Objective:To compare the clinical characteristics in primary hyper(-) parathyroid hormone (PHPT) of the different patholog-ic types. Methods:Clinical data of 140 patients with PHPT proved by operation and pathology during January 2010 to June 2016 were retrospectively analyzed. Results:A total of 140 PHPT patients, including 13 (9.29%) cases of parathyroid carcinoma (PC), 27 (19.29%) cases of parathyroid hyperplasia (PH), and 100 (71.43%) cases of parathyroid adenoma (PA). The duration of the PC group was longer than the PH group and the duration of the parathyroid adenoma (PH) group was longer than the PA group (P<0.05). The percentage of young patients with PC was higher than in the other two groups (P=0.003). The diameters of the PC group were larger than those of the other two groups, and those of the PA group were larger than those of the PH groups (P<0.05). Blood calcium, parathyroid hor-mone (PTH), AKP, fasting blood glucose (FBG), alanine aminotransferase (ALT), aspartate aminotransferase (AST), glutamete transpepti-dase (GGT), blood urine nitrogen (BUN), creatine (CRE), urinary calcium, and phosphorus of the PC group were higher than in the oth-er two groups (P<0.05). The blood calcium, PTH, alkaline phosphatase (AKP), urinary calcium of the PH group were lower than those in PA group (P<0.05). The proportion of ostalgia was 46.15%(6/13), 44.44%(12/27), and 49.00%(49/100). No statistical difference was observed (P>0.05). The postoperative calcium level of PC group was lowest (P<0.001), and the highest was of PTH (P<0.001). The pro-portions of clinical manifestation of the urinary system, digestive system, and nervous system in the PC group were 76.92%(10/13), 76.92%(10/13), and 15.38%(2/13), respectively, and these values were the highest in the three groups (P<0.05). The proportion of the clinical manifestation of the urinary system of the PH group was higher than that of the PA group. The fracture rate (30.77%, 4/13) and constipation rate (38.46%, 5/13) of the PC group were the highest among the three groups (P<0.05). Conclusion:The duration of patients with PC was the longest among the three groups. The percentage of young patients with PC was the highest. The abnormal parathyroid glands in the PC group were the heaviest. The PC group exhibited the lowest postoperative calcium level and the highest PTH level. The biochemistry and clinical manifestations of PC were obvious.

OBJECTIVE: To observe the clinical and pathological features of adenoid cystic carcinoma(ACC) of external auditory canal (EAC, and analyze the possible factors related to prognosis. METHOD: One out of 8 patients with ACC of EAC underwent tumor open biopsy. 5 patients underwent the extensive tumor resection, and 2 patients underwent the modified lateral temporal bone resection (1 of the 2 subjoined a total parotidectomy). Five patients received the postoperative radiotherapy. RESULT: The time of follow up was 5-97 months. Two patients were loss to follow-up, 5 patients with disease free survival, and 1 patient survival with tumor. CONCLUSION In this study, ACC of EAC is more often observed in female. The most common clinical manifestations are otalgia and neoplasm which grows slowly. The disease has high misdiagnosis rate. Surgical treatment is effective for it.
Biopsy ; Carcinoma, Adenoid Cystic ; pathology ; therapy ; Diagnostic Errors ; Disease-Free Survival ; Ear Canal ; Ear Neoplasms ; pathology ; therapy ; Female ; Humans ; Male ; Prognosis ; Retrospective Studies

Objective: To analyze the electrocardiographic (ECG) characteristics in patients with primary hyperparathyroidism (PHPT) and meanwhile, to explore the relationship between ECG abnormality and serum calcium level in relevant patients. Methods: Our study included 2 groups: Observation group,n=84 PHPT patients treated in our hospital from 2010-01 to 2014-04 and Control group,n=80 normal subjects from regular physical examination at the same period. The ECG manifestation was compared between 2 groups. Meanwhile, according to tertile levels of serum calcium, PHPT patients were further divided into 3 subgroups:①Ca2+ level (2.0-2.8) mmol/L,②Ca2+ level (2.8-3.1) mmol/L,③Ca2+ level >3.1 mmol/L andn=28 in each subgroup. The ECG abnormalities were compared among 3 subgroups and the relationship between ECG changes and serum calcium levels were studied. Results: The ECG abnormality rates in Observation group and Control group were as 83.3% vs 18.8%, P<0.001. Compared with Control group, Observation group presented more frequent ST-T changes, QRS duration widening, high left ventricular pressure and QT interval shortening,P<0.001 orP<0.05. In observation group, with the rising of serum calcium, the incidences of ST-T changes and high left ventricular pressure were increased accordingly, the ST-T changes among 3 subgroups were significant,P<0.05; while with the rising of serum calcium, the QT interval was shortened and QRS duration was widened accordingly, the differences were obvious among 3 subgroups, allP<0.05.Conclusion: PHPT patients have the higher incidence with abnormal ECG, while ECG abnormality has beenrelated to serum calcium level in relevant patients.

Objective To assess the value of arterial spin labeling(ASL) MRI in the staging of early renal allograft function. Methods Sixty two renal allograft recipients (2 to 4 weeks after kidney transplantation) and 20 age match volunteers were included in this study. All subjects underwent conventional MRI and ASL MRI which was performed in the oblique-sagittal plane. Recipients were divided into two groups according to the estimated glomerular filtration rate (eGFR), recipients with good allograft function (eGFR≥60 ml · min-1 · 1.73 m-2,n=37) and recipients with impaired allograft function (eGFR<60 ml · min - 1 · 1.73 m - 2,n=25). Renal blood flow (RBF) was measured and an intra-class correlation coefficient (ICC) was calculated to confirm the reproducibility of the measured results from two doctors. One-way analysis of variance (ANOVA) and Bonferroni were used to compare the different cortical RBF among three groups. Correlation of RBF with eGFR was evaluated using Pearson correlation coefficients. The receiver operating characteristic (ROC) curve was performed to assess the diagnostic efficacy of using cortical RBF to discriminate allografts with impaired function from good function. Results RBF values showed good reproducibility between doctors with an ICC larger than 0.90 in different group. Mean cortical RBF were (390 ± 61),(290 ± 69),(201 ± 86) ml · 100 g-1 · min-1 for healthy controls, recipients with good and impaired allograft function, respectively(F=37.313,P<0.01). RBF exhibited a significant correlation with renal function as determined by eGFR for recipients (r=0.60,P<0.01). Mean cortical RBF showed a high area under the ROC curve (0.773) to discriminate renal allografts with different function, with a sensitivity of 56.0% (14/25) and a specificity of 89.2% (33/37). Conclusion ASL MRI can assess the early renal allografts perfusion, and provide valuable information in the staging of renal function. It could be a useful method for evaluating renal function noninvasively.

OBJECTIVETo evaluate the effect of integrative medical therapy on lower limb post-angioplasty arterial restenosis in diabetes patients.

METHODSThirty-six patients with lower limb diabetic arterial disease of Fontaine III/IV stage after successful balloon angioplasty were assigned randomly and equally to two groups, the control group and the treatment group, both were treated with basic therapy for 3 months, but Chinese drugs were given to the treatment group additionally. Level of acroesthesia was determined before and after treatment with simplified McGill pain questionnaire (SF-MPQ) scoring, ankle brachial index (ABI), toe brachial index (TBI), mean flow velocity of dorsal artery (MDA) and tibial artery (MTA) were measured by ultrasound Doppler meter, and blood preparation was determined. Moreover, the ulcer remission rate, ulcer cure rate, restenosis rate, and amputation rate were determined in the 6-month and 12-month follow-up studies.

RESULTSSignificant improvements of ABI, TBI, MDA and MTA, as well as on blood levels of high-sensitivity C-reactive protein (hs-CRP) and fibrinogen (FIB) were shown in the treatment group after treatment, showing significant difference in comparing with those before treatment (P < 0.05 or P < 0.01), also in comparing with the control group (P < 0.05 or P < 0.01) respectively, while in the control group, although a trend of improvement was seen, these indices were insignificantly changed statistically (P > 0.05). Comparisons between groups after 3-month treatment showed significant difference in ischemia remission rate and pain relief rate (P < 0.05). Outcomes of 6-month follow-up displayed that the differences between groups were insignificant in terms of the ulcer cure rate the and amputation rate (P > 0.05), but did show significance in the ulcer remission rate and the restenosis rate (P < 0.05), while all the 4 parameters were insignificantly different between groups after 12-month follow-up (P > 0.05). Overall incidence of adverse event was somewhat higher in the treatment group, but there was no significant statistically difference.

CONCLUSIONIntegrative medical therapy could improve the hemodynamic indices and pain symptoms, raise the ulcer cure rate and reduce the incidence of restenosis in patients with diabetic arterial disease after balloon angioplasty.

Angioplasty, Balloon ; Constriction, Pathologic ; Diabetes Mellitus, Type 2 ; complications ; therapy ; Female ; Humans ; Integrative Medicine ; Lower Extremity ; blood supply ; Male ; Treatment Outcome ; Vascular Diseases ; complications ; therapy

ObjectiveTo study the effects of the Behavior Therapy on outpatient with schizophrenics in relieving symptoms, insight, and attitude to treatment. Methods96 outpatients with schizophrenia were randomly assigned to the Behavior Therapy group and the control group. The Behavior Therapy courses were given to the Behavior Therapy group for six months. All the subjects were evaluated with Positive and Negative Syndrome Scale(PANSS) and Insight and Therapeutic Attitude questionaire(ITAQ). Results94 cases completed the trial. The scores of PANSS, the Negative Subscale, the General Psychopathology Subscale of the Behavior Therapy group decreased significantly after treatment(P<0.01). The score of ITAQ of the Behavior Therapy group increased significantly after treatment(P<0.01).The reductions of PANSS, the Positive Subscale, the Negative Subscale, the General Psychopathology Subscale and ITAQ between two groups were significant different(P<0.05-P<0.01). Conclusions The Behavior Therapy may play an important role in augmenting optimal pharmacotherapy for outpatients with schizophrenia and it is effective in improving symptoms, insight and therapeutic attitude.

Objectives To investigate the ability of T1 mapping and intravoxel incoherent motion imaging (IVIM) parameters for evaluating renal allografts at the early stage after renal transplantation. Methods This prospective study protocol was approved by the local ethics committee, and written informed consent was obtained from all subjects. Sixty two recipients 2 to 4 weeks after kidney transplantation and 20 healthy volunteers (control group) underwent routine MRI, T1 mapping, and IVIM imaging (11 b values, 0 to 700 s/mm2). Recipients were divided into two groups base on their estimated glomerular filtration rate (eGFR):37 recipients with good allograft function (eGFR≥60 ml·min-1·1.73 m-2) and 25 recipients with impaired allograft function (eGFR<60 ml·min-1·1.73 m-2). The ADC, true diffusion coefficient (ADCslow), pseudo-diffusion coefficient (ADCfast), perfusion fraction (f) and T1 values were measured on both cortex and medulla. Differences among groups were compared using the one-way analysis of variance. Correlations between eGFR and the parameters in renal allografts were assessed by using Pearson correlation analysis. ROC was performed to assess the diagnostic utilities of using these parameters to discriminate allografts with impaired function from good function. Results Excepting for cortical T1, ADCfast and medullary T1, f values, allografts with good function showed no differences in other parameters compared with healthy control. Excepting for medullary T1 and ADCfast,the other values showed significantly differences in allografts with impaired function compared to allografts with good function (all P<0.05). Excepting for medullary f and ADCfast values, allografts with impaired function showed significantly differences in the parameters compared with good function group(all P<0.05). In renal allografts, excepting for medullary T1, ADCfast, and f values, cortical T1 exhibited a negative correlation with renal function, and there was a significant positive correlation between eGFR and other parameters. Cortical T1 value showed high sensitivity(91.9%) to discriminate renal allografts with different function, with the threshold of 17.36 × 102 ms, and ADC value showed high specificity(96.0%)with the threshold of 1.98 × 10-3 mm2/s. Conclusion T1 mapping and IVIM technique may be useful for detecting renal allograft dysfunction, and be a reliable imaging for evaluating and monitoring allograft function.

OBJECTIVETo evaluate the early clinical effects of arthroscopic treatment for cruciate ligament cysts of the knee.

METHODSFrom September 2008 to January 2014, 23 patients with cruciate cysts were treated with arthroscopic surgery. There were 11 males and 17 females, with an average age of 28.3 years old (ranged, 16 to 56 years old). Twenty patients had injuries on the right knee and 8 patients had injuries on the left knee. Eight patients had a history of injury,5 patients had a history of chronic injury,and the other 15 patients had no obvious reasons for the symptom. Before the operation, 24 patients were clearly diagnosed as the cruciate ligament cysts of knee joint,and 4 patients were diagnosed as other problems of the knee, but the diagnosis were corrected after the operation. According to the MRI before the surgery,all the patients could be divided into 3 types: 14 were type I, 6 were type II, 8 were type III. After the operation, the patients were suggested to have a rest for 2 weeks, and take exercises everyday at the same time. The knee range of motion, Lysholm score, International Knee Documentation Committee (IKDC) 2000 subjective score, GLASGOW criteria, and McMurray test, pivot shift test, and anterior drawer test were observed to evaluate clinical results.

RESULTSAll the incisions healed at the first stage without complications. Twenty-five patients were followed up, and the duration ranged from 12 to 52 months, with a mean of 26.7 months. Three patients accepted the reconstruction of ACL or tightened elongated ACL using bipolar radio frequency. The Lysholm score increased from preoperative 59.80 +/- 6.58 to 75.32 +/- 6.49 at the latest follow-up; IKDC 2000 score increased from preoperative 65.36 +/- 6.26 to 81.00 +/- 5.76 at the latest follow-up. According to GLASGOW criteria,23 patients got an excellent result and 2 good.

CONCLUSIONIt has a satisfactory curative effect on ACL reconstruction using bipolar radio frequency. It has advantages of firm fixation, simple and secure operation as well as quick postoperative recovery. It's very important to check the MRI before operations, and carefully seek the cysts during the operations, avoiding the omission of any cysts,especially the cases of multiple cysts. Finally, patients should take exercises actively after operations.

Adolescent ; Adult ; Anterior Cruciate Ligament ; physiopathology ; surgery ; Anterior Cruciate Ligament Injuries ; Anterior Cruciate Ligament Reconstruction ; Arthroscopy ; Cysts ; surgery ; Female ; Humans ; Knee Injuries ; physiopathology ; surgery ; Knee Joint ; physiopathology ; surgery ; Male ; Middle Aged ; Range of Motion, Articular ; Young Adult

OBJECTIVETo investigate 30 bp deletion of latent membrane protein (LMP)-1 gene in lymphoepithelial carcinoma (LEC) of the salivary glands and to determine the frequency of this deletion.

METHODSForty-six cases of salivary gland LEC were investigated by PCR to explore the site specific, 30 bp deletion in the 3' terminal region of LMP-1 gene. To guarantee amplifiable DNA extracted from paraffin-embedded tissue sections, PCR amplification of a house-keeping gene (beta-actin) was performed simultaneously. In addition, DNA sequencing of the PCR product was performed in representative cases.

RESULTSAlthough amplifiable DNA was obtained in 42 of the 46 specimens, as indicated by beta-actin gene amplification, successful amplification of LMP-1 gene was achieved in 35/42 (83.3%) cases. Two types of PCR products of LMP-1 gene were observed and confirmed by DNA sequencing. A wild-type PCR product (316 bp) was present in 31 cases (88.6%) and only 4 cases (11.4%) showed an aberrant 286 bp PCR product, corresponding to the 3' terminal 30 bp deletion of the gene.

CONCLUSIONSite-specific 30 bp deletion of LMP-1 gene is not a common feature of salivary gland LEC.

Base Sequence ; Carcinoma ; genetics ; pathology ; virology ; Carcinoma, Squamous Cell ; genetics ; pathology ; virology ; Epstein-Barr Virus Infections ; epidemiology ; virology ; Gene Deletion ; Herpesvirus 4, Human ; genetics ; Humans ; Molecular Sequence Data ; Oncogene Proteins, Viral ; genetics ; Salivary Gland Neoplasms ; genetics ; pathology ; virology ; Sequence Deletion ; Viral Matrix Proteins ; genetics

·AIM: To investigate the preparation of endostatin protein and its biologic activity on vascular endothelial cell.· METHODS: pBlast-hEndostatin and pBlast-Mcs were identified by digesting with Nhe Ⅰ and Sal Ⅰ, by PCR reaction, by sequencing, and by Alignments of PCR products with gene bank using NCBIBLAST software. The identified pBlast-hEndostatin as well as pBlast-Mcs were then purified with QIAGEN Endofree plasmid maxi kit.The purified plasmids transfected human fibroblasts. The expression of endostatin was detected by RT-PCR, Westem-Blot and immunohistochemistry. The endostatin prorein produced by transfected fibroblasts was purified by ultrafiltration and affinity chromatography. The inhibitory action of endostatin on human umbilical vein endothelium was measured by MTT assay.· RESULTS: pBlast-hEndostatin was found to contain human endostatin gene. Endostatin protein was produced by transfected fibroblasts. The inhibitory ratio of 2.5,5,10,20,40,80mg/L endostatin on human umbilical vein endothelium for 48h were 8.5%,13.1%,27.7%,38.1%,56.7%,63.8% respectively. IC50 value was 34.5mg/L.No inhibition action was found on fibroblasts.·CONCLUSIONS: Endostatin protein can be produced by the transfected fibroblasts. The produced endostatin has inhibitory action on human umbilical vein endothelium and has no inhibition action on fibroblasts.