Objective To summarize the experience in diagnosis and management for the space occupying lesion of spleen. Method The clinical data of 29 cases treated by surgery were retrospectively analyzed. Results There were 15 patients with benign masses including 7 hamartomas, 5 hemangiomas, 1 pseudocyst, 2 tuberculoses of the spleen, and 14 with malignant tumors including 9 lymphomas, 3 angiosarcomas, 2 metastatic tumors in the spleen. Splenectomy was performed in all patients. All patients with benign masses survived except 2 patients lost follow up and 1 coexisting with hepataocellular carcinoma died half a year after the operation. Twelve of 14 patients with malignant tumor were followed up.Of them, 5 patients survived more than 5 years and 2 were alive 1 and 3 years after the operation respectively; 5 patients died 6 months to 4 years after the operation. Conclusions Ultrasonography and CT or MRI are the main means of diagnosis for the space occupying lesion of spleen.It is difficalt to make diagnosis of the splenic tuberculosis before operation.Splenectomy is a primary procedure of surgery.

OBJECTIVE: To develop a method of HPLC/MS/MS to determine phenacetin and paracetamol in rat liver microsomal incubation system. METHODS: Samples were separated on XTerra MS C18 column, different ratios of methanol- 0.1% formic acid were used as the gradient eluent, and the flow rate was 0.2mL?min-1. The electrospray ion-quadrupole mass spectrometry and multiple reaction monitor were adopted to detect the concentration of phenacetin and paracetamol. RESULTS: The calibration curves were linear in the ranges of 45～9 000ng?mL-1(r=0.999 8)and 15.2～1 520ng?mL-1(r=0.999 6) for phenacetin and paracetamol respectively; The lowest limits of assay were 9ng?mL-1 and 10ng?mL-1.The average recoveries at three concentrations of phenacetin were (96.2?2.3)%～(98.3?2.4)% and those of paracetamol were (99.6?2.1)%～(100.2?2.6)%; RSD of the intra-day and inter-day were less than 5%. CONCLUSION: The method is rapid, sensitive and suitable for determination of phenacetin and paracetamol in rat liver microsomal incubation system.

Objective To study the changes of activities of phase Ⅰ and Ⅱ drug-metabolic enzymes in the spleen of rats with spleen-kidney yang deficiency syndrome.Methods The rat model of spleen-kidney yang deficiency syndrome was established by gastric gavage of Radix et Rhizoma Rhei decoction combined with injection of hydrocortisone for 17 continuous days.And then we detected the activities of 6 kinds of phase Ⅰ drug-metabolic enzymes of CYP2C19,CYP2D6,CYP2C9,CYP1A2,CYP2C8,CYP3A4,and 4 kinds of phase Ⅱ drugmetabolic enzymes of phenol sulfotransferase (PST),uridine diphosphate glucuronosyl transferase 1 (UGT1),glutathione transferase (GST),estrogen sulfotransferase (SULT1E1) in the spleen.Results Compared with the normal control group,the activities of PST,UGT1,GST and SULT1E1 in the model group were significantly decreased (P ＜ 0.05 or P ＜ 0.01),and the activity of CYP1A2 was significantly increased (P ＜ 0.01),while CYP2C19,CYP2D6,CYP2C8,CYP3A4,CYP2C9 enzymes showed no obvious changes(P ＞ 0.05).Conclusion The activities of splenic drug-metabolic enzymes,in particular the phase Ⅱ enzymes,are significantly varied under the state of spleen-kidney yang deficiency.

Objective To investigate the clinicopathologic features and treatment of thyroid microcarcinoma (TMC). Methods From January 1997 to December 2006,311 patients who underwent surgery and defined as TMC(tumor size≤1 cm)were enrolled. Results TMC was identified incidentally by frozen pathologic examination on thyroidectomy specimens in tentative benign goiters in 181 patients; another 130 patients with clinically detectable primary tumors or suspected nodal metastases were grouped to as clinically overt TMC. The clinically overt TMC had a higher incidence of bilateral multifocal tumors (18.5%vs.9.4%,P=0.03),and cervical lymph node metastases(27.7%vs.10.5%,P=0.000)than that in clinically occult TMC group. Conclusion TMC may vary considerably in clinical and biologic behaviors between these two subtypes: clinically overt and occult. Lobectomy for single lesion, total or near total thyroidectomy for multifocal with central compartment nodal dissection should be performed, lateral nodal dissection was not carried out unless US or physical examination detected nodal metastases. Lobetomy, subtotal or more limited thyroidectomy for occult TMC, diagnosed incidentally following thyroid surgery for initially tentative benign thyroid disease, could all be treatment of choice depending on the preference of surgeons.

Objective To explore the relationship between the disease uncertainty and information demand in preoperative patients with aortic dissection. Methods A total of 100 preoperative patients with aortic dissection were investigated from January 2012 to January 2014 with Mishel′s uncertainty in illness scale ( MUIS) , Hamilton anxiety scale ( HAMA) and self-designed information collection table, and the correlations were analysed. Results The total score of MUIS was (112. 32 ± 9. 66), and the number of patients in middle level was 90 (91. 8%). The score of ambiguity was (42. 32 ± 4. 54), and the number of patients in middle level was 85 (86. 7%). The score of complexity was (22. 43 ± 3. 63), and the number of patients in middle level was 68 (69. 4%). The score of lack of information was (19. 32 ± 2. 75), and the number of patients in middle level was 65 (66. 3%). The score of unpredictability was (15. 43 ± 2. 78), and the number of patients in middle level was 60 (61. 2%). The total score of HAMA was (13. 65 ± 11. 64), and the number of patients in middle level was 60 (61. 2%). The score of information requirements was (141. 34 ± 14. 56), and the number of patients in middle level was 65 (66. 3%). The score of disease and treatment was (62. 32 ± 4. 54), and the number of patients in middle level was 65 (66. 3%). The score of health was (32. 43 ± 3. 63), and the number of patients in middle level was 68 (69. 4%). The score of mental health was (17. 43 ± 2. 78), and the number of patients in middle level was 60 (61. 2%). The score of family health was (9. 64 ± 2. 65), and the number of patients in middle level was 65 (66. 3%). The score of social health was (7. 34 ± 2. 56), and the number of patients in middle level was 60 (61. 2%). The different dimensions of disease uncertainty were positively correlated to anxiety, treatment of disease, physical health, mental health, family health, social health and information demand (P<0. 05). Conclusions Preoperative patients with aortic dissection have the medium level of disease uncertainty and are affected by anxiety. They have a high level of demand for the disease and treatment information, and health information. The information demands significantly affect the patient′s disease uncertainty.

Objective To observe the changes of soluble triggering receptor expressed on myeloid cell-1 (sTREM-1)and inflammatory mediators in serum of senile patients with hospital-acquired pneumonia and explored the state of local inflammatory response in HAP. Methods Twenty senile patients with HAP and twenty healthy controls were in-cluded. Serum sTREM-1, nuclear factor-κB (NF-κB) and interleukin-8 (IL-8) were detected on day 1, 5, 10. Com-bined with CPIS score to analyze the correlation of these indicators and the severity and prognosis of pneumonia. Re-sults The concentrations of sTREM-1, NF-κB and IL-8 in serum were significantly higher than those in controls. There was a significant positive correlation between the sTREM-1, NF-κB and IL-8 and CPIS score. Conclusion sTREM-1, NF-κB and IL-8 is a good marker in diagnosing pneumonia. The levels of sTREM-1, NF-κB and IL-8 have a positive correlation with severity of HAP.

Objective To evaluate the change of clinicopathological features and prognosis of papillary thyroid cancer over a 15-year period.Methods The clinicopathological features and outcomes of papillary thyroid cancer patients were analyzed in three groups according to the time of diagnosis:group Ⅰ (1997-2001),group Ⅱ (2002-2006),and group Ⅲ (2007-2011).Results As time advanced,the average age of papillary thyroid cancer patients increased,tumor stage,like size,extrathyroid invasion and lymph node metastasis decreased dramatically (P ＜ 0.01).The percentage of multifocality and bilaterality increased.The long-term follow up data (median follow up time was 6.6 years),indicated that the 15-year over all survival was 97.8％ and the 15-year disease-free survival was 90.2％.Tumor ≥3 cm,bilaterality,extrathyroid invasion,lymph node metastasis and AJCC stage were correlated with tumor recurrence.By multivariate COX-regression analysis only lymph node metastasis and bilaterality were independent risk factors.Conclusion The clinicopathological features of papillary thyroid cancer changed over 15 years,with the percentage of early-staged patients increased.Lymph node metastasis and bilaterality are two risk factors for tumor recurrence.

Objective To analyze clinicopathological characteristics and the potential risk-related factors of female breast hyperplasia in different age groups.Method From Jan 2015 to Dec 2016,patients diagnosed with breast hyperplasia in 12 hospitals were evaluated.All patients completed the self-designed questionnaires on women'health,including basic demographic information,clinic examination information,radiologic information and pathologic results.The patients were divided into a young group (＜ 45 years old) and an elderly group (from 45 to 75 years old).Results There were 3 684 cases of breast hyperplasia,including 2 291 cases in young group and 1 393 cases in elder group,respectively Clinically breast pain type were most commonly observed in both young and older groups (50.3％ vs.42.7％,P ＜ 0.001).While pathological research based on biopsy showed that breast adenopathy were the most common changes in both groups (67.9％ vs.61.7％,P ＜0.001).More breast cancer cases were identified in elder group than that in young group,especially in clinically lump type patients (9.4％ vs.4.2％,P ＜ 0.001).Compared with elder group,patients in young group have different distribution characteristics regarding to fertility factors,lifestyle factors and psychology scale including anxiety and depression.Conclusion Distributions of clinicopathological characteristics and risk factors of female breast hyperplasia differ across different age groups.

PHA granule binding protein phasin (PhaP) has a high affinity for hydrophobic materials and can bind to hydrophobic polymers via strong hydrophobic interaction. In this study, an EGFR-targeting peptide (ETP) was fused with PhaP and the fusion protein ETP-PhaP was produced in recombinant Escherichia coli BL21 (DE3) (pPI-ETP-P) and then purified by Ni affinity purification. The tumor targeting PHBHHx nanoparticles were developed based on PhaP mediated ETP immobilization and the cellular uptake of the ETP-PhaP modified PHBHHx NPs and none modified PHBHHx NPs by cervical cancer cell lines SiHa (EGFR over expressed) and CaSKi (EGFR low expressed) were analyzed. The purified ETP-PhaP could be adsorbed onto the hydrophobic surface of PHBHHx NPs. The ETP-PhaP modified PHBHHx NPs could target to EGFR over expressed cervical cancer cells SiHa more efficiently than to the EGFR low expressed CaSKi cells. These results demonstrated the advantage in effectiveness and convenience of PhaP mediated ETP adsorption on PHBHHx nanoparticles, providing a novel strategy for hydrophobic nanocarrier surface modification.