Objective To investigate the clinical feature,diagnosis and therapy of isolated Langerhans cell histiocytosis(histiocytosis X) with unusual localization.Methods A case of isolated Langerhans cell histiocytosis of the infundibulum was reported.The endocrinic tests,imaging,immunohistochemical and pathological examinations of this case were detected.Through literature review,the pathological and clinical feature,diagnosis,therapy of isolated Langerhans cell histiocytosis of the infundibulum were overviewed.Results Magnetic resonance imaging(MRI) of the brain showed a 9 mm homogeneously enhancing mass in the region of the infundibulum.No other lesion was found in other organ systems.The patient underwent an occupying lesion resection of the infundibulum via right pterion approach.Langerhans cell histiocytosis was diagnosed through pathologic analysis.She was on hormone replacement therapy and close follow-up visit postoperatively.Conclusion Isolated Langerhans cell histiocytosis of the infundibulum in adult is extremely rare.Understanding of this disease should be improved to avert misdiagnosing.

Objective To explore the expression of KAI1/CD82,E-cadherin and β-catenin in endometrial carcinoma,and to investigate their correlations to clinicopathological parameters of endometrial carcinoma. Methods The expressions of KAI1/CD82,E-cadherin and β-catenin in 76 specimens of endometrial carcinoma,15 specimens of atypical endometrial hyperplasia and 20 specimens of proliferative endometrium were examined by immunohistochemical envision technique.Their correlations to clinicopathological parameters of endometrial carcinoma were statistically analyzed. Results Compare to normal proliferative phase endometrium and atypical endometrial hyperplasia,the expression of KAI1/CD82 in endometrial carcinoma was significantly decreased(P ＜0.01),the abnormal expression of E-cadherin and β-catenin in endometrial carcinoma were significantly higher(all P <0.01).In endometrial carcinoma,the expression of KAI1/CD82 was negative correlated with histological grade and depth of myometrial invasion(P <0.01,P <0.05); The abnormal expression of the E-cadherin is related to histological grade and type(P <0.01,P<0.05); The abnormal expression of β-catenin was positively correlated with histological grade and FIGO stage(P ＜0.01 ,P <0.05).The down-regulation expression of KAI1/CD82 was closely associated with the abnormal expression of E-cadherin and beta-catenin in endometrial carcinoma(P <0.01,P <0.05). Conclusion The down-regulation of KAI1/CD82 and the aberrant expression of E-cadherin and β-catenin could be involved in the development of endometrial carcinoma.The loss or reduced expression of KAI1/CD82 was closely associated with the abnormal expression of E-cadherin and β-catenin in endometrial carcinoma.

Objective To study the technique and clinical effect of endoscopic surgery using high frequency electrotome with suction device for nasopharyngeal angiofibroma. Methods In this study, we retrospective analyzed the clinical data of 10 patients treated between January 2009 and December 2015. All these patients were treated by endoscopic surgery using high frequency electrotome with suction device. The average blood loss during surgery, tumor residual, recurrent tumor and duration of recovery were evaluated. Results The tumor was completely removed in all 10 patients. The average blood loss was 465 ml, there was no postoperative complication, all patients had no residual tumor, and there was no recurrent tumor over a follow-up of 6~18 months. Conclusion Though it was not preoperative transcatheter arterial embolization, the endoscopic surgery using high frequency electrotome with suction device can be used to treated nasopharyngeal angiofibroma which either limited to nasopharyngeal cavities and paranasal sinus with intraoperative blood pressure control.

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Objective To summarize the experience in diagnosis and treatment of rectal injury. Methods The diagnosis and treatment of 40 cases of rectal injury in the recent 6 years were retrospectively analysed. The diagnosis of rectal injury relied on injury history, clinical presentation,anorectal examination , sigmoid coloscopy ,and explorare laparotomy.38 cases treated by surgery ,including rectal repear ,sigmoid colostomy plus drainge ,and resection of injuried segment of rectum.1case treated by non-operation. 1 case died 2h after admittion. Results 39 cases recovered and 1 case died.Conclusions The condition of rectal injury is very complicate.Due attention should be paid to the diagnosis and treatment.

Objective To observe the long-term effect of surgical treatment in infertile varicocele patients. Methods 180 infertile patients with varicocele accepted modified Palomo operation (retroperitoneal high ligation of internal spermatic cord vein) from 2004 to 2007, and the long-term effect of thesurgery were analyzed retrospectively, such as semen parameters and spouse pregnancy. Results The operations were performed successfully in 180 cases, and semen parameters improved significantly after the surgery (Ps ＜ 0. 05 ).Among all patients, 10 cases had spouse pregnancy within 3 months after operation;47 cases had spouse pregnancy from 3 to 6 months after operation; 25 cases had spouse pregnancy from 6 to 12 months after operation;13 cases had spouse pregnancy from 12 to 24 months after operation. The fertility rate was 52. 8% (95/180) in total. Conclusion Surgical treatment of infertile male patients with varicocele has good long-term effects, made it the first choice in these patients.

Objective To investigate the effects of autologous blood transfusion and allogeneic blood transfusion on postoperative complications and outcome of patients underwent craniotomy with traumatic brain injury.Methods All transfusional cases underwent emergency craniotomy with trau-matic brain injury from January,2012 to June,201 6,1 61 males and 38 females,ASA physical statusⅠ-Ⅳ,were respectively analyzed and divided into autologous blood group (n = 108)and allogeneic blood group (n =91)based on whether or not using cell salvage.The restrictive transfusion strategy was applied in the two groups and the red blood cells were infused to maintain the hemoglobin concen-tration at 70-100 g/L.The incidence of postoperative complications and adverse transfusion reaction were analyzed and the clinical outcome was judged by Glasgow outcome score (GOS).Results The incidence of postoperative complications (33% vs.56%,P <0.01 )and adverse transfusion reaction (5% vs.14%,P <0.05)of the autologous blood group were lower than that in the allogeneic blood group,and the clinical outcome was better (P <0.01).Logistic regression analysis showed that allo-genetic transfusion (OR =1.953,95%CI 1.381-2.529)was an independent risk factor of postopera-tive complications.Conclusion The use of autologous blood transfusion in patients with traumatic brain injury can reduce the incidence of postoperative complications and the risk of blood transfusion and improve clinical outcome.

Objective To discuss the diagnosis and management of tracheomalacia complicating large goiter. Methods Clinical data of 36 patients with large goiter complicated by tracheomalacia at Xijing Hospital between 1992 and 2004 were retrospectively reviewed. Preoperative Valsalva-Mueller test were performed in all patients before undergoing subtotal thyroidectomy with tracheal suspension, and two patients were treated by subtotal thyroidectomy with tracheal suspension and tracheostomy. Results Valsalva-Mueller test was positive in all patients. The compressed tracheal cartilage disappeared in 2 cases, became thin and soft in other 34 cases. Thirty-four patients who underwent subtotal thyroidectomy with tracheal suspension recovered and 2 patients were resued by tracheal suspension with tracheostomy. There was no mortality. Postoperative 34 cases were followed-up from 6 months to 13 years. Thirty-two cases had no postoperative respiratory obstruction, 2 patients died of unrelated diseases. Conclusions The diagnosis of tracheomalacia from large goiter is based on Valsalva-Mueller test and operative detection. Subtotal thyroidectomy with tracheal suspension is the treatment of choice for tracheomalacia complicating large goiter.

This paper elaborated the research progress on transduction mechanisms of obese polycystic ovary syndrome (PCOS) and insulin resistance (IR). The action mechanisms of kidney-tonifying, spleen-invigorating and phlegm-resolving in the treatment of obese PCOS and IR were explored. It provided new ideas for the treatment of obese PCOS patients in the clinical practice of traditional Chinese medicine (TCM) gynecology. Literatures on TCM theories and modern signal pathways were used in the analysis of spleen-kidney deficiency and phlegm-dampness retention, which were the key pathogenesis of obese PCOS and IR. The scientific nature of treating obese PCOS and IR from the method of kidney-tonifying, spleen-invigorating and phlegm-resolving was demonstrated. The results showed that the scientific nature of treating obese PCOS and IR from the method of kidney-tonifying, spleen-invigorating and phlegm-resolving was initially demonstrated by the organic combination of TCM and modern medicine theories. It innovatively proposed that the treatment study strategy of transduction molecular mechanism took the interactive dialogue between PI-3K/Akt signal pathway and TNF-α signal pathway as its target. The regulatory role and action mechanism of this method in the treatment of obese PCOS and IR were discussed.

AIM: To investigate the expression of microRNA-375 (miR-375) in hepatocellular carcinoma (HCC) and to analyze the target genes and signaling pathways regulated by miR-375.METHODS: The expression of miR-375 was examined at tissue microarray of HCC by in situ hybridization.The whole human genome chip and bioinforma-tics analysis were applied to screen out the differential expression genes and signaling pathways in 4 HCC cell lines trans-fected with miR-375 mimic.RESULTS:In situ hybridization showed the expression of miR-375 in HCC tissues were obvi-ously higher than that in tumor-adjacent tissues (P<0.05).There were 20 co-upregulated genes and 17 co-downregulated genes in all 4 cell lines.Bioinformatic analysis showed that there were 54 signaling pathways related to up-regulated genes and 48 signaling pathways related to down-regulated genes in all 4 cell lines.CONCLUSION: miR-375 may play a key role in the pathological process of HCC.The bioinformatic analysis is able to screen the target genes and signaling pathways regulated by miR-375 and to provide an explicit direction for further mechanism research on HCC.