Neuroendocrine tumors of the epiglottis were extremely rare. Patients normally had no obvious symptoms and signs of early stage. Epiglottis lingual except (without) tubercle of epiglottis, and hyperplastic mass were observed by using laryngoscopy and also confirmed by biopsy and immunohistochemistry. Immunohis- tochemical studies showed that Syn, a broad spectrum endocrine marker, and CgA, a specific marker of endocrine tumor, were both positive. Which is consistent with the diagnosis of neuroendocrine carcinoma.
Carcinoma, Neuroendocrine ; pathology ; Epiglottis ; pathology ; Humans ; Immunohistochemistry ; Laryngeal Neoplasms ; pathology ; Laryngoscopy

Objective To evaluate the efficacy of retroperitoneoscopic adrenalectomy for pheochromocytoma.Methods From January 2000 to October 2006,a total of 16 patients(aged from 32 to 65 with a mean of 42 years) with pheochromocytoma received retroperitoneoscopic adrenalectomy in our hospital.Among the cases,6 had the tumor on the right side,and 10 on the left.The size of the tumors ranged from 2.5 to 4.6 cm in diameter(mean,3.1 cm).Results The mean preoperative preparation time in this series was 11 days(range,6 to 28).The retroperitoneoscopic adrenalectomy was completed in all but one of the patients,who were converted to open surgery because of extensive adhesion of the tumor to surrounding tissues and massive bleeding.The mean operation time was 110 minutes(90 to 170),and the mean blood loss was 135 ml(80 to 650).Three cases,who had normal blood pressure and thus received no noradrenalin immediately after the surgery,was given noradrenalin emergently 4,6,or 56 hours later owing to a sudden drop of systolic pressure(from 135 mm Hg to 80 mm Hg in 2,and from 140 mm Hg to 85 mm Hg in 1).Postoperative examination showed benign pheochromocytoma in 15 of the cases,and low-grade malignant pheochromocytoma with local invasion of the capsule in the patient who was converted to open surgery.The mean postoperative hospital stay was 12 days(9 to 20).The patients were followed up for 3 to 24 months(mean,13),during which only one received antihypertensive drugs;the others restored normal blood pressure spontaneously.No patient had abnormal levels of 24-hour urine noradrenalin,adrenalin,and catecholamine.Conclusions Retroperitoneoscopic surgery is an effective and minimally invasive treatment for patients with adrenal pheochromocytoma.The patients have a few complications and recover quickly after the operation.Preoperative preparation and postoperative treatment are important for the outcomes of the disease.

Objective To investigate the relationship between levels of serum matrix metalloproteinases(MMPs)and brain edema and neurologic impairment in patients with intracerebral hemorrhage(ICH).Methods The levels of serum MMP-9 and MMP-2 in 31 patients with ICH were tested with ELISA for at 1 d,3 d,7 d and 2 weeks after onset.The volumes of hematoma and its peripheral edema were evaluated by CT,the neurologic impairment was evaluated by NIHSS at 1 d and 14 d after onset.Results Levels of serum MMP-9 and MMP-2 were significant higher in ICH group at each time point after onset than those in normal control group(allP

Objective To investigate the possibility of microsatellite alteration (MA) in diagnosis of bladder cancer of Chinese people, and find the better panel which will be used in clinic. Methods A total of 6 and 10microsatellite markers were chosen, PCR-SSLP silver staining assay was performed in 31 and 32 bladder cancers tissue,exfoliate cells in urine and 10, 15 non-bladder cancers exfoliate cells in urine, respectively. Results MA (+) was found in 28 out of 31, 30 out of 32 bladder cancers, and the sensitivity was 90.3%, 93.7% respectively. The MA of urine sediment of 25 non-bladder cancers was negative, and the specificity was 100%. The cytology was carried out among 19 out of 31, 20 out of 32 bladder cancers at the same time, 2 cases ( 10.3 %) and 3 cases ( 15 % ) were found cancer positive, and the sensitivity is significantly lower than that by the analysis of MA in exfoliated cells. Conclusion MA was not associated with grade and stage of the bladder cancer. MA assay is a sensitive and effective method for the early detection of bladder cancer and post-operation surveillance.

Objective To analyze the cause of delayed hemorrhage after minimally invasive percu- taneous nephrolithotomy(MPCNL),and to summarize the experience in the interventional treatment of severe bleeding after MPCNL by superselective arteriolar embolization.Methods The clinical data of 3812 cases of MPCNL from June 1998 to July 2004 were reviewed.Of them,12 patients(11 men and 1 woman;mean age,45 years)who developed severe hemorrhage after MPCNL were identified.The cause of hemorrhage and the treatment results were analyzed.Results The rate of delayed hemorrhage after MPCNL was 0.31% (12/3812).The mean time to onset of severe bleeding was 10 d after MPCNL.Renal arteriography was per- formed in all 12 patients,showing 5 arteriovenous fistulas and 7 false aneurysms.Superselective arteriolar em- bolization for hemostasis was performed in all 12 cases.All these vascular abnormalities were successfully treated by superselective embolization.Follow-up showed that the hematuria disappeared and renal function recovered well.Conclusions Severe hemorrhage following MPCNL is a rare complication,the incidence of which is significantly lower than that of conventional PCNL.The cause is mainly the arteriolar injury of re- nal puncture passage.Superselective embolization provides effective control of bleeding and currently consti- tutes the treatment of choice based on our experience.

Data is the basis and soul of clinical trials. To obtain accurate data, strict and standard data management is essential, which can be effectively supported by quality control in statistical analysis. In this paper, we briefly introduce the concept of the quality control in clinical trials, and describe its contents and methods. We hope that this work will be helpful to the application of statistical quality control in data management of clinical trials.
Clinical Trials as Topic ; standards ; Data Collection ; standards ; Quality Control ; Statistics as Topic

Objective To investigate the application value of anatomic segmental hepatectomy in treatment of left hepatolithus.Methods The 80 patients with left hepatolithuswere divided into the control group (n =40)and the observation group (n =40)in accordance with dif-ferent surgical methods,and they were given traditional surgery and precise pedicle anatomic segmental hepatectomy respectively.Operation index levels,postoperative complications and stress reaction levels before and after surgery of the two groups were compared.Results The blood loss,operative time,the time of drainage tube remove,time of analgesic drug use,and postoperative hospital stay of the observation group were significantly less than the control group,and the difference was statistically significant (P <0.05).The rate of postoperative com-plications was 17.50% in the control group,while it was 15.00% in the observation group,which showed no significant difference between the two groups (P >0.05).During the surgery,epinephrine,cortisol,IL-6 and CRP levels of patients decreased after a slight increase, while NK cell levels of patients decreased firstly and then increased.There were statistically significant differences in trems of the above inde-xes immediately after surgery to 24 hours after surgery (P <0.05),and the rangeability of the observation group was less than the control group (P <0.05).Until 48 hours after surgery the above indexes recovered to the preoperative level.Followed up for 3 to 24 months,the calculi recurrence rate and abdominal ache recurrence rate of the observation group were lower than the control group,and the difference was statistically significant(P <0.05).Conclusion Precise pedicle anatomic segmental hepatectomy applied in the treatment of left hepatolithus showed makedly curative effect,and it has little effect on the stress response of patients.

Objective:To prepare the production of TIGIT-Fc fusion protein using H22 cells stably integrated the gene by lentivirus vector , and to explore the immunoregulatory effect on macrophages by TIGIT-Fc.Methods: TIGIT-Fc fusion gene were constructed by molecular cloning.The fusion gene was then subcloned to plasmids contained the secretion signaling peptide .The secrected TIGIT-Fc fusion gene was inserted into the lentivirus backbone vector.The purified lentivirus vector was the used to infect the murine H22 cell line.TIGIT-Fc protein was purified by protein A column from the ascites of H 22-injected C57BL/6 mice.Macrophages stimulated by lipopolysaccharide ( LPS ) was challenged to TIGIT-Fc treatment or control.Cytokine levels was then detected by ELISA.Results: TIGIT-Fc protein was purified from the ascites of H 22-injected mice.PVR was upregulated in LPS-treated macrophages.IL-10 level was upregulated in TIGIT-Fc treated macrophages.Conclusion: TIGIT-Fc promotes the mature macrophages to secrete anti-inflammatory cytokine IL-10.

Objective The purpose of the study is to understand the epidemiology,distribution and molecular characteristics of oxacillin susceptible mecA positive Staphylococcus aureus (S.aureus).Methods Totally 1588 S.aureus isolates collected from 12 hospitals in 10 cities of China between 2010 and 2012 were retrospectively characterized.The isolates were characterized by antimicrobial susceptibility test of 20antimicrobial drugs.Three different methods (cefoxitin disc diffusion,agar dilution for oxacillin and cefoxitin) to detect oxacillin susceptible and mecA positive S.aureus were also compared.All the strains were confirmed to be S.aureus by detecting S.aureus specific genes by PCR (including nuc,femB,and mecA gene),which was viewed as the golden standard of MRSA.The molecular typing methods included SCCmec and spa typing.The statistical analyses were carried out in statistical product and service solutions (SPSS),Version 18.0.The significance level P was set at 0.05.Results According to the MICs of cefoxitin and oxacillin,a total of 60 isolates were oxacillin susceptible methicilin resistance Staphylococcus aureus (MRSA).Based on the differences of the specimen collection date,it is found that oxacillin susceptible MRSA have increased from 2010 to 2012 (P =0.05,95％ CI 0.045-0.056,X2 =6.099).These isolates were distributed in 9 major cities,and the highest prevalence is 30.0％ (18/60) in Guangzhou,followed by Beijing (18.3％,11/60),Wuhan (15.0％,9/60),Hangzhou (13.3％,8/60).Most of the isolates were from skin soft tissue infection (35％,21/60),blood stream infection (30％,18/60) and respiratory infection specimens (18.3％,11/60).The resistance rate to cefoxitin,erythromycin,clindamycin and tetracycline was 100％ (60/60),86.7％ (52/60),66.7％ (40/60) and 50％ (30/60),respectively.The molecular characterization showed that 21 spa and 5 SCCmec types were detected.The most predominant clone was spa t437-SCCmec Ⅳ (25.0％,15/60),followed by spa t437-SCCmecV (13.3％,8/60).Conclusions The detection rate of oxacillin susceptible MRSA is significantly higher from 2010 to 2012.The major clone is t437-SCCmec Ⅳ.The use of cefoxitin should replace oxacillin in detecting this type of MRSA.Further study is needed to confirm whether beta lactam antimicrobial agents should be used in the treatment of oxacillin susceptible mecA positive S.aureus.

Objective To evaluate the efficacy of acting κ opioid receptor for prevention of high altitude pulmonary edema (HAPE) in rats.Methods Forty male Sprague-Dawley rats,aged 8 weeks,weighing 250-300 g,were randomly divided into 5 groups (n =8 each) using a random number table:control group (group C),hypobaric hypoxia group (group H),normal saline + hypobaric hypoxia group (group NH),U50488H (a selective kappa-opioid receptor agonist) + hypobaric hypoxia group (group UH),and nor-binaltorphimine (norBNI,a selective kappa-opioid receptor antagonist) + U50488H + hypobaric hypoxia group (group NUH).The rats were put into the hyperbaric chamber and exposed to hypobaric hypoxia (atmospheric pressure 355 mmHg,partial pressure of oxygen 74 mmHg) for 2 days to induce HAPE.At 3 days before HAPE,normal saline 0.5 ml,U50488H 1.25 mg/kg,and nor-BNI 2.0 mg/kg were injected intraperitoneally once a day in NH,UH,and NUH groups,respectively,and in addition U50488H 1.25 mg/kg was injected intraperitoneally 10 min later in NUH group.After 2 h exposure to hypobaric hypoxia,mean pulmonary artery pressure (mPAP) was detected,and arterial blood samples were collected for determination of serum malondialdehyde (MDA) and erythropoietin (EPO) levels.The rats were then sacrificed and lungs were removed for microscopic examination and for determination of the levels of nitric oxide (NO),inducible nitric oxide synthase (iNOS),MDA,superoxide dismutase (SOD),endothelin-1 (ET-1),thromboxane B2 (TXB2),and 6-keto-prostaglandin F1α (6-keto-PGF1α) in lung tissues.Lung water content and TXB2/6-keto-PGF1α ratio was calculated.Results Compared with group C,mPAP,lung water content,ET-1,MDA,TXB2 and 6-keto-PGF1α levels,TXB2/6-ketoPGF1α ratio,and serum MDA and EPO levels were significantly increased,and iNOS,NO and SOD levels were decreased in the other four groups (P ＜ 0.05).Compared with group H,mPAP,lung water content,ET-1,MDA,TXB2 and 6-keto-PGF1α levels,TXB2/6-ketoPGF1α ratio and serum MDA and EPO levels were significantly decreased,and iNOS,NO and SOD levels were increased in UH group (P ＜ 0.05),and no significant changes were found in the indexes mentioned above in NH and NUH groups (P ＞ 0.05).The pathological changes of lung tissues were significantly attenuated in group UH as compared with H group.Conclusion Acting κ opioid receptor can produce prevention for HAPE in rats,and inhibition of lipid peroxidation and correction of the imbalance between vasoconstrictive factors and vasodilative factors may be involved in the mechanism.