Objective To make a further understanding of mammographic features of simple cyst of the breast (SCB).Methods Molybdenum target radiographic signs in 39 cases with SCB proved pathologically and were retrospectively analyzed. Results Of the 56 SCB in 39 cases, 23 were diagnosed rightly as SCB, 10 as fibroadenoma, 2 as cancer and the remaining 4 were undefined. The diagnostic accuracy and misdiagnosis were 59.0% and 41.0% respectively. Radiograph showed round in 12, ovoid in 38, mild lobed in 4 and comet tail form in 2. The borders of cyst were distinct and sharp in 26, distinct partly and indistinct partly in 27,indistinct completely in 3. The density was homogeneous in 54 with calcifications in 2. Of the 56 SCB, the length axes of cyst were upright to chest wall in 20 and towards nipple in 18. The cysts could be transformed with pressure in 4.Conclusion Careful analysis of radiographic features of SCB is helpful for diagnosing accurately this disease.

Objective To investigate the clinical value of prenatal MRI in the diagnosis and differential diagnosis of congenital bronchopulmonary sequestration (BPS). Methods From January 2009 to December 2014, 16 fetuses with BPS were diagnosed by fetal MRI in Huzhou Maternity and Child Care Hospital and Shanghai Children′s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine. The clinical data of these cases were analyzed retrospectively. All were singleton pregnancy, and MRI was carried out within 24-48 hours after routine prenatal ultrasound. All the neonates underwent postnatal enhanced CT scan or surgical biopsy after birth, and the results were compared to prenatal MRI diagnosis. Results (1)With prenatal MRI, 16 cases were diagnosed BPS. The lesions located in left lung in 10 cases, and right lung in 6 cases. As the scope of the lesion, 3 cases located in the whole left lung, 6 cases limited to the left lower lobe, and 1 case was subdiaphragmatic on the left side. 2 cases located in the whole right lung and 4 cases limited to the right lower lobe. One case complicated oligoamnios, and one had pleural effusion. Supplying vessels could be found in 14 cases.(2)When the postnatal results were compared with prenatal MRI, 15 cases were comfirmed as BPS (15/16), including 10 intralobar cases 5 extralobar cases. One that was diagnosed as BPS by prenatal MRI was confirmed to be congenital cystic adenomatoid malformation (CCAM) by pathology. The accuracy of prenatal MRI diagnosis of BPS was 15/16. Prenatal ultrasound missed one case and misdiagnosed two cases, as one was mistakened as CCAM and the other as cystic teratoma. Conclusion Prenatal MRI has good clinical value in the diagnosis and differential diagnosis of fetal BPS.

In the basis of a large amount of literatures, this article sumed up the characteristics and application of eggshell membrane.

OBJECTIVETo analyze the Chinese medical syndrome typing laws in rheumatoid arthritis (RA) patients of the dampness-heat impeding syndrome and the cold-dampness impeding syndrome.

METHODSClinical data and serum of 322 inpatients and outpatients were collected to perform DAS28 score. Laboratory indices including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), albumin (ALB), globulin (GLB), and blood routines (white blood cell, red blood cell, and platelet) were tested by conventional methods, and the serum levels of tumor necrosis factor (TNF)-alpha and interleukin (IL)-1beta were detected by ELISA. The difference of each index was analyzed between RA patients of the dampness-heat impeding syndrome and the cold-dampness impeding syndrome.

RESULTSThe levels of DAS28 scores, ESR, CRP, white blood cell count, and platelet of RA patients of the dampness-heat impeding syndrome were significantly higher than those of the cold-dampness impeding syndrome (P <0.01). The serum level of GLB of RA patients of the dampness-heat impeding syndrome was obviously higher than that of the cold-dampness impeding syndrome (P <0.01), while the serum ALB level of RA patients of the dampness-heat impeding syndrome was obviously lower than that of the cold-dampness impeding syndrome (P<0.01). Compared with the dampness-heat impeding syndrome, ROC curve results showed the area under the curve (AUC) were ranked from large to small as DAS28 score > ESR >CRP >GLB > PLT >WBC (P<0.01). Compared with the cold-dampness impeding syndrome, only ALB was of diagnostic value for cold-dampness impeding syndrome and the AUC was 0.636 (P = 0.000).

CONCLUSIONDAS28 score, ESR, CRP, PLT, WBC, GLB, and ALB could be used as objective index in identifying the differences between the dampness-heat impeding syndrome and the cold-dampness impeding syndrome in RA patients.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Arthritis, Rheumatoid ; classification ; diagnosis ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Young Adult

OBJECTIVETo study therapeutic effects of minimally invasive percutaneous plate osteosynthesis for the treatment of intertrochanteric femoral fractures of Evans III, IV in elderly patients.

METHODSFrom December 2007 to April 2010, 23 patients with intertrochanteric femoral fractures were reviewed. Among the patients, 11 patients were male and 12 patients were female,ranging in age from 62 to 90 years, with a mean of 72.8 years. According to Evans classification, 13 patients were type III and 10 patients were type IV. All the patients were treated with proximal femoral locking plate (minimally invasive percutaneous plate osteosynthesis, MIPPO) surgery.

RESULTSThe operative time ranged from 45 to 60 min, with an average of 50 min. The blood loss ranged from 60 to 100 ml, averaged 80 ml. All the patients were followed up,and the duration ranged from 9 to 18 months, with an average of 11 months. The healing time based X-ray ranged from 3 to 6 months, with an average of 4 months. According to hip scoring criteria evaluation: 18 patients got an excellent results, 5 good.

CONCLUSIONFor the treatment of intertrochanteric femoral fractures of Evans III, IV in elderly patients, MIPPO has advantages such as small trauma, reliable fixation, which has good clinical application.

Aged ; Aged, 80 and over ; Bone Plates ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; adverse effects ; instrumentation ; methods ; Hip Fractures ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; adverse effects ; instrumentation ; methods ; Skin ; Treatment Outcome

OBJECTIVETo study the extent of retinal vascular development and influencing factors at birth and the relation between retinal vascularization and retinopathy of prematurity (ROP).

METHODSFrom October, 2006 to December 2006, retinal vascularization was screened and evaluated in 84 neonates at different weeks of gestation and birth weights (BWs), had dilated fundus evaluation for zone of retinal vascularization by the 130 degrees lens of a digital fundus camera. The infants' pupils were dilated with 2.5% phenylephrine and 0.5% cyclopentolate eye drops. The study cohort was divided into subgroups depending on the weeks of gestation and birth weights. The control group consisted of healthy term infants. Maternal and neonatal factors were ascertained and analysed.

RESULTSVascularization up to zone I and II was considered to be immature retina; vascularization up to zone III or beyond was considered to be mature retina. In this study, 11 of 12 infants who were born at < 30 weeks of gestation, 12 of 26 infants who were born at < 31 approximately 33 weeks of gestation, 1 of 26 babies who were born at < 34 approximately 36 weeks of gestation and none of 20 babies who were born at < 37-40 weeks of gestation had immature retina; 12 of 15 babies at < 1500 g BW, 8 of 14 infants at 1500 g < BW < 1700 g, 4 of 11 infants at 1700 g < BW < 2000 g and of 44 infants at > 2000 g BW had immature retina. Those infants who were born at > 34 weeks of gestational age and at > 2000 g BW had mature retina. Infants who were born between 31 to 34 weeks of gestation and at 1501 to 2000 g BW had variable extent of retinal vascularization at birth. Vascularization was associated with postconceptional age (F = 31.9193, P = 0.000), birth weight (F = 32.4532, P = 0.000), anemia (F = 36.9391, P = 0.000), surfactant (F = 24.000, P = 0.0000), poor nutrition (F = 4.184, P = 0.041), RDS (F = 17.6191, P = 0.000), cesarean delivery (F = 10.972, P = 0.0022) and oxygen > 48 h (F = 22.076, P = 0.0000). Vascularization was affected mainly by the postconceptional age (95% CI = 1.57-261.728, P = 0.021). At last, 15/24 infants with immature retina developed ROP while none of the infants with mature retina developed ROP (chi2 = 45.1087, P = 0.000).

CONCLUSIONThere is considerable variability in the extent of retinal vascularization in infants who we born between 31 to 34 weeks of gestation. Modifiable maternal and fetal factors could influence extent of vascularization at birth. Immature retina is the critical factor of ROP. Gestational age is the main factor of the immature retina in premature infants.

Birth Weight ; Female ; Humans ; Infant, Newborn ; Infant, Premature ; Male ; Neovascularization, Physiologic ; Retina ; anatomy & histology ; Retinal Vessels ; growth & development

Objective To evaluate the feasibility and safety of transumbilical laparoendoscopic sin-gle-site dismembered pyeloplasty ( U-LESS-P ) for the treatment of ureteropelvic junction obstruction (UPJO). Methods Between Mar.2011 and Mar.2012, U-LESS-P was performed in 8 consecutive pa-tients with UPJO by one experienced laparoscopic surgeon .The patients included 5 males and 3 females, with an average age of 28 (16-45) years.Of the 8 patients, six presented with flank pain , and two were a-symptomatic and discovered incidentally by health check .Of the 8 patients, seven had UPJO on the left side and one on the right side .The diagnosis was established by renal ultrasonography , diuretic renal scan , intra-venous urography (IVU) or/and computed tomography urography (CTU).Renal ultrasonography, IVU and ( or) CTU showed hydronephrosis and UPJO in the affected side , while diuretic renal scan demonstrated re-nal function deteriorated .No patients had undergone abdominal surgery previously .A 2-2.5 cm umbilical in-cision was made for single-port access .The procedures were performed using 30°5 mm or 10 mm laparoscope with a combination of conventional and bent laparoscopic instruments . Results All procedures were com-pleted successfully .None was converted to open surgery or traditional laparoscopic surgery .The mean opera-tive time was 153 (117-190) min, and the average estimated blood loss about 20 (10-40) ml.The mean time to resume oral diet was 1.5 days.The drainage remained 2-7 days.The mean hospital stay was 6 (4-8) days.With the follow-up of 3-6 months, symptom-free was investigated in all 8 cases.Ultrasonography , diuretic renal scan and IVU showed decreased or disappeared hydronephrosis .No operative complication , such as anastomotic stoma stenosis , was founded . Conclusions U-LESS-P is a safe and effective proce-dure for the treatment of UPJO , with the advantages of decreased operative morbidity , postoperative rapid re-covery and improved cosmetic result .

?AIM:To analyze the clinical features of Terrien marginal degeneration ( TMD) .?METHODS:Fifty-six patients(90 eyes) admitted in our hospital from January 2013 to January 2015 were selected as observation group.At the same period, 56 healthy (88 eyes) for corneal examination were as control group to analyze the clinical features of TMD. With immunohistochemistry and enzyme linked immunoassay method ( ELISA), the levels of HLA-DR, HLA-DQ and tumor necrosis factor-α( TNF-α) in blood samples of TMD patients were tested.?RESULTS:The transparent degree of the eye, lipid deposition in TMD patients with early, advanced, swelling and hole-wearing period were significantly different (χ2=10.85,χ2=65.32, P<0.05).Astigmatism in TMD patients with early and advanced, swelling and hole -wearing period were significantly different (P<0.05).The levels of HLA-DR, HLA-DQ and TNF-αin blood samples between the two groups were significantly different ( t=45.326, t=23.564, t=19.86, P<0.05).?CONCLUSION: Terrien's marginal degenerative is an inflammatory disease characterized by increased levels of TNF-α, HLA-DQ, and HLA-DR in peripheral blood, decreased corneal transparency, astigmatism and lipid deposition.This research provides experiment evidence for the mechanism of TMD.

OBJECTIVETo investigate short-stage results of audiological change of nasopharyngeal carcinoma patients after radiotherapy and chemotherapy treatment.

METHODSAccording to treatment modus of nasopharyngeal carcinoma, 64 cases (128 ears) patients were divided to simple radiotherapy group (45 cases, 90 ears) and radiotherapy with chemotherapy group (combination treatment group, 19 cases, 38 ears). Meanwhile, 25 cases (50 ears) people took as control group, who had no obviously ear and nose disease. About two or three months after radiotherapy and chemotherapy treatment completion, three groups were detected by otoscopy, pure tone test, tympanogram and eustachian tube function, respectively. Then, hearing variation of all patients after radiotherapy and chemotherapy treatment were investigated and compared each other. At the same time, the character and level of audiological change were also analyzed.

RESULTSEardrum character of nasopharyngeal carcinoma patients appeared change after radiotherapy. Simple radiotherapy and combination treatment groups were found having hearing impairment and eustachian tube functional disturbance. Moreover, most patients of simple radiotherapy group showed conductive deaf (24%, 22/90), and combination treatment group exhibited mingle (24%, 9/38) or sensorineural deafness (29%, 11/38).

CONCLUSIONSRecent hearing of nasopharyngeal carcinoma patients were damaged by radiotherapy and chemotherapy treatment, radiotherapy treatment induced middle ear or eustachian tube function disturbance, chemotherapy treatment had cochleotoxicity, compared with other treatment, combination treatment was more aggravated hearing impairment.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; Audiometry, Pure-Tone ; Case-Control Studies ; Eustachian Tube ; physiopathology ; Female ; Hearing Loss ; etiology ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; physiopathology ; therapy ; Otitis Media ; etiology ; Radiation Oncology

Cerebral palsy is a group of syndromes caused by non-progressive brain injury in the fetus or infant and can cause disabilities in childhood. Etiology of cerebral palsy has always been a hot topic for clinical scientists. More and more studies have shown that genetic factors are closely associated with the development of cerebral palsy. With the development and application of various molecular and biological techniques such as chromosome microarray analysis, genome-wide association study, and whole exome sequencing, new achievements have been made in the genetic research of cerebral palsy. Chromosome abnormalities, copy number variations, susceptibility genes, and single gene mutation associated with the development of cerebral palsy have been identified, which provides new opportunities for the research on the pathogenesis of cerebral palsy. This article reviews the advances in the genetic research on cerebral palsy in recent years.
Cerebral Palsy ; etiology ; genetics ; Chromosome Aberrations ; Cytokines ; genetics ; DNA Copy Number Variations ; Genetic Predisposition to Disease ; Genome-Wide Association Study ; Humans ; Mutation