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.

Objective To explore the clinicopathological characteristics of non-muscle-invasive bladder cancer patients association with chronic kidney disease (CKD).Methods Between Jan 2009 and Dec 2010,536 patients (390 males and 146 females with mean age of 63 years) underwent surgical treatment at our institute for pathologically proven non-muscle-invasive bladder cancer.The clinical and pathological data of these patients were reviewed,and the relationships of these factors and CKD were analyzed.Presence of CKD was confirmed in patients with estimated glomerular filtration rate (eGFR)＜ 60ml/(min · 1.73 m2)calculated using the Modification of Diet in Renal Disease Study equation.Results Of the 536 consecutive cases,57 patients (10.6％) had CKD.Compared to the patients without CKD,there were more females and older patients in the patients with CKD (52.6％ vs 24.2％ and 69 years vs 62 years,both P ＜ 0.05).The patients with CKD proned to have multiple bladder tumor (71.9％ vs 50.9％,P ＜ 0.05) and synchronous upper urinary tract urothelial carcinoma (7.0％ vs 2.3％,P ＜0.05).The history of bladder cancer and upper urinary tract urothelial carcinoma were also predominated in these patients (43.9％ vs 29.0％ and 40.4％ vs 6.5％,both P ＜ 0.05).ConclusionConcurrent CKD in non-muscle-invasive bladder cancer patients is associated with greater risk of multiple tumors in urinary tract,particularly in female patients.

Objective To analyze the clinical characteristics of twin reversed arterial perfusion sequence (TRAP),and investigate its prenatal evaluation and clinical management.Methods Karyotype results and ultrasound data of 25 TRAP cases were retrospectively reviewed,including estimated weight and umbilical blood flow of acardiac twin,cardiac function and middle cerebral artery peak systolic velocity of pump twin.Various managements and the outcomes were analyzed.Results (1) Karyotype of amniotie fluid were tested in 16 pump twins.Mosaicism was found in 1 case (46,XX[36]/46,XY [14]).(2) According to the ultrasound evaluation,large acardia accounted for 87.0％ (20/23) cases.Abundant blood perfusion (inter-twin difference of umbilical resistance index ≤0.20) was indicated in 86.4％ (19/22) cases.Decompensation of cardiac function was suggested in 66.7％ (10/15) pump twins.Fetal anemia of pump twin indicated by middle cerebral artery peak systolic velocity＞1.5 multiples of the median was diagnosed in 75.0％ (12/16) cases.(3) The acardiac twin with abundant blood perfusion was more likely to be a large acardia than those without [94.7％(18/19) vs 1/3,Fisher exact test,P=0.04]; More pump twin with large acardia tended to have cardiac decompensation than non-large acardia pump twins [83.3 ％ (10/12) vs 0/3,Fisher exact test,P=0.02].(4) Eleven patients chose to terminate their pregnancies after being diagnosed.In 14 cases who continue the pregnancies,the survival rate of pump twin was 64.3％ (9/14).In 3 cases of non-large acardia without cardiac decompensation of pump twin,the patients selected conservative observation resulting in 2 term deliveries and 1 termination of pregnancy due to for exacerbation.Among 11 cases with large acardia,which the pump twins were complicated by cardiac decompensation or anemia,five cases selected conservative observation.One ended in spontaneous abortion; three exacerbated (one termination and two cesarean section before term with living births) ; one was stable until delivery.Another 6 cases received bipolar cord coagulation,and successful interruptions of acardiac blood flow were achieved in 5 cases among which 4 pump twins survived.Conclusions Prenatal diagnosis,cardiac function and fetal anemia of pump twin,together with the growth and blood supply of acardia are important indexes for prenatal evaluation of TRAP,on which our prompt management should be based.

Objective To investigate the correlation between specific features on contrast-enhanced CT and its clinical findings of adrenal tuberculosis so as to improve the diagnostic accuracy of the disease. Methods Contrast-enhanced CT features in 30 patients with documented adrenal tuberculosis were retrospectively evaluated blindly for the features of location,size,morphology,attenuation and enhancement patterns on CT images,and compared with clinical and pathological materials.Results The common CT manifestations were as follows:enlargement of the adrenal glands in all 30 cases(bilateral 90%,mfilateral 10%)including mass-like enlargement in 13 cases and enlargement but the contours preserved in 17 cases, heterogeneity(28 cases,93.3%),calcification(17 cases,56.7%),and low attenuation in the center with peripheral enhancement(16 cases,53.3%)of the lesions.After antituberculosis chemotherapy, 5 cases of enlarged adrenal glands decreased in size or returned to normal size and configuration,with disappearance of the central low attenuation and new appearance of dot-like calcification in 2 cases.Cochran Armitage trend test showed there was an increasing tendency of calcification rate with clinical duration(X~2= 7.47,P

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 observe the expressions of matrix metalloproteinase 1(MMP1) and tissue inhibitor of matrix metalloproteinase1(TIMP1) and the collagen type Ⅰ,Ⅲ deposition in the liver tissues,and evaluate the possible fibrosis mechanism of patients with chronic hepatitis B(CHB) in the way of degradation of collagen. Methods The specimens of the biopsy liver in 50 cases with CHB were detected for the expressions of type Ⅰ,Ⅲ collagen proteins,MMP1 and TIMP1 by immunohistochemical staining. Results The expressions of type Ⅰ,Ⅲ collagen proteins and TIMP1,were significantly increased along with the advancing of hepatic fibrosis.There was a positive correlation between the expressions of type Ⅰ,Ⅲ collagen proteins and TIMP1. Conclusions Hepatic fibrosis in the patients with CHB may be related to increase of TIMP1 expression that 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.