Aged ; CDX2 Transcription Factor ; Cysts ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Female ; Homeodomain Proteins ; metabolism ; Humans ; Keratin-20 ; metabolism ; Mucous Membrane ; pathology ; Peritoneal Neoplasms ; metabolism ; pathology ; surgery ; Pseudomyxoma Peritonei ; metabolism ; pathology ; surgery ; Rupture ; Splenic Neoplasms ; metabolism ; pathology ; surgery

OBJECTIVETo summarize and analyze the experience in diagnosis and treatment of primary malignant tumors of the heart and pericardium.

METHODSThe clinical data of 24 patients with malignant tumors of the heart and pericardium treated in our hospital between Jun. 1980 and Mar. 2008 were retrospectively analyzed and the related literature was reviewed.

RESULTSAll 24 patients received surgical treatment. Radical resection in 10 cases and partial resection in 6 cases were performed, and the remaining 8 patients received only surgical exploration due to unresectable tumors. One patient died of cardiopulmonary failure in early postoperative stage and all the other patients died within 4 years after operation due to recurrence or metastases.

CONCLUSIONEchocardiography, CT, MRI, 3D-CT, CT of coronary artery and cardiac angiography are helpful for the diagnosis and selection of operation mode. Histological examination is necessary for the final diagnosis. Early diagnosis and surgical resection of the tumor as complete as possible, and combination with post-operative radiotherapy and/or chemotherapy may improve the survival of the patients.

Adolescent ; Adult ; Aged ; Female ; Follow-Up Studies ; Heart Neoplasms ; diagnosis ; surgery ; Humans ; Male ; Mesothelioma ; diagnosis ; surgery ; Middle Aged ; Myxoma ; diagnosis ; surgery ; Pericardium ; surgery ; Retrospective Studies ; Survival Rate ; Young Adult

Traumatic tricuspid valve insufficiency (TTVI) is a relatively uncommon disease. To summarize the experience in the diagnosis and treatment of TTVI, we have analyzed the clinical data of 3 patients with TTVI who were admitted to the department of cardiac surgery of our hospital between April 1997 to April 2002. Relevant literatures have also been reviewed.
Accidents, Traffic ; Adult ; Cardiac Surgical Procedures ; methods ; Electrocardiography ; Follow-Up Studies ; Heart Injuries ; diagnosis ; surgery ; Heart Valve Prosthesis ; Humans ; Injury Severity Score ; Male ; Middle Aged ; Multiple Trauma ; physiopathology ; Risk Assessment ; Sampling Studies ; Treatment Outcome ; Tricuspid Valve Insufficiency ; diagnosis ; surgery

OBJECTIVETo compare the difference between J-hook and micro-implant anchorage in the treatment of patient with bimaxillary protrusion.

METHODSThirty patients with bimaxillary protrusion were divided into two groups (J-hook and micro-implant groups) and treated with MBT appliance. Four first premolars were extracted in all patients. Cephalometric analyses were carried out before and after treatment.

RESULTSIn J-hook group and micro-implant group,computerized cephalometric analysis revealed that before treatment U6C-PP was (12.4 +/- 0.2) mm and (12.5 +/- 0.1) mm, respectively,and after treatment U6C-PP was (12.6 +/- 0.1) mm and (12.8 +/- 0.1) mm,respectively. The difference between J-hook group and microimplant group was significant (P < 0.01). The other differences of cephalometric analyses between J-hook group and micro-implant group was not significant.

CONCLUSIONSBoth J-hook and micro-implant could provide adequate anchorage in the treatment of patients with bimaxillary protrusion.

Adolescent ; Adult ; Child ; Female ; Humans ; Male ; Malocclusion, Angle Class I ; therapy ; Orthodontic Anchorage Procedures ; instrumentation ; Orthodontic Appliances ; Orthodontics, Corrective ; instrumentation ; methods ; Young Adult

Objective To investigate the cerebral blood flow (CBF) perfusion patterns and related factors in hyperthyroidism patients.Methods Twenty-five patients with hyperthyroidism and twenty-two healthy controls matched for age,sex,education were enrolled.~(99)Tc~m-ethylene cysteinate dimer (ECD) SPECT CBF perfusion imaging was performed at rest.Statistical parametric mapping 5.0 software (SPM5) was used and a statistical threshold of P＜0.05 (corrected) was applied for signifying changes of regional CBF (rCBF).The semiquantitative values of rCBF were extracted automatically by brain search 1.1 software and were correlated with concentrations of serum thyroid hormones(FT_3,FT_4),thyroid autoimmune antibodies:sensitive thyroid stimulating hormone(sTSH),thyroid peroxidase antibody (TPOAb) and TSH receptor antibody (TRAb) by Pearson analysis,with disease duration by Spearman analysis.Results rCBF was decreased significantly in limbic system and frontal lobe,including parahippocampal gyrus,uncus (posterior entorhinal cortex,posterior parolfactory cortex,parahippocampal cortex,anterior cingulate,right inferior temporal gyrus),left hypothalamus and caudate nucleus (P＜0.05,corrected).rCBF in left lingual gyrus,posterior cingulated was negatively correlated with concentration of FT_3(r=-0.468,-0.417,both P＜0.05).rCBF in left lingual gyrus,bilateral inferior temporal gyrus,right superior parietal lobe was negatively correlated with concentration of FT_4(r=-0.4M,-0.418,-0.415,-0.459,all P＜0.05),while that in left mammillary body and putamen was positively correlated with concentration of FT_4(r=0.419,0.412,both P＜0.05).rCBF in left insula was negatively correlated with concentration of sTSH,and right auditory associated cortex was positively correlated with concentration of sTSH(r=-0.504,0.429,both P＜0.05).rCBF in left middle temporal gyrus,left angular gyrus was positively correlated with concentration of TRAb while that in right thalamus,right hypothalamus,left anterior nucleus,left ventralis nucleus was negatively correlated with concentration of TRAb(r=0.750,0.862,-0.691,-0.835,-0.713,-0.759,all P＜0.05).rCBF in right anterior cingulate,right cuneus,right rectus gyrus,right superior marginal gyrus was positively correlated with concentration of TPOAb(r=0.696,0.581,0.779,0.683,all P＜0.05).rCBF in postcentral gyrus,temporal gyrus,left superior marginal gyrus and auditory associated cortex was positively correlated with disease duration(r=0.502,0.457,0.524,0.440,all P＜0.05).Conclusion Hypoperfusions in limbic system and fontal lobe were found in hyperthyroidism Patients,which might be associated with thyroid function and disesse duration.

Objective To investigate the added diagnostic value of SPECT/CT imaging over routine planar whole-body bone scintigraphy (WBBS) for bone metastases from lung cancer. Methods One hundred and forty-six patients with lung cancer, confirmed by pathological examination, underwent routine 99Tcm-MDP (1110 MBq) WBBS, followed by SPECT/CT over the regions with indeterminate findings on WBBS. Both WBBS and bone SPECT/CT images were interpreted by two experienced nuclear medicine physicians in consensus as the positive, negative or uncertain bone metastases. The final diagnosis was comfirmed by pathology or clinical follow-up. x2 test was used to compare the differences between the two imaging methods. Results Finally, 45 patients were diagnosed as positive bone metastases and the other 101 as negative. The diagnostic sensitivity of bone SPECT/CT for bone metastases from lung cancer was 93.3%(42/45), singnificantly higher than that of WBBS (64.4%, 29/45) (x2 = 19.944, P＜0.05). The diagnostic accuracy of bone SPECT/CT was 89.7% ( 131/146), much higher than that of WBBS (44.5%,65/146) ( x2 = 69. 598,P ＜ 0.05). The uncertain and incorrect diagnostic rates of bone SPECT/CT and WBBS were 10.3% ( 15/146, raging from 5.3% to 15.2% with 95% confidence interval (CI) ) and 55.5% (81/146, raging from 47. 4% to 63.5% with95% CI), respectively. Conclusion BoneSPECT/CT provides incremental diagnostic value over routine WBBS for bone metastases from lung cancer.

Objective To investigate the additional diagnostic value of 99Tcm-MDP SPECT/CT over conventional SPECT scan in patients with spinal bone malignancy. Methods Fifty-two patients (mean age (56±14) years) with suspicious spinal bone diseases underwent both bone SPECT and SPECT/CT imaging right after 99Tcm-MDP whole-body planar bone scintigraphy. All patients were pathologically diagnosed by either spine operation or trans-spinal biopsy. The images were evaluated by two independent reviewers; inter-reviewer agreement was evaluated using a weighted Kappa score. Each focus of abnormality was recorded using a 4-point diagnostic confidence scale: benign (B), possibly benign (PB), possibly malignant (PM) or malignant (M). Results Accord to the pathological results, 36 patients had bone malignancy (19 with metastatic tumors and 17 with non-metastatic tumors) and 16 had benign lesions. Over SPECT images, two reviewers rated 73.1% (38/52) and 67.3% (35/52) the lesions as the equivocal (PB or PM) respectively. Over SPECT/CT images, they rated only 25.0% (13/52) and 13.5% (7/52) lesions as the equivocal. Inter-reviewer agreement was 63.5% (weighted Kappa score=0.62) for SPECT and 78.9% (weighted Kappa score=0.81) for SPECT/CT. Conclusions Compared with99Tcm-MDP SPECT, 99Tcm-MDP SPECT/CT results in a significant reduction of equivocal diagnoses for the spinal bone malignancy.

Objective To investigate the incidence and risk factors of acute kidney injury(AKI)within the first postoperative week after off-pump or on-pump coronary artery bypass(OPCAB or CCAB) surgery.Methods Consecutive patients underwent CABG between January 1990 and August 2006 in our institution and had normal serum creatinine(Scr)and estimated creatinine clearance(Ccr)values before operation were retrospectively analyzed. Multivariate logistic regression analysis was performed to identify risk factors for the development of AKI defined as Scr 130-199 μnol/L or Ccr 30-60 ml·min-1·1.73 m-2.Results Incidence of AKI was significantly higher in patients underwent CCAB compared to those underwent OPCAB(63/331 vs.61/518,P<0.01).Peak Scr value was seen at 12th hour post OPCAB and 24th hour post CCAB,respectively.The rapid recovering of Scr occurred between 24th hour to 48th hour in patients underwent OPCAB and 48th hour to 72th hour in patients underwent CCAB surgery.Multivariate forward stepwise logistic regression analysis showed that LVEF<30%,pulse pressure≥60 mm Hg (1 mm Hg=0.133 kPa),peripheral vascular disease,diabetes,emergent procedure,triple-vessel disease,higher body mass index(kg/m2),intraoperative and postoperative IABP,NYHA class Ⅲ or Ⅳ and cardiopulmonary bypass were risk factors for the development of postoperative AKI following CABG,while LVEF>50% and intraoperative and postoperative IABP were associated with lower incidence of AKI( OR<1).Conclusion AKI is not a rare complication post OPCAB or CCAB surgery,especially in patients with reduced LVEF,increased paise pressure,peripheral vascular disease,diabetes,emergent procedure,triple-vessel disease,higher body mass index,intraoperative and postoperative IABP.

OBJECTIVETo provide the basis for AIDS intervention, the study on the relationship between AIDS related risk behaviors and the related factors was carried out among prostitutes, injection drug users and long-distance truck drivers.

METHODSQuestionnaire investigation and statistical analysis as chi(2) test, F test, logistic regression were adopted to analysis the relationship between AIDS related risk behaviors and the correlated factors.

RESULTSKnowledge about AIDS seemed to be related to their level of understanding the problem (in commercial sex workers r = 0.307, P = 0.000, in injection drug users F = 93.07, P = 0.000, in truck man F = 30.06, P = 0.000). Condom use when entertaining their clients last time was related to the knowledge of HIV transmission in commercial sex workers and truck drivers (OR = 1.171, 1.145) and knowledge of HIV prevention (OR = 1.081, 1.397), in drug users regarding gender difference (OR = 2.121).

CONCLUSIONThis study addressed that the effective means to reduce the rate of AIDS risk behaviors and to lessen the harm of AIDS are to improve the knowledge of AIDS and the effective methods to prevent AIDS in the high risk population.

Acquired Immunodeficiency Syndrome ; prevention & control ; Automobile Driving ; China ; Health Education ; Humans ; Risk-Taking ; Sex Work ; Substance-Related Disorders ; Surveys and Questionnaires

BACKGROUNDResistance to thyroid hormone (RTH) is a dominant inherited syndrome of reduced tissue responsiveness to thyroid hormone. It is usually due to mutations located at the ligand-binding domain and adjacent hinge region of the thyroid hormone receptor β (TRβ). We report the clinical and laboratory characteristics and the genetic analysis of a patient with this rare disorder and his family members.

METHODSThe clinical presentations and changes of thyroid function tests (TFTs) including magnetic resonance imaging (MRI) of pituitary and other laboratory tests were analysed. TFTs of his family's members were detected as well. Direct DNA sequencing of the TRβ gene was done for those with abnormal TFTs.

RESULTSThe RTH child had goiter, irritability, aggressiveness, and sudoresis. His TFTs showed high levels of circulating free thyroid hormones (FT(4) and FT(3)) and normal thyroid-stimulating hormone (TSH) concentrations. He felt worse when treated as hyperthyroidism (Grave disease) with thiamazole and his clinical presentations got improved obviously when treated as RTH with bromocriptine without obvious advert effect. We identified a novel missense mutation, A317D, located in exon 9 of the gene of this boy and his mother. His mother had not any clinical presentation, but having abnormal TFTs results.

CONCLUSIONSThis patient reported here was concordant with the criteria of RTH. The feature is dysfunction of hypothalamus-pituitary-thyroid axis. A novel mutation was found in the TRβ, A317D, of this family. This research verified the phenomena that there is a clinical heterogeneity within the same mutation of different RTH patients.

Child ; Diagnosis, Differential ; Humans ; Male ; Mutation, Missense ; Thyroid Hormone Receptors beta ; genetics ; Thyroid Hormone Resistance Syndrome ; diagnosis ; genetics ; therapy