Objective: To study the relationship between different patterns of invasion and extracapsular spread in lymph node metastasis from squamous cell carcinoma of tongue. Methods: Pattern of invasion described by Anneroth was used to evaluate the malignance grade of tongue cancer and immunohistochemical and HE staining were used to detect the extracapsular spread in successive cases of tongue cancer with radical neck dissection. Results: Lymph node metastasis was observed in 0/5 of the cases with pattern I invasion,3/8 pattern II,5/6 pattern III and 1/1 pattern Ⅳ. Extracapsular spread occurred as totally or partly replacement of the lymph node by the tumourcells. The tumour cells infiltrated between lymph nodes, perinodal fibroadipose tissue or sternocleidmastoid muscle in the form of cell cluster or isolated cell. Conclusion: Pattern of invasion is a significant factor for evaluating the malignance grading of tongue cancer. Radical neck dissection should be used to treat the tongue cancer with pattern III or IV invasion.

The purpose of this paper was to evaluate the relationship between the thrombosis and secretory duct dilation, lesion size, clinical types, nature (primary or recurrent) and duration of illness in the development of ranula. A total of 229 cases of sublingual gland cysts were treated with surgical resection from Jan. 1990 to Feb. 2010. The patients' data were investigated on histopathological findings, size of ranula, the clinical types, nature of ranula (primary or recurrent) and duration of illness. Sections from the paraffin-embeded blocks were HE-stained. CK expression was immunohistochemically detected. Among 229 cases the incidence of venous thrombosis was 58.52%. The incidence of venous thrombosis with or without duct dilation was 73.25% and 26.39% respectively, with a significant difference between the two groups (P<0.005). The incidence of venous thrombosis of ranulas with diameter larger or less than 3 cm was 72.22% and 46.28% (P<0.005). The incidence of venous thrombosis of oral ranula, plunging ranula and mixed ranula was 49.37%, 77.19% and 85.71% respectively, with a significant difference found between oral and plunging or mixed ranula (P<0.01). The incidence of venous thrombosis in ranula patients with duration of illness longer or less than 3 months was 69.77% and 51.75% (P<0.01). The incidence of venous thrombosis with recurrent and primary ranulas was 51.85% and 64.85%, without a significant difference noted between them (P>0.05). It is concluded that the formation of venous thrombosis was related to the dilation of secretory duct, lesion size, clinical types, duration of lesion but formation of venous thrombosis was not related to the nature (primary or recurrent) of ranulas.

Objective To investigate the clinical efficacy of electroacupuncture plus weak laser fat dissolution technique in treating female patients with obesity and overweight of stomach heat dampness stagnation type. Methods Forty-seven female patients diagnosed with simple obesity and overweight of stomach heat dampness stagnation type were randomly allocated to a treatment group of 25 cases and a control group of 22 cases. The treatment group received electroacupuncture plus weak laser fat dissolution technique and the control group, weak laser fat dissolution technique alone. Body weight, body mass index (BMI), waist circumference, abdominal circumference, hip circumference, body fat percentage (F%), visceral fat index (VFI) were measured in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups. Results There were statistically significant differences in body weight, BMI, waist circumference, abdominal circumference, hip circumference difference values between before and after one course of treatment, between after one and two courses of treatment and between after two and three courses of treatment in the treatment group compared with the control group (P<0.01,P<0.05). There were statistically significant differences in visceral fat index difference values between after one and two courses of treatment and between after two and three courses of treatment in the treatment group compared with the control group (P<0.05). The total efficacy rate was 92.0%in the treatment group and 36.4%in the control group; there was a statistically significant difference between the two groups (P<0.01). Conclusion Electroacupuncture plus weak laser fat dissolution technique is an effective way to treat female simple obesity of stomach heat dampness stagnation type.

Objective To observe the change of vascular endothelial cells and structure of the auricular posterior vein caused by freezing or pingyangmycin injection alone and freezing in combination with pingyangmycin injection,to investigate the effect of these treatments on the vein. Methods Eighteen rabbits were divided into 3 groups of 6 each, and another rabbit was used as a control. (Pingyangmycin) was injected into the auricular posterior vein in the first group, spray freezing within 20 seconds on the auricular posterior vein was performed in the second group,and freezing in combination with pingyangmycin injection was performed in the third group. Light microscope and transmission electron microscope were used to observe the change of auricular posterior vein in the rabbits.Results Proliferation of endothelial cells,and thickening of vessel wall were induced by pingyangmycin. Thrombus formation, tissue oedema and inflammatory infiltration induced by spray freezing within 20 seconds were reversible. Thrombus formation, proliferation of endothelial cells and thickening of the vessel wall was induced by freezing in combination with pingyangmycin injection.Conclusion Freezing and pingyangmycin injection have the synergistic effect, resulting in the proliferation of endothelial cells, thrombus formation, thickening of vessel wall, and even occlusion of vessels.

Pingyangmycin (bleomycin A5 hydrochloride, PYM) is one of the anti-neoplastic agents which have been commonly used to treat venous malformations. However, the underlying mechanism by which PYM treats venous malformations remains poorly understood. It was reported that venous endothelial cells could recruit neutrophils via adhesion molecules (E-selectin, ICAM-1, ICAM-3, VCAM-1) during the acute/chronic inflammation and subsequent histological fibrosis after sclerotherapy with PYM. This study explored if the expression of E-selectin, ICAM-1, ICAM-3 and VCAM-1 in human venous malformation endothelial cells could be affected by PYM. HVMECs were cultured from human venous malformation tissue. Expressions of E-selectin, ICAM-1, ICAM-3 and VCAM-1 on HVMECs in response to PYM were analyzed by cell ELISA. The relative levels of mRNA expression in the cells were semi-quantified. The results showed that PYM up-regulated the expressions of E-selectin, ICAM-3, VCAM-1 and ICAM-1 in both time- and concentration-dependent manner. Our findings suggested that PYM could induce the expression of adhesion molecules in HVMECs, which might be a possible mechanism by which sclerotherapy by intralesional injection of PYM treats venous malformations.

This paper presents a description about training of post-graduate students majoring in rheumatology.The essential knowledge and theory are highly stressed,and the clinical skill,comprehensive ability are also emphasized to encouraging students to bring forth new ideas.Besides cooperation and team spirit are encouraged through group and pair work.

ObjectiveIn order to confirm the value of high resolution frequency(HFUS) ultrasonography in the early diagnosis of psoriatic arthritis(PsA).MethodsTwenty-nine patients with psoriatic arthritis reporting sixty-nine finger pain and 30 patients with rheumatoid arthritis reporting seventy finger pain and 20 healthy volunteers underwent X-ray and US evaluation.The ultrasonographic characteristics and blood flows in the joints were checked with high resolution ultrasonography.Bilateraljoints were compared each other in every patient.Comparisons between groups were tested by x2 test.ResultsSonographic positive signs were found in all the involved joints in 29 PsA patients,joint effusion in 42 fingers (61％).Synovial thickening was found in 38 fingers (55％).Bone erosions were found in 28 fingers(41％),tenosynovitis were found in 40 fingers (58％),soft tissue inflammation was revealed in 29 fingers (42％).Enthesitis were foundin 30 fingers (43％).In RA patients,joint effusion was found in 52 fingers (74％) and synovial thickening in 48 fingers (69％).Bone erosions were found in 33 fingers (47％).Tenosynovitis,soft tissue inflammation and enthesitis were not found in RA patients.ConclusionHigh resolution ultrasonography is an easy,safe and effective method for the early diagnosis of pathological changes of small joints in psoriatic arthritis.

From the perspectives of social equitable exchange theory, contents and features of exchange between medical staff and patients in the doctor-patient relationship as well as their evalua-tion on social equitable exchange theory were analyzed according to basic features of doctor-patient relationship. Suggestions were proposed from government, industry, hospital and medical staff.

OBJECTIVETo explore the curative effect of surgery and selerotherapy for massive venous malformations of the tongue.

METHODSFrom January 2005 to December 2014, subtotal resection or debulking for 15 cases of massive venous malformation in the tongue was undertaken with multiple sessions of pre- and post-operative injection therapy of pingyangmycin, lauromacrogol and absolute ethanol.

RESULTSAll signs associated with the lesions including eating, sleep and speech disorders disappeared after treatment. Complete or near complete resolution was achieved in 9 cases, and a significant reduction in size in a further 6 cases after surgical excision and peri-operative sclerotherapy.

CONCLUSIONSFor massive venous malformations of the tongue, surgical excision combined with multiple sessions of sclerotherapy is a good treatment option.

Bleomycin ; analogs & derivatives ; therapeutic use ; Combined Modality Therapy ; methods ; Ethanol ; therapeutic use ; Humans ; Injections, Intralesional ; Polyethylene Glycols ; therapeutic use ; Sclerosing Solutions ; therapeutic use ; Sclerotherapy ; Tongue ; blood supply ; Treatment Outcome ; Vascular Malformations ; therapy ; Veins ; abnormalities

Objective To observe the effect of arsenic trioxide on the apoptosis of synovium and IL-l, TNF-? in CIA rat. Methods Seventy-two rats were divided into normal control, model, and As2O3 treatment groups. The experimental models of collagen induced arthritis rats were used as the experimental moldels. The knees′ synovium, cartilage and bone tissue of the rat were taken out, then observed with light microscope and electron microscope and apoptosis were measured by TUNEL after the 15th day of treatment. Meanwhile the level of IL-1 and TNF-? were measured with ELISA kit. Results The pathological injury were improved and the apoptosis of synoviocytes were increased in the As2O3 treatment group, compared with the model group. IL-1 and TNF-? levels were decreased in the arsenic trioxide treatment groups, especially in the Ⅴ and Ⅵ groups (P