent LEEP、CKC 、hysterectomy ,to compare the change of the postoperative biopsy result,the rate of cure and pregnancy. ResultAmong the postoperative biopsy result,66. 4% was consitent with pretreating histopathology,but 3.6% was upgrade,30.0% was downgrade; there were no statistical difference in the rate of cure of the three kinds of surgical management and in the rate of pregnancy of the two kinds of conization. ConclusionThe three kinds of surgical management to treat high-grade cervical intraepithelial neoplasia were effective,while LEEP was the best way.

Objective To analyze the clinical management of women with atypital squamous cells(ASC).Methods During Sep 2003 to Sep 2008,a totle of 956 women in our department were diagnosed with ASC by cytological test,they were further biopsied under the colposcope.The result of TCT,colposcopic test,biopsy and the highrisk factor were recorded and analysed;the based the biopsy were analyzed by the X~2-test;the high-risk factors and the odds Ratio(OR) were counted by SPSS10.0.Results Among the women with ASC,the rate of cervical intraepithelial neoplasia(CIN) diagnosed by the biopsy under the colposcope was 50.7% ,the rate of the high-grade lesion over CINII Was 13.3% ;if the colposcopic test were low-grade lesion,the rate of the cases which biopsys were the highgrade lesion over CINII,was 8.3% ;the high-risk factors which caused the cervical high-grade lesion were the number of sex-partners over 3,the age less than 20 yearold when the sex were made,the cervical erosion,the result of TCT with ASC-H.Conclusion Among the women with ASC,the biopsy shows multiformity;the rate of CIN and the highgrade lesion is also high;if TCT is ASC,the colposcopie test is advised;if the woman who has the high-risk factors,biopsy is advised.