Objective To explore the clinicopathological and immunohistochemical features of primary malignant pericardial mesothe- lioma.Methods Seven cases of primary malignant pericardial mesothelioma,in 4 females and 3 males,with the age ranged from 22 to 51 and a mean of 40 years old,were studied with clinicopathological,immunohistochemical and histochemical techniques,The pertinent litera- ture was also comprehensively reviewed.Results 3 biopsy specimens and 4 surgical specimens,including 2 autopsy specimens,were stud- led.The main clinical symptoms were palpitation and short breath,which were aggravated after movement.The longest course was 4 years,and the mean disease course was 12 months.The chest films demonstrated an obviously increase in heart shadow,and the pericardi- um was thickened in some cases.CT clearly showed tumorous shadow in 2 cases.The histopathologic picture showed tubular type in 2 ca- ses,papillary in 2,signet ring cell type in 1 and myofibroblast types in 2.In 2 autopsy specimens it was found that pericardium was dif- fusely thickened.In one case the tumor was metastasized to the right lung,mediastinum,and pulmonary hilar lymph node.In another case there was metastasis to right kidney.Immunohistochemical staining showed that the neoplastic cells of all cases were positive for CK5/6, calretinin,CK.vimentin and EMA,but negative for CEA.In the histochemical staining seven cases,the malignancy was positive for CI to different extent,but negative for HCL Conclusion Immunohistochemistry and histochemistry play an important role in diagnosis and dif- ferential diagnosis for primary malignant mesothelioma and other tumors in pericardium.

Objective To investigate the expression of p16 gene in malignant mesothelioma,and its relationship with histological types,clinical stages and prognosis.Methods Immunohistochemical staining was used to detect the expression of p16 gene in the specimens of 80 cases of malignant mesothelioma.Results The positive expression of p16 gene was found in 35% malignant mesothelioma specimens,and negative in 65%(P

Adult ; Anesthesia, General ; Bronchoalveolar Lavage ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; surgery ; Ventilators, Mechanical

Objective To explore the dynamic change of serum leptin interleukin-6(IL-6),and interleukin-8(IL-8)during cerebral infarction,and to analyze the possible relationship between these factors and the severity of the disease.Method The levels of serum leptin,IL-6 and IL-8 were measured by radioimmunoassay in 60 patients with acute cerebral infarction,who were admitted to the hospital within 24 hours after stroke.Patients' neurologic impairment were evaluated by European Stroke Scale(ESS)at 1,3 and 7 days respectively after hospitalization.At the same time,another 30 normal adults were enrolled set as control group. Results The levels of serum Leptin,IL-8 in patients group after at 1 days,3 and 7 days were higher than those in the controls(P0.05).The ESS of these patients were 76.77?26.42,70.02?29.17,74.65?28.42 respectively,after 1,3 and 7 days.It shown that ESS simply correlated to the level of IL-8(P0.05).Statistic analysis was carried,but by using t test and linear correlation.(SPSS11.5 statistical package).Conclusion Leptin,IL-6 and IL-8 probably play a role in the inflammatory,reaction during acute cerebral infarction.The IL-8 may reflect the severity of the disease.

AIM: To assess the changes of macular thickness of acquire immunodeficiency syndrome ( AIDS) patients.
METHODS:The study based on the data analysis of 38 human immunodeficiency virus ( HIV ) positive patients ( 64 eyes ) . According to CD4 count and whether cytomegalovirus retinitis ( CMVR) happened, the patients were divided into 3 groups. Group A included 16 patients (32 eyes), in which CD4 count was < 50cells/μL and CMVR did not happen. Group B included 10 patients ( 20 eyes), in which CD4 count was>50cells/μL and CMVR did not happen. Group C included 12 patients (12 eyes), in which CD4 count was < 50cells/μL and CMVR just happened. Group D included 10 healthy people ( 20 eyes ) , as normal control group. By using optical coherence tomography ( OCT ) , thickness of retina along with a 1mm diameter circle centered on macular was evaluated.
RESULTS:The mean foveal thicknesses in groups A, B, C and D were 254. 03±15. 63μm, 263. 11±17. 12μm, 304. 50±50. 62μm and 257. 64±8. 54μm in order. Compared with foveal thickness in each group, there were significant differences in general (F=12. 933, P=0. 000). The mean foveal thickness in groups CMVR increased, which was of significant difference (P= 0. 000), compared with other groups.
CONCLUSION: CMVR can impair the structure and function of macular, which then seriously affects the visual function of patients. It's helpful to understand the progress and prognosis of CMVR disease by observing macular structure with OCT in early time.

Objective To explore the application of video laryngoscope in patients with pituitary adenoma during endotracheal intubation.Methods Fifty-one patients (19 males, 32 females, aged 18-71 years, ASA physical status I or II) scheduled for resection of pituitary adenoma under general anesthesia were enrolled.These patients were randomly divided into two groups: Macintosh laryngoscope Group (group M, n=25) and Video laryngoscope Group (group VL, n=26).When performing endotracheal intubation, Macintosh laryngoscope was used to expose the glottis in group M, and video laryngoscope was used in group VL.Head tilted backward angle, mouth opening, thyromental distance, neck circumference, mandibular ramus length, modified Mallampati classification and the difficulty classification of mask ventilation of the patients in two groups were recorded during peri-operation period.The Cormark-Lehane grade, needed pressing of the cricoids cartilage, the ratio of a second attempt during intubation and the intubation time consumed were recorded.Results Less patients in group VL needed cricoids cartilage press (7.7% vs 48.0%) during the intubation than that in group M (P<0.01).Compared with group M, the Cormack-Lehane grade was significantly lower (P<0.01) and the intubation time consumed was significantly shorter in group VL [(32.4±11.7)s vs (45.8±12.6)s] (P<0.01).Conclusion In patients with pituitary adenoma,video laryngoscope may improve the glottis exposure and the success rate of intubation, as well as shorten the intubation time.

Objective To explore relationship between imaging classification and pathological type,and the electron microscopic ultrastructure by observing the ultrastructural features of congenital cystic adenomatoid malformation (CCAM).Methods Children with CCAM in the Guangdong Women and Children Hospital from May 2014 to November 2014,were analyzed,imaging classification was performed according to enhanced Computed Tomography (CT) scanning,and the surgical specimens were stained by HE and scanning electron microscope was used to observe the tissue structures of various of CCAM.Results Eight cases were enrolled in this research (5 boys and 3 girls),and the mean age of surgery was (5.4 ± 1.1) month old.According to the features of enhanced CT scanning,there were 2 cases of the type-Ⅰ,and the other 3 cases of type-Ⅱ,and 3 cases of type-Ⅲ;According to the characteristics of the pathological types,there was 1 case of type-Ⅰ,4 cases of type-Ⅱ,and the other 3 cases of type-Ⅲ.There was 1 case which classified as type-Ⅰ by CT,however classified as type-Ⅱ by pathological typing.The findings of CT features were in complete correspondence with the pathological types in the rest cases.Electron microscopic findings showed the alveolar spaces were enlarged,the alveolar cells were reduced,the lamellar bodies were decreased and immature and microvilli were also decreased.There was no significant difference between Ⅰ and Ⅱ type under the viewpoint of electron microscope.The common features between type Ⅰ,and type Ⅱ included that the alveolar space was enlarged,the alveolar space had been pressed between enlarged alveolar space,the alveolar cell were decreased and immature,and fibrous hypertrophy was also found.Conclusions There are differences between ultrastructural analysis and clinical pathological typing which suggests the clinical importance of the electron microscopy ultrastructural analysis combined with pathology for typing.There need further clinical and laboratory studies,especially the combination of microscopy-electrical control microscope for typing with related predictive models for follow-up of CCAM.

At present,the doctor-patient relationship in China is a little tense,communication between doctors and patients is not smooth,and the doctor-patient communication skills of the young doctor is obviously insufficient and need to be improved.In this paper,we analyze the factors that affect the communication between doctors and patients in the Department of Neurology through the complexity of professional knowledge,the current background and so on.In addition,we discuss multiple methods of improving communication capability among this group doctors,hoping to strengthen young physicians' clinical basic skills training,and impart doctor-patient communication skills from the linguistic modifiers,oral expression,words and deeds,use of metaphor,simulation training and other aspects,and establish dynamic assessment system of doctor-patient communication ability.

Adult ; Bronchoalveolar Lavage ; adverse effects ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; therapy ; Tachycardia, Sinus ; etiology

Objective To observe the curative effect and adverse reactions of intercostals nerve block combined with fentanyl transdermal system in treatment of post-thoracotomy pain syndrome (PTPS). Methods Intercostals nerve block combined with fentanyl transdermal system was used for treatment of 141 patients with PIPS. The degree of pain relief was evaluated by numerical rating scale (NRS),the quality of life of patients was evaluated by the quality of life score standard,and the adverse reactions were also observed. Results The overall remission rate was 97.85%,there were 51 cases (36.43%)with complete remission, 80 cases (57.14%)with significant remission,and 6 cases (42.85%) with moderate remission. The adverse reactions included nausea,vomiting, constipation,dizziness,skin pruritus and dysuria,no serious liver and kidney function damage and respiratory inhibition. The quality of life of all patients was improved. Conclusion Multimodal analgesia has better curative effect and less adverse reactions in treatment of PTPS,so it deserves clinical promotion.