Objective To evaluate computed tomographic findings of struma ovarii so as to improve the knowledge of the imaging diagnostics of this disease.Methods Computed tomography (CT)scans and clinical data of 12 pathologically proven struma ovarii were reviewed retrospectively.Scans were evaluated for the laterality,size,margins,configuration,internal architecture,presence of intracystic high attenuation lesions on pre-contrast scans,the presence of calcifications,solid components enhancement,cyst wall enhancement,and ascites.Results All tumors were unilateral and had smooth margins.Cystic (n = 3)or mainly cystic (n = 9) appearance was common to all the tumors.Eight tumors showed a high attenuation lesion in the cyst portion of the mass on pre-con-trast scans.Calcification was found in 5 cases.The solid components showed different degrees of enhancement after administration of contrast medium.The cyst wall showed mild to moderate enhancement after administration of contrast medium.Five cases of tumors accompany a small amount of ascites.On pathology,the solid portions of the tumor consisted of the thyroid tissue and stoma which contained abundant blood vessels and fibrous tissue,and the cystic portions were filled with high gelatinous fluid of eosinophil-ic colloid.Conclusion On CT scans,struma ovarii appeared most often as a smooth marginated multicystic mass with a high attenu-ation lesion and calcification on pre-contrast scans with marked enhancement of the solid components.

Objective To investigate the effect of electroacupuncture (EA) on the cognitive function of rats with chronic cerebral hypoperfusion (CCH) and its possible mechanism.Methods Forty male Sprague-Dawley rats were randomly divided into a sham operation group of 10 and an operation group of 30.Permanent bilateral common carotid artery occlusion (BCCAO) was conducted to introduce a model of CCH in the operation group,which was further divided into a model group,an EA 4 w group and an EA 1 w group,each of 10.The EA 4 w group was given 2/100 Hz dilatational wave EA for 4 weeks,and the EA 1 w group was provided with the same EA for one week.A Morris water maze was used to assess the rats' cognitive functioning,and a reverse transcription polymerase chain reaction (RT-PCR) was employed to detect the expression of JAK2/STAT3 mRNA in all the rats' brains.Results Compared with the sham operation group,the rCBF in the operation group had decreased significantly after BCCAO,and it was significantly lower than before the operation.Compared with the model group,the escape latency improved significantly from the 3rd day in the EA 4 w group,and from the 5th day in the EA 1 w group.The targeted quadrant residence time of the EA 4 w group was prolonged significantly.JAK2/STAT3 mRNA expression decreased significantly only in the EA 4 w group.Compared with the EA 1 w group,the escape latency of the EA 4 w group had decreased significantly by the 5th day,with the target quadrant residence time significantly prolonged,and JAK2 mRNA had decreased significantly as well.Conclusion EA can improve cognition in CCH,at least in rats,and especially with early intervention.This may be achieved through inhibiting excessive activation of the JAK2/STAT3 pathway,reducing brain injury.

Objective To evaluate prognostic indicators in severe traumatic brain injury and intracania hamatomas with hernia and analyze which is the most important indicator.Methods Data of 84 cases with severe traumatic brain injury were retrospectively analyze .Age,GCS,pupil reflex,midline shift,compression of the cisteme,decompression time and complex injury were considered as possible prognostic indicators.SPSS13.0 was employed to analyze the data,Logistic regression(Forward conditional)analysis was done to confirm which are the most important prognostic indicators for severe traumatic brain injury and to evaluate the practical value in predicting prognosis(X2= 22.92,P＜ 0.01).Results 48 patients died and 36 survived.56(67%)patients had a bad prognosis(GCS≤3)and 28(33%)had a good prognosis(GCS ＞3).Those who had a shorter decompression time(≤3h)had a better prognosis than those who had a longer decompression time(＞3h),with the mortality rate of 11% and 67% respectively.Lesser cisteme compression predicts better outcome.GCS,pupil reflex,midline shift,and complex injury didn' t enter the logistic regression equation.According to compression time,90.5% of the cases' prognosis was accurately predicted,according to compression time and cisterne compression,95.2% was accurately predicted.Conclusion The mortality rate of severe traumatic brain injury with hernia was high and surgical intervention was effective.Decompression time and cisteme compression were the most important factors affecting prognosis in severe traumatic brain injury and they could predict prognosis of most cases correctly.

Objective:To investigate the role of interleukin-10 (IL-10) and IL-12 in the differential diagnosis of tuberculous and malignant pleural effusion through measuring the serum and pleural effusion IL-10 and IL-12 levels of tuberculous and malignant pleural effusion patients.Methods: Forty-eight inpatients with exudative pleural effusion who didn''t receive any treatment before were selected.According to the pathogeny, the patients were divided into tuberculous pleural effusion group (n=25) and malignant pleural effusion group (n=23).The levels of IL-10 and IL-12 in peripheral blood and pleural effusion of the patients in two groups were detected by Cytometric Bead Array (CBA).The differences in IL-10, IL-12 levels and IL-12/IL-10 ratio were compared between two groups.The ROC curves of the above indexes, cast-off and adenosine deaminase (ADA) were used to compare the effects in differential diagnosis of tuberculous and malignant pleural effusion.Results: There were no statistical differences in the levels of serum IL-10, IL-12 and IL-12/IL-10 ratios of the patients between tuberculous and malignant pleural effusion groups (P>0.05),and the IL-12 level in pleural effusion and the IL-12/IL-10 ratio of the patients in malignant pleural effusion group were lower than those in tuberculous pleural effusion group (P<0.005).The area under the ROC curve for the levels of IL-12 in pleural effusion (0.984) was higher than those for the ratio of IL-12/IL-10, cast-off and ADA (0.744, 0.804 and 0.911, respectively) in the differential diagnosis of tuberculous and malignant pleural effusion.Conclusion: The detection of IL-12 levels in pleural effusion is helpful for the differential diagnosis of tuberculous and malignant pleural effusion, and the pleural effusion is easy to obtain, therefore the detection of IL-12 in pleural effusion is worth to be widely applied in clinic.

Adenocarcinoma ; drug therapy ; secondary ; surgery ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents ; adverse effects ; therapeutic use ; Benzenesulfonates ; adverse effects ; therapeutic use ; Carcinoma, Renal Cell ; drug therapy ; secondary ; surgery ; Diarrhea ; chemically induced ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; drug therapy ; pathology ; surgery ; Liver Neoplasms ; drug therapy ; secondary ; Lung Neoplasms ; drug therapy ; secondary ; Male ; Middle Aged ; Niacinamide ; analogs & derivatives ; Phenylurea Compounds ; Pyridines ; adverse effects ; therapeutic use ; Remission Induction

Objective To compare the fetal and maternal outcomes of labor undergoing epidural block anesthesia with and without using hand-and-knee position in the second stage of labor.Methods A total of 1,158 subjects were included in the study.There were 560 subjects in the study group and 598 cases in the control group.All the subjects were divided into study and control group according to the randomized numbers.Both groups underwent epidural block anesthesia and used the same labor way in stage I and stage 3.In the study group,the hand-and-knee position was used for 15～30 minutes combined with uterine contractions and the delivery was done in the lithotomy position.In the control group,the gradidea took the semi-recumbent position with bent knees and bed elevated 40°,combined with uterine contractions until the delivery was done in the lithotomy position.The labor time of stage1,stage2,stage3 and all abor,labor way,perinaueum,complications and newborns were compared.Results The average time of the second stage labor and all labor in the observation group were significantly shorter than those of the control group (P＜0.05).The labor ways in the observation group was better than that of the control group (P＜0.05).The incidence of postpartum urinary retention in the observation group was significantly lower than that of the control group (P＜0.05).The differences of labor time for stage 1,stage2,perinaueum,blood loss rate,newboms' s tomor and neonatal asphyxia between two groups were not statistically significant (P＞0.05).Conclusions Under continuous epidural block anesthesia,the use of the hands-and-knees position in the second stage of labor can reduce the incidence of operative delivery,shorten the labor process,and reduce maternal complications.The method is worthy of promotion.

Objective To make hiatal hernia(HH) children grow and develop well by making correct early diagnosis and reducing misdiagnosis.Methods Reviewing clinical data of 12 patients with HH,including clinical character,X-ray diagnosis,correct examination,treatment and prognosis.Results Of 12 patients,9 cases were left HH,and 3 cases were right HH.All of them had internal expectant treatment;4 of them had operation.All of them had a good prognosis.Conclusions X-ray radiograph is a chief method of diagnosis of hiatal hernia.It is important to choose a specific position properly during radiograph examination.

Objective To compare the clinical utility of alpha-fetoprotein (AFP) and des-gammacarboxyprothrombin (DCP) in diagnosing hepatocellular carcinoma (HCC) in patients with a hepatic mass.Methods From January 2015 to May 2015,141 patients were diagnosed to have a liver tumor after imaging examinations in the Hepatobiliary Surgical General Hospital of PLA,Beijing,China.Preoperative AFP and DCP were measured using commercial assay kits.The reference standard was either pathologic or clinical diagnosis of HCC.The performance of AFP and DCP in diagnosing HCC was determined using receiver operating characteristic curve analysis.Results Of 141 patients,98 were diagnosed to have HCC and 43 without.The levels of AFP were significantly higher in patients with HCC than those without [80.0(3.9-1 375.0) μg/L vs.2.1 (1.6-3.2) μg/L,Z =6.98,P ＜ 0.01].Similar results were observed in the levels of DCP [141.5 (24.0-978.0) AU/L vs.19.0 (14.0-25.5) AU/L,Z =5.18,P ＜ 0.01].Receiver operating curves (ROC) indicated the cut-off value with the best sensitivity and specificity was 3.6 μg/L for AFP and 35 AU/L for DCP.The difference in the area under ROC between AFP and DCP was not statistically significant (0.87 vs.0.78,Z =1.72,P =0.085).The sensitivity and specificity for detection of HCC in patients with a hepatic mass were 56.1％ and 95.4％ for AFP ＞ or =20 μg/L,69.4％ and 83.7％ for DCP ＞ or =40 AU/L,respectively.The level of AFP was associated with DCP in patients with HCC (x2 =9.12,P ＜ 0.01,r =0.292) and parallel testing of AFP and DCP gave an optimal sensitivity of 79.6％ with a specificity of 81.4％ in diagnosing HCC.Conclusions DCP is a useful biomarker and it gave an equal performance as AFP in diagnosing HCC in patients with a liver mass in this study.Parallel testing of AFP and DCP effectively increased the diagnostic sensitivity.Although the biomarkers only marginally improved the diagnostic results,it could be useful in diagnosing HCC in individuals who had atypical imaging results.

Objective To investigate the expression of stem cell associated protein CD90 in primary hepatocellular carcinoma (HCC) and its relationship with clinical pathological characters ;to analyze the relation between CD90 and epithelial mesenchymal transition (EMT) markers E‐cadherin (E‐cad) and N‐cadherin (N‐cad) .Methods The expressions of CD90 ,E‐cad and N‐cad in 53 tissues of HCC were detected by immunohistochemistry streptavidin‐perosidase (SP ) method , and 10 surrounding of liver benign lesions were studied as control .The expression of E‐cad and N‐cad in CD90 positive cells of two HCC cell lines (M HCC97‐L and HCCLM‐3 ) was measured by flow cytometry .Chi square test and Spearman rank correlation analysis were performed for count data .Independent sample t test was used for measurement data comparison .Results There was no CD90 expression in control liver tissue . The positive rate of CD90 expression in HCC tissue was (34% ,18/53) ,and the difference between two groups was statistically significant (χ2 = 4 .755 , P< 0 .05) .The expression of CD90 in HCC was positively correlated with portal vein cancer embolus (r= 0 .378 , P< 0 .05) and was negatively correlated with histological differentiation degree and capsular infiltration (r= -0 .398 and -0 .519 ,both P<0 .05) .The expression of CD90 was negatively correlated with the expression of E‐cad (r= -0 .341 , P<0 .05) ,however was positively correlated with the expression of N‐cad (r=0 .441 ,P<0 .05) .The positive expression rate of E‐cad in CD90 positive HCCLM‐3 cells was lower than that of MHCC97‐L cells ((2 .56 ± 0 .29)% and (4 .31 ± 0 .18)% ,t= 8 .757 ,P< 0 .05) ,while the positive expression rate of N‐cad was higher than that of MHCC97‐L cells ((8 .10 ± 1 .45)% and (5 .51 ± 0 .44)% ,t= -9 .667 ,P<0 .05) .Conclusions The expression of stem cell associated protein CD90 is correlated with the EMT of HCC .Their interaction promote tumor infiltration metastasis w hich may be a new target of HCC treatment .