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Objective:To analyze the clinical characteristics and possible causes of familial spontaneous pneumothorax in combination with literatures.Methods:The detailed clinical information of 8 cases of FSP were retrospectively reviewed, and the clinical characteristics of FSP were analyzed combined with literatures.Results:Among 265 FSP patients in 76 families, the ratio of male to female is 1.55∶1, age of onset over 40 years old was 48.30%, 17.11%(13/76)of the cases occurred in the same generation, 67.10%(51/76)in two generations, 14.47%(11/76)in three generations and 1.31%(1/76)in four generations, and no intergenerational phenomenon was found. The proband had the mutation in the FLCN gene. The recurrence rates of observation, thoracentesis, chest tube drainage and operation were 21.62%(8/37), 48.39%(30/62), 38.89%(35/90)and 4.00%(4/100), respectively.Conclusion:Compared with sporadic cases of PSP, the clinical characteristics of FSP are as follows, the incidence of pneumothorax in man is higher than women, but women is significantly higher, and the age of pneumothorax is later, most of them are two generations, which may be related to heredity. And the effect of surgical treatment is the best.
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Objective To investigate the polymorphisms of human cytomegalovirus ( HCMV ) UL146 gene in asymptomatic children. Methods Urine samples were collected from 47 asymptomatic chil-dren who were positive for HCMV DNA. PCR was performed to amplify the open reading frame ( ORF) of UL146 gene. Positive bands were sequenced and variations in UL146 gene were analyzed by using bioinfor-matics software. Results Seventeen samples were successfully amplified and sequenced. Variations spread all over the sequence of UL146 gene and the variability in nucleotide and amino acid sequences ranged from 0％ to 42. 5％ and 0％ to 67. 7％ respectively. Compared with the Towne strain, there was diversity in sig-nal sequence and C-terminal region. Phylogenetic analysis indicated that UL146 in the 17 asymptomatic chil-dren belonged to four genotypes, which were G1, G8, G9 and G11. Forms of post-translational modification varied greatly among the four genotypes, while the important functional region of ELRCXC chemokine was highly conservative. Secondary structure prediction showed that random-coli conformation was the predomi-nant structure of active proteins. Isoelectric point ( PI) and molecular weight ( MW) were dissimilar among the four genotypes. Conclusion HCMV UL146 gene in asymptomatic children was hypervariable in both nucleotide sequence and amino acid structure. However, the important functional region was highly con-served. The predominant genotypes of UL146 in these children were G1, G8, G9 and G11, and the geno-type distribution in them showed no significant difference with previous findings in children with symptomatic HCMV infection.
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Objective To investigate the polymorphisms of human cytomegalovirus ( HCMV ) UL146 gene in asymptomatic children. Methods Urine samples were collected from 47 asymptomatic chil-dren who were positive for HCMV DNA. PCR was performed to amplify the open reading frame ( ORF) of UL146 gene. Positive bands were sequenced and variations in UL146 gene were analyzed by using bioinfor-matics software. Results Seventeen samples were successfully amplified and sequenced. Variations spread all over the sequence of UL146 gene and the variability in nucleotide and amino acid sequences ranged from 0％ to 42. 5％ and 0％ to 67. 7％ respectively. Compared with the Towne strain, there was diversity in sig-nal sequence and C-terminal region. Phylogenetic analysis indicated that UL146 in the 17 asymptomatic chil-dren belonged to four genotypes, which were G1, G8, G9 and G11. Forms of post-translational modification varied greatly among the four genotypes, while the important functional region of ELRCXC chemokine was highly conservative. Secondary structure prediction showed that random-coli conformation was the predomi-nant structure of active proteins. Isoelectric point ( PI) and molecular weight ( MW) were dissimilar among the four genotypes. Conclusion HCMV UL146 gene in asymptomatic children was hypervariable in both nucleotide sequence and amino acid structure. However, the important functional region was highly con-served. The predominant genotypes of UL146 in these children were G1, G8, G9 and G11, and the geno-type distribution in them showed no significant difference with previous findings in children with symptomatic HCMV infection.
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Objective To probe the precision of the magnetic resonance spectroscopy (MRS)in assessing the fat content in the vertebral bone marrow and the changes at different vertebrae.Methods A total of 46 female volunteers were recruited in this study. After routine MRI examination,single voxel (SV)was chosen for the 1 H-MRS acquisition at L1 -L4 vertebral body.Thirty subjects were scanned twice to evaluate the precision of MRS.The fat fraction (FF%),unsaturation index (UI)and coefficients of variation (CV) were calculated by amplitude and area under the peak respectively.The changes of fat content in marrow at L1 -L4 vertebrae was further evaluated.Results The CV related to peak amplitude was 1.7% in quantification of vertebral FF%,while the CV related to peak area was 6.3%.In quantification of vertebral UI,the CV related to amplitude and area was 2.4% and 7.8% respectively.The FF% was ascended from L1 to L4,while UI of bone marrow declined.A significant correlation was observed between FF% and UI (r=-0.714,P <0.01).The correlation of FF% among L1 -L4 were also significantly observed (r =0.612 -0.923,P <0.01). Conclusion MRS at 3.0 T provides reliable measurement for marrow fat content with a good precision associated with amplitude. Meanwhile,there is a preferential increase in saturated lipids compared to unsaturated lipids from L1 to L4.There is a high correlation of FF%among L1-L4.MRS is a valuable tool for providing complementary information on osteoporosis research.
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<p><b>BACKGROUND</b>Diffusion tensor imaging can evaluate white matter function in human brain. Fractional anisotropy is the most important parameter. This study aimed to find regional reduction of fractional anisotropy (FA) with aging in the whole brain and the changing rules of anisotropy with aging.</p><p><b>METHODS</b>Fifty volunteers from 20 to 75 years old were divided into five consecutive age groups; a young group and four senior groups. FA values were calculated with diffusion tensor imaging (DTI) studio software. The difference of FA between the young group and the four senior groups were analyzed by analysis of voxel-level height threshold in Statistic Parametric Mapping (SPM), and the regions with decreased FA were obtained. The FA values of these regions were then extracted using an in-house developed program, and a multiple linear regression model was built to assess the influence of age and sex on the FA values of these regions.</p><p><b>RESULTS</b>Eight regions, including frontal lobe, postcentral gyrus, optic radiation, hippocampus, cerebella hemisphere, corona radiate, corpus callosum and internal capsule, were found to have decreased FA. There was a strong negative correlation between age and the FA in the frontal lobe, postcentral gyrus, optic radiation, hippocampus, and cerebella hemisphere, while a weaker negative correlation in the corona radiate, corpus callosum, and internal capsule was found. The FA reduction in the frontal lobe, postcentral gyrus, optic radiation, hippocampus and cerebella hemisphere were found earlier than in the corona radiate, corpus callosum and internal capsule. There was no correlation between sex and FA in these regions.</p><p><b>CONCLUSIONS</b>The FA in the subcortical white matter area reduces earlier than that in deep white matter. The areas with decreased FA continuously enlarge with aging. The FAs in these regions have a strong negative correlation with age.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Aging , Physiology , Brain , Pathology , Diffusion Magnetic Resonance Imaging , Methods , White Matter , PathologyABSTRACT
Objective To explore the correlation of chemosensitivity in vitro of anti-cancer drugs between peripheral blood lymphocytes and tumor cells in non-small cell lung cancer of elderly patients.Methods The MTT method was used to test the sensitivity of the peripheral blood lymphocyte and the tumor cells of 52 patients with nonsmall cell lung cancer to 13 kinds of anti-cancer drugs.Results The sensitivity test in eleven drugs include CDDP,CBP,LOHP,PTX,CTX,ICTX,THP,VP-16,GEM,VCR and NVB in the peripheral blood lymphocyte were associated with that in the tumor cells.But no dependablity in two drugs,ADM and HCPT.Conclusion The peripheral blood lymphocytes could be replace tumor cells to test the chemosensitivity of anti-cancer drugs in patients with non-small cell lung cancer.
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Objective To investigate the change of gastroesophageal reflux including acid reflux,duodenogastroesophageal reflux (DGER) and its effect on expression of COX-2 and TNF-α in the remnant esophagus in different period after esophagectomy for cancer.Methods Thirty-two patients who underwent esophagectomy for cancer were selected randomly.Twentyfour-hour pH and spectrometric bilirubin monitoring,endoscopy were periodically performed.Esophageal mucosa samples were obtained by endoscopic biopsy.Expression of COX-2 and TNF-α within remnant esophageal mucosa was detected using immunohistochemical assay.Results ( 1 ) The incidence of reflux esophagitis and extent of acid reflux gradually increased over time after surgery for cancer ( P ＜ 0.05 ).(2) Very low level of COX-2 and TNF-α expression was detected in normal esophageal squamous mucosa.The expression of COX-2 and TNF-α was observed in cytoplasm of basal cell of esophageal epithelium after esophagectomy for cancer.High intensity of COX-2 and TNF-α expression was detected in the metaplastic columnar mucosa.The level of TNF-α expression in the remnant esophagus where reflux esophagitis occurred was higher than that in the normal remnant esophagus ( P =0.0274 ).There was no significant difference in level of COX-2 expression in the remnant esophagus between reflux esophagitis occurred and not ( P =0.7403 ).Conclusion ( 1 ) The extent of acid reflux and incidence of esophagitis gradually increases over time.(2) The expression of COX-2 and TNF-α may represent an early change associated with gastroesophageal reflux.The expression of COX-2 may serve as a molecular marker of gastroesophageal reflux occurred.( 3 ) The durative expression TNF-α is likely involved with the pathogenesis of chronic reflux esophagitis.
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Objective To investigate the effect of different operative approaches on perioperative respiratory and cardiac function of patients with gastric cardia carcinoma. Methods The perioperative changes of SpO2 ,Breath Rate (BR) and Heart Rate(HR) of patients with gastric cardia carcinoma underwent surgical therapies through transthoracic ( n = 30 ), transabdominal ( n = 37 ) or trans-thoracoabdominal ( n = 10 )approaches were compared respectively. Results On the postoperative 1st,2nd,4th and 7th day,the changes of BR in transthoracic (5. 20 ± 0. 96,5. 17 ± 1. 58,3.93 ± 1.53,2. 63 ± 1.25 )/min and trans-thoracoabdominal (5.80 ±0. 79,6. 10 ± 1.20,4. 80 ± 1.32,3.00 ± 1.49)/min approach groups were significantly greater than that of transabdominal group (4. 35 ± 1.06,3.89 ±0. 99,2. 24 ± 1.30,1.16 ±0. 65)/min (Ps ＜0. 05). At the meanwhile, the changes of SpO2 at 2nd, 4th postoperative day of transthoracic ( [ 8. 30 ± 1.95 ] %, [ 7.23 ±2. 01 ] % ) and trans-thoracoabdominal ( [ 8.60 ± 1.43 ] %, [ 7. 70 ± 2. 11 ] % ) approach groups were significantly greater than that of transabdominal group ( [ 7. 08 ± 1.82 ] %, [ 6.24 ± 1.88 ] % ) ( Ps ＜ 0. 05 ), but there were no significant differences observed among three groups on the postoperative 1st,7th day. On the postoperative 1 st,2nd and 4th day, the changes of HR of transthoracic ( 18.00 ± 3.79,13.47 ± 4. 42,8. 60 ±4. 13 )/min and trans-thoracoabdominal ( 19. 80 ± 4. 96,14. 80 ± 3.33,8.70 ± 3.47)/min approach groups were significantly greater than that of transabdominal group ( 13.62 ± 4. 00,10. 84 ± 4. 16,6. 32 ± 2. 53 )/min, too (Ps ＜0. 05) ,but no differences were observed among three groups on the postoperative 7th day (Ps ＞0. 05).Coniclusion Transthoracic,transabdominal and trans-thoracoabdominal approachs resulted in different effects on respiratory and cardiac function in patients with gastric cardia carcinoma.
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Objective To assess the value of MRS in evaluating vertebral bone marrow. Methods A total of 152 female volunteers (mean age 58±14 years, ranged 30～80 years) were recruited in this study. All subjects underwent vertebral MRS examination after routine MRI examination (sagittal T_2WI, T_1WI and axial T_2WI). Single voxel (SV) was chosen for the 1H MRS acquisition at L_2～L_4 vertebral body with PRESS sequence. MRS parameters were measured by SAGE 7.0 software. Results The fat fraction (FF%) of vertebra ascend with aging;the water line width (LW) decrease with aging and there was not obvious tendency with lipid LW. Conclusion Vertebral MRS can be considered as a noninvasive examination added to routine spine MRI to demonstrate the changes of vertebral bone marrow.
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Objective:To investigate the feasibility of detecting excision repair cross-complementing 1(ERCC1)and ERCC2 in peripheral venous blood instead of cancer tissues from esophageal squamous cell carcinoma patients. Methods:The expressions of ERCC1 and ERCC2 mRNA were detected by using RT-PCR in 39 cases of peripheral venous blood samples, esophageal squamous cell carcinoma tissues, and adjacent normal tissues. ELISA was used to determine the levels of ERCC1 and ERCC2 proteins in serum. The periphe-ral blood from 10 healthy volunteers was used as control. Results:Expression levels of ERCC1 and ERCC2 mRNA and protein were significantly higher in peripheral blood from healthy control than those in esophageal carcinoma patients (P<0.05). There was a positive correlation between the expression of ERCC1 and ERCC2 mRNA in peripheral blood and cancer tissues (P<0.01). Conclusion:The expression levels of ERCC1 and ERCC2 mRNA in peripheral blood can indirectly reflect their expression levels in human esophageal squamous cell carcinoma tissues.
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Objective To study the metabolic change of proton magnetic resonance spectroscopy (1 H-MRS)in the visual cortex and optic radiation region of patients with diabetic retinopathy (DR).Methods 1H-MRS was performed in 20 patients with DR and 20 healthy volunteers on GE 1.5 T MR system respectively.Metabolic peaks of N-acetylasparte(NAA),creatine(Cr,in 3.02 and 3.94 ppm),choline-containing compounds(Cho)and myo-inositol(mI)were observed,and the ratios were analyzed by each other.Independent-samples t test was performed between two sets of data.Results In both visual cortex and optic radiation,the ratios of ml/Cr and mI/CrSee in DR group(0.664 ± 0.052 and 1.453±0.068 in visual cortex,0.717±0.074 and 1.484±0.114 in optic radiation)were significant higher than those in normal group(0.602±0.047 and 1.249±0.044 in visual cortex,0.679 ± 0.075 and 1.334±0.089 in optic radiation,P＜0.05).In DR group,the ratios of CrSec/Cr,Cho/Cr and NAA/Cr in visual cortex and optic radiation were 0.458±0.043 and 0.488±0.052,0.481±0.057 and 0.807±0.110,1.633±0.105 and 1.709±0.140 respectively.In control group.the ratios of those were 0.484±0.041 and0.502±0.056,0.471±0.065 and 0.786±0.109,1.625±0.098 and 1.716±0.135 respectively.The ratios of CrSec/Cr,Cho/Cr and NAA/Cr had no statistic difference between two groups(P＜0.05).Conclusion mI/CrSec is a typical change in the visual cortex and optic radiation region,1H-MRS as a noninvasive examination could provide biochemical and metabolic informations for diabetic patients.
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Objective To evaluate spiral CT diagnosis of gastrointestinal stromal tumors (GIST).Methods The CT findings and clinicopathological data of 32 GIST cases were retrospectively analyzed. Results Of the 32 GIST cases, 1 located in the esophagus, 22 in the stomach, 1 in the mesentery, 6 in the small intestine and 2 in the colon. There were 4 benign and 28 malignant cases. Expression of CD117 and CD34 was 75% and 81% respectively. The lesions were exogenous in 56% cases. The average size of the benign and malignant masses was 4. 75cm and 6.78cm respectively. Conclusions Spiral CT could provide important information for the diagnosis and localization of GIST, but the final diagnosis still relies on pathology.
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Objective To investigate the correlation between vertebral diffusion weigllted imaging (DWI)and dual X-ray absorptiometry(DXA),quantitative computed tomography(QCT)for the evaluation of bone mineral density(BMD).Methods A total of 152 female volunteers[aged from 30 to 80 years,mean age(58.2±14.2)years 1 were recruited in this study.All subjects underwent lateral thoracicolumbar radiographs,dual X-ray absorptiometry(DXA)and quantitative computed tomography(QCT),as well as DWI examination.Lateral spine radiographs(T4-L4)were evaluated with Genant's semiquantitative assessment.BMD was obtained by both DXA and QCT at lumbar spine(L2-L4).Axial vertebral(L2-4)DWI was performed with single shot spin-echo echo-planar imaging(SS-SE-EPI)sequenee (b value=500 s/mm2)after routine MRI examination(saginal T2 WI,T1 WI and axial T2 WI).Apparent diffusion coefficient(ADC)was measured with GE-Functool DWI software.Pearson correlation analysis was used for the statistics.Results There was a decreasing tendency in ADC value with age.A positive correlation was found between ADC(0.241×10-3 mm2/s)and BMD results measured by both DXA (1.038 S/cm3)and QCT(104.2 mg/cm3)examinations(r=0.461,0.731,respectively,P＜0.01).Conclusion DWI is an useful tool for noninvasive evaluation of the pathophysiologic changes of bone marrow in volunteers with difierent bone mineral density.
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<p><b>BACKGROUND</b>Adenosquamous carcinoma of the lung is a rare pathologic type of lung cancer. The aim of this study is to explore the clinical features of adenosquamous carcinoma of the lung.</p><p><b>METHODS</b>A total of 115 patients with adenosquamous carcinoma of the lung were retrospectively analysed, who were diagnosed by operation and pathology.</p><p><b>RESULTS</b>Among the 36 female patients, 7 were under 49 years (19.44%). There were 14 patients (12.17%) without any symptom and 16 patients had residual carcinoma at the resection margin (14.04%). The degree of lymph node metastasis was 37.51%. The proportion of stage III patients was 54.78%.</p><p><b>CONCLUSIONS</b>The incidence of adenosquamous carcinoma of the lung in young women (under 49 years, especially under 39 years) is rather high. The residual carcinoma at the resection margin often occurs after routine operation. The degree of lymph node metastasis is rather high.</p>
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<p><b>OBJECTIVE</b>To study a group of patients with abnormalities of esophageal motility in manometric investigation.</p><p><b>METHODS</b>From 1990 to 1999, 14 patients with dysphagia (9), chest pain (3), or both (2) were studied. All patients denied symptoms of heartburn, regurgitation, odynophagia, epigastric discomfort, and investigation failed to show any evidence of ischemic heart disease. A perfused catheter with 4 separate lumens was used and connected to output transducers (Medtronic, PC Polygraf HR).</p><p><b>RESULTS</b>Of the 14 patients, 11 had motor disorders of the esophageal body including simultaneous contractions without normal peristalsis (5), alternative occurrence of simultaneous contractions and normal peristalsis (3), aperistalsis (2) and very low amplitude peristalsis (1). Seven patients were diagnosed with motility disorders of the lower esophageal sphincter including incomplete relaxation or no relaxation on swallowing (6), short relaxation duration (1). Four patients had more than one abnormal manometric findings.</p><p><b>CONCLUSIONS</b>Non-specific esophageal motility disorder is not a real diagnostic entity, but only a group of manometric abnormalities. The relationship between the symptoms of the patients and the manometric findings was analysed. It is uncertain that these disorders have a common etiology. The revision of these abnormalities is difficult because the pathogenesis is unknown.</p>