Objective To investigate the imaging manifestations of granular cell tumor of soft tissue,and to improve its diagno-sis.Methods The clinical,CT and MRI data of 21 granular cell tumors of soft tissue confirmed by surgery and pathology were ret-rospectively analyzed.Results Among 21 cases,there were 8 cases located in skin and subcutaneous soft tissue,3 cases in saddle ar-ea,2 cases in throat,and each 1 case in broad ligament of the uterus,mediastinum,tongue,breast,penis,vagina,ileocecal region and the bladder.The imaging findings were solid masses in 12 cases,cystic and solid masses in 7 cases,and cystic masses in 2 ca-ses.Conclusion Granular cell tumor of soft tissue does not have specific predilection sites and obvious imaging specificity.There-fore,the final diagnosis often relies on pathology.

Objective To evaluate the accuracy of continuous noninvasive partial pressure of carbon dioxide monitoring in the old diabetic patients undergoing general anesthesia.Methods Sixty-six old diabetic patients of both sexes,aged 65-76 yr,weighing 49-95 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective surgery under general anesthesia,were included in this study.Transcutaneous partial pressure of carbon dioxide (TcPCO2) was monitored by a noninvasive transcutaneous carbon dioxide monitor.Arterial blood samples were collected at 30 and 60 min after endotracheal intubation,partial pressure of arterial carbon dioxide (PaCO2) was monitored,and TcPCO2 and end-tidal pressure of carbon dioxide (PET CO2) were recorded.Bland-Altman analysis was used to measure the agreement.Results At 30 min after intubation,the results of Bland-Altman analysis showed that the mean difference between PaCO2 and TcPCO2 was 1.3,95％ confidence interval (CI) was 1.0-1.6,and the limit of agreement was-1.1-3.7;the mean difference between PaCO2 and PETCO2 was -3.2,95％CI:-3.6--2.8,and the limit of agreement was-6.6-0.2.At 60 min after intubation,the results of Bland-Altman analysis showed that the mean difference between PaCO2 and TcPCO2 was 1.4,95％ CI was 1.1-1.7,and the limit of agreement was-1.0-3.4;the mean difference between PaCO2 and PETCO2 was-3.1,95％CI was-3.5--2.7,and the limit of agreement was-6.7-0.5.The repeatability coefficients of PaCO2,TcPCO2 and PETCO2 were 2.1,2.3 and 2.3,respectively,at 30 and 60 min after intubation.Conclusion Continuous noninvasive partial pressure of carbon dioxide monitoring provides good accuracy and can be used as an alternative to PaCO2 monitoring,and the accuracy is higher than that of PETCO2 for the old diabetic patients undergoing general anesthesia.

Objective To evaluate how well the risk factors associated with stroke recurrence been controlled by community-based medical centers in urban areas of Beijing.Methods A cross-sectional study was performed in 5 community-based medical centers in urban areas of Beijing.A total of 999 patients with the experience of ischemic stroke were evaluated from Dec.2004 to Nov.2005.Results Ninety-six percent of patients suffered from at least one of the most common diseases(risk factors) associated with stroke recurrence,i.e.hypertension(HT),heart disease,diabetes,hyperlipidemia and obesity,and 80% of patients were with more than 1 disease.The proportion of HT was 79.1%(790/999) and the awareness,treatment and control rates of HT patients were 93.3%(737/790),84.3%(666/790) and 40.3%(318/790),respectively.The proportion of heart diseases and obesity among 999 stroke patients were 34.4% and 19.1%%,respectively.31.9%(319/999) of patients had diabetes and 84.0%(268/319) of the patients knew their history of diabetes.Of 319 diabetes patients,68.3%(218/319) were under active treatment and 45.4%(99/218) of them had their fasting blood glucose well controlled.The proportion of hyperlipidemia was 72.9% and the treatment rate for hyperlipidemia was as low as 29.5%(215/728).There were 43.7% and 50.0% of patients quit smoking and alcohol drinking after their acute stroke.72.7%(726/999) of patients were receiving aspirin regularly.Conclusion The proportion of cardiovascular diseases were high among the patients with ischemic stroke who were under the management of community-based medical centers.The community-based medical centers have played an important role in the secondary prevention of stroke.However,the management for ischemic stroke patients with diabetes and hyperlipidemia needs to be improved.

BACKGROUND: Magnetic labeling of stem cells is a recently developed stem cell in vitro labeling technique. Through in conjunction with magnetic resonance imaging (MRI), it can monitor transplanted stem cells in vivo. OBJECTIVE: To identify the method of superparamagnetic iron oxide (SPIO) labeling pig bone marrow mesenchymal stem cells (BMSCs), to investigate the characteristics of stem cells labeled by various SPIO following MRI, and to determine the minimum amount of labeled cells fer MRI. DESIGN, TIME AND SETTING: A control observation was performed at the laboratories of Department of Cardiovascular Surgery, Medical College of Soochow University, and Medical Imaging Centre, First Affiliated Hospital, Soochow University between September 2006 and March 2007. MATERIALS: Fresh porcine iliac bone marrow was collected from Taihu Meishan pigs. SPIO nanometer particles were purchased from Schedng, Germany. Ultramicro SPIO (USPIO) nanoparticles were provided by School of Chemistry and Chemical Engineering, Soochow University. For such particles, crystal nucleus surface was coated with dextran, and following coating, they were named 1#, 2#, 3# for short according to particle size. METHODS: Following isolation, purification, and culture, BMSCs were in vitro labeled by various kinds of SPIO nanoparticles. The labeled cells were subjected to Prussian blue staining and fluorescence microscope observation. The cell growth was observed using MTT method and the growth curve was plotted. For Feridex-labeled cells, 1×106), 5×105, and 1×105 three cell amount groups were set, for unlabeled cells, a 5×105 cell amount group was included, and for 1#, 2#, and 3# SPIO-labeled cells, only 5×105 cell amount group was used. MRI was conduced for measurement of signal intensity of cells labeled by different scanning sequences, followed by statistical analysis. MAIN OUTCOME MEASURES: Detection of SPIO nandparticles-labeled cells by Prussian blue staining; Growth curves of SPIO nanoparticles-labeled cells; Detection of cellular apoptosis by double staining; Determination of signal intensity of cell masses from different Ependoff tubes using MRI with T1WI, T2WI, and fast field echo (FFE) sequences. RESULTS: BMSCs could be labeled with SPIO and the labeling efficiency was 100%. Different amounts of blue-stained Fe particles could be observed in the cytoplasm by Prussian blue staining. SPIO labeling caused a significantly lower signal attenuation effect in T2WI and FFE (T2*WI) images than in T1WI images. In a labeling concentration of 25 mg/L Fe solution, the minimum cell amount for MRI was 1 x 105. The signal intensity exhibited significant difference in 2#, 3#USPIO- and Feridex-labeled cells in no matter T2WI or T2*Wl images(P < 0.01). But no significant difference was found between 1#USPIO- and Feridex-labeled cellss in no mater T2WI or T2*WI images(P > 0.05). There was significant difference in signal intensity of Feridex-labeled BMSCs between T2WI, T2*WI and T1Wl images (P < 0.01). CONCLUSION: BMSCs can be easily and efficiently labeled by SPIO nanoparticles without interference, at proper concentrations on cell viability and proliferation. MRI visualization of SPIO-labeled BMSCs is feasible in both T2WI and T2*WI images.

Objective To evaluate the effect of hydrogen on the expression of nuclear factor E2?related factor 2 ( Nrf2 ) during endotoxin?induced oxidative injury to macrophages. Methods Normally cultured Raw264.7 cells were divided into 4 groups ( n=36 each) using a random number table: control group (group C), hydrogen?rich saline group ( group H), endotoxin group ( group E) and endotoxin plus hydrogen?rich saline group (group EH). In E and EH groups, endotoxin was added with the final concentration of 1 μg∕ml. Hydrogen?rich saline ( hydrogen concentration 0. 06 mmol∕L) was added in H and EH groups. All the cells were incubated for 48 h. At 6, 24 and 48 h of incubation, cells were collect?ed to detect the activity of reactive oxygen species ( ROS) , and cells were collected and proteins extracted for determination of superoxide dismutase ( SOD) and catalase ( CAT) activities and Nrf2 expression by Western blot. Results Compared with group C, the ROS activity was significantly increased, the levels of SOD and CAT were significantly decreased, and the expression of Nrf2 was significantly up?regulated in E and EH groups (P<0.05), and no significant change was found in the parameters mentioned above in group H (P>0.05). Compared with group E, the ROS activity was significantly decreased, the levels of SOD and CAT were significantly increased, and the expression of Nrf2 was significantly up?regulated in group EH (P<0.05). Conclusion Hydrogen can attenuate endotoxin?induced oxidative injury to macro?phages, and the mechanism may be related to up?regulated expression of Nrf2.

Objective To investigate the clinicopathological characteristics,treatment methods and prognosis of rectal cancer in patients younger than 40 years old.Methods From Jan,1998 to Dec,2003,325 treated rectal cancer patients with complete surgical records were divided into two groups:young patients group(younger than 40 years old)49 patients,accounted for 15.1%;middle and old patients group(older than 40years old)276 patients,accounted for 84.9%.The clinicopathological characteristics,treatment methods and follow-up data were compared.Results Among the younger patients,cancer in middle and lower segments of rectum accouned for 79.6%(39/49),infiltrative cancer accounted for 55.1%(27/49),mucous and low-differentiated cancer accounted for 83.7%(41/49),cancer invasion of serosa occurred in 87.8%(43/49),lymph node metastasis in 75.5%(37/49),Miles operation was performed in 65.3%(32/49)and Dixon operation in 34.7%(17/49).These characteristics differewed significantly from middle-aged and old patients.And the 5-year survival-rate in youn patient group was 32.7% and in middle and old patient proup was 60.9% respectively,(P

Objective To evaluate the role of ERK1/2 signaling pathway in mitigation of myocardial ischemia-reperfusion (I/R) injury by diazoxide postconditioriing in rats.Methods Sixty adult male SpragueDawley rats,aged 3 months,weighing 240-260 g,were randomly divided into 5 groups (n =12 each) using a random number table:sham operation group (S group),I/R group,vehicle group (Ⅴ group),diazoxide postconditioning group (D group),and ERK1/2 signaling pathway inhibitor U0126 group (U group).Myocardial I/R was produced by occlusion of left anterior descending branch of coronary artery for 30 min followed by 120 min reperfusion.In V and D groups,0.4％ DMSO and diazoxide 7 mg/kg (in 1 ml 0.4％ DMSO) were administrated,respectively,through the femoral vein at the onset of the reperfusion.In U group,U0126 was given through the femoral vein at 10 min before reperfusion,and the following procedures were similar to those previously described in group D.At 120 min of reperfusion,myocardial specimens were obtained for detection of myocardial infarct size,cell apoptosis (using TUNEL),and expression of ERK1/2 mRNA (by RT-PCR),total ERK1/2 (t-ERK1/2) and phosphorylated ERK1/2 (p-ERK1/2) (by Western blot).Apoptosis index was calculated.Results Compared with S group the myocardial infarct size and apoptosis index were significantly increased in the other groups,the expression of ERK1/2 mRNA and p-ERK1/2 was down-regulated in I/R,V and U groups,and no significant change was found in the expression of ERK1/2 mRNA and p-ERK1/2 in Dgroup.Compared with I/R group,the myocardial infarct size and apoptosis index we re significantly decrcaed,and the expression of ERK1/2 mRNA and p-ERK1/2 was up-regulated in D group,and no significant change was foundin the parameters mentioned above in V and U groups.Compared with D group,the myocardial infarct sizeand apoptosis index were significantly increased,and the expression of ERK1/2 mRNA and p-ERK1/2 was down-regulated in U group.There was no significant difference in t-ERK1/2 expression between five groups.Conclusion Diazoxide postconditioning mitigates myocardial I/R injury possibility through activating ERK1/2 signaling pathway in rats.

Objective To evaluate the influence of diabetes mellitus on changes in plasma osmotic pressure during bowel preparation in patients undergoing radical resection for colon cancer.Methods Sixty patients,of ASA physical status Ⅰ or Ⅱ,aged 40-60 yr,weighing 50-75 kg,scheduled for elective radical resection for colon cancer,were included in the study.Of the 60 patients,30 patients with type 2 diabetes mellitus served as test group (group DM),and 30 patients without diabetes mellitus served as control group (group C).Polyethylene glycol electrolyte powder was given orally for bowel preparation before surgery.In the early morning of the day on which preoperative preparation was performed (T1) and before opening venous channels after admission to the operating room (T2),venous blood samples were taken for determination of plasma colloid osmotic pressure (COP) and concentrations of plasma electrolytes (Na+,Cl-,K+) and blood glucose.Thirst was assessed using visual analogue scales at T1 and T2.Results Compared with the baseline value at T1,the plasma COP and degree of thirst were significantly increased at T2 in C and DM groups,blood glucose concentrations were decreased at T2 in group DM,and no significant changes were found in the plasma concentrations of electrolytes at T2 in both groups.Compared with group C,blood glucose concentrations were significantly increased,and no significant changes were found in the plasma concentrations of electrolytes at T1,2,no significant change was found in plasma COP and degree of thirst at T1,and the degree of thirst was decreased at T2,while the plasma COP was increased at T2 in group DM.Conclusion After bowel preparation in patients undergoing radical resection for colon cancer,although the thirsty sensation of the patients with diabetes mellitus is decreased,the plasma COP is obviously increased; thus infusion of appropriate crystalloid solution instead of colloid solution is required in case hyperosmolar coma develops.

Objective To investigate the value of the application of fibrobronchoscopy in extubation for patients suffering from acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with low cough peak expiratory flow(CPEF). Methods A single-center prospective controlled study was conducted. The ventilated AECOPD patients who were cooperative at the time of extubation in Department of Critical Care Medicine of Guangzhou Institute of Respiratory Disease of Guangzhou Medical University from June 2009 to May 2014 were enrolled. All patients successfully passed the spontaneous breathing trial(SBT). Extubation was performed after determination of CPEF following energetic coughing. According to the CPEF,the patients were divided into CPEF≥60 L/min group (high CPEF group)and CPEF<60 L/min group(low CPEF group). After extubation,fibrobronchoscopic drainage was given to the patients in high CPEF group when necessary. Fibrobronchoscopic drainage was given to the patients in low CPEF group at least once a day,and the frequency of such treatment could be increased according to the patient's condition. If the patients did not require re-intubation within 48 hours,extubation was recorded as successful. The gender,age,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score before extubation,ventilation time,the time of intensive care unit(ICU)stay,the mortality in ICU,the rate of re-intubation,the ability to cough and the frequency of application of fibrobronchoscopy after extubation were recorded. Results A total of 102 patients with AECOPD were enrolled,58 patients in high CPEF group and 44 in low CPEF group. Compared with high CPEF group,the mean age in low CPEF group was older(years:74.3±15.2 vs. 69.5±11.4,t=2.164,P=0.041),the time of ICU stay was significantly longer(days:20.1±11.2 vs. 17.4±7.3,t=2.274,P=0.030), but there was no significant difference in gender〔male/female(cases):35/9 vs. 45/13,χ2=0.057,P=0.812〕, APACHEⅡscore(11.9±1.9 vs. 10.3±4.2,t=1.290,P=0.200),mechanical ventilation time(days:14.8±10.8 vs. 13.3±9.6,t=0.677,P=0.501)and the rate of re-intubation〔18.18%(8/44)vs. 12.07%(7/58),χ2=1.412, P=0.235〕between low CPEF group and high CPEF group. The cough strength of patients in high CPEF group was almost alwaysstrong(52 cases),and in the low CPEF group,most of them wasmoderate(14 cases)orweak(26 cases). The frequency of application of fibrobronchoscopy in low CPEF group was higher than that in high CPEF group(times:4.1±1.8 vs. 1.3±0.9,t=2.626,P=0.011). All patients underwent weaning successfully,and no death occurred. Conclusion The application of fibrobronchoscopy in the extubated AECOPD patients with low CPEF can reduce the rate of re-intubation,avoid the prolonged ventilation,but cannot reduce the time of ICU stay.

Objective To evaluate the relationship between extracelluar signal?regulated protein kinase 1∕2 (ERK1∕2) and signal transducer and activator of transcription 3 (STAT3) signaling pathways involving in cardioprotection induced by diazoxide postconditioning in rats. Methods Sixty adult male Sprague?Dawley rats, aged 3 months, weighing 240-260 g, were randomly divided into 5 groups ( n=12 each) using a random number table: sham operation group ( SH group ) , ischemia?reperfusion ( I∕R ) group, diazoxide postconditioning group ( D group ) , ERK1∕2 inhibitor U0126 group ( U group ) , and STAT3 inhibitor Stattic group ( St group) . Myocardial I∕R was produced by occlusion of anterior descending branch of the coronary artery followed by 120 min reperfusionIn I∕R and D groups, 0?4% dimethyl sulfoxide 1 ml and 7 mg∕kg diazoxide ( in 1 ml of 0?4% dimethyl sulfoxide) was injected through the femoral vein at the onset of reperfusionIn U and St groups, U0126 100 μg∕kg and Stattic 500 μg∕kg were injected through the femoral vein at 10 min before reperfusion, and the other procedures were similar to those previously described in group DAt 120 min of reperfusion, the rats were sacrificed, and myocardial specimens were obtained from the left ventricle for determination of myocardial infarct size, cell apoptosis, and ERK1, ERK2 and STAT3 mRNA expression ( real?time PCR), and phosphorylated ERK1∕2 ( p?ERK1∕2) and phosphorylated STAT3 (p?STAT3) (using Western blot). Apoptosis index (AI) was calculated. Results Compared with group S, the myocardial infarct size and AI were significantly increased, and the expression of ERK1, ERK2 and STAT3 mRNA, p?ERK1∕2 and p?STAT3 was down?regulated in group I∕R. Compared with group I∕R, the myocardial infarct size and AI were significantly decreased, and the expression of ERK1, ERK2 and STAT3 mRNA, p?ERK1∕2 and p?STAT3 was up?regulated in group D. Compared with group D, the myocardial infarct size and AI were significantly increased in U and S groups, the expression of ERK1, ERK2 and STAT3 mRNA, p?ERK1∕2 and p?STAT3 was down?regulated in group U, and the expression of STAT3 mRNA and p?STAT3 was down?regulated, and no significant change was found in ERK1 and ERK2 mRNA and p?ERK1∕2 expression in group S. Conclusion STAT3 signaling pathway is located downstream of ERK1∕2 signaling pathway in the mechanism by which diazoxide postconditioning reduces myocardial I∕R injury in rats.