Objective To evaluate the value of helical CT scan in the diagnosis of small renal cell carcinoma.Methods The helical CT features of small renal cell carcinoma proved by operation and pathology in 14 cases were studied retrospectively.Results CT showedisodense mass in 7 cases,slightly low density mass in 5 cases,slightly hyperdense mass in 1 case,cystic and solid mass in 1 case,and among them 2 cases showed punctural calcification.The lesions showed marked enhancement in cortical phase in 12 cases,slight to moderateenhancement in 2 cases,in parenchymal phase,the tumor density dropped promptly,and in the pelvic phase the tumor density droppedfurther. Conclusion Small renal cell carcinoma is of certain characteristic on multi-phasic spiral CT contrast-enhanced scan,it is a very valuable method in diangosis of small renal cell carcinoma.

Objective To explore the risk factors of newly emerging advanced schistosomiasis patients in endemic areas.Methods The study areas were selected in two counties of Dongting Lake regions and a 1 :2 match case-control study was designed.Sixty schistosomiasis patients,who newly evolved into advanced schistosomiasis from 2006 to 2007,were selected into the case group,and 120 cases with chronic schistosomiasis into the control group.Questionnaires including potential risk factors of advanced schistosomiasis were designed and the information was collected based on face to face interviews.SPSS 12.0 was used to analyze the simple factors and multi ones (logistic regression) attributable to the development of advanced schistosomiasis.Results The history of hepatitis B (OR = 10.729),models of water contact (OR = 3.919) ,yearly exposure days to the infested water (OR = 5.457) and times of chemotherapy in the nearly 10 years(OR = 1.578) were the risk factors of development of advanced schistosomiasis.The times of examinations with positive schistosome eggs were protective factors.No association was found between yearly income,education degree,times of checking for schistosomiasis,times of examination with sera positive results and the emergence of advanced schistosomiasis.Conclusion The high frequency of exposure to the infested water,repeated infections,incomplete diagnosis and treatment are the risk factors of advanced schistosomiasis.The concurrent infection with hepatitis B is associated with the acceleration of development of advanced schistosomiasis.

Objective To synthesize a quantum dot (QD) to recognize glioma cells for imaging and photodynamic therapy. Methods By one-pot aqueous approach, near infrared-emitting CdTe was produced. After detection of its physicochemical characterizations, RGD was conjugated. Emission images were observed with confocal microscopy. To test its toxicity, CdTe-RGD with various concentrations was separately added into U251 and 3T3 cells for incubation in dark circulation. To test its photodynamic effect, U251 and 3T3 cells were then irradiated for 5 ~ 60 min using 632.8 nm laser. Results The QD (Φ = 3.75 nm, PL peak wavelength =700 nm, PLQY=20%) achieved was a spherical crystal with excellent monodispersity. Under confocal microscope , U251 cells were visualized but 3T3 cells not. In dark circulation, the survival rates of both U251 and 3T3 cells were above 85%. After laser irradiation, the survival rate of U251 cells decreased to (37 ± 1.6)%with the increasing of irradiation time and CdTe-RGD concentration. Conclusion With good physicochemical characterization and low toxicity, CdTe-RGD could be applied in biomedical imaging and photodynamic therapy of gliomas.

Objective:To evaluate the effects of perioperative glutamine-supplemented total parenteral nutrition support on nutritional status of patients with gastrointestinal cancer.Methods:60 patients with gastrointestinal cancer were randomized into three groups.The group of A(standard TPN group)and B(glutamine-supplemented TPN group) were given an isocaloric(104.6 kJ/(kg?d) and isonitrogenous(0.20 g/kg?d~(-1)) total parenteral nutrition for 10 days(5 days before operation and 5 days after operation) together with a course of chemotherapy before operation lasting for 5 days.The 25%～35% of nitrogenous source of group B was supplied by glutamine dipeptiven.The group of C(control group) was treated by routine program.Nutritional status was determined by body weight,triceps skinfold thickness,arm muscle circumference,plasma concentrations of albumin,prealbumin transferin,glutamine,muscle concentration of glutamine and nitrogen balance.Results:No serious complications occurred in any groups during the trial.Body weight,triceps skinfold thickness,arm muscle circumference,plasma concentrations of prealbumin,transferin and nitrogen balance were not significantly different among groups.On postoperative day 6,the concentration of glutamine in blood and muscle in Gln-TPN group was higher than that in other two groups.Conclusions:Glutamine-supplemented TPN is beneficial to alleviating the state of catabolism caused by chemotherapy and operation.It can raise the concentrations of glutamine in blood and muscle,decrease the loss of muscle and fat tissue and promote synthesis of protein.

Objective:To evaluate the perioperative effects of glutamine-supplemented total parenteral nutrition support on immune function of patients with gastrointestinal cancer.Methods:60 patients with gastrointestinal cancer randomized into three groups.The groups of A(standard TPN group)and B(glutamine-supplemented TPN group) were given an isocaloric 104.6 kJ/(kg?d) and isonitrogenous 0.20 g/(kg?d)total parenteral nutrition for 10 days(5 days before operation and 5 days after operation) together with a course of chemotherapy before operation lasting 5 days.The 25%～35% of nitrogenous source of group B was supplied by glutamine dipeptiven.The group of C(control group) was treated by routine program.All variables were measured before and after operaition.Immune function and inflammatory responses were investigated.Results:No serious complication occurred in any group during the trial.The percentages of CD3~(+)cell and CD8~(+) cell decreased in three groups after operation.The percentage of CD4~(+)cell and NK cell and the ratio of CD4~(+)/CD8~(+) of group B was the highest in the three group on the sixth day after operation.Total lymphocyte count was higher in group B than that in group A and the levels of C reactive protein and prostaglandin E_(2) in group B were lower than those in group A.Conclusions:Glutamine-supplemented TPN is beneficial in raising total lymphocyte count and decreasing the level of C reactive protein and prostaglandin E_(2).And it can also modulate immunosuppressive status and inflammatory response of postoperative patients.

OBJECTIVETo control the quality of the product, quantitative fingerprint was used to evaluate the composition of the amino acids in the Xingnao Tongluo injection.

METHODThe method of the quantitative fingerprint to the amino acids composition was established through AccQ Tag precolumn derivatization. The quality was evaluated by the quantitative test of the amino acids and the similarity in ten batches.

RESULTThe Xingnao Tongluo injection contained 12 amino acids and the contents of these amino acids were stable. All the ten batches of the samples had similarity of more than 0.90.

CONCLUSIONThe method was accurate, feasible and could be a simple and effective way to evaluate the quality of the traditional Chinese medicine.

Objective To investigate the effects of small volume resuscitation on hemodynamics and visceral perfusion in dog model of hemorrhagic shock. Methods Twenty-four dogs were hemorrhaged to hold mean arterial blood pressure at 45-55 nun Hg for 45 minutes, and then eight dogs were resuscitated with 6 ml/kg of hypertonic saline (HS group) solution and the other eight resuscitated with 6 ml/kg of hypertonic saline-hydroxyethyl starch (HSS group) solution. The rest eight dogs were set as control and resuscitated with normal saline (NS). Hemodynamics and gastrointestinal intramucosal pH (pHi) were detected after fluid resuscitation. Results (1) All three kinds of solutions could improve early hemodynamics and visceral perfusion. But 30 minutes after fluid resuscitation, the hemodynamics of dogs in HS group, HSS group and NS group began to decrease, with more obvious decrease HS group and NS group compared with HSS group. (2) pHi of three groups began to decrease 120 minutes after fluid resuscitation, but the level of arterial lactate remained unchanged. Conclusions (1) HS has the similar effect as NS in aspect of resuscitation, and HSS is better than HS and NS.(2) pHi is an ideal marker in monitoring the visceral perfusion and has higher sensitivity than arterial lactate.

BACKGROUND: The therapy of nonunion has been a difficult issue in orthopedics all the time. Part of nonunion can't heal even after many times of operations. The effects of non-surgical treatments are not satisfactory. Extracorporeal shock waves (ESW) is a new method that popular abroad in recent years.OBJECTIVE: To investigate the effect of ESW on nonunion, and preliminarily probe into its mechanism.DESIGN: Randomized group-division design, animal experiment.SETTING: Department of Orthopedics, Renmin Hospital of Wuhan University.MATERIALS: The experiment was conducted in the Medical Experimental Center of Animal, Wuhan University from September 1997 to March 1999. Forty healthy male rabbits were selected to establish model of nonunion. Thirty-two rabbits with hypertrophic nonunion were taken as materials and randomly divided into treatment group and control group with 16 rabbits in each group.METHODS: A multifunctional ESW apparatus of type HX902Ⅲ was adopted to treat the broken ends of nonunion in the treatment group with the energy, frequency, dose and focus range of 0.54 m J/mm2, 60 times/minute,2 000 times and 1.5 cm2 respectively. The second focus of shock wave was adjusted, aiming at corresponding parts in distal and proximal sites of nonunion, and acted 1 000 times. After that, rabbits were re-fixed with external apparatus and acted freely. Rabbits in the control group were fixed with external apparatus without any other treatments.MAIN OUTCOME MEASURES: Examination of the healing of nonunion with radiograph, transmission electron microscope (TEM) and in histology.RESULTS: A total of 32 enrolled animals were involved in the analysis of results.①X-ray photograph: During the treatment with ESW, the gaps of nonunion were more and more indistinct in X-rays, and the densities of two sclerotic ends were reduced, and the sclerotic marrow cavities became unobstructed. The X-rays of nonunion-gaps before ESW were significantly narrowed than those after the treatment. At 6 weeks after the treatment,nonunion in 6 rabbits of the treatment group (6/14) healed, and that in 12 animals (12/12) healed on the 12th week. However, only the nonunion in one rabbit (1/12) healed in the control group on the 12th week. Test of fourfold-table exact probability demonstrated that the healing status of nonunion in the treatment group was better than the control group, and the differences were remarkable (P＜0.001).②Examination under light microscope: large quantity of osteoblasts and mesenchymal cells assembled and were active in proliferation on the 2nd week of treatment in the treatment group, and plentiful bone trabeculae formed on the 6th week, and the nonunion healed on the 12th week of treatment. However, there were chronic inflammation and few trabeculae in the control group. ③TEM examination: the osteoblasts in the treatment group proliferated on the 2nd week of treatment, and there were abundant chondrosomes in the intracytoplasm,which could secrete collagen fibers with periodical transverse lines. On the 6th week, large amount of bone lacunas formed. However, little visible cells could be seen in the control group, and osteoclasts were found in act.CONCLUSION: The effect of ESW on hypertrophic nonunion is satisfactory, which may become a reliable and non-invasive treatment of nonunion.

Acute Disease ; Adult ; Cholecystitis, Acute ; diagnosis ; pathology ; Diagnostic Errors ; Female ; Humans ; Myocarditis ; diagnosis ; pathology

Bronchi ; Humans ; Lung ; Trachea ; Tracheostomy