Breast Neoplasms ; epidemiology ; metabolism ; pathology ; Cadherins ; metabolism ; Carcinoma, Lobular ; epidemiology ; metabolism ; pathology ; Catenins ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Keratins ; metabolism ; Lymphoma ; metabolism ; pathology ; Mastitis ; metabolism ; pathology ; Plasmacytoma ; metabolism ; pathology

Objective To grasp the basic situation concerning visits by emergency outpatients to big urban hospitals before the implementation of reform in the medical insurance system in our city. Methods An investigation was made by means of profile survey questionnaires into the form of medical security of emergency outpatients, the sources of patients, referrals of patients, and the evaluation of doctors. Results Current emergency outpatient services in big urban hospitals have the following features: fairly great medical demands and attraction, widespread sources of patients, and pretty strong advantages in comprehensive clinical treatment. At the same time, before the implementation of reform in the basic medical insurance system, existing medical security setups, which are in the stage of transition, are characterized by a variety of types, a pretty narrow coverage in the provision of medical security and a rather high proportion of self-paying patients. Conclusion It is imperative to actively promote reform of the medical insurance system, formulate regional health plans that conform to the situation in our country, and expand the functions of community medical healthcare.

Objective To investigate the effects of different afferent nerve injury on development of neuropathic pain and its relationship with brain-derived neurotrophic factor (BDNF) in spinal cord and dorsal root ganglion (DRG) in rats. Methods Twenty-four male SD rats aged 2 months weighing 200-250 g were randomly divided into 3 groups:group Ⅰ sham operation (group S); group Ⅱ sural nerve injury (group SUR) and group Ⅲ gastrocnemius-soleus nerve injury (group GS). Sural nerve and gastrocnemius-soleus nerve were transected in group SUR and GS respectively. Paw withdrawal threshold to von Frey filament stimulation was measured the day before and at day 3 and 7 after operation. The animals were killed at postoperative day 7 after the measurement of paw withdrawal threshold. The ipsllateral L5 DRG and L5 segment of the spinal cord were removed. BDNF expression in the spinal dorsal horn was determined. The percentage of BDNF positive neurons and ATF-3 positive neurons in the total DRG neurons and the percentage of BDNF positive neurons in the damaged neurons (ATF-3 positive) were calculated. Results Mechanical hyperalgesia developed after transection of gastrocnemius-soleus muscle in group GS. Mechanical pain threshold was sinificantly lower, while BDNF expression in the spinal dorsal horn and the percentage of BDNF positive neurons in total DRG neurons were significantly higher in group GS than in group S and SUR (P ＜ 0.01). There was no significant difference in all variables between group SUR and S (P＞0.05). There was no significant difference in the percentage of ATF-3 positive neurons in the total DRG neurons between group GS and SUR (P ＞ 0.05), but the percentage of BDNF positive neurons in the damaged neurons (ATF-3 positive) was significantly higher in group GS than in group SUR (P ＜ 0.05). Conclusion Transection of the afferent nerve innervating muscle can produce neuropathic pain through up-regulation of BDNF expression in spinal dorsal horn and DRG in rats, while transection of the afferent nerve innervating skin can not.

Antidiuretic Hormone Receptor Antagonists ; Heart Failure ; drug therapy ; Humans

Aim To evaluate the effect and mechanism of vascular endothelial growth factor(VEGF) and Cysteine protease aspartic acid-3(Caspase-3) inhibition of human hepatocellular carcinoma(HCC)implants in nude mice by nanometer magnetic interferon-?2b liposome targeting therapy.Methods Thirty nude mices bearing human HCC were divided into 5 groups of 6 mice:group 1,saline(NS);group 2,free interferon-?2b group(IFN);group 3,interfe-ron-?2b liposome group(IL);group 4,magnetic liposome group(ML);group 5,nanometer magnetic interferon-?2b liposome group(MIL).Above dosage of 200 ?l/nude mice was respectively injected through the caudal vein in these 6 groups.Meantime,magnetic field with the strength of 5000 GS was added to the tumor surface about 30 min,and this therapy was done three times.After 30 days,the mices were killed and the tumors were taken out.The difference at the mRNA expression level of VEGF and Caspase-3 was observed by RT-PCR between the experimental group and control group.The protein expression level of VEGF and Caspase-3 was detected by western blot between the experimental group and control group.Results Targeting therapy study in nude mice bearing human HCC displayed that the growth speed of tumor in the MIL group significantly slowed down than other groups.The tumor inhibition rate of MIL group was 62.50%,which was remarkably higher than those of the IFN group(27.61%) and IL group(28.17%).RT-PCR showed that the mRNA expression of VEGF of MIL group is the lowest of all groups(P

Coronary Sinus ; abnormalities ; Humans ; Male ; Middle Aged ; Subclavian Vein ; Vena Cava, Superior

ObjectiveTo discuss the characters and management of renal lymphangiectasia.MethodsThe clinical data of two cases of renal lymphangiectasia were reviewed. The first patient was a 37-year-old woman with the chief complaint of lumbago in the right flank for 8 days.B-ultrasound showed mixed echo in perinephric space. On CT, similar appearances of fluid collections were seen, but not conspicuous. Conservative treatment was taken for three weeks and the symptoms were relieved. Three month later the patient had right lumbago relapse. CT scan revealed a large amount of fluid collection under the capsule of the right kidney. Percutaneous drainage was carried out. Two months later B-ultrasound showed fluid collection in perinephric space and percutaneous drainage again the fluid was sent to pathology. The second case was a 32-year-old woman with the chief complaint of lumbago in the left flank for the past three years. Ultrasonography revealed hyperechoic surrounding the left kidney. CT scan showed a left perinephric collection of fluid attenuation and circumferentially draping around the kidney. Renal lymphangioma was diagnosed and the patient underwent surgery.ResultsNeedle aspiration of the perinephric fluid was carried out, and laboratory analysis showed most leucocytes were lymphocytes. The pathologic diagnosis of the first case was renal lymphangiectasia. There was no recurrence during follow - up of two months. The second case was diagnosed renal lymphangioma pathologically. Follow - up for nine years, revealed no relapse.ConclusionsUltrasonography and CT contributed to the diagnosis of renal lymphangiectasia. Needle aspiration bioposy and histology could confirm it. Treatment of asymptomatic cases is not required. When collections are very large and cause symptoms, percutaneous drainage may be carried out however there is a risk of relapse.

OBJECTIVETo investigate the pathological diagnostic features and the differential diagnosis of radial sclerosing lesions of the breast.

METHODSMorphological observation and immunohistochemistry were applied to forty-four cases of radial sclerosing lesions of the breast.

RESULTSAll forty-four patients were females, the mean age was 40.3 years (range 17 to 54 years). In the 31 consultation cases, 13 were misdiagnosed as carcinoma. The lesions had a radiating outline, and a central scar area where squeezed or pressed irregular shaped tubules were frequently seen. Dilated tubules and proliferated ducts or lobules were seen radically arranged at the periphery accompanied sometimes with the apocrine glands or columnar cell metaplasia and hyperplasia. Aside, there were 14 cases displaying necroses and 8 cases showing atypical ductal hyperplasia. Immunostaining showed myoepithelial cells around the pseudo-infiltrating tubules, and the florid proliferating epithelial cells were positive for CK5/6.

CONCLUSIONSRadial sclerosing lesions of the breast possess characteristic histological features, and may be misdiagnosed as carcinoma. The lesions should be differentiated from ductal carcinoma in situ, lobular neoplasia, tubular carcinoma and invasive ductal carcinoma.

Adenocarcinoma ; pathology ; Adolescent ; Adult ; Breast ; pathology ; Breast Diseases ; metabolism ; pathology ; Breast Neoplasms ; pathology ; Carcinoma in Situ ; pathology ; Carcinoma, Ductal, Breast ; pathology ; Carcinoma, Lobular ; pathology ; Diagnosis, Differential ; Diagnostic Errors ; Female ; Humans ; Hyperplasia ; Keratin-14 ; metabolism ; Keratin-5 ; metabolism ; Keratins ; metabolism ; Middle Aged ; Sclerosis ; metabolism ; pathology ; Young Adult

Major depression disorder is an increasing heavy burden in modem society, but its pathological mechanism is still vague. Recent evidence indicated that two pore potassium channel, TREK1, is one of the important drug targets of antidepressants. The structural and functional research progress of TREK1 potassium channel were reviewed with an emphasis on its roles in anti-depression, neuronal protection, and neuronal plasticity. The complicated interactions between TREK1 potassium channel and monoamine transmitters-receptors were also reviewed and future directions to explore the underline mechanism were also discussed.
Animals ; Antidepressive Agents ; pharmacology ; Depressive Disorder, Major ; genetics ; metabolism ; physiopathology ; Drug Delivery Systems ; Gene Knockout Techniques ; Humans ; Neuronal Plasticity ; Polymorphism, Genetic ; Potassium Channels, Tandem Pore Domain ; genetics ; metabolism ; physiology ; Receptors, Serotonin ; metabolism ; Receptors, Serotonin, 5-HT4 ; Serotonin ; pharmacology

OBJECTIVETo compare the therapeutic effects between anatomical locked plate combined with coracoclavicular ligament reconstruction and clavicular hook plate for treatment of distal clavicle fracture of Neer type II b.

METHODSFrom August 2010 to August 2013, 42 patients with Neer II b distal clavicle fractures were randomly divided into two groups as group A and group B. In group A, there were 22 cases including 14 males and 8 females with an average age of (44.2±11.6) years old. In group B, there were 20 cases including 11 males and 9 females with an average of (45.6±12.4) years old. The patients of group A were treated with anatomical locked plate combined with coracoclavicular ligament reconstruction,the patients of group B were treated with hook plate. All fractures were fresh, the time between injuries and operation was 24 hours to 7 days (mean,72 h). General information between the two groups was comparable before operation(P>0.05). Postoperative radiographic were followed up to observe the fracture healing,internal fixation and to measure coracoclavicular distance of two groups. Shoulder function after operation was evaluated by Constant-Murley score system.

RESULTSAll patients were followed up with an average of 16.8 months (ranging 12 to 24 months). There was no nonunion,infection and other complications between two groups. The clavicular stress fracture occurred in 1 clavicular hook patient at 6 months after the operation. According to the Constant-Murley score system, that the scores of group A were 90.6±6.2, 91.8±4.8, 94.7±3.6 and 97.8±1.2 at 1st, 3rd, 6 month and last follow-up after operation were higher than those of group B 74.8±3.4, 78.4±4.4, 82.2±2.8 and 94.6±3.6 (P 0.05). The fracture healing time of group A (21.6±2.2) weeks was shorter than that of group B (25.8±2.5) weeks (P 0.05). There were no statistically significant differences between two groups in coracoclavicular distance at last follow-up (P>0.05).

CONCLUSIONThe anatomical locked plate combined with coracoclavicular ligament reconstruction need not expose shoulder and can reduce the incidence of postoperative pain and limited activity of shoulder, with fewer complication, it is advantageous to the shoulder joint function early recovery.

Adult ; Bone Plates ; Clavicle ; injuries ; surgery ; Female ; Fractures, Bone ; surgery ; Humans ; Ligaments, Articular ; surgery ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods