Objective To find a proper way for accurate results on complete blood counts.Methods Based on the results from automatic hematology analyzer, set up criteria for blood cell microscopic examination. 9 992 blood specimens were detected and the results were analyzed according to the criteria, statistics on the data were made to find out the reliability of the policy.Results The criteria could help to find more abnormal cells, it was very useful for clinical diagnosis and proper treatment.There were 29.3% of CBC specimens needed for microscopic examination, 32.2% of which had increased bands or increased atypical lymphocytes or other abnormalities.Conclusions It was very important to set up the criteria for performing peripheral blood smear. It can provide more accurate and reliable information to clinical doctors.

Objective To observe the effects of methionine enkephalin (M-Enk) on migration of macrophages from mice with impaired liver and its immunomodulatory mechanisms. MethodsLiver of mice was impaired by feeding CCl4 and macrophage migration inhibitory factor (MMIF) was produced by Con A-stimulated spleen lympho- cytes. Inhibition of macrophage migration was measured in reaction system by adding M-Enk. Results Migration of macrophages in both liver-impaired and control group were suppressed by MMIF, but the suppression might be re- versed by adding 1 μmol/L M-Enk (P＜0. 05). M-Enk could significantly inhibit in vitro both of the combination of MMIF with macrophages and production of MMIF from lymphocytes (P＜0. 01). Macrophages from liver-imparied group showed a higher sensitivity compared to the control group (P＜0. 05). ConclusionThe study suggests that opi- oid peptieds play an important role in the modulation of the immune response under stress as liver impairment.

BACKGROUND: Stellate ganglion block has the ability to improve the imbalance of the autonomic nervous system in perimenopausal syndrome. Lumbosacral plexus is an automatic nervous block, and exerts similar effects with stellate ganglion block. OBJECTIVE: To investigate the effect of lumbosacral plexus block on the serum level of hormones and histology of the ovary in rabbits, thus providing a new treatment strategy for perimenopausal syndrome. METHODS: This was a randomized controlled animal experiment, which was finished at the Animal Center of Guiyang Medical Unversity, China. The healthy rabbits were randomly divided into experimental and control groups, and underwent lumbosacral plexus block by injecting 0.5 mg of vitamin B12, 100 mg of lidocaine and 10 mL of normal saline into the psoas compartment, and the same volume of normal saline, respectively. The effect of lumbosacral plexus block on the serum levels of hormones (estradiol, gonadotropin releasing hormone, follicle-stimulating hormone and luteinizing hormone) at rabbit proestrus, estrus and metaestrus were observed, respectively. The pathological changes of the ovary in a complete estrus cycle were observed. The relationship between the treatment time of lumbosacral plexus block and the levels of hormones was investigated after 1, 3 and 6 complete estrus cycles. The experimental followed the national guidelines for the Care and Use of Laboratory Animals, and Consensus author guidelines on animal ethics and welfare by the International Association for Veterinary Editors (IAVE), and prepared in accordance with the Animal Research: Reporting of In Vivo Experiments Guidelines (ARRIVE Guidelines). RESULTS AND CONCLUSION: Lumbosacral plexus block can increase the serum level of estrogen, reduce the serum levels of follicle-stimulating hormone and luteinizing hormone, and regulate the hypothalamic-pituitary-ovary axis function. Presumably, it may be used as a treatment method or adjuvant therapy of perimenopausal syndrome. Future experiments are needed to explore the effect of lumbosacral plexus block on the serum levels of hormones in a rabbit after oophorectomy to determine whether it exhibits the same effect on ovarian failure.

Currently, the number of systematic reviews on Chinese medicine (CM) increases gradually. However, the quality of the reviews varied, which resulted in great limitations in guiding clinical practice. This article refers to the Cochrane Handbook and PRISMA Statement to introduce the reporting specification of the systematic review, including asking a research question, review methods, presentation of the results, discussion and conclusion. We analyzed the methodology issues in the published systematic reviews on CM in order to improve the quality of future reviews.
Medicine, Chinese Traditional ; Research Design ; Review Literature as Topic ; Writing ; standards

Objective To evaluate low-mechanical-index contrast-enhanced ultrasound (CEUS) in assessing the clinical efficacy and feasibility of percutaneous microwave ablation (MWA) for the treatment of renal cell carcinoma (RCC). Methods From March 2006 to July 2013, a total of 105 RCC patients with 109 lesions, mean size being (3.1 ± 1.3) cm, were treated with ultrasound-guided percutaneous MWA. CEUS results obtained on the third day after MWA were compared with the contrast-enhanced CT/MRI and biopsy findings in the corresponding period. Follow-up examinations with CEUS and CT/MRI were carried out 1, 3 and 6 months after the treatment and once every 6 months thereafter to evaluate the short-term and the long-term therapeutic effectiveness. Results Three days after MWA, CEUS showed that 94 of 109 lesions (86.2%) were completely ablated, and residual tumor tissue was seen in 15 of 109 lesions (13.8%). Among the 15 lesions with residual tumor tissue, 13 (86.7%) were proved by contrast-enhanced CT/MRI and/or biopsy performed in the corresponding period. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of CEUS for the evaluation of the short-term MWA effectiveness were 100%, 97.9%, 98.2%, 86.7% and 100%, respectively. Patients were followed up for 3 - 90 months with a median period of 24.6 months. During the follow - up period, CEUS detected recurrence in 7 patients, and 6 of them were consistent with CT/MRI results. The sensitivity, specificity, accuracy, positive and negative predictive value of CEUS for the evaluation of the long-term MWA effectiveness were 85.7%, 99.0%, 98.2%, 85.7% and 99.0%, respectively. Conclusion For the evaluation of the effectiveness of percutaneous microwave ablation in treating renal cell carcinoma, CEUS is a sensitive, reliable and convenient technique.

The surgical treatment of craniofacial malformation is a sophisticated task which needs careful and detailed preoperative planning. However, based on the patient's 2-D CT and X-ray images, the surgeons always feel hard to produce a convincible and satisfying surgical scheme. In this article, a craniofacial surgery simulation system based upon 3-D reconstruction and volume calculation of two eye sockets is presented. By using this system, the surgeon can virtually repose bone fragment according to the D-value between the volumes of two eye sockets. The D-value serves as a guideline to direct the bone reposing. The simulated key steps of real surgical procedure are presented, which demonstrate the efficiency of the system. The contrast images between postoperative and preoperative surgery are also given.
Anthropometry ; Computer Simulation ; Computer-Aided Design ; Craniofacial Abnormalities ; surgery ; Humans ; Imaging, Three-Dimensional ; Orbit ; anatomy & histology ; Prosthesis Design ; Surgery, Computer-Assisted

OBJECTIVETo investigate the feasibility, safety and efficacy of ultrasound-guided percutaneous microwave ablation (MWA) of splenic tumors.

METHODSSeven patients with 8 pathologically confirmed splenic tumors (including 2 metastases from the ovary and 4 from the lung, gastric adenocarcinoma, hepatocellular carcinoma, or rectal carcinoma; 1 hemangioma and 1 inflammatory pseudotumor) with sizes ranging from 1.3 to 6.2 cm (mean 3.1 ± 1.9 cm) were treated with MWA. A cooled shaft needle antenna was percutaneously inserted into the tumor under ultrasound guidance. A thermocouple was placed about 0.5 cm away from the tumor to monitor the temperature in real time during the ablation. The microwave emitting power was set at 50-60 W. The treatment efficacy was assessed by contrast-enhanced imaging at 1, 3 and 6 months following the procedure, and every 6 months thereafter.

RESULTSAll the tumors were completely ablated in a single session and no complications occurred. No local tumor progression was observed during a median follow up time of 13 months (4 to 92 months). The ablation zone, well defined on contrast-enhanced imaging, was gradually reduced with time. A new metastatic lesion was detected in the spleen at 11 months after the ablation in a ovarian carcinoma patient and was successfully treated by a second MWA. The post-ablation survival of the patients with splenic metastasis was 13 months (range 4 to 92 months). No complications other than fever and abdominal pain were observed in these patients.

CONCLUSIONUltrasound-guided percutaneous MWA is a safe and effective minimally-invasive technique for treatment of splenic tumors in selected patients.

Adenocarcinoma ; pathology ; Carcinoma, Hepatocellular ; pathology ; Catheter Ablation ; Contrast Media ; Female ; Humans ; Liver Neoplasms ; pathology ; Microwaves ; Minimally Invasive Surgical Procedures ; Ovarian Neoplasms ; pathology ; Splenic Neoplasms ; diagnostic imaging ; radiotherapy ; secondary ; Stomach Neoplasms ; pathology ; Treatment Outcome ; Ultrasonography

OBJECTIVETo investigate the value of real-time contrast-enhanced ultrasound (CEUS) in the diagnosis and differential diagnosis of renal solid renal lesions (RSLs).

METHODSWe retrospectively analyzed 140 cases of 152 RSLs with a mean diameter 3.1∓1.9 cm. CEUS was performed and the perfusion characteristics were analyzed using contrast pulse sequences (CPS) technique. CEUS findings were compared with biopsy histopathologic findings.

RESULTSA total of 137 malignant lesions (including 127 renal clear cell carcinomas, 8 renal papillary carcinomas and 2 chromophobe cell carcinomas) and 15 benign lesions (13 angiomyolipomas and 2 renal oncocytomas) were detected. Of the 137 malignant lesions, 98 (71.5%) showed contrast agent fast perfusion and hyper-enhancement or iso-enhancement in cortical phase, 104 (75.9%) showed hypo-enhancement in later corticalmedullary and late phase, and 125 (91.2%) showed rim-like enhancement. Tumors with a diameter ≤2 cm presented with homogeneous enhancement, and those ranging from 2 to 4 cm showed heterogeneous enhancement with a honeycomb feature; tumors greater than 4 cm featured heterogeneous enhancement with large no-enhancement necrotic areas. Of the benign lesions, 13 angiomyolipomas and 2 renal oncocytomas showed slow wash-in and slow wash-out mode. The diagnostic specificity, accuracy and positive predictive value of CEUS for RSLs were 94.9%, 96.1%, and 73.7%, as compared to 72.3%, 71.1%, and 19.1% with conventional US, respectively (P<0.001). The sensitivity and negative predictive value of CEUS were 93.3% and 99.2%, respectively, significantly higher than those of conventional US (60% and 94.3%, P=0.084, and 0.062, respectively).

CONCLUSIONReal-time CEUS can provide valuable information for improving the diagnosis and differential diagnosis of RSLs.

Adenoma, Oxyphilic ; diagnostic imaging ; Carcinoma, Renal Cell ; diagnostic imaging ; Contrast Media ; Diagnosis, Differential ; Humans ; Kidney Diseases ; diagnostic imaging ; Kidney Neoplasms ; diagnostic imaging ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography

OBJECTIVETo explore the expression and clinical significance of Caudal-type homeobox transcription factor 2 (CDX2) gene in acute myeloid leukemia (AML) patients.

METHODReal time quantitative PCR (RQ-PCR) was used to test the expression level of CDX2 gene in 108 de novo AML patients and the clinical features of these patients were analyzed.

RESULTSCDX2 gene transcript levels were detectable in bone marrow mononuclear cells from 108 AML patients and 7 healthy donors, the median expression level were 1179.44 (range 14.15 - 867 961.10) and 105.30 (range 22.30 - 453.11). There was a statistically significant difference in expression level of CDX2 gene between the AML patients and normal donor (P < 0.01). All 14 patients with FLT3-ITD(+) were in CDX2 gene higher expression group (P = 0.018), including 10 patients with normal karyotype. In the 83 treated AML patients (P = 0.046) and 57 higher WBC count (≥ 10×10(9)/L, P = 0.048) patients, the higher expression level of CDX2 gene was associated with lower complete remission (CR) rates.

CONCLUSIONSHigher expression level of CDX2 gene was seen mostly in AML patients with FLT3-ITD mutation and with lower CR rates. CDX2 gene might be a prognostic molecular marker in AML patients with normal karyotype.

Adolescent ; Adult ; Aged ; CDX2 Transcription Factor ; Case-Control Studies ; Female ; Homeodomain Proteins ; genetics ; Humans ; Karyotyping ; Leukemia, Myeloid, Acute ; diagnosis ; genetics ; Male ; Middle Aged ; Mutation ; Prognosis ; Young Adult ; fms-Like Tyrosine Kinase 3 ; genetics

OBJECTIVETo evaluate breast reconstruction with a combined skin flap of the deep inferior epigastric perforator (DIEP) and the transverse rectus abdominis musculocutaneous (TRAM).

METHODSThe DIEP and TRAM united flap was elevated with the vessel pedicle of the deep inferior epigastric perforator on the affected side and the rectus abdominis muscle pedicle on the intact side. The reconstructive breast was shaped after the deep inferior epigastric vessels were anastomosed to the internal mammary vessels or the thoracodorsal vessels ipsilaterally.

RESULTSWe have used the DIEP and TRAM united flaps for breast reconstruction in 17 cases. All of the flaps survived, and the reconstructed breasts were well-shaped with the follow-up of 6-18 months.

CONCLUSIONSThe DIEP and TRAM united flap possesses of advantages such as rich blood supply, abundant tissue volume and easy shaping. It is especially applicable to the cases who have large chest defect and need large volume tissue.

Adult ; Epigastric Arteries ; transplantation ; Female ; Humans ; Mammaplasty ; methods ; Middle Aged ; Rectus Abdominis ; transplantation ; Skin Transplantation ; Surgical Flaps ; blood supply