Thyroid-Associated Orbitopathy: Evaluating Microstructural Changes of Extraocular Muscles and Optic Nerves Using Readout-Segmented Echo-Planar Imaging-Based Diffusion Tensor Imaging

OBJECTIVE: We aimed to investigate the ability of readout-segmented echo-planar imaging (rs-EPI)-based diffusion tensor imaging (DTI) in assessing the microstructural change of extraocular muscles (EOMs) and optic nerves in patients with thyroid-associated orbitopathy (TAO) as well as in evaluating disease activity.MATERIALS AND METHODS: We enrolled 35 TAO patients and 22 healthy controls (HCs) who underwent pre-treatment rs-EPI-based DTI. Mean, axial, and radial diffusivity (MD, AD, and RD) and fractional anisotropy (FA) of the medial and lateral EOMs and optic nerve for each orbit were calculated and compared between TAO and HC groups and between active and inactive TAO groups. Factors such as age, sex, disease duration, mediation, and smoking history between groups were also compared. Logistic regression analysis was used to evaluate the predictive value of significant variables for disease activity.RESULTS: Disease duration was significantly shorter in active TAOs than in inactive ones (p < 0.001). TAO patients showed significantly lower FA and higher MD, AD, and RD than HCs for both medial and lateral EOMs (p < 0.001), but not the AD value of lateral EOMs (p = 0.619). Active patients had significantly higher FA, MD, and AD than inactive patients for medial EOMs (p < 0.005), whereas only FA differed significantly in the lateral EOMs (p = 0.018). The MD, AD, and RD of optic nerves were significantly lower in TAO patients than HCs (p < 0.05), except for FA (p = 0.129). Multivariate analysis showed that the MD of medial EOMs and disease duration were significant predictors for disease activity. The combination of these two parameters showed optimal diagnostic efficiency for disease activity (area under the curve, 0.855; sensitivity, 68.4%; specificity, 96.9%).CONCLUSION: rs-EPI-based DTI is promising in assessing microstructural changes of EOMs and optic nerves and can help to indicate the disease activity of TAO, especially through the MD of medial EOMs.

Comparison of diagnostic value of TIRADS, BSRTC, BRAFV600E mutation detection and their combined use in differentiating thyroid nodules / 中华内分泌代谢杂志

Objective To compare the diagnostic efficiency of the thyroid imaging reporting and data system (TIRADS), the Bethesda system for reporting thyroid cytopathology(BSRTC) and BRAFV600E detection, and their combined use in the differentiation between benign and malignant thyroid nodules. Methods One hundred and twenty eight patients with 128 thyroid nodules who were scheduled for ultrasound-guided fine-needle aspiration biopsy (FNAB) were recruited for the study. All of them underwent ultrasound, fine-needle aspiration cytology(FNAC) examination, and BRAFV600E detection. TIRADS and BSRTC systems were adopted to judge the ultrasound and FNAC results. The receiver operating characteristic curve was established to assess the diagnostic value of each method. Results The sensitivity, specificity, and AUC of TIRADS were 74. 3%, 84. 5%, and 0. 794, respectively. BSRTC had higher specificity(98. 3%) and equal sensitivity compared to TIRADS. The sensitivity, specificity, and AUC of BRAFV600E detection were the highest ones among the three methods. Combinations of different methods could increase the diagnostic sensitivity and accuracy. The combination of FNAC and BRAFV600E detection significantly increased the diagnostic efficiency(AUC=0. 984), with sensitivity 98. 6% and specificity 98. 3%. Conclusions The diagnostic value of BRAFV600E detection in the differentiation of benign and malignant thyroid nodules is better than both TIRADS and BSRTC, and the combination of FNAC and BRAFV600E detection reaches the best diagnostic efficiency.

Vitamin D level in children with bloodstream infection / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the difference in serum 25(OH)D level between children with bloodstream infection and healthy children.</p><p><b>METHODS</b>A case-control study was conducted among 60 children with bloodstream infection who were hospitalized between January 2010 and December 2013 and had positive results of two blood cultures. Meanwhile, 60 aged-matched healthy children who underwent physical examination during the same period of time were enrolled as the healthy control group. Chemiluminescence was applied to measure the serum 25(OH)D level, and the constituent ratios of children with different serum 25(OH)D levels were compared between the two groups.</p><p><b>RESULTS</b>The bloodstream infection group had a significantly lower serum 25(OH)D level than the healthy control group (P<0.01). Compared with the healthy control group, the bloodstream group had significantly lower constituent ratios of children with normal Vitamin D level (8% vs 35%) or vitamin D insufficiency (22% vs 43%) (P<0.05). Compared with the healthy control group, the bloodstream group had significantly higher constituent ratios of children with vitamin D deficiency (42% vs 13%) or severely vitamin D deficiency (28% vs 8%) (P<0.01).</p><p><b>CONCLUSIONS</b>Vitamin D insufficiency prevails among children, and children with bloodstream infection have a significantly lower serum 25(OH)D level than healthy children.</p>

Ultrasonographic diagnosis and differential diagnosis of thyroid follicular adenoma / 重庆医学

Objective To investigate the ultrasonic imaging features of thyroid follicular adenoma for conducting the correct diagnosis and differentiation diagnosis.Methods The clinical and imaging data in 64 cases of pathologically proven thyroid follicular adenoma were analyzed on the maximal diameter of tumor,nodularity number,high and low echogenicity,peripheral halo,echo hom-ogeneity,calcifications,and so on.The misdiagnosis causes were investigated.Results The mass was mainly solid or cystic-solid mixed echo.The ultrasonic imaging features of thyroid follicular adenoma were non-peripheral halo or thin wall halo,hyperecho or isoecho,internal macrocalcifications and peripheral calcifications,homogeneous echo structure.Conclusion The ultrasonographic examination can provide the better diagnosis and differentiation diagnosis on thyroid follicular carcinoma.

A pathogen analysis within 174 cases of hand-foot-mouth disease in the summer of 2009 / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To analyze the pathogen and characteristics of the serum types of enterovirus of hand-foot-and-mouth disease (HFMD) in the summer, 2009.</p><p><b>METHODS</b>Both throat swab and herpes fluids were taken respectively from 174 children with HFMD in the outpatient infection during April to September, 2009. Anti-Cox A16 and anti-EV71 IgMs in the serum were detected with ELISA. And RNA were extracted from each sample followed with real-time fluorescence quantitative RT-PCR kits with three reagents: universal enterovirus primer, Coxsackievirus A16 (CA16) primer and enterovirus 71 (EV71) primer. Parts of positive samples were sequenced and analyzed.</p><p><b>RESULTS</b>(1) EV genes were detected from 167 cases, of which ,112 cases were positive for CA16 and 46 were positive for EV71. CA16: EV71 was 2.43: 1. (2) There were 51 cases with CA16 IgM positive and 25 cases with EV71 IgM positive in the early collected sera, and in the later samples, 98 cases with CA16 IgM positive and 32 cases with EV71 IgM positive. (3)The nucleotide homologies were 88.7%-98.5% of VP1 gene among CA16. The nucleotide homologies were 94.9% - 99.7% of VP1 gene among EV71, and were 92.1% - 95.3% with C4 subtype.</p><p><b>CONCLUSION</b>The mainly pathogen causing HFMD in children in the summer, 2009 were CA16 and EV71. EV71 infection, mainly C4 subtype, was highly elevated according to the earlier reported. Real-time RT-PCR is more appropriate than the serological test.</p>

Clinical study on cross-infection of mycoplasma pneumoniae and other viruses in children / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the clinical cross infections of mycoplasma pneumoniae (MP) and other viruses in children, providing a reference for the diagnosis and treatment of respiratory disease.</p><p><b>METHODS</b>Serum specimens of the children hospitalized with fever, respiratory symptom besides positive results of MP-Ab IgM detection were collected. And several common viruses popular in children were investigated within the specimens collected by ELISA kits or indirect immunofluorescence.</p><p><b>RESULTS</b>(1) The PCT levels of 385 cases (81.7%) appear to be under 0.5 ng/ml. (2) In the 514 cases detected for Cox-IgG and Cox-IgM, the positive rates are respectively 40.3% and 35.6%. (3) 2 cases (0.8%) appear to be influenza B virus positive. And the positive rates of parainfluenza virus 1, 2 and 3 are 0.8%, 0, and 9%. 4, 84 cases (11.8%) are positive for EB-IgM and 451 cases (63.6%) positive for EB-IgG.</p><p><b>CONCLUSION</b>Cross infections rarely occur between MP and common respiratory viruses in Children. The cross-infection rate between Cox-virus and MP is up to 35.6%.</p>

Detection and analysis of the enterovirus infection within 159 cases of hand-foot-mouth disease by a real-time reverse transcription-PCR assay / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To reveal the enterovirus infection within children suffering hand-foot-mouth disease (HFMD) in the Capital Institute of Pediatrics from Aprial to August, 2009, for the sake of clinical diagnosis and treatment.</p><p><b>METHODS</b>Both throat swab and vesicle fluid were taken respectively from 159 children with HFMD. And RNA were extracted from each sample followed with real-time fluorescence quantitative RT-PCR kits with three reagents: universal enterovirus primer, Coxsackievirus A16 (CA16) primer and enterovirus 71 (EV71) primer. Parts of postivive samples were sequenced and analyzed.</p><p><b>RESULTS</b>(1) EV genes were detected from 152 cases, of which, 102 cases were positive for CA16 and 43 were positive for EV71. (2) CV16:EV71 was 2.37:1. The positive rates of throat swabs and vesicle fluid samples were not statistically significant. (3) The PCR results were same with that of sequence analysis.</p><p><b>CONCLUSION</b>The hand-foot-mouth disease recently appeared in our hospital was mainly related to the EV71 or CA16 infection. And the percentage of EV71 infections obviously increased compared to that of 2007.</p>

Proinsulin gene therapy in diabetic rats——Comparison of the effects on blood glucose by intraportal infusion and intramuscular injection / 中华内分泌代谢杂志

Objective To compare the effects of rat proinsulin gene therapy via intraportal infusion and intramuscular injection blood glucose level in streptozotocin-induced diabetic rots. Methods (1) Recombinant eukaryotic cell expression plasmid of rat proinsulin gene pCMV/proiusulin was transferred into streptozotocin-induced diabetic rats by intraportal infusion and intramuscular injection to observe the effect of rat proiusulin gene therapy in diabetic rats. The treatment group by intraportal infusion (group A) and the group by intramuscular injection (group C) were given pCMV/proinsulin naked plasmid DNA 100 μg, while the control groups by intraportal infusion (group B) or by intramuscular injection (group D) were treated with similar amount of pCMV DNA. Normal group and diabetes mellitus group were also observed at the same time. (2) Blood glucose level was tested and serum insulin was determined by radioimmunoassay. RT-PCR and immunohistochemistry were used to detemine proinsulin mRNA and protein expressions in liver and skeletal muscle and protein. Results (1) The blood glucose levels in two treated groups were both decreased. In group A, levels of blood sugar decreased about 7 mmol/L and glycemie control was maintained for 3-4 weeks. Serum insulin levels step up significantly after pCMV/proinsulin gene therapy. The blood glucose level in group A was significantly lower than those of group B and DM group (P<0.05), while the serum insulin level was higher than those of two groups (P<0.05). In group C, blood glucose levels decreased about 4 mmol/L and glycemic control was maintained for 1-2 weeks. Meanwhile, the concentrations of insulin increased markedly after gene therapy. The blood glucose in group C was significantly lower than those of group D and DM group (P<0.05), while the serum insulin level was higher than those of two groups (P<0.05). (2) Proinsulin mRNA and protein expressions could be detected in either hepatic cell of group A or skeletal muscle cell of group C, not in group B and group D. Conclusion Proiusulin genetherapy via intraportal infusion or intramuscular injection lowers significantly blood glucose in diabetic rats, and thus offers a potential approach to treatment of diabetes.

Relation between acute respiratory infection and enterovirus in children in Beijing area / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To probe into the relation between acute respiratory infection and enterovirus (EV), season, age and sex of children in Beijing area.</p><p><b>METHODS</b>Nasopharyngeal secretion samples from 402 inpatient children with acute respiratory infection (ARI) were obtained, and EV RNA was detected by reverse transcriptase polymerase chain reaction (RT-PCR). The distribution of month, age and sex among the children positive for EV were analyzed.</p><p><b>RESULTS</b>Seventy of the 402 cases were positive for EV RNA, the positive rate was 17.4 percent. The EV positive rate was 17.7 percent in children with lower respiratory tract infection, and 15.9 percent in children with upper respiratory tract infection. The EV positive rates were 0-36.1 percent in different months, which was the highest in the May (36.1 percent) and lower in December (4.3 percent). The positive rate of EV was 14.8 percent-21.9 percent in different age groups except for children 12 years of age and older, the positive rate was the lowest in the 4-6 years age group, and the highest in the 7 month-1 year age group. The EV infected boys and girls accounted for 16.2 percent and 19.7 percent of total numbers of boys and girls, respectively.</p><p><b>CONCLUSION</b>The EV positive rate was higher in children with lower respiratory infection, which suggests that EV may play an important role in ARI of children. The EV positive rate was higher from late spring to autumn. EV infection was common in children under 12 years of age. The rate of EV infection was not significantly different between boys and girls.</p>

Changes of CD4~+CD_(25)~+ Regulatory T Cells in Children with Autoimmune Diseases / 实用儿科临床杂志

Objective Through detecting CD4+CD25+ T regulatory cells(Treg)in the peripheral blood in children suffering autoimmune diseases and normal controls to learn about the changes of Tregs during the diseases and to acquire some references for clinical diagnosis and treatment.Methods The data were reviewed for CD4+CD25+ Treg cells of the 93 children diagnosed as pediatric autoimmune disease in Children′s Hospital Affiliated to Capital Institute of Pediatrics from Nov.2007 to Jun.2008.Thirty-five normal children in the contempora-neous physical examination were selected as the control group.The percentage of CD4+CD25+ Treg cells and CD4+ T cells to the total T cells were determined by flow cytometric method.Data of the JRA group(22 cases),SLE group(12 cases) and HSP group(12 cases),which were the first three according to the number of cases,were respectively compared with the controls.Independent-samples t test was performed for a statistic analysis with SPSS 11.5 software.Results 1.The percentages of CD4+CD25+ Treg cells to the total T cells and CD4+ T cells in the autoimmune diseases children[(6.14?3.21)% and(21.85?11.68)%,respectively] were both higher than those in the control group[(3.68?1.02)% and(12.83?3.61)%,respectively Pa

Diagnostic Value of Fluorescent Quantitative Polymerase Chain Reaction for Mycoplasma Pneumoniae Pneumoniae in Children with Mycoplasma Pneumoniae Pneumonia / 实用儿科临床杂志

Objective To evaluate the diagnostic value of fluorescent quantitative polymerase chain reaction(PCR) for Mycoplasma pneumoniae (MP) in children with MP pneumonia(MPP).Methods From Jun.2008 to Jan.2009,153 cases hospitalized with pneumonia were enrolled,and 30 cases without respiratory infection were enrolled as control group.Their respiratory secretion (including nasopharyngeal secretion,sputum,bronchialalveolar lavage fluid or pharyngeal swab) samples were collected for fluorescent quantitative PCR for MP.And their single or paired serums were collected for specific MP antibody detection.Results There were 123 cases confirmed with MPP by serology,among whom 114 cases were MP PCR positive.The quantitation of MP DNA was among 1.20?106-3.66?1010 gene copys/L. There were 30 cases with pneumonia negative with MP by the paired serum serology,among whom 2 cases were MP PCR positive,and the quantitation of MP DNA was (1.08-3.02)?107gene copys/L.All cases of control group were MP PCR negative.During the first and second weeks of the MPP onset,the sensitivity of MP-IgM from the first single blood samples were 66.7% and 83.9%,respectively.While the sensitivity and specificity of MP PCR were 92.7% and 93.3%,respectively.From the third week of the disease onset,the sensitivity of MP-IgM from the first single blood samples increased to 90.9%-100%.The clinical manifestations of MPP were nonspecific.Conclusions PCR is superior to serology for early diagnosis on MP infection.Combination of the 2 methods may be helpful to early and accurate diagnosis on MP infection.

Effects of all-trans retinoic acid on proliferation,iodide uptake and thyroid specific gene expression in different cell lines of human thyroid carcinoma / 中华内分泌代谢杂志

Different human thyroid carcinoma cell lines were treated with all-trans retinoic acid(RA). RA could inhibit cell growth,improve iodide uptake and increase some thyroid specific genes and retinoid acid receptor(RAR)mRNA expressions in FTC-133 cells.However,RA had no effect in C643,HTH74 and XTC. UC1 cells.These findings indicate that different thyroid carcinoma cells display diverse responses to RA.