Adult ; Breast Neoplasms ; secondary ; Diagnosis, Differential ; Female ; Humans ; Melanoma ; metabolism ; pathology ; secondary ; Melanoma-Specific Antigens ; metabolism ; Middle Aged ; S100 Proteins ; metabolism ; Sarcoma, Clear Cell ; pathology ; Skin Neoplasms ; pathology

The study on mycoflora in bottled purified d rinking water was carried out.91 Samples of products were colleted from 59 bottl ing factories in Fujian Province and were examined and identified.461 Strains of fungi were isolated from 58(63 74%)different samples.Fungi imperfecti was the e umycetes isolated most frequently.These fungi were not closely related to the ae robic bacterial count and coliform of the studied waters but was clearly associa ted with the packaging of the products.The result confirmed that the cross conta minations on the process of post-purification were the main source of fungi in the final products.

Objective To compare the image quality of renal artery in-flow inversion recovery MR angiography (IFIR MRA), CTA and contrast-enhanced MR angiography (CE-MRA) and to assess the value of renal artery IFIR MRA. Methods Thirty five patients were prospectively included in this study.Renal artery CTA was performed in 19 patients and renal artery CE-MRA was performed in 16 patients. In addition to renal artery CTA or CE-MRA, all patients underwent renal artery IFIR MRA. Two radiologists separately graded renal artery image quality, renal venous artifact and the visualization of renal artery branches regarding these three different techniques. Wilcoxon signed rank test of paired samples was used to compare the grading results, t test of paired samples was applied to compare the results of renal artery (accessory renal artery) trunk diameter. The consistency evaluation of renal artery image quality and renal venous artifact grades between two radiologists employed Kappa analysis. Results There was no significant difference between IFIR MRA and CTA with renal artery image quality and renal venous artifact (P>0.05). There was significant difference between IFIR MRA and CE-MRA with renal artery image quality and renal venous artifact (P<0.05). The consistency evaluation results of renal artery image quality and renal venous artifact grades between two radiologists were both good. Kappa value were 0.425 to 1.000. CTA of 19 cases depicted 48 renal arteries (38 renal arteries, 10 accessory renal arteries), IFIR MRA depicted them all. The grades of visualization of renal artery branches about IFIR MRA and CTA were (3.7 ± 0.7) and (3.8 ± 0.6) respectively, renal artery trunk diameter of IFIR MRA and CTA were (4.9 ± 1.3) and (5.0 ± 1.4) mm respectively, there was no significant difference between IFIR MRA and CTA (P>0.05).CE-MRA of 16 cases depicted 38 renal arteries (32 renal arteries, 6 accessory renal arteries), IFIR MRA depicted them all. The grades of visualization of renal artery branches about IFIR MRA and CE-MRA were (3.4±0.8) and (2.5±0.9) respectively, and there was significant difference between IFIR MRA and CE-MRA (Z=-4.040, P<0.01). Renal artery trunk diameter of IFIR MRA and CE-MRA were (4.7±1.3) and (4.7±1.2) mm respectively, there was no significant difference between IFIR MRA and CE-MRA (P>0.05). Conclusions The image quality of renal artery IFIR MRA was equal to CTA and superior to CE-MRA. It could be considered as an alternative technique for renal artery angiography.

ObejectiveTo evaluate the efficacyofacupointthread embedding in easing painafterMilligan-Morgan(M-M)for mixed hemorrhoids.MethodSixty patients undergone M-M for mixed hemorrhoids were randomized into a treatment group of 30 cases and a control group of 30 cases. After M-M, patients in the treatment group received thread embedding at Changqiang (GV1) and bilateral Zhibian (BL54), while the control groupdidn’treceive any intervention. The onset time of post-operative pain, average pain index within a week, and pain index after defecation, electromyogram (EMG), change of anal canal pressure, patients’ satisfaction, and adverse-event rate were observed.ResultThe average pain index and pain index after defecation in the treatment group were significantly lower than that in the control group (P<0.05), and the onset of pain in the treatment group was significantly later than that in the control group (P<0.01); after surgery, the anal canal resting pressure in the treatment group was markedly lower than that in the control group (P<0.05); there wasno significant difference in comparing the squeeze pressure of anal canal between the two groups (P>0.05). According to the motor unit potential (MUP) analysis, there were significant differences in comparing the amplitude (Ampl) and Ar/Am of the restingphase between the two groups (P<0.05), while there were no significant differences in comparingthe Ampl, Area, Ar/Am, and Freq of the contraction phase between the two groups (P>0.05). There were significant differences in comparing the patients’satisfaction, adverse-event rate, and use of analgesics between the two groups (P<0.05). ConclusionAcupoint thread embedding can produce a content analgesic effect, and it’s safe and reliable.

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China ; Coltivirus ; Encephalitis, Tick-Borne ; virology ; Humans

Objective To explore the fibrosis mechanism of patients with fibrosing cholestatic hepatitis(FCH) in the way of degradation of collagen.Methods The expressions of matrix metalloproteinase 1(MMP1) and tissue inhibitor of metalloproteinase 1(TIMP1),and contents of type I,III collagen proteins were detected by immunohistochemical staining in the liver tissues of 9 cases with FCH associated with HBV developed following renal transplantation and 5 cases without liver disease as controls.Results The expressions of MMP1 and TIMP1,and type I,III collagen proteins in the patients with FCH were significantly higher than those in the control group.There was a positive correlation between the expressions of type I,III collagen proteins and TIMP1/ MMP1 ratio.Conclusion Hepatic fibrosis in the patients with FCH associated with HBV developed following renal transplantation may be relative to the increase of TIMP1 expression which inhibit the degradation of collagen.

OBJECTIVE To study the diagnosis and management of epistaxis caused by traumatic pseudoaneurysm.METHODS The clinical data of 16 cases with epistaxis caused by traumatic pseudoaneurysm were retrospectively studied.There were 12 males and 4 females.Their ages ranged from 16 to 41 years with an average of 25.4 years.RESULTS All the patients were cured via digital subtraction angiogrophy(DSA) and embolization except one died.The time between the hospitalization and the DSA examinat ion was 3 to15 days.Interestingly,every patient had received anterior and posterior nasal packing one to 5 times.CONCLUSION If the anterior and posterior nasal packing were not effective to the patients with repeated and vast nasal bleeding,who had trauma history before nasal bleeding,the DSA examination should be carried out immediately to identify whether the pseudoaneurysm exists.

Objective to investigate the feasibility and outcomes of different surgical treatments for adrenal metastasis after previous radical ne-phrectomy for patients with renal cell carcinoma. Methods A total of 18 adrenal solitary metastasis of renal cell carcinoma were identified from da-tabase of two institutions between 2003 and 2013. Clinical and pathologic data were collected and analyzed. Results Of 9 patients who had ipsilater-al metastasis of the renal tumor,the estimated blood loss were obviously fewer in the transperitoneal LA group. Of 9 cases who had contralateral me-tastasis of the renal tumor,the fasting time[(1.4±0.8)h vs(4.0±1.4)h,P = 0.036]and length of hospital stay[(4.5±1.2)d vs(7.0±4.5)d,P =0.041]were obviously fewer in the retroperitoneal LA group. the averages of the fasting time and length of hospital stay in the retroperitoneal LA group were obviously smaller than in the transperitoneal LA group. Conclusion LA for treatment of renal cell carcinoma metastasis is technically feasible in selected patients. transperitoneal and retroperitoneal LA can be respectively recommended as an appropriate approach for isolated adrenal metastases of ipsilateral and contralateral renal cell carcinoma after nephrectomy.

Objective:To study the clinicopathological features and differential diagnosis of metaneph-ric adenoma (MA).Methods:The clinicopathological data of 16 cases with MA diagnosed and treated in Peking University First Hospital from 2004 to 2016 were retrospectively analyzed,and the clinical characteristics,pathologic parameters,differential diagnosis,treatment options and prognosis of MA were analyzed with literature review.Results:The patients included 10 females and 6 males.The age of pa-tients ranged from 14 to 83 years (mean =33.7 years).The partial nephrectomy was carried out for most patients.All cases were located in renal codex with 3 growing into the renal sinus.Histologically,the tumor was composed of tubules,papillary or glomeruloid structures and psammoma bodies were focally seen.Immunohistochemical study showed that all the cases expressed vimentin,and 94% cases ex-pressed CD57,63% WT1,75% AE1 /AE3,19% cytokeratin 7 (CK7 )and 13%α-methylacyl-CoA racemase (AMACR),and negative expressions for MA included CD10,neuron-specific enolase (NSE) and CD56.Follow-up information from 1 to 125 months was available in all the patients;and none of the patients showed any evidence of recurrence and metastasis.Conclusion:The benign tumor characteris-tics of MA are not obvious for preoperative imaging diagnosis,and the diagnosis of MA should be based on the unique pathological features.Positive immunostain of CD57 is a useful indicator for MA diagnosis and differential diagnosis.The partial nephrectomy surgical treatment can achieve good clinical cure with good prognosis.