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This article reported a case of malignant pheochromocytoma and paraganglioma with cranial metastasis. The patient was a 25-year-old man. At the age of 10, he was diagnosed with retroperitoneal paraganglioma. He received radiotherapy after partial resection of the tumor. At the age of 15, when he consulted for headache and hypertension, a space occupying lesion was found on the right adrenal without further diagnosis and treatment. His headache and hypertension were aggravated at the age of 25. Then he visited our medical center and diagnosed with right adrenal pheochromocytoma. He undertook an operation to remove the right adrenal lesion, and his blood pressured could be controlled in the normal range with oral antihypertensive medication. One year after the surgery, a cranial lesion with positive 131I-metaiodobenzylguanidine imaging was found following the increase of norepinephrine and dopamine in both blood and urine. The diagnosis of malignant pheochromocytoma with cranial metastasis was confirmed. The cranial lesion was treated with cyberknife therapy for 4 times, and the lesion was slightly reduced. Four year after the removal of right adrenal tumor, he developed multiple bone metastasis in the right ribs and left ilium, and then he received 131I-metaiodobenzylguanidine radiotherapy. Additionally, the results of gene test indicated a pathogenic mutation of SDHB. During the follow-up period of one year after the treatment, his blood pressure fluctuated to about 140/90mmHg with 10mg of phenoxybenzamine once a day. The case is a malignant pheochromocytoma with multiple bone metastasis characterized by a long course with an ideal prognosis in a way. Consequently, we suggested the diagnostic pathway with genetic testing based on clinical phenotype to approach more timely diagnosis and reasonable evaluation of the prognosis in pheochromocytoma and paraganglioma. Furthermore, clinicians should pay more attention to the long-term surveillance.
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@#Higher education institutions face major challenges in managing the impact of the COVID-19 pandemic. The risk of exposure from the community poses a threat to campus staff and students. This study describes epidemiological characteristics of suspected COVID-19 cases among a public university’s students and staff. This is a retrospective review on data collected from the institute’s COVID-19 Preparedness and Respond Centre, located at the main campus in Kota Kinabalu, the capital city of Sabah from mid-January to April 2020. Incidence rate was calculated, and epidemiological information retrieved from interviews and relevant documents. The majority of suspected COVID-19 cases were staff (57.1%) with incidence rates higher among males (IR=40.2/1,000 population) and those working in the frontline (IR=39.6/1,000 population). Suspected COVID-19 cases were mostly related to occupation (37.3%) and social contacts (27.3%). Student cases were largely related to household (38.1%) and during travel (33.3%). One positive COVID-19 case was reported of out of the 161 suspected cases (0.6%) in the institution. An operational team must be set up to conduct situational analysis and integrate management with other departments. Suspected COVID-19 cases must be quarantined and monitored on a daily basis. A high index of suspicion and effective containment of suspected cases will prevent spread of the virus among students and staff.
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Objective To determine the correlation between papillary thyroid cancer( PTC) malignancy with thyroid antibody expression level. Methods In this retrospective study, 4046 goiter patients with complete clinical data who have undergone thyroidectomy were separated into the benign nodule ( n=1357) and PTC groups ( n=2689), and their preoperative thyroglobulin antibody ( TgAb) and thyroid peroxidase antibody ( TPOAb) were assessed through antibody analysis. HT was determined based on the postoperative histopathology. The collected data were then evaluated for the correlation with PTC malignancy through statistical tests. Results In general, patients in the PTC group showed a significantly higher TgAb positivity ( 10. 9％) than those in the benign group ( 5. 6％, P<0.01) . Among female patients, a higher TgAb positivity was observed for those in the PTC group than those in the benign group (14.0％ vs 7.0％, P<0.01), while no significant difference between groups was observed in male patients. The high odds ratio of 2.18 supports the significant correlation between TgAb-positive status and higher risk of developing PTC in women (P<0.05). However, the risk of developing PTC was not correlated with higher TgAb titre. TgAb was not significantly correlated with the mass size, multifocality, lymph node metastasis or the TNM classification of malignant tumor stage Ⅲ/Ⅳ. Conclusion The increasing risk of PTC is related to TgAb among female patients, but it will not increase as TgAb titer rises. It is not associated with PTC aggressiveness.
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Objective To explore the potential influence of gender on screening value of aldosterone-renin ratio (ARR) for primary aldosteronism (PA).Methods The biochemical parameters were collected of 451 PA patients and 300 essential hypertension (EH) patients who were diagnosed in the General Hospital of PLA from 1992 to 2014. Each group was then divided into two groups by gender. The clinical characteristics were compared and then the receiver operating characteristic curve (ROC) was conducted to evaluate the best cut-off value.Results The plasma aldosterone concentration (PAC), serum sodium and ARR were much higher, but the plasma rennin activity (PRA), serum potassium and BMI were much lower in PA patients than in EH patients (P0.05). The best cut-off value of ARR in male PA patients was 19.11, the relevant area under the curve (AUC) was 0.968, the sensitivity and specicantcity was 92.44% and 93.08%, and the Youden index (YI) was 0.86. The best cut-off value of ARR in female PA patients was 27.26, with AUC 0.956, sensitivity 92.07%, specicantcity 90.00% and YI 0.82, respectively. If the cut-off value was set at 27.26 in males, the specicantcity would rise a little, but the sensitivity and YI would sharply decrease. Similarly, the sensitivity would increase a little but the specicantcity and YI would fall substantially if the cut-off value in females was set at 19.11. The best cut-off value of ARR in men was smaller than the ocantcial value recommended by guidelines.Conclusion Gender is an important factor should be considered while ARR is used in PA screening, and the cut-off value of ARR in screening female PA patients should be setting higher.
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Objective To observe the interventional effect of Qingqihuatan Decoction on airway inflammation and inflammatory reaction of lung tissue in asthmatic mouse.Methods Forty-five BALB/c mice were randomly divided into the normal control group(CON),asthmatic model group(MOD),dexamethasone group(TRE),Qingqihuatan Decoction group(X1) and Qingqihuatan Decoction combined dexamethasone group(X2).The asthmatic mouse model was established by the sensitization and inhalation of OVA and aluminium hydroxide gel.The bronchoalveolar lavage fluid (BALF) was performed the cell counts and eosinophil counts,and the pathological changes of lung tissue were observed.Results Compared with CON group,BALF cell count and eosinophil count in the model group were increased obviously,which in the treatment group were significantly decreased.The effect of the X1 group and X2 group had statistical difference between on 5 d and 15 d.(P＜0.05 or P＜0.01);the treatment groups could reduce the pathogenical infiltration,lung bullae production and airway epithelial thickening of mouse lung tissue,especially the inflammation damage in X2 group was mild.Conclusion Qingqihuatan Decoction can relieve the airway inflammation and improves the lung tissue inflammatory response in model mouse.
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Objective To investigate the trends in the clinicopathological characteristics of thyroid cancer patients undergoing surgery from 1994 to 2013. Methods A retrospective analysis was conducted on the clinical data of inpatients with thyroid nodular diasease undergoing thyroidectomy with pathology results from January 1994 to December 2013. The trends in the pathogenic constituent of thyroid nodule and the clinicopathological characteristics of 3 399 patients with thyroid cancer were analyzed. Results (1) Over the past 20 years, the proportion of patients diagnosed as thyroid cancer was gradually increased, especially those with papillary thyroid cancer (PTC). Whereas the proportions of benign nodule and other rare thyroid cancer were gradually decreased(P<0.01). (2) The average age of patients with thyroid cancer was (44.30±11.72) years, with the peak incidence at 30~59 years. The incidence of thyroid cancer was increasing in both males and females, especially more evident in the absolute increase in women(P<0.05). (3) Among 3 399 patients with thyroid cancer, 56.20%(1 910/3 399)underwent subtotal lobectomy. 20.74%(705/3 399)underwent total/near total thyroidectomy, showing an increase trend (P<0.01). Ultrasound-guided aspiration biopsy for thyroid nodule were performed in 48.87% (1 661/3 399)patients before operation. The proportion of aspiration biopsy was gradually increased since 2004. (4) An increase in thyroid cancer of tumor sizes less than 2.0 cm was observed, especially those size≤1.0 cm(P<0.01). 83.96%(2 854/3 399)patients revealed TNM Ⅰ~Ⅱ stage, and the proportion of patients with TNM Ⅲ~Ⅳ stage was gradually decreased since 2006(P<0.01). Conclusion Over the past 20 years, the proportion of thyroid cancer, especially papillary thyroid microcarcinoma reveals an ascending tendency. The percentages of patients undertaking total/near total thyroidectomy and ultrasound-guided aspiration biopsy before operation are on the rising.
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Objective To investigate the correlation between body mass index (BMI) and the occurence of papillary thyroid carcinoma (PTC) among the patients with thyroid nodules. Methods This cross-sectional study collected the data of 4 350 patients with thyroid nodules who underwent thyroidectomy in our hospital from January 1994 to December 2013. The patients were divided into normal weight (BMI 18.50~23.9 kg/m 2), overweight (BMI 24.0~27.9 kg/m 2), and obese (BMI≥28.0 kg/m 2) groups according to BMI, as well as benign nodules and papillary thyroid carcinoma groups based on their pathological finding. The differences of age-sex composition, nodule diameter, TSH level, overweight and obese constituent ratio between two groups were also analyzed. Logistic regression method was used to evaluate the risk factors of PTC. Results (1) Compared with the benign nodule group, there was a higher proportion of patients under the age of 40 years (34.1% vs 19.5%, P<0.01) in PTC group, with smaller tumour diameters [ 1.0 (0.7-2.0) cm vs 3.0 (2.0-4.0) cm, P<0.01]and higher TSH levels [ 1.9 (1.2-3.0) mU/L vs 1.6 (0.9-2.5) mU/L, P<0.01]. (2) The proportion of obese patients was higher in PTC group than that in the benign nodule group (28.7% vs 20.7%, P<0.01) among male patients. While the difference was not found among female patients. (3) Stratification analysis according to gender and age showed that the proportion of overweight (49.4% vs 44.1%, P<0.05) or obese (26.5% vs 15.3%, P<0.01) in PTC group was higher than that of benign nodule group among male patients aged≤40 years and the proportion of obese patients in PTC group was higher than that of benign nodule group (30.8% vs 22.2%, P<0.01) among male patient aged 41 to 65 years. (4) A multivariate analysis indicated that overweight (OR=4.947) and obesity (OR=7.648) were all independent risk factors for PTC (P<0.01) among male patients aged≤40 years. Conclusion Overweight and obesity are associated with higher PTC risk for male patients aged 40 years or less.
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Objective To evaluate the therapeutic effect of systemic infusion of MSC culture supernatant in STZ-induced diabetic rats, and explore the mechanism of effect of MSC secretion on promoting regeneration of the islet tissues. Methods The diabetic animal model was reproduced in 35 SD rats by intraperitoneal injection of a single large dose of streptozotocin (STZ, 65mg/ kg). The 30 successfully induced diabetic rats were randomly divided into MSC culture supernatant infusion group (CM, n=15) and medium infusion group (M, n=15), and in addition, 15 normal rats were used as control. Animals were intravenously transfused with MSC supernatant (CM group) or raw medium (M group), then the contents of blood glucose were determined 3 days after infusion. The serum insulin and C-peptide levels were monitored and the intraperitoneal glucose tolerance test (IPGTT) was performed on the 7th day of infusion to evaluate the therapeutic effect of MSCs supernatant infusion in diabetic rats. Finally, all the experimental animals were sacrificed at indicated time points and the pancreatic tissues were collected for multiple immunofluorescence staining (MIFS), in order to observe the β-cell regeneration after MSCs supernatant infusion, and to further explore the possible mechanism involved in the experiment. Results At the early stage after infusion (<7 days), the blood glucose level declined and the contents of serum insulin and C-peptide increased obviously in CM group as compared with that of M group (P<0.05). IPGTT showed that the islet function was significantly enhanced in CM group compared with M group. MIFS showed that the number of β cells in the destroyed islets in CM group rats was significantly increased as compared with that of M group rats. In addition, the proliferation rate of β cells was obviously higher in CM group (4%) than in control group (0.5%, P<0.01). Conclusion Treatment with MSCs culture supernatant obviously prompted β cell proliferation in the destroyed islets, resulting in regeneration of the islets with islet function recovery, thus it effectively controls the advance of diabetes.
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Objective To explore the features of patients with acute leukemia (AL) in Hematology Department of Shenzhen Hospital affliated to Beijing University during the past six years. Methods The data of the 1056 acute leukemia dignosed in our department between 2002-2007 were collected and analyzed retrospectively. Results The male patients was predominant (male/female ratio was 1.78). The number of patients with acute myeloid leukemia(AML) was higher than that of patients with acute lymphoblastic leukemia (ALL) (AML/ALL ratio was 1.85). Most of the AML patients were young adult (65 %) and elderly ALL patients were very rare(1.33 %). AL cases were tended to increase gradually by year. The ratio of treatment-related AL in Shenzhen was lower than that reported literature in other countries. The major cause of the treatment-related AL were chemotherapy/radiotherapy and psoriasis treated with bimolane. Conclusion Some of the features of AL patients in China were further confirmed and some new features were also found in this study. These changes should be demonstrated by the next national epidemiology survey of leukemia.
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<p><b>OBJECTIVE</b>To observe effects of combination of different points on glucose metabolism in the patient of cerebral infarction.</p><p><b>METHODS</b>Neiguan (PC 6), Shuigou (GV 26), Fengchi (GB 20), Sanyinjiao (SP 6), Yinlingquan (SP 9), Taichong (LR 3) were selected for the Xingnao Kaiqiao group (n =7), and Hegu (LI 4), Quchi (LI 11), Zusanli (ST 36), Yanglingquan (GB 34) and Xuanzhong (GB 39) for the routine acupuncture group (n = 5). PET-CT was used to observe the local cerebral glucose metabolism.</p><p><b>RESULTS</b>The cerebral regions activated in the the Xingnao Kaiqiao group included infarction center, gyrus temporalis superior, thalamus, gyrus temporalis inferior, gyrus rectus, insula, lateral occipital lobe, parietal lobe and cerebellum, and in the routine acupuncture group included gyrus frontalis inferior, caudate nucleus, cingulated gyrus, hippocampus, precuneus and parietal lobe.</p><p><b>CONCLUSION</b>PET is very suitable for exploring acupuncture mechanisms in treatment of cerebral infarction, and further shows the specificity of acupoints-brain functional region.</p>
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Adult , Female , Humans , Male , Middle Aged , Acupuncture Points , Brain , Metabolism , Cerebral Infarction , Metabolism , Therapeutics , Electroacupuncture , Glucose , Metabolism , Positron-Emission TomographyABSTRACT
<p><b>AIM</b>To investigate the relationship between low androgen level and ultrastructure of vascular endothelium.</p><p><b>METHODS</b>Forty-eight male Sprague-Dawley rats were randomly divided into four groups: group A, normal rats with sham castration; group B, castrated rats; group C, castrated rats given testosterone (T) undecanoate; and group D, intact rats treated with 5alpha-reductase inhibitor. After 10 weeks of treatment or castration, rats in different groups were killed and serum T, free T (FT) and dihydrotestosterone (DHT) were measured. The aortic endothelia were scanned under electron microcopy and the Vascular Endothelium Structure Score (VESS) was computed.</p><p><b>RESULTS</b>Serum T and FT concentrations of rats in group B were significantly lower than those of the other three groups (P < 0.01); DHT concentrations of group D rats were significantly decreased (P < 0.01) when compared with those of groups A and C. Rats in groups B and D rats (with low androgen levels) had obvious damage to their endothelial surfaces, which appeared crimpled, rough, adhesive and ruptured, and had high destruction of VESS.</p><p><b>CONCLUSION</b>These results suggest that low concentrations of T and DHT are associated with ultrastructural damage of the aortic endothelia in male rats.</p>
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Animals , Male , Rats , 5-alpha Reductase Inhibitors , Aorta , Dihydrotestosterone , Blood , Endothelium, Vascular , Enzyme Inhibitors , Pharmacology , Orchiectomy , Rats, Sprague-Dawley , Testosterone , Blood , PharmacologyABSTRACT
<p><b>OBJECTIVE</b>To explore nm23 gene mRNA expression and its clinical significance in acute leukemias (AML).</p><p><b>METHODS</b>The levels of nm23-H1 and nm23-H2 transcripts in 22 patients with acute myeloid leukemia (AML), 9 AML in complete remission (AML-CR), 12 acute lymphoblastic leukemia (ALL) and 4 chronic myeloid leukemia in chronic phase (CML-CP) were assayed by reverse transcriptase-polymerase chain reaction (RT-PCR).</p><p><b>RESULTS</b>The expression of nm23-H1 in AL especially in AML-M4 and AML-M5 was significantly higher than that in normal blood cells. An analysis of correlation between nm23 expression and clinicopathological parameters showed that increased nm23-H1 mRNA levels were associated with some poor-prognostic factors such as extramedullary infiltration, high white blood cell count (WBC), high lactate dehydrogenase (LDH) activity and high CD(7) expression, while inversely correlated with t(8; 21) and t(15; 17) which had a good-prognostic effect. The expression of nm23-H1 in AML patients in CR was significantly decreased compared with those untreated.</p><p><b>CONCLUSION</b>nm23-H1 was overexpressed in AL, especially in AML-M4 and AML-M5. High expression of nm23-H1 may be a poor prognostic factor.</p>
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Adult , Female , Humans , Male , Middle Aged , Gene Expression , Leukemia, Myeloid, Acute , Genetics , Pathology , NM23 Nucleoside Diphosphate Kinases , Nucleoside-Diphosphate Kinase , Genetics , RNA, Messenger , Genetics , Reverse Transcriptase Polymerase Chain ReactionABSTRACT
Objective To investigate the role of CD4~+CD25~+ Treg cells on the pathogenesis of ankylos- ing spondylitis(AS), and to study the machanism of tumor necrosis factor(TNF)-?blocker on the treatment of AS by detecting the number of CD4~+D25~+ Treg cells before and after the treatment. Methods The diagno- sis of 10 AS patients was made based on the 1984 modified New York criteria. The patients received subcuta- neou injection of recombinant human tumor necrosis factor receptor-Fc fusion protein(rhTNFR-Fc)(etaner- cept)50 mg weekly for 8 weeks and 10 heathy subjects were enrolled for control. The mononuclear cells were isolated from peripheral blood in beth patients and controls. The number of CD4~+CD25~+ T cells and CD4~+ CD25~(high)T cells and the expression of CTLA-4. were detected by flow cytometry. Results The proportion of CD4~+CD25~+ T cells(24?19)% in total CD4~+ T lymphocytes of peripheral blood and CD4~+CD25~(high)T/CD4~+ T (6?6)% from AS patients before treated with rhTNFR-Fc was higher than that in healthy volunteers and AS patients after treatment(P
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The uhrastructure and atrial natriuretic peptide(ANP)mRNA in myocardium of streptozotocin-induced diabetic rats were studied along with the effect of rosiglitazone.It was found that the myocardial ultrastructure was demaged in diabetic rats.Rosiglitazone may ameliorate the lesion in myocardium,and lower the ANP mRNA in diabetic rats(1.14?0.05 at 6 weeks and 1.12?0.09 at 10 weeks vs 0.97?0.14,both P