Investigation of Correlation between Parameters of Thrombelastogram and Platelet Count in Perioperative Patients / 现代检验医学杂志

Objective To investigate thrombelastogram (TEG) correlation between parameters and platelet count in perioperative period patients.Methods Selected 139 patients,69 cases with thrombocytopenia,35 cases with normal platelet number and 35 cases with thrombocytosis from 2012 January to 2014 May,monitored TEG,blood coagulation function and the change of blood routine during perioperative period.Spearman test was used to analyze the different level of platelet count and other coagulation parameters.Results The positive correlation between platelet count and TEG parameters were:MA (r=0.57,P＜0.57),Angle (r=0.54,P＜0.000 1),CI (r=0.57,P＜0.000 1),and R was negatively correlated with platelet count (r=-0.27,P＜0.000 1).There was no significant correlation between PT,APTT and platelet count.In mild lack of platelet group [(87.34 ± 10.43) × 109/L] and normal group [(198.47 ± 45.30) × 109/L],platelet count was positively correlated with MA and Angle.In severe lower [(39.33±10.63) × 109/L] and higher group [(330.34±35.43) × 109/L],there was no correlation between platelet platelet count with MA or Angle.Conclusion Platelet count was significantly correlated with CI,Angle and MA,but in patients with moderately severe lower platelet and platelet increase the platelet count do not reflect the aggregation function,MA is more sensitive response to platelet function.

Comparison of Drospirenone- with Cyproterone Acetate-Containing Oral Contraceptives, Combined with Metformin and Lifestyle Modifications in Women with Polycystic Ovary Syndrome and Metabolic Disorders: A Prospective Randomized Control Trial / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>While combined oral contraceptives (COCs) are commonly used to treat polycystic ovary syndrome (PCOS), comparative data regarding metabolic effects of different progestogens on this patient population are missing. This study aimed to compare the different effects of drospirenone (DRP)-containing COCs with cyproterone acetate (CPA)-containing COCs, combined with metformin and lifestyle modifications in women with PCOS and metabolic disorders.</p><p><b>METHODS</b>Ninety-nine women with PCOS and a metabolic disorder between January 2011 and January 2013 were enrolled into this prospective randomized clinical trial. Participants were randomized into two groups such as DRP-containing COCs, and CPA-containing COCs. Participants took COCs cyclically for 6 months, combined with metformin administration (1.5 g/d) and lifestyle modifications (diet and exercise). Clinical measures and biochemical and hormone profiles were compared. Comparisons for continuous variables were evaluated with paired and unpaired Student's t-tests. The Wilcoxon signed rank test was used when the data were not normally distributed. Analysis of covariance was used to control for age, body mass index (BMI), and baseline data of each analyzed parameter when compared between the two groups.</p><p><b>RESULTS</b>A total of 68 patients have completed the study. The combination regimen of COCs, metformin, and lifestyle modifications in these patients resulted in a significant decrease in BMI, acne, and hirsutism scores when compared to baseline levels in both groups (P < 0.05). Blood pressure (BP) was significantly different in the CPA group when compared to baseline (75.14 ± 6.77 mmHg vs. 80.70 ± 5.60 mmHg, P < 0.01), and after 6 months of treatment, only the change in systolic BP was significantly different between the two groups (4.00 [-6.00, 13.00] mmHg vs. -3.50 [-13.00, 9.00] mmHg, P = 0.009). Fasting glucose, fasting insulin, and homeostasis model assessment-insulin resistance decreased significantly in the DRP group (5.40 ± 0.41 mmol/L vs. 5.21 ± 0.32 mmol/L, P = 0.041; 13.90 [10.50, 18.40] μU/ml vs. 10.75 [8.60, 13.50] μU/ml, P = 0.020; 3.74 [2.85, 4.23] vs. 2.55 [1.92, 3.40], P = 0.008) but did not differ between the two groups. While individual lipid profiles increased in both groups, no statistically significant difference was observed.</p><p><b>CONCLUSIONS</b>DRP-containing COCs combined with metformin and lifestyle modifications could better control BP and correct carbohydrate metabolism in women with PCOS and metabolic disorders compared with CPA-containing COCs.</p><p><b>TRIAL REGISTRATION</b>Chinese Clinical Trial Registry, ChiCTR-TRC-11001143; http://www.chictr.org.cn/showproj.aspx?proj=8395.</p>

Diagnostic value of endometrial thickness determined by transvaginal sonography in infertile women with endometrial polyps / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Endometrial polyps (EPs) occur in approximately 34.9% of infertile women. Transvaginal sonography (TVS) is a routine, non-invasive component of fertility evaluation. Most ultrasonographic studies of EPs have focused on abnormal uterine bleeding; few have assessed EPs in infertile women. Furthermore, no studies have explored endometrial thickness and its correlation with EPs in infertile women. This study aimed to assess transvaginal sonographic assessment of endometrial thickness and its value in diagnosis and prediction of EPs in infertile women.</p><p><b>METHODS</b>A retrospective study on 314 infertile women was conducted from June to December 2010. After TVS, endometrial biopsies were obtained by hysteroscopy. Pathologically confirmed EPs were taken as the gold standard.</p><p><b>RESULTS</b>Based on recognized criteria, TVS had a sensitivity of 37.04%, specificity of 98.71%, positive predictive value of 90.91%, negative predictive value of 81.85%, and accuracy of 82.80% for diagnosing EPs. Mean endometrial thickness was significantly different in patients with and without EPs (P = 0.0001). In women in the mid and late-proliferative phase, the endometrial thickness was significantly greater in those with EPs than in those without them (P = 0.0001 and 0.024). Receiver operating characteristic analysis showed that endometrial thickness had a sensitivity of 85.2% and specificity of 38% in the diagnosis of EPs, the area under the curve being 0.64. In the mid-proliferative phase, sensitivity was up to 90.9%, the area under the curve being 0.70.</p><p><b>CONCLUSIONS</b>TVS is poor at detecting EPs in infertile women; however, transvaginal sonographic measurement of endometrial thickness is helpful. It is suggested that the diagnostic value of TVS for EPs in infertile women could be improved by adding the measurement of endometrial thickness to the variables that are routinely assessed.</p>

Immunophenotypes in 207 pediatric patients with ALL and theirs correlation with cytogenetics and clinical features / 中国实验血液学杂志

The objective of this study was to investigate the immunophenotypic subtype profiles of 207 pediatric patients with acute lymphoblastic leukemia (ALL) and its correlation with cytogenetics and clinical features. 207 children with ALL were immunophenotyped by four color flow cytometry using a panel of monoclonal antibodies. 207 patients were enrolled in this study, out of which 146 cases were subjected to karyotype analysis by R-banding technology. The results showed that 11.6% out of 207 children with ALL were identified as T-ALL, 88.4% as B-ALL. Myeloid antigen (MyAg) expression was documented in 42.5% out of 207 cases analyzed and CD13 was the most commonly expressed MyAg (31.4%). No difference was observed in the expression of MyAg between the groups of patients with T-ALL (41.7%) and B-ALL (42.6%). Abnormal karyotypes were detected in 84 out of 146 (57.5%) children. The clinical and biological characteristics of ALL patients between MyAg(+) and MyAg(-) groups showed that higher percentage of patients with high WBC count (> 50 × 10(9)/L) and higher CD34 positivity were found to be correlated with MyAg(+) ALL. It is concluded that immunophenotype analysis is useful for ALL diagnosis and classification, and the immunophenotypes are in relevance to the abnormal cytogenetic changes as well as clinical features in childhood ALL.

Computed tomography and magnetic resonance imaging features of desmoid-type fibromatosis: comparison with the pathological findings / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the computed tomography (CT) and magnetic resonance imaging (MRI) features of desmoid-type fibromatosis, and improve the diagnostic accuracy and understanding of the disease.</p><p><b>METHODS</b>The CT and MRI features of 18 cases of surgically and pathologically confirmed desmoid-type fibromatosis were reviewed retrospectively. Among the patients, 10 received CT pre- and post-contrast scanning, and 8 patients had MRI pre- and post-contrast scanning. The CT and MRI features were analyzed in comparison with the pathological findings.</p><p><b>RESULTS</b>In the extra abdominal cases, the tumors occurred in the head and neck in 3, in the dorsal part of the chest in 2, in the abdominal wall and groin area in 9, and in the peritoneal cavity in 4; concomitant Gardner syndrome was found in 1 case. In 4 cases the tumor occurred within 1 to 3 years after abdominal surgeries. Pathologically, the lesion was hard and composed of fusiform fibroblasts and myofibroblast. The cells showed no obvious heteromorphism with few karyokinesis, growing invasively and recurrent locally but without distant metastasis. Immunohistochemically, the fibroblasts and myofibroblasts expressed vimentin, and the myofibroblasts were positive for SMA. On CT and MRI, the lesion appeared benign with malignant growth pattern, and caused compression of the adjacent organs and vessels or encasement of the vessels; the border was unclear without encapsulation, and necrosis and calcification was scarce. The density and signal of the tumor were well distributed. Twelve patients displayed obvious enhancement and 5 showed uneven enhancement.</p><p><b>CONCLUSION</b>The CT and MRI features of desmoid-type fibromatosis are characteristic, and CT and MRI are valuable modalities for the diagnosis and differential diagnosis of the tumor.</p>

Role of caspase-8 in TRAIL-induced apoptosis of neuroblastoma cell lines / 中国当代儿科杂志

<p><b>OBJECTIVE</b>The aim of this study was to investigate whether the induction of caspase-8 by γ-interferon (IFNγ) renders neuroblastoma (NB) cells sensitive to tumor necrosis factor related apoptosis inducing ligand(TRAIL).</p><p><b>METHODS</b>Caspase-8 mRNA expression was determined by RT-PCR. The effects of IFNγ, TRAIL, IFNγ +TRAIL and caspase-8 inhibitor+ TRAIL on the growth and apoptosis of NB cells were detected with the methods of reduction rate of Alamar Blue assay and flow cytometry. The relative caspase-8 activity was measured with colorimetric assay.</p><p><b>RESULTS</b>Caspase-8 expression was detectable in CHP212 cells which were sensitive to TRAIL, with an increased expression after treatment with IFNγ. Caspase-8 was undetectable in SH-SY5Y(SY5Y) cells which were resistant to TRAIL, but an increased expression of caspase-8 mRNA was found after treatment with IFNγ. Moreover, TRAIL combined with IFNγ induced apoptosis in SY5Y cells. The relative caspase-8 activity of CHP212 cells increased with the prolonged TRAIL action time. The relative caspase-8 activity of SY5Y cells in the IFNγ+TRAIL group was significantly higher than those of the control, IFNγ, TRAIL and inhibitor groups.</p><p><b>CONCLUSIONS</b>NB cells expressing caspase-8 are sensitive to TRAIL. TRAIL induces apoptosis in NB cells with an increase of relative caspase-8 activity.</p>

A comparative study of diffusion-weighted magnetic resonance imaging and pathological findings of liver fibrosis in rabbits / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the alteration of apparent diffusion coefficient (ADC) in diffusion-weighted MR imaging (MR-DWI) of liver fibrosis and its pathological basis in rabbits.</p><p><b>METHODS</b>Five rabbits in the control group and 22 with experimental liver fibrosis induced by transperitoneal injection of carbon tetrachloride (CCl4) were examined with MR-DWI. Diffusion-weighted SE EPI sequence with a relatively high b factor (b=600 s/mm2) was used to measure the ADC. The mean values of ADC were compared among the rabbits in different stages of liver fibrosis and analyzed in relation to the pathological findings.</p><p><b>RESULTS</b>The mean ADC value decreased significantly with increased severity of liver fibrosis (P<0.05). Pathologically, the amount and extension of fibrotic matrix increased, and the hepatic necroinflammation worsened with the progression of the liver fibrosis.</p><p><b>CONCLUSION</b>The ADC value decreases with the progression of liver fibrosis possibly as the result of water diffusion limitation due to increased fibrous tissue in the liver and abnormal water diffusion within the intracellular and extracellular spaces.</p>

Effect of rabbit peripheral sensory and motor nerve homogenates on the proliferation and calcification of rabbit osteoblasts in vitro / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of rabbit saphenous and sciatic nerve homogenates on the proliferation and calcification of rabbit osteoblasts in vitro.</p><p><b>METHOD</b>The saphenous nerves (sensory nerves) and the muscular branches of the sciatic nerve (motor nerve) were collected from 48 New Zealand white rabbits to prepare the nerve tissue homogenates. Bone marrow mesenchymal stem cells (MSCs) were isolated from the rabbits and cultured in vitro, and after 14 days of routine osteogenic induction, the resultant osteoblasts were identified by immunohistochemistry, alkaline phosphatase (ALP) and Alizarin red S staining. The osteoblasts were then incubated in the induction medium containing the saphenous (sensory nerve group) or sciatic homogenates (motor nerve group), with the cells in the dexamethasone-containing, dexamethasone-free osteogenic induction medium and control medium as the control. The proliferation, total protein and ALP activity of the osteoblasts were measured every other day until the 8th day, and Alizarin red S staining was used for quantitative analysis of calcification of the cells after two weeks.</p><p><b>RESULTS</b>The application of the saphenous nerve homogenates significantly promoted cell proliferation, total protein and ALP activity (P<0.01, P<0.05 and P<0.05), while exposure of the osteoblasts to dexamethasone inhibited the cell proliferation (P<0.001). Compared to dexamethasone-free group, the saphenous homogenates enhanced the mineralization of the osteoblasts (P<0.001).</p><p><b>CONCLUSION</b>Saphenous nerve homogenates significantly promotes the proliferation, differentiation, ALP activity and mineralization of rabbit osteoblasts, but sciatic nerve homogenates do not show osteogenic effects on the cells.</p>

Experience of Congenital Choledochal Cyst in Adults: Treatment, Surgical Procedures and Clinical Outcome in the Second Affiliated Hospital of Harbin Medical University

This study was undertaken to analyze and evaluate the diagnosis and principal treatment methods for congenital choledochal cyst, focusing on various surgical procedures and clinical outcome. A comprehensive, retrospective study was conducted on 72 adult patients who presented with choledochal cyst from 1985 to 2002. Surgical procedures were cyst excision with hepaticojejunostomy in 25 cases for type I or type IV-B, extrahepatic cyst excision with hepaticojejunostomy in 8 cases for type IV-A, extrahepatic cyst excision with modified hepaticojejunostomy in 2 cases for type IV-B, non-cyst excision with or without hepaticojejunostomy in 27 cases for types I, II, IV-A, IV-B. The early postoperative morbidity and mortality rate were 16.1% (9/62) and 6.5% (4/62) respectively, and the complication rate related to surgical procedure was 30.6% (19/62). The incidence of cholangiocarcinoma with non-cyst excision or non-operated congenital choledochal cyst was 10.8% (4/37). One patient died of primary hepatocellular carcinoma after cyst excision with hepatojejunostomy. In conclusion, our results showed that complete exci-sion of choledochal cyst for types I, II, and IV-B and complete excision of extra-hepatic choledochal cyst from the hepatic hilum in type IV-A with hepaticojejunostomy or modified hepaticojejunostomy are the treatment of choice for choledochal cyst in adult patients.

Initial study of quantitative analysis of fatty liver by ~1H-MR spectroscopy imaging / 中华放射学杂志

Objective To investigate the feasibility of ~1H-MR spectroscopy(~1H-MRS)imaging to quantitatively detect fatty liver.Methods Twenty patients with fatty liver and 11 healthy volunteers underwent plain CT scan,conventional MR imaging and ~1H-MRS analysis.The blood lipid and liver function were tested on the same day as the MR examination.~1H-MRS sequence measured the peaks of H_2O and lipid,and the areas under the peaks.The relative contents of the lipid compound were calculated,and compared with the results of CT scan and liver function tests.Results The CT values of the normal group and the fatty liver group were(59?9)HU and(24?11)HU respectively.On ~1H-MRS a protruding high H_2O peak and a flat low lipid peak were observed in the normal group,while the protruding high H_2O peak and a high lipid peak appeared in the fatty liver group.The values of lipid peak in the normal group and the fatty liver group were(0.05?0.01)?10~5,(0.70?0.24)?10~5 respectively(t=4.32,P0.05),the areas under the lipid peak were(1.36?0.73)?10~9、(2.35?1.15)?10~9 respectively(t=5.21,P0.05).Conclusion ~1 H-MRS imaging is feasible to quantitatively detect liver fat and is a non-invasive method for detecting early fatty liver.