Correlation between CT-feature of lobulation and epidermal growth factor receptor gene mutations in advanced pulmonary adenocarcinoma / 中华放射学杂志

Objective@#To investigate the correlation between the feature of lobulation, degree of lobulation on CT images and epidermal growth factor receptor gene (EGFR) mutations in advanced pulmonary adenocarcinoma.@*Methods@#Two hundred and one patients who were diagnosed with advanced pulmonary adenocarcinoma between January and December 2017 and had undergone a chest CT and EGFR mutation testing at Shanghai Pulmonary Hospital were enrolled in this retrospective study. The clinical and imaging data of the patients were analyzed. The patients were classified into EGFR mutations group (107 cases) and wild type group (94 cases) according to whether EGFR gene mutation occurred. The feature of lobulation (described as presence of lobulation, absence of lobulation, or obscured margin), degree of lobulation (including deep lobulation, shallow lobulation, no lobulation, and obscured) on CT images were statistically compared between the two groups.@*Results@#Based on the presence or absence of lobulation sign, there were 99, 0, 8 cases with lobulation, no lobulation, obscured margin in the EGFR mutations group and 80, 1, 13 cases in the wild type group, respectively. There was no significant difference in lobulation sign between the EGFR mutations group and wild type group (P=0.152). According to the degree of lobulation, there were 32, 67, 0, 8 cases of deep lobulation, shallow lobulation, no lobulation, obscured margin in EGFR mutations group and 60, 20, 1, 13 cases in wild type group. Significant differences of frequency were found regarding deep lobulation and shallow lobulation between the two groups (P<0.001). However, there was no significant difference between the two groups in the presence of no lobulation, and obscured margin (P>0.05).@*Conclusions@#EGFR mutations are significantly associated with shallow lobulation in advanced pulmonary adenocarcinoma. Conversely, deep lobulation is more likely to appear in advanced pulmonary adenocarcinoma with wild-type EGFR. However, there is no association between EGFR mutation status and the presence of lobulation.

Correlation between CT?feature of lobulation and epidermal growth factor receptor gene mutations in advanced pulmonary adenocarcinoma / 中华放射学杂志

Objective To investigate the correlation between the feature of lobulation, degree of lobulation on CT images and epidermal growth factor receptor gene (EGFR) mutations in advanced pulmonary adenocarcinoma. Methods Two hundred and one patients who were diagnosed with advanced pulmonary adenocarcinoma between January and December 2017 and had undergone a chest CT and EGFR mutation testing at Shanghai Pulmonary Hospital were enrolled in this retrospective study. The clinical and imaging data of the patients were analyzed. The patients were classified into EGFR mutations group (107 cases) and wild type group (94 cases) according to whether EGFR gene mutation occurred. The feature of lobulation (described as presence of lobulation, absence of lobulation, or obscured margin), degree of lobulation (including deep lobulation, shallow lobulation, no lobulation, and obscured) on CT images were statistically compared between the two groups. Results Based on the presence or absence of lobulation sign, there were 99, 0, 8 cases with lobulation, no lobulation, obscured margin in the EGFR mutations group and 80, 1, 13 cases in the wild type group, respectively. There was no significant difference in lobulation sign between the EGFR mutations group and wild type group (P=0.152). According to the degree of lobulation, there were 32, 67, 0, 8 cases of deep lobulation, shallow lobulation, no lobulation, obscured margin in EGFR mutations group and 60, 20, 1, 13 cases in wild type group. Significant differences of frequency were found regarding deep lobulation and shallow lobulation between the two groups (P<0.001). However, there was no significant difference between the two groups in the presence of no lobulation, and obscured margin (P>0.05). Conclusions EGFR mutations are significantly associated with shallow lobulation in advanced pulmonary adenocarcinoma. Conversely, deep lobulation is more likely to appear in advanced pulmonary adenocarcinoma with wild?type EGFR. However, there is no association between EGFR mutation status and the presence of lobulation.

Window Settings in the Diagnosis of Invasiveness of Lung Adenocarcinoma with Ground Glass Opacities / 中国医学影像学杂志

Purpose To explore the value of window width adjustment in diagnosing the invasiveness of lung adenocarcinoma manifested as ground glass opacities on high-resolution CT, and to provide guidance for the diagnosis of lung adenocarcinoma in different types. Materials and Methods The preoperative CT data of 102 preinvasive lesions and 107 invasive lesions of lung adenocarcinoma were analyzed retrospectively. Among 102 cases of preinvasive lesions, 25 were atypical adenomatous hyperplasia (AAH), 77 were adenocarcinoma in situ (AIS). Among 107 cases of invasive lesions, 78 were minimally invasive adenocarcinoma (MIA), and 29 were invasive adenocarcinoma. The lesions were ground glass opacity (GGO) on lung window while were invisible on mediastinal window. The window width was adjusted constantly until the lesions were invisible with the fixed mediastinal window level (40 HU). When the lesions became invisible, the window width was compared and the best cut-off was found on ROC curve in the two groups. Results The window width of lesions between preinvasive lesions and invasive lesions was different (Z= - 6.203, P<0.05). Window width was a good indicator for the invasiveness of pulmonary adenocarcinoma (area under the ROC was 0.748, P<0.05), and the window width of 1303 HU was the best cut-off for preinvasive lesions and invasive lesions (sensitivity was 56.9%, specificity was 86.0%. Conclusion Window width may be useful for the diagnosis of the invasiveness of the GGO of lung adenocarcinoma on HRCT. The lesion disappearing when the window width is larger than 1303 HU is more likely to be preinvasive; while the lesion disappearing when the window width is smaller than 1303 HU is more likely to be an invasive one.

Observation of endovascular stent insertion for non-small cell lung cancer patients with superior vena cava syndrome / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the effectiveness and safety of endovascular stent insertion for non-small cell lung cancer patients with superior vena cava syndrome.</p><p><b>METHODS</b>We retrospectively studied 123 patients referred to our hospital for the treatment of non-small cell lung cancer presenting with superior vena cava syndrome. Patients were devided in two groups according to the use of endovascular stent insertion in superior vena cava syndrome or not. 64 patients underwent endovascular stent insertion was designed as the stenting group and 59 without stenting as control group. The differences between the two groups in complete response, complication and survival were analyzed.</p><p><b>RESULTS</b>The complete response rate of superior vena cava obstruction was 92.0% for the stenting group, and 42.0% for the control group, showing a significant difference between the two groups (P < 0.001). The median time to complete response was (3.76 ± 2.83) days in the stenting group, significantly shorter than that of the control group (28.08 ± 16.06) days (P < 0.001). The relapse rate after complete response was 12.0% in the stenting group and 16.0% in the control group, showing a non-significant difference between the two groups (P = 0.607). The median time to relapse was 2.7 months in the stenting group and 1.1 months in the control group (P = 0.533). In the stenting group, stent stenosis occurred in 1 case and thrombosis was observed in 3 cases. The incidence rate of complications was 6.3%. Thrombosis occurred in 1 case of the control group, with an incidence rate of complications of 1.7%, showing a non-significant difference between the two groups (P = 0.201). Seven among the 123 patients were still alive at the endpoint of following up. The median survival time was 8.0 months (stenting group) and 5.5 months (control group) (P = 0.382).</p><p><b>CONCLUSIONS</b>Endovascular stent insertion is effective and safe for non-small lung cell cancer patients with superior vena cava syndrome, and it may be recommended as the first choice for palliative treatment of superior vena cava obstruction.</p>

Correlation analysis between curvature ratio measured at cardiac MR and systolic pulmonary artery pressure / 中华放射学杂志

Objective To observe the value of detection of pulmonary arterial hypertension(PAH) with curvature ratio measured at cardiac MR.Methods We performed a retrospective study of 48 patients with cardiac MR,systemic systolic blood pressure and right heart catheterization(RHC) data.The parameter curvature ratio (Rc) was measured at cardiac MR and transseptal/transmural pressure ratio (RP) was calculated.By using the regression analysis between Rc and RP,the SPAP was calculated.Bland-Altman analysis was used to compare the SPAP calculated with SPAP obtained by RHC.The accuracy of the SPAP calculated in detecting PAH was analyzed by using receiver operating characteristic (ROC) curves (SPAP higher than 40 mmHg as cutoff).The normality of parameter is tested by K-S test.Bivariate correlation Pearson test was used to test the consistency of parameters obtained by different measurers.Linear regression analysis was performed to find the relationship between Rc and RP.Results Parameter RP =0.28 ± 0.37 (-0.50-0.83) and RC =0.31 ± 0.57 (-0.78-0.97).Linear relationship was found between Rc and RP (r =0.94,P ＜ 0.01) and regression equation:Rc =1.44 × RP-0.09.Bland-Altman analysis showed satisfactory limits of agreement with the SPAP calculated and obtained by RHC.ROC analysis of the diagnostic value in PAH revealed 94.4％ (34/36) of sensitivity and 100.0％ of specificity (12/12,area under ROC curve =0.942,P ＜ 0.01).Conclusions Our study suggests that with curvature ratio measured at cardiac MR,the SPAP estimated have considerable sensitivity and specificity for detecting PAH.It may be a useful non-invasive assessment in patients that suspected of PAH.

Pulmonary arterial dimensions and right ventricular function by cardiac MRI / 中华放射学杂志

Objective To evaluate the diagnostic value of cardiac magnetic resonance imaging (CMRI) for pulmonary arterial hypertension(PAH).MethodsOne hundred and thirty patients with PAH confirmed by right cardiac catheterization were examined by CMRI and the results were compared with that of 31 healthy control participants.The main pulmonary artery diameter( MPAD),aortic diameter( AOD),main pulnonary arterydiameter/aorticdiameter(MPAD/AOD), rightventricular end-diastolicvolume ( RVEDV ),right ventricular end-systolic volume ( RVESV),right ventricular ejection fraction (RVEF) and right ventricular mass (RVM) were measured.The independent samples t-test was used to compare the PAH group with the control group.The Pearson correlation analysis and linear regression analysis were used to evaluate the relationship between cardiac and arterial measurements and pulmonary arterial pressure (PAP).ResultsThe MPAD,MPAD/AOD,RVEDV,RVESV,RVM in PAH group[ (3.88 ±0.57) cm,1.36 ±0.17,(161.63 ±56.37) ml,( 112.61 ±41.46) ml,(82.70 ± 20.73) g,respectively ] were increased compared with those in normal control group[ (2.74 ±0.31 ) cm,0.90 ±0.07,( 131.31 ± 15.14) ml,(61.33±9.00) ml,(44.39±5.87) g,respectively].The RVSV and RVEF in PAH group[(49.02 ±19.20) ml,( 30.76 ± 5.85 ) ％,respectively ] were decreased compared with those in normal control group [ (69.95 ± 9.63 )ml,(53.28 ± 4.14 )％,respectively ].The MPAD,MPAD/AOD,RVEDV,RVESV,RVSV,RVEF,RVM were significantly different between PAH patients and control participants(tMPA =10.82,tMPAD/AOD=14.93,tRVEDV=2.96,tRVESV=6.83,tRVSV=-5.89,tRVEF=-20.22,tRVM=10.12,respectively,P＜0.01).There were no significant correlations between MPAD,RVEDV,RVESV,RVSV and PAP (r=0.299 for MPAD,r =0.127 for RVEDV,r=0.278 for RVESV,r =-0.229 for RVSV).Moderate positive correlations were found between MPAD/AOD, RVM and PAP (r =0.702 for MPAD/AOD,r =0.683 for RVM ).A moderate negative correlation was found between RVEF and PAP (r=-0.660).Conclusion CMRI is an excellent imaging modality for the diagnosis of PAH. The MPAD/AOD,RVM,and RVEF can be used to indicate the severity of PAH.

Clinical characteristics of amyloidosis with isolated respiratory system involvement: a review of 13 cases

Isolated pulmonary amyloidosis is a very rare disease. We retrospectively reviewed the records of patients with pathologically proven isolated pulmonary amyloidosis treated at our hospital from 1990 to 2011. There were 9 males and 4 females with a mean age of 54.7 years [range, 45-72 years] and the mean course of disease was 46.5 months [range, 5 months-15 years]. The most common symptoms were cough [10/13], expectoration [8/13], hemoptysis [4/13], chest tightness [12/13], dyspnea [10/13], chest pain [3/13], fever [5/13], and body weight loss [2/13]. Radiological findings included tracheal stenosis [2/13], bronchial stenosis with atelectasis [5/13], pulmonary nodules [3/13], lung consolidation [1/13], and lymph node enlargement with pleural effusion [2/13]. Treatments included endotracheal stenting, endoscopic resection of tracheal and bronchial lesions, lung resection, and drug therapy with glucocorticoids, antineoplastic agents, or antibiotics. Four patients died of the disease within 1 year of diagnosis, 2 died of pneumonia at 3-4 years after original treatment, and the remaining patients are alive with follow-up ranging from 3 to 15 years. Isolated pulmonary amyloidosis is a rare disease with a relatively high mortality and its various manifestations make diagnosis challenging. Surgical resection of lesions and chemotherapy tend to be effective treatments

Endovascular embolization for the management of cryptogenic massive hemoptysis in long-term smokers / 中华放射学杂志

ObjectiveTo determine the effectiveness of endovascular embolization in patients with cryptogenic massive hemoptysis who were all long-term smokers.Methods Aortography and subclavian artery angiography were performed in 21long-term smokers with cryptogenicmassive hemoptysis.Transarterial embolization (TAE) was performed in patients with detectable pathologic systemic arteries.The angiographic findings were reviewed and the clinical and follow-up CT results were observed.ResultsThe pathologic systemic arteries were all bronchial arteries (BAs) and thirty-five arteries were involved.The angiography demonstrated peripheral hyperplasia in all BAs,with 24 pathologic BAs supplying the right lung and 25 supplying the upper lobes.In thirty-five BAs,24 showed hypertrophy and 11 were normal.TAE of the pathologic BAs was successfully performed and cessation of bleeding was achieved in all patients.During follow-up,one patient had episodic bloody sputum after embolization and no recurrence in all patients.The follow-up CTdemonstratednoadditionalabnormalitybesidespre-existingpulmonaryemphysema.Conclusion Cryptogenic massive hemoptysis in long-term smokers efficiently treated by endovascular embolization of the responsible bronchial artery.

Mucoepidermoid carcinoma of the tracheobronchial tree: CT findings / 中华放射学杂志

Objective To explore the CT findings of mucoepidermoid carcinoma (MEC) of the tracheobronchial tree and improve the diagnostic accuracy. Methods The CT images, histopathological and clinical data in 24 patients with pathologically proved MEC of the tracheobroncbial tree were retrospectively analyzed. Results The clinical symptoms included cough, sputum, fever, wheezing, chest pain and hemoptysis. The patient was proved to be low-grade (n=19) and high-grade (n=5) MEC histopathologically. One lesion was located in trachea, 6 in main bronchus, 12 in lobar bronchus and 5 in segmental, subsegmental and distal bronchus. The tumor presented as no-invasive endotracheobronchial well-defined round-like nodule (n=13, locating in lobar and higher bronchus) and columnar sharp (n=3, locating in main bronchus), or intra-and-extraluminal well-defined round-like nodule or mass (n=6, locating in lobar and lower bronchus) and irregular mass with invasive pattern (n=2, high-grade type). The density of lesion was similar to the muscule and the calcification within lesion was showed in 4 patients on non-enhanced CT. The lesion had marked enhancement in 17 patients on enhanced CT. Obstructive changes were found in 20 patients. Conclusion MEC of the tracheobronchial tree is usually low-grade malignancy and locates in main and lobar bronchus with no-invasive well-defined airway mass, marked enhancement and calcification on CT.

Endovascular embolization through pulmonary artery access for refractory massive hemoptysis / 中华放射学杂志

Objective To determine the effectiveness of endovascular embolization through pulmonary artery access in patients with refractory massive hemoptysis in whom systemic artery (SA)embolization is ineffective or contraindicated. Methods A total of 102 patients were treated with SA embolization for hemoptysis. Of the 102 patients, 6 patients had severe persistent hemoptysis despite complete SA embolization and 1 patient had severe hemoptysis following complete bronchial artery embolization and other SA embolization was contraindicated. The underlying diseases were chronic cavitary pulmonary tuberculosis (n = 3), chronic cavitary pulmonary tuberculosis complicated with aspergilloma (n=1), tuberculous bronchiectasis (n=1), severe necrotizing pneumonia (n=1) and bronchiectasis complicated with pneumatocele (n=1). The findings of SA angiography, main pulmonary angiography and selective pulmonary angiography were analyzed. Endovascular embolization was performed in patients with the detectable pathology in PA and the clinical results were observed. Results The findings of SA angiography showed bronchopulmonary shunting in all cases, and pseudoaneurysm of PA in 2 cases and hypertrophy of peripheral PA in 2 cases. The main PA angiography demonstrated pseudoaneurysm of PA in 1 case and hypoperfusion of the diseased PA in other case. The selective PA angiography demonstrated pseudoaneurysm of PA in 4 cases (1 case with extravasation of constrast medium) and hypertrophy ofperipheral PA in 2 cases. Coil embolizations of the pathologic PA were successfully performed and bleeding ceased in all patients. During follow-up, 1 patient had episodic bloody sputum after embolization, and 2 died day 6 and 15 of severe infection and respiratory failure and the remaining patients were all stable.Conclusions In patients with refractory massive hemoptysis after systemic embolization, the possibility of PA pathology, especially pseudoaneurysm of PA should be considered. Selective pulmonary angiography is necessary to demonstrate the pathology in PA. Endovascular management of the pathologic PA appears to be a safe and effective treatment.

Nonbronchial systemic arteries: incidence and endovascular interventional management for hemoptysis / 中华放射学杂志

Objective To investigate the incidence and relation to primary diseases of the nonbronchial systemic arteries (NBSA) supply to the pulmonary lesions, and to evaluate the clinical value of transcatheter arterial embolization (TAE) of the responsible NBSA for hemoptysis. Methods The aortography and subclavian artery angiography were performed in 139 patients with hemoptysis, including pulmonary tuberculosis in 66 cases (2 cases with post-thoracoplasty, 1 case with post-lobectomy, and 1 case with ventricular septal defect), bronchiectnsis in 41 ( 1 ease with post-lobectomy and 1 case with post- ligation of patent ductus arteriosus), bronchiogenic carcinoma in 15, unknown hemoptysis in 7, silicosis in 3, broncholithiasis in 3, bronchial cysts in 1, empyema in 1, postoperative lung cancer in 1, and chronic pulmonary embolism in 1, respectively. TAE was performed in patients with the discoverable responsible NBSA. The frequency, distribution and relation to primary diseases of the responsible NBSA were evaluated and the clinical results and complications were observed. Follow-up time ranged from 6 months to 5 years. Results Seventy-three patients (52. 5% ) had nonbronchial systemic contributions, including 5 cases of post-thoracotomy with pulmonary lesions, 1 case complicating with ventricular septal defect, 1 ease with post-ligation of patent ductus arterinsns, and 1 case of chronic pulmonary embolism. The total number of NBSA were 181 including posterior intercostal arteries (n = 88), internal thoracic arteries (n = 27 ), inferior phrenic arteries ( n = 21 ), proper esophageal arteries ( n = 20 ), lateral thoracic arteries ( n = 9 ), subscapular arteries ( n = 7 ), eostocervical trunks ( n = 5 ) and thyrocervical trunks ( n = 4 ) . Main responsible NBSA were posterior intercostal arteries (n = 75 ) and branches of subclavian and axillary artery (n =44) in patients with pulmonary tuberculosis, and proper esophageal arteries (n = 16 ) and inferior phrenic arteries (n = 17 ) in bronchiectasis. The clinical result was satisfactory and the bleeding ceased immediately in 69 eases including 19 cases of failed or repeated bronchial artery embolization (the arteries had been obstructive) and 4 cases of the normal bronchial arteries. No severe complications occurred except ipsilateral cerebellar infarction after subclavian artery angiography in 1 case and respiratory failure after internal thoracic artery embolization in another case. Sixty patients were followed up for more than 6 months. The result demonstrated episodic bloody sputum in 16 patients, re-bleeding in 11 and non-bleeding in another after TAE. Eight patients had non-bleeding and 2 patients had episodic bloody sputum who were re- bleeding and underwent repeated TAE. Conclusions The stimulation of adjacent lesions and the cardiovascular diseases with weakened or defected pulmonary perfusion can lead to the responsible NBSA supply to the lung in hemoptysis. During TAE for hemoptysis, the integrity angiograpby and TAE can improve the curative effect.

CT findings of primary pulmonary non-Hodgkin lymphoma / 中华放射学杂志

ObjectiveTo analyze the CT appearances of primary pulmonary non-Hodgkin lymphoma(PPNHL)in order to improve its diagnosis.MethodsCT manifestations of 19 cases with PPNHL confirmed by pathology and clinical follow-up were retrospectively analyzed.ResuitsNodules 7 cases and masses 8 cases in PPNHL were ill-defined and markedly enhanced,in which air bronchogram was commonly seen.Muhiple patchy areas distributed in the bilateral lungs were found in 9 cases.Consolidation 7 cases was lobar and markedly enhanced,in which air bronchogram was commonly seen.Interstitial change manifested as bilateral diffuse ground-glass opacities and reticular shadow was found in 1 case.Mixed imaging manifestations were detected in 10 cases.Pleural effusion 4 cases was uncommon.Conclusion CT manifestations of PPNHL are varied,but some specific imaging features still exist,CT examination combined with clinical manifestations is helpful for the diagnosis of PPNHL.

Angiographic manifestation and transcatheter arterial embolization of proper esophageal artery in hemoptysis / 中华放射学杂志

Objective To investigate the angiographic manifestation of the proper esophageal artery (PEA),the hish risk factom for the presence of the anomalous PEA in hemoptysis and to evaluate the safety of transcatheter aaefial embolization(TAE) of the PEA using gelatin sponge(GS).Methods Selective esophageal arteriography WSS performed in forty-three patients with hemoptysis,including 15 cases of pulmonary tuberculosis,18 cases of bmnchiectasis,7 cases of posttuberculous bronchiectasis and three cases of lung cancer. One case experienced failure of bronchial arterial embolization. The angiographic manifestation of the PEAs Was studied.The complications of the procedure and clinical results were observed in the patients who underwent TAE using GS.Results Thirty-nine PEAs were catheterized selectively in 37 patients(86.0%).Eighteen anomalous PEAs(46.2%)were catheterized selectively in 17 patients (45.9%).The anomalous PEAs showed tortuosity,dilatation,hyperplasia,shunting with pulmonary artery and anastomosis with the bronchial artery.All lesions involved basal segment of inferior pulmonary lobar. Bronchiectasis Was the most frequent disease for PEA abnormality. No complications occurred and satisfactory curative effect Was achieved with TAE of the anomalous PEAs.Conclusions It is necessary to perform selective proper esophageal arteriography when the lesion involves basal segment of inferior pulmonary lobar in hemoptysis.Supplemental TAE of the anomalous PEA using GS is safe and valuable in the management of hemoptysis.

The morbidity and mortality trend and prediction of lung cancer in residents of Nangang District of Harbin in China during the past 10 years / 中国肺癌杂志

<p><b>BACKGROUND</b>It is not clear yet about the secular changes of morbidity and mortality trend of lung cancer in residents of Nangang District of Harbin in China. The aim of this study is to estimate the trend of lung cancer morbidity and mortality in residents of Nangang District from 1992 to 2001 and to predict their levels in the future 5 years.</p><p><b>METHODS</b>Data were collected from the annual statistic reports on cancer death cause from Nangang District in Harbin. The classification of death cause was made according to the ICD-9. Predictions about morbidity and mortality were made by the gray system GM(1,1).</p><p><b>RESULTS</b>During the past 10 years, the morbidity and mortality of lung cancer were placed in uptrend slowly. The average morbidity and mortality of lung cancer were 44.75 per 100000 and 41.37 per 100000 respectively, and lung cancer was the first leading cancer for both episode and death of malignant tumors. The proportions of lung cancer were 25.91% and 33.29% for episode and death in all malignant tumors respectively. A half patients with lung cancer was 20-64 years old. Predictive morbidity and mortality of lung cancer would be 47.79/100000 and 44.81/100000 for men and 45.80/100000 and 42.02/100000 for women respectively.</p><p><b>CONCLUSIONS</b>The morbidity and mortality of lung cancer show a slowly increasing trend. Lung cancer is one of main malignant tumors among people of 20-64 years old. The gradually aging population, environmental pollution and individual unhealthy living habits are the important factors of lung cancer increasing.</p>

Value of clopidogrel in emergency corona interventional therapy for myocardial infarction patients with non-ST segment elevation:report of 112 cases / 第三军医大学学报

Objective To observe the efficiency of clopidogrel combined with emergency corona interventional therapy for non-ST segment elevation myocardial infarction.Methods A total of 112 patients with non-ST segment elevation myocardial infarction who were admitted in our hospital from February 2004 to November 2007 were divided into 2 groups at random with 56 patients in each,the experimental group and the control group.All patients were treated with emergency corona interventional therapy and the other routine standard therapies.The experimental group was treated with clopidogrel(75 mg,once per day for 8 weeks),and the control group administered ticlopidine(250 mg,twice per day for 8 weeks).The two group were followed up for a time of half a year.Results The TIMI(thrombolysis in myocardial infarction) myocardial-perfusion grade 3 angiographic flow was achieved in 91.1% of the experimental group,higher than that of the control group(87.5%),but there was no significant difference between them.What's more,there was no obvious difference between the 2 group in cardiac functional grading and life-threatening bleeding.The experimental group had significantly lesser hyporrhea,and lower platelet degradation and total white blood cells counts in comparison to the control group.After the followed-up of half a year,there was significant difference between them in combination-end point.Conclusion Addition of clopidogrel is effective in emergency corona interventional therapy for non-ST segment elevation myocardial infarction,which can degrade the risk of emergency corona interventional therapy.

Problem and Countermeasure in Executing Technical Support of Medical Equipment in Earthquake Relief Mission / 医疗卫生装备

The actual condition of executing technical security of medical equipment in 5.12 Wenchuan serious earth-quake disaster was summarized, and the occurring problem of emergency technical security of medical equipment are ana-lyzed so as to provide useful reference and countermeasure of affairs.

A case-control study on the relationship among indoor air pollution,depression and oncogenesis of lung cancer / 中国肺癌杂志

<p><b>BACKGROUND</b>To evaluate the relationship among indoor air pollution, depression and oncogenesis of lung cancer.</p><p><b>METHODS</b>An 1:3 matched case-control study was carried out. Conditional logistic regression was applied to process the data.</p><p><b>RESULTS</b>After some confounding factors were adjusted, the ORs increased 122% and 113% for the amount of coal using ≥46kg/m² and heating by coal stove respectively. The ORs elevated more than five-folds for disharmony and rupture of marriage, difference of accommodation and acclimation by oneself and human relationship respectively. The risk of lung caner obviously increased for frequent exposure to indoor cooking smoke combinated with depressed mood or mental scar respectively.</p><p><b>CONCLUSIONS</b>The indoor air pollution, depression and mental scar are important factors of oncogenesis of lung cancer.</p>

TRANSDERMAL DELIVERY OF CYCLOSPORIN A SOLUBILIZED IN MIXED MICELLES THROUGH MICE SKIN / 药学学报

AIM　To investigate the transdermal delivery effects of cyclosporine A solubilized in mixed micelles composed of phospholipid and different surfactants. METHODS　When applied onto the excised abdominal skin of the mice occlusively, the enhancing effects of various mixed micelles on the penetration of cyclosporin A were assessed by an in vitro permeation technique. In vivo study was carried out by topical application of sodium cholate-phospholipid mixed micelles onto the mice skin and drug blood concentration was detected. RESULTS　In vitro, mixed micelles containing different surfactants displayed distinct permeability and corresponded to the following order: sodium cholate > sodium deoxycholate > Trition X-100 > Tween-20. In vivo, peak drug concentration was detected at 5 h and after that the concentration fell down slowly. CONCLUSION　Mixed micelles were shown to be efficient carrier for the transdermal delivery of the lipophilic polypeptide when kept in solution during the application process.

MR-guided needle percutaneous biopsy for the lesions of infratemporal space / 介入放射学杂志

Objective To evaluate the clinical application of MRI guided percutaneous biopsy for the lesions of infratemporal space.Methods An open design 0.2T MRI set was used for MRI guided percutaneous biopsy in seven patients with the masses of infratemporal space. Results Of this series, the accuracy of needle puncture was 100% with diagrostic accuracy of 85.7% and no complications.Conclusions MRI guided percutaneous biopsy is helpful in the diagnosis for the lesions of infratemproal space.

Clinical significance of subclavian artery angiography in arterial embolization for hemoptysis / 介入放射学杂志

Objective To study the subclavian artery angiography for hemoptysis and its clinical value.Methods Thirty-eight cases of hemoptysis undertook subclavian artery angiography after embolization of bronchial arteries and branches of thoracic aorta. Group A: 4 recurrent cases underwent subclavian artery angiography (unilateral: n =2, bilateral: n =2). Group B: 16 cases underwent subclavian artery angiography according to the manifestation on X-ray and CT (right: n =10, left: n =6). Group C: 18 cases underwent bilateral subclavian artery angiography.Results of subclavian artery angiography were divided into three classes: normal(-),chaotic and hyperplasia of small branchi vessels(+),obviously bleeding (++).Some of the obviously bleeding cases were embolized and analysed for clinical efficacy and complications. Results Bleeding cases accounted for 63.2%(24/38)and bleeding subclavian arteries accounted for 50%(29/58), including(++):37.9%(22/58) and(+): 12.1%(7/58). Positive rate of chronic fibro-cavitary pulmonary tuberculosis was the highest. Bleeding sites were coincided with lung lesions. Twelve cases were embolized with the immediate cessation rate of hemoptysis reaching 100%. Eight cases with long-term follow-up showed 5 cured, 1 with significant effect and 2 recurrent. The complications occurred with fever, vomiting, chest pain, hiccup and dyspnoea.Conclusions Subclavian artery angiography has important clinical value in artery embolization for hemoptysis, especially for lesions in the upper lobes of lungs and with more fruitful result for chronic fibro-cavitary pulmonary tuberculosis.