Fibrous Tissue Hyperplasia Research Articles

Resección de fibroma en mucosa oral. Técnica del estrangulamiento

El fibroma traumático es considerado un crecimiento tumoral benigno queaparece en cualquier órgano, pero lo hace con mayor frecuencia en la cavidadoral. Se define como, una hiperplasia reactiva de tejido conectivofibroso, siendo su factor etiológico el traumatismo o la irritación local. Sepresenta generalmente asintomático, en sitios como, mucosa de revestimiento,bordes laterales de lengua y reborde alveolar de pacientes edéntulos.La lesión por lo general no se asocia con síntomas y se observacon mayor frecuencia en adultos, pero puede encontrarse en individuosde cualquier sexo y edad. En el presente artículo, se proponen una técnicapara la extirpación quirúrgica de la lesión. Es un procedimiento simple enel que se busca disminuir el aporte vascular. No requiere mayor tiempooperatorio, además no implica un riesgo importante, ni complicaciones intrao extraoperatorias para los pacientes. Las recurrencias no son frecuentes,a menos que no se elimine el factor irritante.Abstract:The traumatic fibroma is considered a benign growth tumor that can appearsin any organ, but it does most frequently in the oral cavity, and it isdefined as a reactive hyperplasia of fibrous connective tissue, and it´s etiologicalfactor is trauma or local irritation. It usually occurs asymptomaticin places like mucosal lining, tongue and side edges of alveolar ridge ofedentulous patients. The injury usually is not associated with symptomsand is most often seen in adults, but can be found in individuals of any ageand gender. In the present article, a new technique is proposed, which consistof surgical removal of the lesion. It is a simple procedure in which decreasedvascular supply pressure is proposed and does not require moreoperating time, also does not involve a significant risk or complications forpatients. Recurrences are rare, unless the irritant factor is eliminated. DOI: http://dx.doi.org/10.21615/cesodon.29.1.8

Significance of Simultaneous Analysis of Bone Marrow Smear and Bone Marrow Biopsy in the Diagnosis of Multiple Myloma

To explore the value of bone marrow smear and biopsy simultaneously applied to diagnosis of multiple myloma (MM). Clinical data of 30 cases of multiple myloma were collected from our hospital in the year 2014 and analyzed retrospectively, and the results of the bone marrow smear and the simultaneous bone marrow biopsy were compared. Hyperplasia levels in bone marrow biopsy was significantly higher than that in bone marrow smears, and the active and highly active hyperplasia of nucleated cells were observed in all the bone marrow biopsies; the myeloma cells showed a focal or diffuse distribution, the binuclear or polynuclear myeloma cells were observed in 22 patients (73%), but the detection rate of abnormal myeloma cells was 40% in bone marrow smear (P < 0.05). There was mild to moderate hyperplasia of fibrous tissue in bone marrow biopsy, and the hyperplasia degeree of fibrous tissue strongly positively correlated with the myeloma cell ratio (r = 0.412). The bone marrow smear and aspiration biopsy can complement each other so as to reduce the misdiagnosis rate, therefore contributes to the early diaglosis and treatment.

Nur77 deficiency leads to systemic inflammation in elderly mice.

Background Nur77, an orphan member of the nuclear receptor superfamily, has been implicated in the regulation of inflammation. However, the in vivo function of Nur77 remains largely unexplored. In the current study, we investigated the role of Nur77 in inflammation and immunity in mice.FindingsWe found that elderly 8-month-old Nur77-deficient mice (Nur77−/−) developed systemic inflammation. Compared to wild-type (WT) mice (Nur77+/+), Nur77−/− mice showed splenomegaly, severe infiltration of inflammatory cells in several organs including liver, lung, spleen and kidney, increased hyperplasia of fibrous tissue in the lung and enlargement of kidney glomeruli. Additionally, Nur77−/− mice had increased production of pro-inflammatory cytokines and immunoglobulin, and elicited pro-inflammatory M1-like polarization in macrophages as revealed by increased expression of CXCL11 and INDO, and decreased expression of MRC1.ConclusionsThese in vivo observations provide evidence for a pivotal role for Nur77 in the regulation of systemic inflammation and emphasize the pathogenic significance of Nur77 in vivo.Electronic supplementary materialThe online version of this article (doi:10.1186/s12950-015-0085-0) contains supplementary material, which is available to authorized users.

Pathological Characteristics of Bone Marrow in Non-Hodgkin's Lymphoma Patients with Secondary Myelofibrosis and Their Relationship with Prognosis

To investigate the pathological characteristics of bone marrow in non-Hodgkin's lymphoma(NHL) patients with secondary myelofibrosis and their relationship with disease prognosis. The pathological characteristics of bone marrow in 14 NHL patients with secondary myelofibrosis and 30 NHL patients without secondary myelofibrosis received from January 2012 to December 2013 in Department of Hematology, the First Affiliated Hospital Xi'an Jiaotong University Medical School were analysed, and overall survival and progress-free survival rates of NHL patients with and without secondary myelofibrosis were analyzed and compared. 14 cases of NHL with secondary myelofibrosis including 9 cases of lymphoma cell leukemia were all at stage IV and had hyperplasia of bone marrow fibrous tissue, the Gomori staining were all positive. When the lymphoma cells in bone marrow decreased or negative, their Gomori staining were negative. If the disease relapsed, the Gomori staining became positive again. There were 30 cases of NHL at stage IV wihtout secondary myelofibrosis. The overall survival rates and progression-free survival rates at 1,3,5 years in these patients were 100%, 93.1%, 57.6% and 100%, 92.6%,52.6% respectively. The overall survival rates and progression-free survival rates at 1,3,5 years in 14 NHL patients with secondary myelofibrosis were 92.9%,81.3%, 48.8% and was 71.8%, 62.3%, 47.9%, respectively. NHL patients with secondary myelofibrosis are almost at stage IV, especially in the patients with lymphoma cell leukemia. They had different degree of hyperplasia of bone marrow fibrous tissue, and the myelofibrosis would be reduced or disappeared when the disease in remission. The overall and progression -free survival rates decrease in NHL patients with secondary myelofibrosis, compared with patients without secondary myelofibrosis. Secondary myelofibrosis is one of the indicators of poor prognosis.

Study of Clinical Practical Model of Urinary System Injury

Background:In order to improve the clinical treatment level of urinary system injury, it is necessary to build up an animal model of urinary system wound, which is not only analogous to real clinical practice, but also simple and practical.Methods:We have developed the third generation of firearm fragment wound generator based on the first and the second producer. The best explosive charge of the blank cartridge was selected by gradient powder loading experiments. The firearm fragment injuries were made to the bulbous urethra of 10 New Zealand male rabbits. One week preoperatively and 2, 4 and 8 weeks postoperatively, all the animals underwent urethroscopy and urethrography. At 2, 4 and 8 weeks postoperatively, two animals were randomly selected and killed, and the urethra was cut off for pathological examination.Results:The shooting distance of the third generation of firearm fragment wound generator is 2 cm. The best explosive charge of the blank cartridge is 1 g of nitrocotton. All rabbits survived the procedures and stayed alive until they were killed. Injuries were limited to bulbous urethra and distal urethra. Round damaged areas, 1–1.5 cm in length, on the ventral wall were observed. Ureteroscopy results showed that canal diameter gradually shrank by over 50% in 9 rabbits. The rate of success was 90%. Urethrography result noted that a 1–1.3 cm stricture was formed at the bulbous urethra. Histology results of injured stricture urethra showed that fibrous connective tissue hyperplasia and hyaline degeneration caused further stricture in the canal.Conclusions:The third generation of firearm fragment wound generator imitates the bullet firing process and is more accurate and repeatable. The corresponding rabbit model of traumatic complex urethral stricture simulates the real complex clinical conditions. This animal model provides a standardized platform for clinical researches on treating traumatic injuries to the urinary system.

Effect of interleukin-1beta and dehydroepiandrosterone on the expression of lumican and fibromodulin in fibroblast-like synovial cells of the human temporomandibular joint.

Several epidemiological studies have reported that temporomandibular disorders (TMDs) are more prevalent in women than in men. It has recently been proposed that sex hormones such as estrogen, testosterone and dehydroepiandrosterone (DHEA) are involved with the pathogenesis of TMDs. Although studies have investigated the relationship between estrogen and testosterone and the restoration of TMDs, the relationship between DHEA and TMDs is unknown. The synovial tissue of the temporomandibular joint (TMJ) is made up of connective tissue with an extracellular matrix (ECM) composed of collagen and proteoglycan. One proteoglycan family, comprised of small leucine-rich repeat proteoglycans (SLRPs), was found to be involved in collagen fibril formation and interaction. In recent years, the participation of SLRPs such as lumican and fibromodulin in the internal derangement of TMJ has been suggested. Although these SLRPs may contribute to the restoration of the synovium, their effect is still unclear. The purpose of this study was to investigate the effect of DHEA, a sex hormone, on the expression of lumican and fibromodulin in human temporomandibular specimens and in cultured human TMJ fibroblast-like synovial cells in the presence or absence of the pro-inflammatory cytokine interleukin-1beta (IL-1beta). In the in vivo study, both normal and osteoarthritic (OA) human temporomandibular synovial tissues were immunohistochemically examined. In the in vitro study, five fibroblast-like synoviocyte (FLS) cell lines were established from human TMJ synovial tissue of patients with osteoarthritis. The subcultured cells were then incubated for 3, 6, 12 or 24 h with/without IL-1beta (1 ng/mL) in the presence or absence of DHEA (10 μM). The gene expression of lumican and fibromodulin was examined using the real-time polymerase chain reaction (PCR) and their protein expression was examined using immunofluorescent staining. We demonstrated that the expression of lumican differs from that of fibromodulin in synovial tissue and furthermore, that IL-1beta induced a significant increase in lumican mRNA and immunofluorescent staining in FLS compared to cells without IL-1beta. DHEA plus IL-1beta induced a significant increase in fibromodulin, but not in lumican mRNA, compared to DHEA alone, IL-1beta alone and in the absence of DHEA and IL-1beta. In immunofluorescent staining, weaker fibromodulin staining of FLS cells was observed in cells cultured in the absence of both DHEA and IL-1beta compared to fibromodulin staining of cells cultured with DHEA alone, with DHEA plus IL-1beta, or with IL-1beta alone. These results indicate that DHEA may have a protective effect on synovial tissue in TMJ by enhancing fibromodulin formation after IL-1beta induced inflammation. DHEA enhancement of fibromodulin expression may also exert a protective effect against the hyperplasia of fibrous tissue that TGF-beta1 induces. In addition lumican and fibromodulin are differentially expressed under different cell stimulation conditions and lumican and fibromodulin may promote regeneration of the TMJ after degeneration and deformation induced by IL-1beta.

Empirical study of protcetive effect of olmesartan on acute lung injury induced by paraquat in rats

Objective To explore the therapeutic effect of olmesartan (OLM) on acute lung injury induced by paraquat (PQ) in rats in order to study its action mechanism.Methods A total of 70 Wister rats wererandomly (random number) divided into 5 groups,namely control group (C group,n =10),poisoning group (PQ group,n =15),rats treated by OLM with low dose (LD group,n =15),moderate dose (MD group,n=15) and high dose (HD group,n =15).PQ (80 mg/kg) was administered by gavage route in PQ group and in OLM groups for paraquat poisoning modelling,while in C group,equivalent normal saline was given instead.The OLM was administered by gastric instillation in OLM treatment groups (LD group:5 mg/kg; MD group:10 ng/kg; HD group:15 mg/kg) 6 hours after paraquat gavage and once a day for 7 days,while in C group and PQ group,normal saline was used instead.All rats were sacrificed 12 hours after the last dose treatment.The levels of glutathione peroxidase (GSH-Px,energy units),superoxide dismutase (SOD,U/mg pro),malondialdehyde (MDA,nmol/mg pro) in lung tissue,and the levels of serum transforming growth factor beta-1 (TGF-β1,pg/mL) and pH,oxygen partial pressure (PaO2) and bicarbonate ions concentration (HCO3-) were determined.Further,the lung coefficient and lung fibrous tissue hyperplasia grading were calculated.Correlation analysis was carried out to explore the correlation among GSH-Px,SOD,MDA,lung coefficient,lung hyperplasia of fibrous tissue and TGF-β1.The lung tissue were prepared for microscopy observation after Hematoxylin-eosin staining method (HE staining) as well.The difference between groups was compared by one-way analysis of variance,and correlation analysis carried out by using Pearson and Spearman rank correlation coefficient.Results The levels of GSH-Px and SOD in lung tissue of PQ and OLM treatment groups were significantly lower than those in C group,while in OLM treatment groups,those were higher than those of PQ group,and the HD group showed most obvious (all P ＜ 0.05).The level of MDA in lung tissue in PQ and OLM treatment groups were significantly highcr than that in C group while in OLM treatment groups,that was lower than that in PQ group,and the HD group showed most obvious (all P ＜ 0.05),and there were no differences between the LD group and MD group (all P ＞ 0.05).The lung coefficient and lung fibrous tissue hyperplasia grading in PQ and OLM treatment groups were significantly higher than those in C group,while in OLM treatment groups,those were lower than those in PQ group,and the HD group showed most obvious (all P ＜ 0.05).The level of serum TGF-β1 in PQ and OLM treatment groups were significantly higher than that inC group,while in OLM treatment groups,that was lower than that in PQ group,and the HD group showed most evident (all P ＜ 0.05),and there were no differences between the LD group and MD group (all P ＞0.05).The pH,PaO2 and HCO3-in PQ and OLM treatment groups were significantly lower than those in C group,while difference between LD and HD groups was also statistical significance (all P ＜ 0.05),while there were no differences between the PQ group and LD group as well as the LD group and MD group (all P ＞ 0.05).The correlation analysis showed GSH-Px and SOD had negative correlation with TGF-β1 [the correlation coefficient (r) were respectively-0.860 and-0.856,all P＜0.05],while MDA,lung coefficient and lung fibrous tissue hyperplasia grading had positive correlation with TGF-β1 (r were respectively 0.800,0.830 and 0.656,all P ＜ 0.05).Lung tissue section showed the degree of alveolar septa widened,alveolar collapse and inflammatory cells infiltration in OLM treatment groups were milder than those in PQ group,and the mildest in HD group.Conclusions OLM can attenuate the pulmonary edema and pulmonary fibrosis caused by paraquat poisoning and maybe it is associated with reducing the expression of TGF-β1 and inhibiting oxidative stress reaction. Key words: Paraquat; Poisoning; Lung injury ; Olmesartan ; Anti-inflammatory; Serum transforming growth factor beta-1

Therapeutic effect of Zeng Ye decoction on primary Sjögren’s syndrome via upregulation of aquaporin-1 and aquaporin-5 expression levels

The aim of this study was to investigate the curative effect of Zeng Ye decoction on primary Sjögren's syndrome (pSS) and further explore its underlying mechanism involving aquaporin (AQP)‑1 and AQP‑5. The pSS model was established based on the immune induction method, and the saliva flow, submandibular gland index, morphological structures of salivary glands, and AQP‑1 and AQP‑5 protein expression levels in the salivary glands were determined. The saliva flow and the submandibular gland index were significantly reduced in the model group (P<0.01, compared with those in the control group), and significantly increased following interferon (IFN), Zeng Ye decoction extraction (ZYE) and Zeng Ye decoction (ZY) treatment (P<0.01, compared with those of the model group). Submandibular gland atrophy, fibrous tissue hyperplasia and multiple focal lymphocytic infiltration were observed in the model group and were attenuated when subjected to IFN, ZYE and ZY treatment. The AQP‑1 and AQP‑5 expression levels increased following IFN, ZYE and ZY treatment (P<0.01, compared with those of the model group), particularly in the ZYE‑35 group. This result indicated that ZYE had a significant protective effect on pSS via upregulation of the expression levels of AQP‑1 and/or AQP‑5. However, the AQP‑1 expression levels increased and the AQP‑5 expression levels decreased in the model groups compared with those in the control group, which indicated different regulatory pathways of the salivary gland damage on the basis of AQP‑1 and AQP‑5. This study provided a significant reference for the prevention and treatment of pSS.

Effect of matrine on transforming growth factor β1 and hepatocyte growth factor in rat liver fibrosis model

ObjectiveTo observe the preventive and control effect of matrine on transforming growth factor (TGF-β1) and hepatocyte growth factor (HGF) of liver fibrosis tissue in rats. MethodsA total of 48 SD rats were randomly divided into A, B, C, D groups with 12 in each, group A as the normal control group and groups B, C, D as liver fibrosis models using composite modulus method with carbon tetrachloride (CCL4). Group B was the model group, group C adopted γ-interferon lavage therapy in the second day of modeling, and group D adopted matrine lavage treatment, at 4 and 8 weeks after treatment. Six rats were executed for detection of TGF-β1 and HGF, liver tissue histology and comparison fibrosis degree changes of rat liver tissue between groups. ResultsGroups B, C, D showed a more significantly increased TGF-β1 at each time point compared with group A (P<0.05); Group B showed a more significantly increased TGF-β1 than groups C and D at weeks 4 and 8 (P<0.05); group D showed a lowest level of TGF-β1, followed by groups C and B. HGF of group B decreased more significantly than A group at weeks 4 and 8 (P<0.05); HGF of groups C and D was significantly elevated at 4 and 8 weeks than groups A and B (P<0.05), in which the group D showed the highest level of HGF. According to tissue histologic observation, rat liver tissue structure of group A was clear and normal, tissue structure of group B was destroyed with obvious fibrous tissue hyperplasia and fatty change of hepatic cells; groups C and D showed a slighter liver tissue damage, cell necrosis and connective tissue hyperplasia in collect abbacy than group B with a trend of obvious improvement. ConclusionsMatrine can reduce TGF-β1 expression and enhance the activity of HGF, so as to realize the inhibition effect on liver fibrosis in rats.

Preliminary study on real-time tissue elastography for evaluation the degree of fibrosis in Hashimoto's thyroiditis

Objective To investigate the correlation between strain ratio(SR) of real-time tissue elastography (RTE) and the degree of fibrosis in Hashimoto's thyroiditis(HT).Methods The SR of 80 HT patients was examined by RTE.The pathological lesions were observed by using optical microscope and those patients were divided into 3 groups according to Doniach standard.:the lymphocytic group,the oxyphilic group,and the fibrous group.50 volunteers with normal thyroid functions were enrolled as a control group,the correlation coefficient between the SR and the serum thyroid stimulating hormone(TSH) was evaluated and the differences of SR among each group were statistically analyzed.Results The Spearman's correlation coefficient between the SR and the serum TSH was 0.601,which was significant (P ＜ 0.05).The SR increased in an ascending order among the control group,the lymphocytic group,the oxyphilic group,and the fibrous group(P ＜0.05).As shown on the optical microscope:the lymphocytic group showed the vigorous functioning small follicular which mainly was lymphocyte infiltration in “ + + ～ + + + ” without glands or a few fibrosis; the oxyphilic group showed oxyphilic-changed epithelium mass which mainly were follicular epithelial cells eosinophilic change “ + + + ～ + + + + ” and fibrous tissue hyperplasia“ + ～ + + ”;the fibrous group showed tiny follicular which mainly was fibrous tissue hyperplasia “ + + + ～ + + + + ”.Conclusions There is certain linear relationship between SR and fibrosis degree of HT.The heavier the degree of fibrosis and the greater the SR was,the worse the thyroid function would be. Key words: Ultrasonography; Hashimoto disease; Fibrosis; Strain ratio

Histopathological change of levator aponeurosis in patients with congenital blepharoptosis

Background Congenital blepharoptosis is a common disorder of eyelid movement.Overseas research showed that the most likely mechanism of congenital blepharoptosis is the hypoplasia of levator.But the study on Chinese is still lack.Objective This study was to investigate the pathological features of hypoplasia in levator aponeurosis in Chinese congenital blepharoptosis patients.Methods Twenty-one patients with congenital blepharoptosis were divided into mild group (3 cases),moderate group (14 cases) and severe group (4 cases).Samples of the levator aponeurosis were obtained during the levator palpebrae superioris muscle shortening surgery.Hematoxylin-eosin,special staining and immunohistochemistry were performed to analyze the characteristics of the samples.Normal samples of fresh levator aponeurosis were obtained from the donors in the eye bank of Beijign Tongren Hospital.Results Hematoxylin-eosin staining and special staining showed that with the increase of severity,the cases of levator fibers sparse,fibrous tissue hyperplasia and endomysium defect were gradually increased,showing significant differences among the different groups (Z =-0.702,P =0.002 ; Z =0.738,P ＜ 0.001 ; Z =0.746,P ＜ 0.001).Four samples (19％) presented with adipose in the interstitial tissue.Immunohistochemistry showed that the expression of muscle proteins myosin was weaker in the levator aponeurosis of patients with congenital blepharoptosis than that in the normal samples,and the expression intensity of collagen type Ⅲ in the samples enhanced in comparison with the normal samples.However,there were no significant differences in the expression of actin,myoglobin,fibronection,collagen type Ⅵ and laminin among various groups (all at P＞0.05).Conclusions The levator aponeurosis appears developing abnormality in Chinese patients with congenital blepharoptosis.The histopathological change degree is parallel with the severity of congenital blepharoptosis. Key words: Blepharoptosis/congenital; Levator aponeurosis; Histopathology; Development

One-step method of bone marrow aspiration and biopsy applied in diagnosis of the bone marrow metastatic cancer

This study was aimed to explore the value of one-step method of bone marrow aspiration and biopsy applied in diagnosis of the bone marrow metastatic cancer. The total of 46 cases of bone marrow metastatic cancer were analyzed retrospectively, and the results of the bone marrow smear and the bone marrow biopsies were compared. The results indicated that the success rate of one-step method of bone marrow aspiration and biopsy was 95.7%. Metastatic carcinoma cells in clumps or clusters with morphological changes were observed in the bone marrow biopsies of the 45 patients (97.8%), but the metastatic carcinoma cell clusters were observed only in bone marrow smears of the 25 patients (54.3%). There were mild to moderate hyperplasia of fibrous tissue in the patients with metastatic cancer. In addition to the 83.3% diagnostic rate of esophageal cancer, the rest diagnostic rate of bone marrow biopsy for metastatic carcinoma was 100%. The diagnostic rate of bone marrow smear for ovarian cancer, lung cancer, gastric cancer, thoracic tumor, sigmoid colon cancer, esophageal cancer and metastatic cancer of unknown primary cancers were 33.3%, 50%, 72.2%, 60%, 50%, 33.3% and 25%, respectively. The diagnostic rate of bone marrow biopsy was higher than that of bone marrow smear. It is concluded that the success rate of drawing specimen by one-step method of bone marrow aspiration and biopsy is high. The bone marrow biopsy is better than that of aspiration in diagnosis of metastatic cancer. Combining biopsy with aspiration can improve the accuracy of diagnosis.

Long-term testosterone supplementation is useful for ED with testosterone deficiency

Long-term testosterone supplementation is useful for ED with testosterone deficiency

Echinococcus multilocularis infection leads to increased expression of proliferation and anti-apoptosis factors in liver cells in BALB/c mice

To investigate the effects of Echinococcus multilocularis on host liver cell proliferation in vivo using a BALB/c mouse alveolar hydatid infection model. Sixty-five 8-10-week-old female BALB/c mice were randomly divided into an experimental group (n = 40) and a control group (n = 25) and administered an abdominal injection into the left liver lobe of E. multilocularis protoscolices in saline solution or saline solution alone, respectively. At post-injection day 2, 8, 30, 60, and 90, liver samples were collected for analysis of lesions and lesion-adjacent tissue by hematoxylin-eosin staining and differential expression of proliferating cell nuclear antigen (PCNA), cyclin D1, cyclin A, and cyclin B1 by immunohistochemical staining. The significance of intergroup differences was assessed by Student's t-test. The control group showed normal liver histology at all time points. The experimental group developed E. multilocularis lesions that showed increased severity of pathological features, such as inflammatory cell invasion, steatosis and fibrous connective tissue hyperplasia, over time. At post-injection days 2 and 8, enlarged, binuclear and apocyte hepatocytes were observed close to the lesions. At post-injection days 30, 60, and 90, the number of hepatocytes expressing PCNA progressively increased in the experimental group, and the numbers were significantly higher than in the control group (7.01 +/- 1.89 vs. 1.03 +/- 0.52, 8.41 +/- 2.80 vs. 0.93 +/- 0.31, and 13.4 +/- 4.43 vs. 1.07 +/- 0.94; all P < 0.05). The same progressively increasing trend was seen in the number of hepatocytes expressing CyclinD1, but was only significantly different from controls at post-injection days 30 and 60 (6.73 +/- 2.52 vs. 0.48 +/- 0.43 and 8.22 +/- 3.09 vs. 0.55 +/- 0.34; both P < 0.05). In contrast, the number of hepatocytes expressing cyclin A was significantly increased at post-injection day 30 and then showed a decreasing trend at days 60 and 90, although the numbers of expressing cells remained significantly higher than control levels at all time points (7.75 +/- 3.05 vs. 0.69 +/- 0.36, 3.42 +/- 1.80 vs. 1.14 +/- 0.42, and 3.03 +/- 1.50 vs. 0.69 +/- 0.31; all P < 0.05). The number of hepatocytes expressing CyclinB1 in the experimental group was less robust than the other cyclins (with a general temporal trend of increase followed by decrease), but the differential expression was not significantly different from the control levels at any time point. E. multilocularis infection may promote the expression of host factors related to proliferation and anti-apoptosis in liver. This pathogen-mediated modulation of host cell-survival mechanisms may provide a rationale explanation for the clinical observations of hepatomegaly and the unexpected survival of alveolar echinococcosis patients following major hepatic resection.

Ureteral obstruction and urinary fistula due to fibrin glue after partial nephrectomy: A case report and review of the literature

In the present study, we report the case of a 69-year-old female who developed urinary leakage following partial nephrectomy (PN) to remove left renal masses. The results of CT and MR urography revealed left proximal ureteral obstruction and urinary fistula. Reoperation was performed on the 16th postoperative day to explore the left kidney and ureter in order to relieve the obstruction. The left proximal ureter was found to be enfolded by fibrin glue and showed marked stiffness and adhesion during the reoperation. The lesion of the ureter was resected and the ureter was anastomosed with the routine double-J stent. Pathological examination of surgical specimens revealed fat fibrous scar tissue hyperplasia with inflammatory cell infiltration. The patient recovered completely without exudate. Our experience suggests that care should be taken to avoid touching the ureter with fibrin glue during PN surgery.

Contrast-enhanced ultrasonographic findings of hepatic paragonimiasis

To investigate the features of hepatic paragonimiasis on contrast-enhanced ultrasound (CEUS) imaging. Fifteen patients with hepatic paragonimiasis who were admitted to our hospital between March 2008 and August 2012 were enrolled to this study. The conventional ultrasound and CEUS examinations were performed with a Philips IU22 scanner with a 1-5-MHz convex transducer. After conventional ultrasound scanning was completed, the CEUS study was performed. Pulse inversion harmonic imaging was used for CEUS. A bolus injection of 2.4 mL of a sulfur hexafluoride-filled microbubble contrast agent (SonoVue) was administered. CEUS features were retrospectively reviewed and correlated with pathological findings. In total, 16 lesions were detected on CEUS. The mean size of the lesions was 4.4 ± 1.6 cm (range, 1.7-6.6 cm). Subcapsular location was found in 12 lesions (75%). All the lesions were hypoechoic. Six lesions (37.5%) were of mixed content, seven (43.8%) were solid with small cystic areas, and the other three (18.8%) were completely solid. Ten lesions (62.5%) were rim enhanced with irregular tract-like nonenhanced internal areas. Transient wedge-shaped hyperenhancement of the surrounding liver parenchyma was seen in seven lesions (43.8%). Areas with hyper- or iso-enhancement in the arterial phase showed contrast wash-out and appeared hypoenhanced in the late phase. The main pathological findings included: (1) coagulative or liquefactive necrosis within the lesion, infiltration of a large number of eosinophils with the formation of chronic eosinophilic abscesses and sporadic distribution of Charcot-Leyden crystals; and (2) hyperplasia of granulomatous and fibrous tissue around the lesion. Subcapsular location, hypoechogenicity, rim enhancement and tract-like nonenhanced areas could be seen as the main CEUS features of hepatic paragonimiasis.

Abstract P5-01-16: Value of ultrasonography appearance of breast mass in prediction of histologic type

Abstract Objective to determine the relationship of sonographic features to the histological typing and grading of breast mass. Methods: 292 breast masses were prospectively evaluated with ultrasonography. Sonographic features included irregular shape, microlobulation, spiculated margin, halo, posterior attenuation, microcalcification, ductal distortion. Lesion morphology was analyzed and correlated with histopathologic results, which included tumor typing and grading. Then we make a retrospective analysis and evaluation of patients scanned completely by qualitative and semi-quantitative methods. All patients have signed the informed consent form before the test, together with the recognition of the Ethics Committee. Resuls: Among these masses, there are breast cancer accounted for 45.89% (134/292), A rounded or lobular mass was strongly associated with ductal carcinoma in situ(DCIS), poorly differential invasive ductal carcinoma(IDC), or some of the specific invasive cancer. Mastitis accounted for 8.22% (24/292), fibroadenoma accounted for 43.84% (128/292), and phyllodes tumor accounted for 2.05% (6/292). In 134 breast cancer cases, 92.70% (127/134)have obviously sonographic features with justled growth was found around the turmor with lamellar necrosis in different extents and lympholeukocytic infiltration, microlobulation, speculated margin, halo, posterior attenuation, microcalcification, ductal distortion, with justled growth was found around the turmor, neoplastic cell array showed as massive nest, patchy and satin ribbon structure, and the membrane of tumor cells was unsharpness with less cytoplasma, round or oval nucleus, great heteromorphism, higher karyoplasmic ratio and common nuclear mitotic figures. Other 7 cases with fibrous tissue hyperplasia under microscope show a regular shape. In fibroadenoma, phyllodes tumor and mastitis team, they shows unobviously sonographic features and the cell morphology contrast with breast cancer are quite different. Conclusions:Ultrasonography appearance of breast masses is related to pathologic characteristics and can be a predictor of histopathologic pattern preoperatively. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P5-01-16.

Multidisciplinary Surgical Management of Cherubism Complicated by Neurofibromatosis Type 1

Cherubism is a rare, autosomal dominant, mostly self-limiting disease of the jaw. It is characterized by bilateral fibrous tissue hyperplasia, giant cell proliferation, and bony degeneration in the lower facial skeleton, which can result in a massive and severely deforming prominence of the maxillomandibular structure. This case study examines the multidisciplinary management of a severe case of cherubism complicated by neurofibromatosis type 1, 2 codominant nonsegregating conditions that were clinically and genetically diagnosed, an extremely rare combination. Adequate mandibular reduction, reconstruction, and dental implantation afforded good restoration of oral function as well as a marked aesthetic improvement. A 14-year-old Fijian girl was referred to our unit for management of severe overgrowth of her mandible that compromised her speech and deglutition. In addition, she displayed clinical features consistent with neurofibromatosis type 1. Radiologic, histologic, and genetic analyses confirmed the diagnosis of both conditions. Our craniofacial multidisciplinary team undertook mandibular reconstruction followed by placement of osseointegrated dental implants. Mandibular reduction, reconstruction, and dental implantation resulted in a significantly improved functional and aesthetic outcome with no further regrowth at 3-year follow-up when she returned to the United Kingdom for osseointegrated dental implant insertion. The successful outcome of this surgically challenging, grossly disfiguring, and rare condition was largely a result of the combined input from our multidisciplinary team, adequate preoperative planning, and the use of a novel surgical technique in debulking and reconstructing her mandible.

IgG4-related idiopathic hypertrophic pachymeningitis: one case report and review of the literature

Objective To study the clinical, neuroimaging and histopathological features of IgG4-related idiopathic hypertrophic pachymeningitis (IHP). Methods One case of pathologically confirmed IgG4-related IHP was reported, and related literature of the clinical, radiological and pathological characteristics of this disease was reviewed. Postoperative specimen was sent to Department of Pathology, Xuanwu Hospital. It was sliced and then stained with HE method and examined by immunohistochemistrical study (S-100, Ki-67, CD20, CD3, IgG, IgG4). Results The case was a 55-year-old male patient with IHP. The clinical manifestations of IHP were variable. The patient firstly presented seizures of epilepsy showing left limb convulsions. Brain contrast-enhanced MRI showed that the pachymenx was partly thickened with line-like or nodular enhancement. Microscopically, meningeal biopsies showed dura mater encephali was thickened and hardened. Under microscope, meningeal biopsies showed abnormal thickening of the pachymenx with fibrous connective tissue hyperplasia and infiltration of many inflammatory cells. Inflammatory cells were mainly composed of lymphocytes and plasmocytes with a small amount of eosinophils. Immunohistochemistrical study showed a large number of lymphocytes with expression of IgG, and a small part with expression of IgG4. The treatment of IgG4-related IHP with hormones and immunosuppressive agents was effective. Conclusion IHP is a class of unknown etiologic diseases, with dural fibrous inflammatory lesion, and part of the IHP patients may be suffering from IgG4-related IHP. DOI：10.3969/j.issn.1672-6731.2011.05.011

Role of apoptosis in hepatic injury of rat and patients with Clonorchis sinensis infection

Objective To investigate the liver injury and pathological changes of rat and patients with Clonorchis sinensis(C, sinensis) infection, and to clarify the role of apoptosis in the injury induced by C. sinensis.Methods Wistar rats were divided into two group: 60 in infection group and 20 in control. The rats in infection group were infected with C. sinensis via oral feeding encysted cercaria;rats in control group were fed with normal saline. The rats were sacrificed 4, 6, 8 and 12 weeks after infection, respectively. Liver tissue specimens of the patients infected with C. sinensis were collected. The pathological changes of liver tissue were observed by light microscopy and the apoptofic rate of hepatocyte was detected by terminal deoxynucleotidyl transferase dUTP nick end labeling(TUNEL) assay. Results Parasites and eggs could he seen around the bile duct, and the duct was associated with mucosa and adenoma papillary hyperplasia, wall thickening, inflammatory cell infiltration, a small amount of fibrous tissue hyperplasia, and periportal liver cells surrounded by a number of nuclear condensation, all these changes meant morphological characteristics of apoptosis. Apoptotic rates of liver cells in infection group 4, 6,8 and 12 weeks after infection were (7.15 ± 1.50)%,(11.61 ± 3.09)%,(13.21 ± 3.47)% and (11.26 ± 4.06)%,respectively, which was significantly higher than that in control group [(2.57 ± 0.72)%, (3.17 + 0.77)%, (3.67 ±0.96)% and (2.84 ± 0.87)%, t values were 4.45, 5.49, 5.95 and 4.74, respectively, all P < 0.01]. Conclusions These findings indicate that C, sinensis can stimulate both hepatoeytic apoptosis and degeneration which may he related to clinical manifestations and liver lesions in patients with clonorchiasis. Key words: Clonorchis sinensis; Infection; Apoptosis; Hepatoeyte