Objective To assess the diagnostic value of Logistic model in differentiating between malignant and benign ovarian lesions. Methods Thirty-five indexes of clinical and ultrasound data were recorded in 601 ovarian lesions confirmed by surgical pathology. The Logistic model was developed on a training set( n - 400) and tested on a test set( n = 201). Results Variable selection resulted in a set of 10 variables for the models: personal history of ovarian cancer, maximal diameter of the lesion, maximal diameter of the solid component, multilocular-solid tumor, solid tumor, ascites, flow within papillation, irregular walls, very strong intratumoral blood flow (i. e. color score 4) and acoustic shadows. Test set area under the receiver-operating characteristics curve was 0.963 with a sensitivity 93.9% and a specificity 93. 1 %. Conclusions Logistic model can accurately separate malignant from benign ovarian masses.

Objective To investigate the research quality of present medical graduates and propose suggestions for improvement.Method A self-designed questionnaire entitled Investigating Questionnaire for Research Quality Analysis of Medical Graduates in Peking Union Medical College Hospital was distributed to the clinical and academic medical graduates in the hospital from July to August 2015.Among 276 collected questionnaires,270 were validated as effective.SPSS 18.0 software was used to statistically describe the result and to perform t test on different subgroups.Results The research quality average of the surveyed hospital was 10.28.Results revealed that in regard of the three aspects of research quality,research consciousness ranked first,followed by the research ability,while scientific spirit was the weakest.Academic medical graduates showed significantly higher scores than clinical graduates in terms of total research quality and every single aspect (P values less than 0.05).Conclusions To better cultivate the academic leaders in medical research,it is necessary to strengthen the research training for the graduates,practice their scientific thinking especially the clinical graduates,reinforce tutors' guidance,and promote communication and collaboration.

Objective To evaluate the changes of the upper airway of the patients with obstructive sleep apnea syndrome (OSAS) before and after operations and to know the effects of operations by MSCT. Methods The upper airway dimensions of 26 patients with OSAS were measured on multiplanar reformatted (MPR), curved-planar reformatted (CPR), volume rendering(VR) images of 16-slice spiral CT. The measurements include the anteroposterior calibres and the areas on the reformatted axial images on the pharyngeal cavity levels, the calibres and the minimum areas in retropalatal and retroglossal regions, the areas of the soft palate and uvula on the reformatted sagittal view with maximum thickness, the maximum wall thickness of the right and left the upper airway on the coronary images, the volume of the upper airway before and after the operations. The measurements were correlated with the polysomnography (PSG) records. The data were analyzed paired-samples t-test and Pearson correlations. Results By comparison, the anteroposterior calibres and the cross-sectional areas on the reformatted axial view of the lower retropalatal region (slice 4) of the upper airway increased significantly after operations. The anteroposterior diameter increased from 5. 9 mm before operations to 12.8 mm after operations, where t = - 5.506, P < 0.05. The areas increased from 51.0 mm~2 before operations to 275.0 mm~2 after operations, where t = -5.011, P <0.05. In the higher retropalatal region (shce 2) of the upper airway, the anteroposterior diameter decresased from 14.8 mm before operations to 9.2 mm after operations, where t = 2.867, P < 0.05. The areas decreased from 241.0 mm~2 before operations to 128.0 mm~2 after operations, where t = 3.087, P < 0.05. The anteroposterior calibres of retroglossal region (slice 7) decreased from 12.7 mm before operations to 10.3 mm after operations,where t = 3.718, P <0.05. The L-R calibres and the minimum areas of of retropalatal increased significantly from 6.4 mm, 33.0 mm~2 before operation to 10.9 mm, 76. 0 mm~2 after operation, where t = -3.413, -2. 216, respectively and P < 0.05. Of the 9 cases whose apnea and hypopnea index (AHI) ≤5 events/hour after operations, the minimum areas of retropalatal region, the anterio-posterior diameter, L-R calibres increased significantly. The areas increased from 41.0 mm2 before operations to 76.0 mm~2 after operations, were t = -4. 932, P <0.05. The anteroposterior calibres increased from 4.6 mm before operations to 6.6 mm after operations, where t = - 7. 308, P < 0.05. The L-R calibres increased from 8.3 mm before operations to 13.6 mm after operations, where t = - 4.320, P < 0.05. Conclusions MPR、CPR、VR of MSCT can evaluate the not only the morphology but the function changes of the upper airways on the OSAS patients. The increasing of the minimum cross-sectional area may be one of the important indications for evaluating operations. The narrowing of the higher retropalatal region of the upper airway after operations should be an alert to the clinicians.

Objective To evaluate the clinical value of multislice-CT angiography (MSCTA)in planning for the patients undergoing deep inferior epigastric artery perforator (DIEAP) flap operations. Methods Eighteen patients were performed with a 16-slice CT scanner to evaluate the deep inferior epigastric artery perforator prior to DIEAP flap operations. Axial, multiplanar reconstruction( MPR), maximum intensity projection(MIP) and volume rendered (VR) images were analysed and the origins, calibers, courses and anatomic relationships of the deep inferior epigastric artery perforator were evaluated. The anastomosis between the superficial inferior epigastric artery and the main perforator was observed as well. The images were classified into three grades based on the vessels'appearance. A + indicated the vessel appeared clear,continuous and thick. A- indicated the vessel appeared foggy,discontinuous and thin or the vessel partly showed. B indicated no related vessel can be seen. Other 18 patients undergoing conventional abdomen-pelvis CT scans for other reasons were used for control group to compare their CT findings of the deep inferior epigastric artery perforator. Results MSCTA well showed the course of the deep inferior epigastric artery (DIEA). Of the 18 cases, 17 cases appeared as A +, another one A -. It precisely displayed the origins, subcutaneous and intramuscular courses, relations of the main perforators on all cases of showing A +. The exact points where the chosen perforator vessels emerged from the rectus abdominis muscle fascia were located precisely. The superficial inferior epigastric arteries were mostly displayed and the connection between the arteries and the largest-caliber perforator from the deep system could also be shown clearly. Strict concordance with operative findings was found in CTA. Conclusion MSCTA can precisely locate the chosen perforator vessels emerging from the rectus abdominis muscle fascia and it may be a feasible, fast, safe and effective method for preoperative evaluation of DIEAP.

Objective:To investigate the regulation and mechanism of chronic Trichinella spiralis ( Ts) infection on liver immunopathology in mice co-infected with Plasmodium berghei ANKA( PbA). Methods:According to body weight, 64 specific pathogen free female Kunming mice (6 - 8 weeks old, weighting 22 - 25 g) were divided into 4 groups by using random number table method. Control group: uninfected; Ts group: mice were mono-infected with 30 Ts larvae by oral gavage on day 0; PbA group: mice were mono-infected with 1 × 10 6PbA-infected red blood cells in 0.1 ml of phosphate buffer (PBS) administered by intraperitoneal injection on day 121; co-infected ( Ts+PbA) group: mice were infected with 30 Ts larvae by oral gavage and intraperitoneal injected with 1 × 10 6PbA-infected red blood cells in 0.1 ml PBS on day 121 after Ts infection. There were 16 mice in each group, in which 10 mice in each group were monitored for the survival rate. The peripheral red blood cell parasitemia of PbA group and Ts + PbA group were monitored every other day by light microscope examination of Giemsa-stained thin tail-blood smears from day 3 after PbA infection. Mice were sacrificed at day 135 after Ts infection and/or at day 15 after PbA infection, the mouse body weight and liver weight were measured, and the liver index were calculated. Ts-infected mice were monitored by a light microscope examination of diaphragm compression slide. Under a light microscope, the liver pathology and liver fibrosis of mice were observed and compared with hematoxylin-eosin (HE) staining and Sirius red staining, respectively. The F4/80 + Kupffer cells in liver of mice were examined by immunohistochemical staining. Results:After infection with Ts or PbA, Ts larvae cysts were observed in diaphragm tissues and PbA were observed in red blood cells under the light microscope. After PbA infection, there was no significant difference in survival rate between PbA group and Ts+ PbA group ( P > 0.05). Compared with PbA group, the peripheral red blood cell parasitemia was significantly decreased in Ts+ PbA group on days 11 and 15 after PbA infection (%: 27.104 ± 7.623 vs 45.032 ± 9.849, 60.218 ± 2.776 vs 76.778 ± 6.351, P < 0.05), and the liver index and the liver pathology score were significantly decreased in Ts+ PbA group ( P < 0.05). Sirius red staining showed that the positive area of liver fibrosis in Ts+ PbA group was significantly higher than that in PbA group ( P < 0.05). Immunohistochemical staining showed that the average optical density value of F4/80 + Kupffer cells in Ts+ PbA group was significantly higher than that in PbA group ( P < 0.01). Conclusion:Chronic Ts infection may reduce the peripheral red blood cell parasitemia, increase F4/80 + Kupffer cells expression in liver, and attenuate liver pathology in mice co-infected with PbA.

Objective To assess prenatal heart disease screening program by ultrasound. Methods A total of 11 544 second-trimester screening scans were performed before 24 weeks′ gestation on 11 410 women between February 2004 and May 2007 in Obstetrics and Gynecology Hospital of Fudan University. Fetal heart screening was based on four-chamber and outflow tract views( left ventricular outflow + three vessel view). The sensitivity and specificity of different views were evaluated. Follow-up data of newborns was obstained. Results (1) Among 11 544 cases, 48 cases of congenital heart disease (CHD) were diagnosed in utero. Six cases were false negative, and 2 cases were false positive. The incidence of CHD was 0.47% (54/11 544). (2) Thirty-three CHDs were detected based on the four-chamber view, including 18 ventricular septal defect (9 with conotroncal anomalies),6 anomalous atrioventricle valve, 9 disproportion of left/right ventricle. The sensitivity of the four-chamber view alone was 61.11% (33/54), and the specificity was 99. 98% ( 11 488/11 490). Fifteen CHDs were detected based on the left ventricular outflow and three vessel views, including 1 pulmonary atresia, 3 pulmonary valve stenosis, 2 transposition of the great arteries ( TGA ), 1 pulmonary stanosis with TGA, 6 tetralogy of Fallot, and 2 pulmonary stenosis. The sensitivity of the combination of the four-chamber and outflow tract views was 88. 89% (48/54), and the specificity was 99. 98% (11 488/11 490). (3)Of 48 CHDs,11 cases were eceompanied by other malformations. Eleven cases were performed amniocentesis, amony whom 5 cases were trisemy 21. Conclusion The screening program based on four-chamber and outflow tract views shows good sensitivity and excellent specificity. Our prenatal heart screening program is clinically feasible.

The heptadecapeptide orphanin FQ(OFQ)is a recently discovered neuropeptide that exhibits structural features reminiscent of the opioid peptides and that is an endogenous ligant to a G protein-coupled receptor sequentially related to the opioid receptors.OFQ was originally isolated from brain,but the presence of OFQ in peripheral tissues,especially in cardiovascular system,has not been clarified.The present study was designed to investigate the peripheral tissue distribution of OFQ precusor Mrna in stroke-prone spontaneously hypertensive rats(SHRSP)and compare the difference of OFQ precusor Mrna expression in aorta or cultured vascular smooth muscle cells(VSMCs)between SHRSP and wistar-Kyoto normotensive(WKY)rats.By using quantitative reverse transcription-polymerase chain reaction(RT-PCR),OFQ precusor Mrna was detected in aorta and ovary at high levels comparable with the amounts found in brain.Moderate expression was found in testis,while a little OFQ precusor Mrna could be detected in atrium.All other peripheral tissues examined from SHRSP,including ventricle,liver,lung and kidney,showed no expression of OFQ precusor Mrna.In the vascular system,OFQ precusor Mrna was expressed in aorta,pulmonary artery,renal artery and vein at high levels comparable with the amounts found in brain.We also found that OFQ precusor Mrna levels were much higher in aorta or cultured VSMCs from SHRSP than those from WKY rats.In conclusion,the present study has shown that OFQ precusor Mrna is present in some peripheral tissues,especially in cardiovascular and reproductive system,suggesting that OFQ possibly involves in the regulation of cardiovascular and reproductive functions.

Parasitic diseases still remain the world's greatest health problems and cause huge economic burden in poor areas. The drugs currently used to treat protozoiases and helminthiases have certain defects, and it is urgent to develop more effective therapeutic drugs for these diseases. Berberine is one kind of important anti-inflammatory agents originally derived from Coptis rhizoma. The derivatives of berberine are obtained by modifying the structural site of berberine. In addition to its anti-inflammatory and anti-microbial activities, berberine and its derivatives also have significant anti-parasitic activity. In this paper, we summarized recent progress in the use of berberine and its derivatives against the infections of protozoa ( Leishmania spp ., Trypanosoma spp. , Toxoplasma gondii, Plasmodium falciparum, and Eimeria tenella) and helminths ( Schistosoma mansoni, Schistosoma. japonicum, Echinococcus granulosus, and Toxocara canis), which may providea useful reference for researchers in this field.

Objective:To investigate the clinicopathological features, diagnosis and prognosis of polymorphous low-grade neuroepithelial tumor of the young (PLNTY).Methods:Two cases of PLNTY diagnosed during January 2016 to December 2019 were collected from Ningbo Diagnostic Pathology Center, Zhejiang, China. The clinical features, histopathological characteristics, immunohistochemical and molecular genetic findings were analyzed and the relevant literature was reviewed.Results:The two patients were both female, at the ages of 14 and 25 years, respectively. Both patients presented with seizure attacks. The imaging study showed a mixed signal in the cerebral cortex, located in the occipital and temporal lobes, respectively. Microscopically, the tumors were characterized by the invariable presence of oligodendroglioma-like appearance, often with calcification. Immunohistochemically, the tumors were diffusely and intensely CD34 positive with ramified, CD34-expressing neural elements in regional cortex. The tumors were positive for GFAP, Olig2 and ATRX, and negative for IDH1, Neu N, nestin and EMA. The Ki-67 labeling index was less than 2%. The case number 2 harbored the BRAF V600E mutation, while the case number 1 was negative for both the BRAF V600E mutation and 1p/19q codeletion. Both patients recovered very well and were free of seizures after the following-up of 2 and 24 months, respectively.Conclusions:PLNTY is an uncommon neuroepithelial tumor. Histopathologic and immunohistochemical examinations are necessary for establishing the diagnosis and for excluding oligodendroglioma. PLNTY should be considered as a benign tumor corresponding to WHO Grade I. The prognosis is overall good after complete tumor-resection.

Objective To explore the related factors affecting the sensitivity of neoadjuvant immuno-therapy combined with chemotherapy for treating esophageal squamous cell carcinoma(ESCC).Methods The clinical data of 51 cases of ESCC were retrospectively analyzed.The patients were divided into the neoad-juvant immunotherapy combined with chemotherapy sensitivity group(n=29)and resistance group(n=22)according to the treatment effects.The statistical methods were employed to analyze the factors affecting the sensitivity of neoadjuvant immunotherapy combined with chemotherapy for treating ESCC.Results The uni-variate analysis results showed that the lesion depth detected by CT after treatment had statistical difference between the sensitivity group and resistance group(P＜0.001).The lesion depth also had statistical difference before and after treatment(P=0.002).The endoscopic evaluation showed that the proportion of the patients with pathological remission in the sensitivity group was higher than that in the resistance group with statisti-cal difference(P＜0.001).The multivariate analysis results showed that degree of pathological remission(P=0.042,95％CI:1.096-161.519)and pathological lymph node metastasis(P=0.025,95％CI:0.003-0.670)evaluated by endoscopy were the independent influencing factors of the sensitivity to neoadjuvant im-munotherapy combined with chemotherapy.Meanwhile,the patients with tumor infiltration depth difference≥0.750 cm measured by CT were more sensitive to the immunotherapy combined with chemotherapy(AUC=0.750,sensitivity 41.4％,specificity 55.0％,P=0.002,95％CI:0.618-0.882).Conclusion Preop-erative chest CT calculation of lesion depth and endoscopic assessment of pathological remission degree could predict the sensitivity of ESCC patients to neoadjuvant immunotherapy combined with chemotherapy,which provides reference for formulating the treatment regimen,however,it is necessary to enlarge the sample size and further study the various influencing factors.