Background and purpose: About 20 cases of BML have been reported in the literature,they occurred in females with history of uterus leiomyoma.BML appears as a histopathologic benign smooth muscle tumor located far from the uterus,often in the lungs.Firstly,it should be confirmed as originating from smooth muscle by immunohistochemistry,Secondly,its primary tumor should be confirmed as benign,with mucoid degenenation,it also should be distinguished from myxoid leiomyosacroma.Methods:We report a case of benign metastasizing leiomyoma,study its clinical,histopathologic and immunohistologic features,discuss the diagnosis and differential diagnosis and give a review of the related references.Results:The case occurred in a forty-two year old female who was found to have bilateral lung nodules after hysterectomy of her uterus leiomyoma six years ago.An open lung biopsy revealed the nodules to consist of proliferating smooth muscle cells with a histopathologic feature similar to her uterus leimyoma,consistent with the diagnosis of BML.Positive staining of estrogen and progesterone receptors was detected in both the uterus leiomyoma and the metastasizing lesions.No significant increase or enlargement of the lung nodules were found seven months after the operation with no therapy except taking Chinese traditional medicine.Conclusions:BML is a rare entity usually occurring in females with history of uterus leiomyoma.It appears as a histopathologic benign smooth muscle tumors distant from the uterus.It is hormone dependent and progresses slowly.

Objective To investigate the distribution of the single nucleotide polymorphism (SNP) of-251 (rs4073) in cytokine interleukin 8 gene promoter region and +781 (rs2227306) in the first intron in Nantong area population, to explore the correlation between the genotypes of these sites and the risk of suffering hepatocellular carcinoma (HCC), and to analyze the interaction between the genotypes and different exposure factors inducing the occurrence of HCC. Methods By using case-control study and restriction fragment length polymorphism polymerase chain reaction (RFLP-PCR) technique, the genotypes of IL-8 gene-251 site and+781 site were classified. Results (1) In individuals with-251 heterozygous mutation genotype AT the risk of developing HCC increased (OR=1.99, 95%CI: 1.01-3.85), and in individuals with +781 mutation genotype CT and TT the risk of developing HCC increased (+781 CT genotype, OR=1.78, 95%CI:1.03-3.1; +781 TT genotype, OR=1.36, 95%CI: 1.01-2.62). (2) In individuals with -251 and +781 AT-CT, TT-CT, AT-CC combined genotypes the risk of developing HCC increased (AT-CT combined genotype, OR=2.10,95%CI:1.52-2.9;TT-CT combined genotype, OR=3.33, 95%CI: 1.01-10.50; AT-CC combined genotype, OR=3.67, 95%CI:2.28-5.90). (3)SNP of-251 had positive interactions with drinking, HBV infection and family history of HCC in the occurrence of HCC, while negative interactions existed between SNP of this site and exposure factors, including age, gender and smoking, in the occurrence of HCC. SNP of +781 had positive interactions with drinking and family history of HCC in the occurrence of HCC, while negative interactions existed between SNP of this site and exposure factors, including age, sex, smoking and HBV infection, in the occurrence of HCC. Conclusion Definite correlation exists between SNP of -251,+781 sites in interleukin 8 gene and the risk of the occurrence of HCC in Nantong area population;and there are interactive effects between SNP of -251, +781 sites in interleukin 8 gene and several exposure factors.

The levels of low-density lipoprotein(LDL)glycation from control group,diabetic HbA1C < 7.0%,and HbA1C>7.0% groups were(17.7±2.31),(34.29±5.73),and(48.79±7.82)Glycogroups/LDL by fluorimetry.The LDL binding to its receptor in three groups were(37.65±5.20),(27.36±4.34),and(15.07± 2.23)ng/mg cell protein measured by enzyme-linked immunoreceptor assay.The glycated levels in two diabetic groups were higher than that in control group,and higher in HbA1C>7.0% group than in HbA1C<7.0% group(all P< 0.01).The results of LDL binding capacity to its receptor were just the opposite.

Objective To evaluate the effects of metformin on thyrotropin(TSH)levels. Methods From the patients with type 2 diabetes mellitus or metabolic syndrome, 48 patients with primary hypothyroidism were enrolled and grouped. 17 patients were treated only with metformin(group A), 19 patients with metformin and stable L-T4substitution(group B), and the remaining 12 patients with antidiabetic drugs(other than metformin)and L-T4(group C). Meanwhile, 20 euthyroid patients with other thyroid abnormalities(group D)and 30 patients without thyroid diseases(group E)served as control. TSH, FT3, FT4, TT3, TT4, and blood glucose were determined regularly in all these subjects. Results After administration of metformin for 12 months, serum TSH were decreased in group A [(5.05±1.07 vs 2.61±0.91)mU/L, P＜0.01] and group B [(2.67±1.03 vs 1.35±0.74)mU/L, P＜0.01]. No difference was found in FT3and FT4in both groups. TSH levels were raised from(1.30±0.71)to(2.58±1.02)mU/L(P＜0.01)within 8～12 weeks in 13 out of 15 patients after metformin withdrawal. Serum TSH and thyroid hormones in the other 3 groups were not significantly changed. Conclusion Administration of metformin may lead to reduction of serum TSH level.

Objective To observe the efficacy and safety of remifentanil in patients with mechanical ventilation in Intensive Care Unit (ICU) .Methods Totally 90 cases were enrolled ,patients with mechanical ventilation were randomly divided into two groups (remifentanil vs .fentanyl) ,45 cases in each group .We used facial expression score (FPS) to monitoring pain ,richmond se‐dation agitation score (RASS) was the sedation tool for measuring quality and depth of sedation .Propofol wase used for sedation therapy .We recorded the data including FPS and RASS and vital signs during the treatment .The primary outcome was the time to reach the goal of analgesia sedation ,cases of using propofol and doses of propofol .The secondory outcome was mechanical ventila‐tion time ,ICU length of stay and adverse events .Results Fentanyl and remifentanil all could achieve the desired analgesic effect . Compared with fentanyl group ,FPS scores showed significantly decreased after 5 min application of remifentanil (P< 0 .05) ,but FPS scores showed significantly decreased after 10 min application of fentanyl .Analgesia goal time of the remifentanil and fentanyl were(5 .00 ± 1 .37)min and (30 .00 ± 4 .50)min ,respectively .Only 28 .9% of the patients should be combined use of propofol in remifentanil group ,but fentanyl group was 64 .4% (P<0 .01);the dosage of propofol of remifentanil group was lower than those of fentanyl group ;there was no significant difference in central venous pressure (CVP) and heart rate(HR) between the two groups at each time point(P>0 .05) .The mechanical ventilation time ,ICU length of stay in the patients with remifentanil were significantly shorter(P<0 .05) ,and adverse events occur less(all P<0 .05) .Conclusion Remifentanil analgesia in patients mechanical ventilated patients is fast onset of action ,analgesic effect significantly ,with less sedative drug dosage .It also can shorten mechanical ventila‐tion time ,ICU length of stay and has no obvious side effects .

BACKGROUND:Recent studies have found that stem cellpluripotency and differentiation is regulated by many long non-coding RNAs (LncRNAs). The expression and effect of LncRNA AK089560 during differentiation of stem cells is unclear. OBJECTIVE:To investigate the expression of LncRNA AK089560 in mesenchymal stem cells C3H10T1/2 undergoing osteogenic and adipogenic differentiation. METHODS:Osteogenic differentiation of mesenchymal stem cells C3H10T1/2 was induced by recombinant human bone morphogenetic protein-2 and evaluated using alkaline phosphatase staining. The adipogenic differentiation of mesenchymal stem cells C3H10T1/2 was induced by three factors (dexamethasone, indomethacin and insulin) and evaluated by oil red O staining. The dynamical expression of LncRNA AK089560 was detected by qRT-PCR assay. The AK089560 secondary structure was predicted using RNAfold software. The relationship between AK089560 and neighboring protein-coding genes was analyzed using UCSC genome browser and visualized by fancyGENE online software. RESULTS AND CONCLUSION:Over 70%of C3H10T1/2 cells were positive for alkaline phosphatase after osteogenic induction and more than 80%of the cells positive for oil red O staining after adipogenic induction. qRT-PCR results showed that the expression of LncRNA AK089560 at days 2, 4, 6 of both osteogenic and adipogenic differentiation was significantly decreased compared with the control group (P<0.05). Bioinformatics analysis showed that there was a stem-loop structure for AK089560 and sense overlap relationship between AK089560 and protein-encoding gene Sema3a. These findings indicate that LncRNA AK089560 expression is reduced during osteogenic differentiation and adipogenic differentiation, showing that AK089560 may be involved in regulating the multi-directional differentiation of stem cells.

Objective:To analyze the correlation factors between peripapillary duodenal diverticulum (PDD) and choledochectasia by CT scan.Methods:The clinical data of 220 patients with duodenal diverticulum detected by multi-slice spiral CT scan and confirmed by gastrointestinal angiography or endoscopic retrograde cholangiopancreatography (ERCP) in Dahua Hospital, Xuhui District of Shanghai City were retrospectively analyzed. The correlation of the PDD, the contact of common bile duct (CBD), length of contact and exudation with choledochectasia in patients with PDD were analyzed.Results:A total of 236 duodenal diverticulum were found in 220 patients. Among them, there were 152 PDD, 41 diverticulum located superior to the duodenal papilla, 28 diverticulum located inferior to the duodenal papilla, 3 diverticulum located lateral to the duodenal papilla, and 12 diverticulumlocated in the horizontal portion. The incidence of choledochectasia in patients with PDD contacted with CBD was significantly higher than that in patients with PDD not contacted with CBD: 59.35% (73/123) vs. 37.93% (11/29), and there was statistical difference ( P<0.05); the incidence of choledochectasia in patients with contact length of PDD and CBD ≥1.5 cm was significantly higher than that in patients without contact of PDD and CBD and patients with contact length of PDD and CBD <1.5 cm: 82.43% (61/74) vs. 24.49% (12/49) and 37.93% (11/29), and there was statistical difference ( P<0.05); the incidence of choledochectasia in PDD patients with exudation was significantly higher than that in PDD patients without exudation: 10/11 vs. 52.48% (74/141), and there was statistical difference ( P<0.05). Conclusions:The patients with contact length of PDD and CBD ≥1.5 cm and patients with PDD combined with exudation could be prone to choledochectasia.

Objective To investigate a Chinese pedigree suffering from Leydig cell hypoplasia ( LCH) based on clinical data and genetic diagnosis. Methods The patient was diagnosed by means of clinical data, hormone profiles, and human chorionic gonadotropin ( hCC) test. The luteinizing hormone/chorionic gonadotropin receptor(LHCGR) gene of the patient and family members was amplified and sequenced. Results The patient presented with male pseudohermaphroditism, low level of testosterone, which did not respond to hCG. Genetic analysis of the LHCGR revealed two novel mutations: a missense mutation located in exon 5, resulting in Ile replaced by Thr in the extracellular domain; and a splice site mutation in the 3' terminal of intron 6( IVS6-3 C→A). Proband's sister (46, XX) who lacked clinical manifestations showed the identical genotype with the patient. Conclusions A mutation in the consensus sequence of 3' splice site, in addition to a missense mutation (Ile 152Thr)in the extracellular ligand-binding domain is the cause of inactivation of the LHCGR gene in patient with Leydig cell hypoplasia.

Aged ; Female ; Humans ; Nasopharyngeal Neoplasms ; diagnosis ; pathology

OBJECTIVE: To study the methods of the surgical treatment for the nasal septum mass. METHOD: Two hundred and fifty-three cases of nasal septum mass were treated by surgery in our department from March 1983 to August 2007. Their clinical data were retrospectively analyzed. RESULT: After follow-up, most cases had no postoperative recurrence of nasal obstruction and epistaxis. CONCLUSION If the diagnosis was confirmed, the effect of the surgical treatment for the nasal septum benign tumor is satisfactory. Follow-up should be done in cases with malignant tendency and malignant tumors.
Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Nasal Septum ; pathology ; Nose Neoplasms ; diagnosis ; surgery ; Retrospective Studies ; Young Adult