Objective To study the clinical and pathologic features of aggressive angiomyxoma (AAM) and its occurrence, treatment and prognosis Methods The 8 cases of AAM were analyzed retrospectively, among which 6 cases in vulva, 2 cases in perineum, vagina and pelvis As well we performad immunohistochemical studies Results The neoplastic cells were at least focally immunoreactive for vimentin (7/7), smooth muscle actin (7/7), factor 8 (7/7), proliferating cell nuclear antigen (4/7), estrogen (3/7) and pregesterone (4/7) receptors All of the examined tumors were negative for S100 protein and cluster designation 68 Conclusions AAM is an uncommon mesenchymal tumor that preferentially involves the pelvic and perineal regions of females In immunohistochemical investigation the neoplastic cells of AAM exhibit fibroblastic and myofibroblastic features They are characterized by slow growth, infiltration of adjacent structures, absence of distant metastases, a tendency to recur locally and a fairly good prognosis Treatment should consist of wide surgical excision, as complete as technically possible

Objective To discuss the cause,treatment and prevention of splenic injury during the urological surgery.Methods The clinical data of 16 cases with splenic injury in operation for renal and adrenal tumors in 496 cases were retrospectively analyzed.Nine cases were left radical nephrectomy,3 cases were left renal hamartoma enucleation,4 cases were left adrenal tumor resection.Damage located at outer edge of the spleen in 8 cases,the splenorenal ligament in 6 cases,and the splenic hilum in 2 cases.In these 16 cases,14 patients spared the spleen (Ⅰ Grade injury 8 cases,Ⅱ grade 6 cases).The injuryed spleen was directly pressed with hemostatic gauze in 3 cases; 5 patients used coagulation,bonding,hemostatic gauze to stop bleeding; 2 cases of grade Ⅱ injury used U-shaped suture and coated with fibrin glue,then compressed with hemostatic gauze to stop bleeding; 2 cases of grade Ⅱ injuries with the greater omentum stitched into the seam,sprayed biological glue,were compressed with gelatin sponge; 2 cases of grade Ⅱ injury underwent splenic artery branch ligation.The other 2 cases (1 Ⅱ grade and 1 Ⅲ grade) underwent splenectomy.Results All of the 16 patients were cured and followed up for 6 months to 5 years.There was no delayed bleeding of spleen and splenic dysfunction.One patient died of tumor recurrence 6 months after operation.Conclusions Splenic injury is a common complication during urological surgery,especially the tumor is large or adhered to spleen in the upper pole of left kidney.Once spenic injury occurs,doctors should choose the right treatment plan according to surgical injury,and try to save the spleen.

Objective To analyze the clinical characteristics, risk factors and prevention measures of nosocomial infection in senile patients with hematologic disorders. Methods The clinical data of 581 senile patients with hematologic disorders from July 2005 to June 2007 were retrospectively analyzed. Results The nosoeomial infection rate was 30.5%(177/581). The 581cases developed nosocomial infection for 254 times [43.7% (254/581)]. Lower respiratory tract infection was the most frequent infection site, followed by intestinal infection and upper respiratory infection. The species were predominated by Gram-negative bacillus (67.1%) . The risk factors of nosocomial infection were non-remission of malignant diseases,chronic underlying diseases, long time hospitaliation, community infection, granulocytopenia, invasive manipulation and application of adrenocortical hormone and antibiotic. Conclusions The nosoeomial infection rate is high in senile patients with hematologic disorders and it can be decreased by taking prevention measures according to the risk factors.

Objective To investigate the autophagy capacity in clear cell renal cell carcinoma tissue compared with adjacent normal tissue.Methods Sixty-nine pairs of samples from human clear cell renal cell carcinoma tissues and relatively healthy renal tissues adjacent to the tumor were collected during surgical resection.The expressions of proteins that were participating in the regulation and execution of autophagy were detected by immunohistochemisty.Electron-microscopy was also carried out for the morphometrical analysis.Results The protein expression of p-mTOR (P =0.004),P62 (P =0.000) and ULK1 (P =0.000) were up-regulated in the carcinoma tissue,while the expression of Beclin1 (P=0.000),LC3 (P =0.000) and ATG7 (P =0.000) were down-regulated,and the expression of ATG5 (P =0.349) had no signif-icant difference compared with adjacent normal tissue.Morphometrical analysis showed that the basal autophagic activity (measured by the presence of autophagy vacuole compartment) was remarkably down-regulated in carcinoma tissue,compared with adjacent normal tissue.The expression level of mTOR was correlated with P62,LC3 and ATG7,but results showed no correlation between mTOR and Beclin 1.Conclusion Our studies show a relatively reduced autophagy capacity in clear cell renal cell carcinoma,which is regulated by multiple autophagy-related proteins such as mTOR,Beclin 1 and LC3.

Objective To investigate the experience in management of the high risk benign prostatic hyperplasia (BPH) patients in order to improve the safety of the operation.Methods The high-risk factors of 115 patients with BPH who had been treated with transurethral resection of prostate (TURP) were analyzed.The blood pressure of hypertensive patients should be controlled below 140/90 mm Hg.The patients with myocardial infarction should be in stable condition for more than 6 months.Smoking cessation,oxygen inhalation,and pulmonary function training should be carried out during the perioperative period in patients with chronic obstructive pulmonary disease,correct expectoration methods and rational use of antibiotics were also needed to improve the maximum amount of pulmonary ventilation to more than 70％.The blood-glucose of diabetic patients should be controlled below 8 mmol/L by insulin.Catheter was indwelled in patients with chronic obstructive renal insufficiency for more than 2 weeks so that the blood Cr could be below 130 μmol/L.Anticoagulant therapy should stop at least 5 days before surgery.Patients were encouraged to have physical training early after surgery and to have ankle stretch movement when they recovered form anesthesia,and pressure cycle drive therapeutic apparatus were also used to prevent deep venous thrombosis.Results All the patients tolerated TURP safely.Operation time was 30 to 60 min,the weight of the resection prostate tissue was 12 to 37 g,blood loss was 80 to 150 ml,and catheterization time was 3 to 7 days.The overall incidence of complications was 1.7％.There were 2 cases with deep venous thrombosis,who recovered after anticoagulant therapy.There were no pulmonary infection,bleeding,TUR syndrome,and other complications.Conclusion Correct analysis and effective management of the perioperative risk factors in high-risk BPH patients treated with TURP can improve the safety of the operation and reduce the complications.

OBJECTIVETo study the clinicopathological characteristics of papillary cystadenoma of the epididymis.

METHODSUsing routine pathology and immunohistochemistry, we observed the surgically obtained samples from 2 cases of papillary cystadenoma of the epididymis, analyzed their pathological features and clinical presentations, and reviewed the related literature.

RESULTSThe 2 patients were both adult males. The tumors typically manifested as painless swelling in the epididymis, with occasionally dull pain and tenesmus in 1 of the cases. Pathologically, the lesions exhibited three morphological features, i. e., dilated ducts and small cysts surrounded by fibrous connective tissue, adenoid papillary hyperplasia into the cysts embraced by fibrovascular stroma, and acidophil substance present in the cysts. Immunohistochemistry showed that the tumors were strongly positive for CK8/18, CK7, and EMA, but negative for CK20, CEA, MC, Calretenin, P53, P63, SMA, VHL, and CD10, with the positive rate of Ki-67 <1%. Follow-up visits revealed good prognosis in both cases.

CONCLUSIONPapillary cystadenoma of the epididymis is a rare benign tumor in the male urogenital system, which may be accompanied by the VHL syndrome. Surgery is the first choice for its treatment.

Adult ; Cystadenoma, Papillary ; chemistry ; pathology ; Epididymis ; Genital Neoplasms, Male ; chemistry ; pathology ; Humans ; Immunohistochemistry ; Male ; von Hippel-Lindau Disease

Objective To investigate the usage of distortion product otoacoustic emissions(DPOAE) in normal infants hearing screening.Methods One hundred infants(200 ears) without clinical condition of illness were checked in GSI 70 DPOAE screening.The pure tones were 2,3,4 kHz,the OAE screener scored the test result as a pass,when the responses were above the PASS/REFER line and the signal-to-noise was at least 10 dB.Results Ninty-four infants(188 ears) passed hearing screening. Four infants(8 ears) with ceruminous impaction didn′t pass screening;after extracting impacted cerumen from the external auditory meatus,the 4 infants(8 ears) passed screening.Two infants(2 ears) with secretory otitis media didn′t pass screening,but after medicine treatment for 1 week,they passed screening too.Conclusion DPOAE has advantages in infants hearing screening.J Appl Clin Pediatr,2006,21(3):168-169

Field studies were conducted for a season to determine potential for alterations in the rhizosphere fungi quantity dynamics and dominant populations of 4 wild sugarcane clones(S.spontaneum L.) with different UV-B sensitivity under an enhanced ultraviolet-B(UV-B,280 nm～310 nm) radiation.The quantity of rhizosphere fungi was most in tillering stage,second in seedling stage and lest in elongating stage and maturing stage,the sequence wasn’t alternated by UV-B radiation.The rhizosphere fungi quantity of tolerant clone was obviously increased and greater than the sensitive clone under the enhanced UV-B radiation,however,the number of dominant populations decreased and Penicillium was the dominant population during the periods of 4 wild sugarcane clones.

Objective:To specify optimize condition of process for mixture extraction of three kinds of volatile oil and preparation of ? CYD inclusion compound of Yuxianling Granules.Methods: Taking weight of volatile oil to evaluate the extraction process and percentage recovery of inclusion compound, transfer rate of oil, inclusion rate of oil to evaluate the inclusion process. Orthogonal design was applied. Results: The optimum extraction condition was to add five times amount of water into the mixture of crude drugs, to soak for 90 min, to heat up to boiling and reflux 4h. The trituration method is suitable for the productive preparation of inclusion compound, the optimum inclusion condition was ? CYD: Volatile oil in proportion as 8∶1 was mixed, adding two times amount of water into the mixture and trituration 30 min.Conclusions: Above condition of process was the most rational in extraction and inclusion of three kinds of volatile oil.

Objective To study the effect of shenfu injection on the neuron apoptosis in hippocampal CA1 region of newborn with hypoxic-ischemic brain damage(HIBD).Methods The experiment included 2 parts.One was to measure the apoptosis rate by the flow cytometry,and the other was to investigate the expression of Bcl-2 and Bax of neurons in left hippocampal CA1 region.Models of postnatal 7-day Sprague-Dawley(SD)rats with HIBD were established,and were equally divided into 4 groups:sham operation(group S),control group(group C),shenfu injection pretreatment(group P),and shenfu injection treatment(group SF).The neuron apoptosis rate in hippocampal CA1 region in every group was measured at 2 h before and 2,12,24 h,3,7,14 and 28 d after hypoxic ischemic(HI) insult.The expressions of Bcl-2 and Bax were performed by immunohisochemistry.Results The apoptosis of neuron in hippocampal CA1 region in group P and group SF after HI insult was significantly less than that of group C(P