Clinical observation of Xuanfeitongfu method in cluster treatment of severe pneumonia / 实用医学杂志

Objective To observe the clinical efficacy of Xuanfeitongfu method in treatment of severe pneumonia and to explore its clinical value in the management of severe pneumonia. Methods Totally,62 patients with severe pneumonia were randomly divided into the control group (n = 30) and the treatment group (n = 32). The control group was given cluster treatment,including oxygen cure,anti-infection and nutrition support and maintaining a stable internal environment and etc. The treatment group was treated with Tongfu decoction orally(one dose a day,a total of 5 days)on a basis of cluster treatment. The comparison was conducted in the 2 groups in the levels of C reaction protein,calcitonin,the change of blood gas analysis,the time of mechanical ventilation and the mortality of severe pneumonia in ICU at baseline and 3,5 days after treatment. Results The level of C-reactive protein,calcitonin,the change of blood gas analysis were statistically significant (P < 0.05). The time of mechanical ventilation and the mortality were better in the treatment group (P < 0.05). Conclusion Xuanfeitongfu method can effectively improve oxygenation ,assist the anti-infection effect ,reduce the time of mechanical ventilation and ICU retention time ,ultimately improve the outcome of severe pneumonia.

Effect of point massage combined with foot bathing in hot water on sleep quality of patients after gynecological operation / 现代临床护理

Objective To investigate the effect of acupoint massage combined with foot bathing in hot water on sleep quality of patients after gynecological operation. Methods Ninety-nine gynecological patients were divided into the control group (n=49) and the observation group (n = 50) after gynecological operation according to time of admission. The control group received the routine nursing and the observation group was treated with acupoint massage and foot bathing in hot water besides routine nursing. Pittsburgh sleep quality index was used to investigate the sleep quality at the day before operation 1 and 8 days after operation. Result The sleep quality of postoperative patients in the observation group was significantly better than that of the control group (P < 0.05). Conclusions The acupoint massage with hot bathing in hot water can improve the quality of sleep of the patients after gynecological operations. For its convenience in manipulation, it is popular among patients and their families.

Clinical study of PEI combined with HIFU for treating unresectable middle and advanced stages of primary liver cancer / 重庆医学

Objective To investigate whether the percutaneous ethanol injection (PEI)under sedation and analgesia can in-crease the energy deposition and curative efficiency of the high intensity focused ultrsound(HIFU)in treating unresectable middle and advanced stages of primary liver cancer.Methods Thirty-six cases of clinically diagnosed unresectable middle and advanced sta-ges of primary liver cancer were randomly divided into the PEI+ HIFU group(combination group,n = 23)and the simple HIFU group (HIFU group,n=13);10mL of the mixture of 99.7% ethanol and iodized oil (9:1)was given by intratumoral injection at 30 min before ablation in the PEI+HIFU group,while 0.9% physiological saline 10mL was replaced in the simple HIFU group.The ablation energy efficiency factor(EEF)and irradiation time were compared between the two groups.Results The ablation EEF in the PEI+HIFU group and the simple HIFU group were (13.82+4.26)J/mm3 and (25.63+6.31)J/mm3 respectively,the PEI+HIFU group was significantly lower than the simple HIFU group (P <0.05);the irradiation time were (1 468.28+253.21)s and (2 352.56+463.34)s respectively;which in the PEI+ HIFU group was significantly shortened (P <0.05).Conclusion PEI can enhance the HIFU ablation energy deposition and improve the efficiency of HIFU for treating unresectable primary liver cancer.

Effect of health belief model on compliance behavior of PICC patients after discharge / 现代临床护理

Objective To explore the effect of health belief model on compliance behavior of patients with PICC(peripherally inserted central catheter).Methods According to admission order,75 cases of PICC were divided into control group(n=36)and observation group(n=39).Patients in the control group received conventional health education and regular visits after discharge and besides the regular methods,patients in the observation group were intervened by health belief model for the compliance behavior.All patients of two groups were investigated with self-designed scale for compliance behavior.Result The compliance behavior of the observation group was better than that of control group with significant difference(P<0.05).Conclusion The health belief model of education can improve the compliance behavior of PICC patients after discharge from hospital.

Transcription expression and clinical significance of CK19 mRNA in pleural fluid of patients with lung cancer / 中国肺癌杂志

<p><b>BACKGROUND</b>Conventional cytology is valuable in diagnosing the cancer cells in pleural fluid of patients with lung cancer. However, the diagnostic value of detecting pleura micrometastasis is limited. The aim of this study is to investigate clinical significance of CK19 mRNA expression in pleural fluid of patients with lung cancer.</p><p><b>METHODS</b>Reverse transcriptase-polymerase chain reaction (RT-PCR) was used to detect CK19 mRNA in pleural fluid from 86 patients with lung cancer and 40 patients with benign lung diseases, and the results were compared with the results of conventional cytologic diagnosis.</p><p><b>RESULTS</b>The positive rates of CK19 mRNA in pleural fluid were 93.0%(80/86) from patients with lung cancer and 20.0% (8/40) from patients with benign lung diseases, which showed an obvious difference between two groups (Chi-square=65.69, P < 0.01). The positive rates of CK19 mRNA in pleural fluid of patients with lung cancer had no correlation with histopathology types (P > 0.05). The sensitivity and accuracy of CK19 mRNA were obviously higher than those of diagnosis of conventional cytology in pleural fluid of patients with lung cancer (P < 0.01).</p><p><b>CONCLUSIONS</b>CK19 mRNA can be taken for a molecular marker to detect pleura micrometastasis, it may be helpful to diagnose the cancer cells in pleural fluid of patients with lung cancer and evaluate the clinical staging more correctly.</p>

Clinical value of liquid-based cytologic test in sputum examination of patients with lung cancer / 中国肺癌杂志

<p><b>BACKGROUND</b>There are lots of mucus, blood, inflammatory cells and necrotic material in the pick-and-smear slides, resulting in a low detection rate. Liquid-based cytologic test (LCT) has been applied for cervical cytology diagnosis successfully and widely, however it is few reported yet for sputum cytology diagnosis at present. The aim of this study is to evaluate the clinical value of LCT in sputum examination of patients with lung cancer, and to find a novel method of early diagnosis of lung cancer.</p><p><b>METHODS</b>The cytologic findings and the diagnostic rate for lung cancer were compared between LCT and conventional pick-and-smear method.</p><p><b>RESULTS</b>There were smaller area of smear membrane, clearer background, more distinctly cytologic picture and stereoscopic fell by LCT comparing with pick-and-smear method. The diagnostic rate for small cell lung cancer by LCT was significantly higher than that by pick-and-smear method (P < 0.05). After combined detection of the two methods, the diagnostic rate for lung cancer was obviously improved (85.1%), which was remarkably higher than that by pick-and-smear method alone (P < 0.01).</p><p><b>CONCLUSIONS</b>It is operated easily for LCT to be well controlled in making smear and dyeing. LCT may be a novel technique worthy of wide use. Combination of LCT with pick-and-smear method appears to be of great value in clinical application.</p>

Expression and significance of CEA and CA153 in pleural fluid of patients with lung cancer / 中国肺癌杂志

<p><b>BACKGROUND</b>Finding the cancer cells in pleural fluid of patients with lung can-cer by conventional cytology is always a difficult point. In order to enhance the diagnostic rate of pleural fluid with lung cancer, carcinoembryonic antigen (CEA) and cancer antigen 153 (CA153) were detected in serum and pleural fluid, and their diagnostic values on lung cancer were analyzed.</p><p><b>METHODS</b>Quantities of CEA and CA153 were detected by chemiluminescence in both serum and pleural fluid of patients with lung cancer (74 cases) and without lung cancer (34 cases).</p><p><b>RESULTS</b>The levels of CEA and CA153 in pleural fluid of patients with lung cancer were significantly higher than those without lung cancer (P < 0.01). The levels of CEA and CA153 in serum of patients with lung cancer were distinctly higher than those without lung cancer (P < 0.01). The levels of CEA and CA153 in pleural fluid were obviously higher than those in serum (P < 0.01). The optimal diagnostic assay of lung cancer was CEA+CA153 combination: sensitivity and specificity were 85.1% and 97.1% respectively.</p><p><b>CONCLUSIONS</b>It could be of important clinical significance for diagnosing lung cancer by assaying CEA and CA153 in pleural fluid of patients with lung cancer.</p>

Clinical value of capture of cancer cells in pleural fluid of patients with lung cancer by cytochip / 中国肺癌杂志

<p><b>BACKGROUND</b>Immunocytochemistry is valuabale in differentiating malignant fluids from benign ones. However, the diagnostic value of a single tumor marker is limited. The aim of this study is to evaluate the clinical value of capture of cancer cells in pleural fluids of patients with lung cancer by cytochip.</p><p><b>METHODS</b>A new pattern cytochip was developed to immunize hybridization of cells in pleural fluids of patients with 42 lung cancers and with 20 lung benign lesions. Ten antibodies were fixed on the cytochip, they were epithelial specific antigen (ESA), CD44V6, ND-1, T cell (CD3), CD45RO, B cell (CD20), CD79a, Hodgkin's cell (CD15), CD30 and macrophage (CD68).</p><p><b>RESULTS</b>The point of positive hybridization showed round distribution with clear border, and the shape of cell displayed well. The positive numbers of ESA, CD44V6, ND-1 were 35, 30, 38 respectively in pleural fluids of 42 patients with luog cancers; lymphocytes and neutrophils were found on the 1 ESA and 1 ND-1 respectively, and only lymphocytes were found on the 3 CD44V6 in 20 ones with lung benign lesions; the other 7 antibodies did not capture cancer cells except for lymphocytes, neutrophils and macrophages from two pleural fluids.</p><p><b>CONCLUSIONS</b>The cytochip could be an important practical foreground in clinic for diagnosing cancer cells in pleural fluids of patients with lung cancer.</p>

Diagnostic value of determination of CEA, CA125, CA153 and CA199 assay in pleural fluid for lung cancer / 中国肺癌杂志

<p><b>BACKGROUND</b>To study the diagnostic value of detection of carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), cancer antigen 153 (CA153) and cancer antigen 199 (CA199) in pleural fluid samples for lung cancer.</p><p><b>METHODS</b>Immunoprotein quantity of CEA, CA125, CA153 and CA199 was analyzed in pleural fluid and serum from patients with lung cancer (52 cases) and in pleural fluid from non cancerous patients (50 cases) by chemiluminescence.</p><p><b>RESULTS</b>The levels of CEA, CA125, CA153 and CA199 in pleural fluid of patients with lung cancer were significantly higher than those of non cancerous patients ( P < 0.01 or P < 0.05). In lung cancer patients, the levels of CEA, CA125, CA153 and CA199 in pleural fluid were obviously higher than those in serum ( P < 0.01 or P < 0.05). The sensitivity and the specificity of CEA+CA199 were 96.2% and 96.0%, respectively.</p><p><b>CONCLUSIONS</b>Detection of CEA, CA125, CA153 and CA199 in pleural fluid might be helpful for diagnosing lung cancer, and the optimal combination for assay is CEA+CA199.</p>

Immunohistochemical and ultrastructual study of so-called sclerosing hemangioma of the lung suggests different origins of cells / 中国肺癌杂志

<p><b>BACKGROUND</b>To study the morphological characteristics, immunohistochemical stain and histological origin of so-called sclerosing hemangioma of the lung (S-SH), and to investigate the significance and diagnostic value of expressions of surfactant protein B (SP-B), thyroid transcription factor-1 (TTF-1) and other markers in S-SH.</p><p><b>METHODS</b>Using transmission electron microscope and immunohistochemistry methods, the expressions of SP-B, TTF-1, mast cell trypsin (MCT), epithelial antigen markers (CK-H, CK-L, EMA, CEA), mesothelial antigen (MC), neuroendocrine markers (NSE, Ch-A, synaptophysin, calcitonin, ACTH, GH), vimentin and CD34 were observed in 30 cases of S-SH.</p><p><b>RESULTS</b>S-SH demonstrated a mixture of four histological patterns: solid, papillary, hemorrhagic and sclerotic pattern, which often showed transitional phenomena. Cuboidal cells on the surface, which contained short microvilli and lamellar bodies in cytoplasm, arranged in one row and sometimes interfused into multinuclear giant cells. Immunohistochemical results showed that these cells demonstrated strongly positive staining to SP-B, TTF-1, CK-L, EMA and CEA. The other major cell component-polygonal stromal cells were strongly positive to vimentin and TTF-1, and positive or weakly positive to 2 or 3 neuroendocrine markers in each case. Sparse neuroendocrine granulae and abundant microtubules were observed in cytoplasm of the cells. Both cuboidal and polygonal cells displayed negative immunohistochemical results to CD34 and MC. Some cell clusters in solid region were positive for SP-B and EMA. Mast cells which were positive for MCT existed sparsely in almost full vision field.</p><p><b>CONCLUSIONS</b>Cuboidal cells of S-SH originate from reactive proliferating type II pneumocytes and sometimes interfuse into multinuclear giant cells. The polygonal cells in stroma probably originate from multipotential primitive respiratory epithelium and have multiple differentiating ability. The presence of mast cells is also one of histological characteristics of S-SH.</p>

A panel of monoclonal antibodies for distinguishing metastasis adenocarcinoma cells from reactive mesothelial cells in serous fluids / 中华检验医学杂志

Objective To enhance the diagnosis rate for metastasis adenocarcinoma cells in serous fluids and detect a panel of a monoclonal antibodies for distinguishing adenocarcinoma cells from reactive mesothelial cells in serous fluids. Methods Three marks of low molecular weight cytokeratin (CK LMW ), carcinoembryonic antigens (CEA) and mesothelial cells (MC) were used to immunostain the cells in serous fluids from 50 patients and in peritoneal washing from 14 patients. Results Expression rate of three groups of cells positive from CK LMW , CEA and MC in adenocarcinoma cells was 95.83%, 70.83%, 16.67%, in suspicious cancer cells 100%, 50.00%, negative, in reactive mesothelial cells 33.33%, 33.33%, 66.66%. The four suspicious cases and two reactive cases in primary cytopathological classifiecation should be reclassified as adenocarcinoma cases. The sensitivity, specificity and reliability of CK LMW , CEA and MC were 96.30%, 80.00%, 77.10%; 70.37%, 90 00%, 61 60%; 90.00%, 85.20%, 75.30%, respectively. Conclusion Immunocytochemistry, using a panel of CK LMW , CEA and MC antibodies appears to be adjunct of important value for distinguishing adenocarcinoma cells from reactive mesothelial cells in serous fluids.

The Cytologic Diagnosis and Analysis of Canceration of Breast Intraductal Papillomas / 中国医科大学学报

Objective: The cytologic methods were used in the diagnosis of cancerous change of (intraductal papillomas,IP) and its significance was discussed. Methods： We studied the nipple discharge smear by using Wright-Gimsa staining. Meanwhile, infrared ray scanning B-ultrasound and X-rays were performed. Results： One hundred and twenty-eight patients were with IP， among them， 15 (11.7%)were confirmed as tumors by surgery and pathological examination. The cancerous change of cytomorphology was based on IP. The average age of patients with cancerous change was 48.1.The nipple discharge in patients with cancerous change was primarily bloody(66.7%). Conclusion： Introductal papillomas is carcerous. The possibility of canceration in persons with longer time of nipple discharge is larger than those with shorter time of nipple discharge. Women who are elder than 45 years old, with nipple discharge and post menopause, should be considered to have the possibility of cancerous change.