Risk assessment of malignancy in solitary pulmonary nodules in lung computed tomography: a multivariable predictive model study / 中华医学杂志(英文版)

BACKGROUND@#Computed tomography images are easy to misjudge because of their complexity, especially images of solitary pulmonary nodules, of which diagnosis as benign or malignant is extremely important in lung cancer treatment. Therefore, there is an urgent need for a more effective strategy in lung cancer diagnosis. In our study, we aimed to externally validate and revise the Mayo model, and a new model was established.@*METHODS@#A total of 1450 patients from three centers with solitary pulmonary nodules who underwent surgery were included in the study and were divided into training, internal validation, and external validation sets (n = 849, 365, and 236, respectively). External verification and recalibration of the Mayo model and establishment of new logistic regression model were performed on the training set. Overall performance of each model was evaluated using area under receiver operating characteristic curve (AUC). Finally, the model validation was completed on the validation data set.@*RESULTS@#The AUC of the Mayo model on the training set was 0.653 (95% confidence interval [CI]: 0.613-0.694). After re-estimation of the coefficients of all covariates included in the original Mayo model, the revised Mayo model achieved an AUC of 0.671 (95% CI: 0.635-0.706). We then developed a new model that achieved a higher AUC of 0.891 (95% CI: 0.865-0.917). It had an AUC of 0.888 (95% CI: 0.842-0.934) on the internal validation set, which was significantly higher than that of the revised Mayo model (AUC: 0.577, 95% CI: 0.509-0.646) and the Mayo model (AUC: 0.609, 95% CI, 0.544-0.675) (P < 0.001). The AUC of the new model was 0.876 (95% CI: 0.831-0.920) on the external verification set, which was higher than the corresponding value of the Mayo model (AUC: 0.705, 95% CI: 0.639-0.772) and revised Mayo model (AUC: 0.706, 95% CI: 0.640-0.772) (P < 0.001). Then the prediction model was presented as a nomogram, which is easier to generalize.@*CONCLUSIONS@#After external verification and recalibration of the Mayo model, the results show that they are not suitable for the prediction of malignant pulmonary nodules in the Chinese population. Therefore, a new model was established by a backward stepwise process. The new model was constructed to rapidly discriminate benign from malignant pulmonary nodules, which could achieve accurate diagnosis of potential patients with lung cancer.

Preparation and evaluation of the rat model of chronic nonbacterial prostatitis induced by carrageenan / 中国实验动物学报

Objective To establish an animal model of chronic nonbacterial prostatitis induced by chemical sub-stances, and provide a reliable animal model and evaluation method for pathological mechanism and pharmaceutical re-search of chronic nonbacterial prostatitis. Methods SD male rats were randomly divided into control group and model groups A, B and C. The three model groups were respectively treated with 20, 50 and 100 μL of 1% sterile carrageenan, injected into the left and right ventral lobes of rat prostate. The control group was injected 50μL sterile normal saline. The rats were sacrificed at 7 days after carrageenan injection, and the anatomical changes were analyzed, and the prostate in-dex, leukocyte count, the histology of prostate, and the protein expressions of TNF-α, NF-κB, IKKα, p-IKB-α and COX-2 were analyzed. Results Compared with the sham operation group, the softness of prostate tissue of groups A, B and C was decreased, the elasticity of the prostatic tissue was weakened, and the prostate tissues of model groups were ad-hered to surrounding tissues. The total number of leukocytes and the prostate index of model groups A, B and C were signif-icantly increased (P<0. 01), by 21. 1%, 61. 7% and 72. 7%, respectively. The total increase rate of white blood cell in the model groups A, B and C was 75%, 103. 6% and 114. 8%, respectively. Pathological examination showed that the in-terstitial edema of the prostate of model group A was minimal, but obvious in the groups B and C. Moreover, in the group C, the prostate atrophy was obvious, and some of the glands were degenerated and necrotic. The protein expression levels of NF-κB, IKKα, p-IKB-α, TNF-α, and COX-2 in the prostate tissue were increased to a different extent in all model groups. Conclusions Inflammatory reactions can be induced by injecting 20, 50 or 100 μL of 1% sterile carrag-eenan into the right and left ventral lobes of the rat prostate. However, the 20μL dose is too small, inducing only weak in-flammatory response, with considerable operation error, while the dose of 100μL induced excessive inflammatory response, even rat death. The dose of of 50 μL injection is most suitable to establish rat models of nonbacterial prostatitis, showing apparent activation of NF-κB inflammatory signaling pathway.

Preparation and evaluation of the rat model of chronic nonbacterial prostatitis induced by carrageenan / 中国实验动物学报

Objective To establish an animal model of chronic nonbacterial prostatitis induced by chemical sub-stances, and provide a reliable animal model and evaluation method for pathological mechanism and pharmaceutical re-search of chronic nonbacterial prostatitis. Methods SD male rats were randomly divided into control group and model groups A, B and C. The three model groups were respectively treated with 20, 50 and 100 μL of 1% sterile carrageenan, injected into the left and right ventral lobes of rat prostate. The control group was injected 50μL sterile normal saline. The rats were sacrificed at 7 days after carrageenan injection, and the anatomical changes were analyzed, and the prostate in-dex, leukocyte count, the histology of prostate, and the protein expressions of TNF-α, NF-κB, IKKα, p-IKB-α and COX-2 were analyzed. Results Compared with the sham operation group, the softness of prostate tissue of groups A, B and C was decreased, the elasticity of the prostatic tissue was weakened, and the prostate tissues of model groups were ad-hered to surrounding tissues. The total number of leukocytes and the prostate index of model groups A, B and C were signif-icantly increased (P<0. 01), by 21. 1%, 61. 7% and 72. 7%, respectively. The total increase rate of white blood cell in the model groups A, B and C was 75%, 103. 6% and 114. 8%, respectively. Pathological examination showed that the in-terstitial edema of the prostate of model group A was minimal, but obvious in the groups B and C. Moreover, in the group C, the prostate atrophy was obvious, and some of the glands were degenerated and necrotic. The protein expression levels of NF-κB, IKKα, p-IKB-α, TNF-α, and COX-2 in the prostate tissue were increased to a different extent in all model groups. Conclusions Inflammatory reactions can be induced by injecting 20, 50 or 100 μL of 1% sterile carrag-eenan into the right and left ventral lobes of the rat prostate. However, the 20μL dose is too small, inducing only weak in-flammatory response, with considerable operation error, while the dose of 100μL induced excessive inflammatory response, even rat death. The dose of of 50 μL injection is most suitable to establish rat models of nonbacterial prostatitis, showing apparent activation of NF-κB inflammatory signaling pathway.

Clinical Profiles and Short-Term Outcomes of Acute Disseminated Encephalomyelitis in Adult Chinese Patients

BACKGROUND AND PURPOSE: Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disorder that predominantly affects children. Previous studies have mostly involved children in Western developed countries. METHODS: This study retrospectively reviewed the clinical profiles of ADEM in adult Chinese patients. RESULTS: ADEM occurred during summer and autumn in about two-thirds of the 42 included patients. Prior infection was found in five patients and no preimmunization was recorded. The most frequent clinical presentations were alterations in consciousness (79%) and behavior changes (69%), followed by motor deficits (64%) and fever (50%). About one-quarter (26%) of the patients showed positive results for oligoclonal bands, and about half of them exhibited increases in the IgG index and 24-hour IgG synthesis rate. Magnetic resonance imaging showed white- and gray-matter lesions in 83% and 23% of the patients, respectively. Steroids were the main treatment, and full recovery occurred in 62% of the patients, with residual focal neurological deficits recorded in a few patients. After a mean follow-up period of 3.4 years, two patients exhibited recurrence and one patient exhibited a multiphasic course. One patient was diagnosed with multiple sclerosis (MS). CONCLUSIONS: With the exception of the seasonal distribution pattern and prior vaccine rate, the clinical profiles of ADEM in adult Chinese patients are similar to those in pediatric populations. No specific markers are available for distinguishing ADEM from MS at the initial presentation. Careful clinical evaluations, cerebrospinal fluid measurements, and neuroradiological examinations with long-term follow-up will aid the correct diagnosis of ADEM.

Clinical Profiles and Short-Term Outcomes of Acute Disseminated Encephalomyelitis in Adult Chinese Patients

BACKGROUND AND PURPOSE: Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disorder that predominantly affects children. Previous studies have mostly involved children in Western developed countries. METHODS: This study retrospectively reviewed the clinical profiles of ADEM in adult Chinese patients. RESULTS: ADEM occurred during summer and autumn in about two-thirds of the 42 included patients. Prior infection was found in five patients and no preimmunization was recorded. The most frequent clinical presentations were alterations in consciousness (79%) and behavior changes (69%), followed by motor deficits (64%) and fever (50%). About one-quarter (26%) of the patients showed positive results for oligoclonal bands, and about half of them exhibited increases in the IgG index and 24-hour IgG synthesis rate. Magnetic resonance imaging showed white- and gray-matter lesions in 83% and 23% of the patients, respectively. Steroids were the main treatment, and full recovery occurred in 62% of the patients, with residual focal neurological deficits recorded in a few patients. After a mean follow-up period of 3.4 years, two patients exhibited recurrence and one patient exhibited a multiphasic course. One patient was diagnosed with multiple sclerosis (MS). CONCLUSIONS: With the exception of the seasonal distribution pattern and prior vaccine rate, the clinical profiles of ADEM in adult Chinese patients are similar to those in pediatric populations. No specific markers are available for distinguishing ADEM from MS at the initial presentation. Careful clinical evaluations, cerebrospinal fluid measurements, and neuroradiological examinations with long-term follow-up will aid the correct diagnosis of ADEM.

Oxygen glucose deprivation post-conditioning protects cortical neurons against oxygen-glucose deprivation injury: Role of HSP70 and inhibition of apoptosis / 华中科技大学学报（医学）（英德文版）

In the present study, we examined the effect of oxygen glucose deprivation (OGD) post-conditioning (PostC) on neural cell apoptosis in OGD-PostC model and the protective effect on primary cortical neurons against OGD injury in vitro. Four-h OGD was induced by OGD by using a specialized and humidified chamber. To initiate OGD, culture medium was replaced with de-oxygenated and glucose-free extracellular solution-Locke's medium. After OGD treatment for 4 h, cells were then allowed to recover for 6 h or 20 h. Then lactate dehydrogenase (LDH) release assay, Western blotting and flow cytometry were used to detect cell death, protein levels and apoptotic cells, respectively. For the PostC treatment, three cycles of 15-min OGD, followed by 15 min normal cultivation, were applied immediately after injurious 4-h OGD. Cells were then allowed to recover for 6 h or 20 h, and cell death was assessed by LDH release assay. Apoptotic cells were flow cytometrically evaluated after 4-h OGD, followed by re-oxygenation for 20 h (O4/R20). In addition, Western blotting was used to examine the expression of heat-shock protein 70 (HSP70), Bcl-2 and Bax. The ratio of Bcl-2 expression was (0.44±0.08)% and (0.76±0.10)%, and that of Bax expression was (0.51±0.05)% and (0.39±0.04)%, and that of HSP70 was (0.42±0.031)% and (0.72±0.045)% respectively in OGD group and PostC group. After O4/R6, the rate of neuron death in PostC group and OGD groups was (28.96±3.03)% and (37.02±4.47)%, respectively. Therefore, the PostC treatment could up-regulate the expression of HSP70 and Bcl-2, but down-regulate Bax expression. As compared with OGD group, OGD-induced neuron death and apoptosis were significantly decreased in PostC group (P<0.05). These findings suggest that PostC inhibited OGD-induced neuron death. This neuro-protective effect is likely achieved by anti-apoptotic mechanisms and is associated with over-expression of HSP70.

Oxygen glucose deprivation post-conditioning protects cortical neurons against oxygen-glucose deprivation injury: role of HSP70 and inhibition of apoptosis / 华中科技大学学报（医学）（英德文版）

In the present study, we examined the effect of oxygen glucose deprivation (OGD) post-conditioning (PostC) on neural cell apoptosis in OGD-PostC model and the protective effect on primary cortical neurons against OGD injury in vitro. Four-h OGD was induced by OGD by using a specialized and humidified chamber. To initiate OGD, culture medium was replaced with de-oxygenated and glucose-free extracellular solution-Locke's medium. After OGD treatment for 4 h, cells were then allowed to recover for 6 h or 20 h. Then lactate dehydrogenase (LDH) release assay, Western blotting and flow cytometry were used to detect cell death, protein levels and apoptotic cells, respectively. For the PostC treatment, three cycles of 15-min OGD, followed by 15 min normal cultivation, were applied immediately after injurious 4-h OGD. Cells were then allowed to recover for 6 h or 20 h, and cell death was assessed by LDH release assay. Apoptotic cells were flow cytometrically evaluated after 4-h OGD, followed by re-oxygenation for 20 h (O4/R20). In addition, Western blotting was used to examine the expression of heat-shock protein 70 (HSP70), Bcl-2 and Bax. The ratio of Bcl-2 expression was (0.44±0.08)% and (0.76±0.10)%, and that of Bax expression was (0.51±0.05)% and (0.39±0.04)%, and that of HSP70 was (0.42±0.031)% and (0.72±0.045)% respectively in OGD group and PostC group. After O4/R6, the rate of neuron death in PostC group and OGD groups was (28.96±3.03)% and (37.02±4.47)%, respectively. Therefore, the PostC treatment could up-regulate the expression of HSP70 and Bcl-2, but down-regulate Bax expression. As compared with OGD group, OGD-induced neuron death and apoptosis were significantly decreased in PostC group (P<0.05). These findings suggest that PostC inhibited OGD-induced neuron death. This neuro-protective effect is likely achieved by anti-apoptotic mechanisms and is associated with over-expression of HSP70.

Initial study of magnetic resonance diffusion tensor imaging in brain white matter of early AIDS patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>HIV is a neurotropic virus which can cause brain white matter demyelination, gliosis, and other pathological changes that appear as HIV encephalitis or AIDS dementia. The purpose of this study was to investigate the change of the diffused condition of water molecules in brain white matter in early acquired immune deficiency syndrome (AIDS) patients using MR diffusion tensor imaging (DTI).</p><p><b>METHODS</b>DTI examinations were performed on a Siemens 3.0T MR scanner in 23 AIDS patients with normal brain appearance by conventional MRI and 20 healthy volunteers as the control group. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were measured in nine regions; corpus callosum (CC) knee, CC body, CC splenium, periventricular white matter, frontal lobe white matter, parietal lobe white matter, occipital lobe white matter, and the anterior and posterior limbs of the internal capsule. The mean FA and ADC values from each region were compared in three groups: the symptomatic, asymptomatic and the control.</p><p><b>RESULTS</b>The mean FA values were significantly lower and the mean ADC values were significantly higher in all nine regions in patients in the symptomatic group than in the asymptomatic and control group patients. In the asymptomatic group, the mean FA values were significantly lower and the mean ADC values were significantly higher at the CC knee, CC body, CC splenium, periventricular white matter, frontal lobe white matter and parietal lobe white matter, than in the control group. There were no significant differences at other regions between the two groups.</p><p><b>CONCLUSIONS</b>The diffused changes of water molecules in brain white matter in AIDS patients are related to brain white matter regions. DTI examination can detect the brain white matter lesions early in AIDS patients.</p>

The verification of a new DNA double-detection diagnostic kit for identifying novel influenza A (H1N1) / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To verify a new kit of "universal and novel influenza A (H1N1) virus nucleic acid double-detection methods (PCR-fluorescence probe)".</p><p><b>METHODS</b>150 cases of throat swab specimens were collected consecutively. After RNA was extracted, the specimens were detected by the verified kit. At the same time, the same specimens were detected by Real-time PCR diagnostic kit from Beijing CDC as the control. The data were analysed by the Kappa in agreement and by McNemar chi2 in difference test.</p><p><b>RESULTS</b>The consistency rate of the verified kit and the Beijing CDC kit was universal primer M 97.33%, H1N1 98.67% respectively. The Kappa test and McNemar chi2 test showed that two methods had a higher consistency. Compared to the CDC kit, the "false negative rate" and "false-positive rate"of double-check kit were lower.</p><p><b>CONCLUSION</b>The kit of "universal and novel influenza A (H1N1) virus nucleic acid double-detection methods (PCR-fluorescence probe)" from Shanghai Kehua Bio-Engineering Co., Ltd can be used to detect influenza A and novel influenza A (H1N1).</p>

The early diagnosis value of EV 71 IgM class antibodies in the hand, foot and mouth disease / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>Assessment of detection of IgM antibodies for human enterovirus 71 (EV 71) in early diagnosis for the hand, foot and mouth disease (HFMD).</p><p><b>METHOD</b>The sera and throat swabs from 38 patients which were clinical diagnosis as HFMD, were continuous daily collected in our hospital in 2010. These specimens were detected by EV 71 IgM antibodies assay, real time RT-PCR methods for EV 71 and Enterovirus.</p><p><b>RESULTS</b>Among 38 HFMD patients, the cumulative positive rates of EV 71 IgM antibodies were: 60.5% on day 1, 71.1% on day 2, 81.5% in the first 3-4 days, 92.1% on day 5, 92.1% on day 6, and the positive rate of nucleic acid detected by the real time RT-PCR for EV 71 and Enterovirus were 60.5%, 73.6%.</p><p><b>CONCLUSION</b>The positive rate of EV 71 IgM antibodies in the hand, foot and mouth disease just can occur on day 1, and reach to peak on day 5, which can be used as one of indicators of early diagnosis of hand, foot and mouth disease.</p>

Clinical and laboratory characteristics of a new influenza A (HIN1) epidemic / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To analysis the clinical and laboratory characteristics of Patients infected with new influenza A (HIN1) virus.</p><p><b>METHODS</b>All cases with new influenza A (H1N1) confirmed on polymerase chain reaction assay on throat swabs. There were included in a prospective evaluation of clinical characteristics, laboratory results, treatment and overcome of new influenza A (H1N1).</p><p><b>RESULTS</b>There were 35 patients in the epidemic. Clinical illness developed within a mean of 1.7 days. Fever occurred in 97.1%, sore throat 65.7% cough 51.4%, headache 28.6%, and myalgia 31.4%. All patients were treated with oseltamivir lasted 5 days. The mean duration of viral shedding was 4.5 days. All were cured and left hospital after day 7.</p><p><b>CONCLUSION</b>It was infected by new influenza A (H1N1) typically in this epidemic.</p>

Evaluation of the ELISA and the enhanced chemiluminescence immunoassay in use to determine the serum markers for liver fibrosis / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To evaluate the detection method of ELISA and Enhanced Chemiluminescence Immunoassay (ECLIA) in use to determine serum hyaluronate acid (HA), laminin (LN), type IV collagen (IV-C) and type III procollagen (PC III).</p><p><b>METHODS</b>253 patients with chronic hepatitis B were determined the four liver fibrosis serum markers with both the ECLIA and ELISA, and then compared with pathology results separately.</p><p><b>RESULTS</b>Both the detection results of ELISA and ECLIA can reflect that the patient's liver fibrosis from hepatitis to liver cirrhosis aggravated gradually. Compared with ELISA, the results of ECLIA and pathology have a better correlation.</p><p><b>CONCLUSIONS</b>The detection of four liver fibrosis serum markers by ECLIA could indicate the better the response of the state of live fibrosis.</p>

Effects of bone marrow mesenchymal stem cells transplantation on heart function and ventricular remodeling in rats with isoproterenol-induced congestive heart failure / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the effects of transplanted BMSCs (bone marrow mesenchymal stem cells) on cardiac function and ventricular remodeling in rats with isoproterenol (ISO) induced heart failure.</p><p><b>METHODS</b>Wistar rats (n=50) received ISO (170 mg x kg(-1) x d(-1) for 4 days) injection. Four weeks later, rats with left ventricular ejection fraction (LVEF < 70%, n=26) were randomly assigned to receive intramyocardially BMSCs (2 x 10(7)/ml, 150 microl) injection (n=13) or equal volume culture medium (n=13). Another 10 normal rats served as normal controls. Four weeks after transplantation, heart function was assessed again by echocardiography, left ventricular morphology was evaluated through H&E and Masson's trichome staining. Transplanted cells were observed by fluorescent microscope. RT-PCR and Western blot were performed to examine the myocardial expressions of type I and type III collagens, as well as MMP-2 and MMP-9.</p><p><b>RESULTS</b>LVEF [(78.51 +/- 6. 78)% vs. (65.40 +/- 12. 33)%] and LVFS [fractional shortening, (42.09 +/- 6. 53)% vs. (32.38 +/- 10. 22)%, all P < 0. 05] were significantly increased and LVDs [left ventricular systolic diameter, (2.91 +/- 0. 54) mm vs. (3.83 +/- 0.69) mm, P < 0.05] was significant decreased in BMSCs treated rats compared with culture medium treated rats. Myocardial fibrosis was also significantly attenuated in BMSCs rats than that in culture medium treated rats. The myocardial expressions of type I and type III collagens, as well as MMP-2 and MMP-9 were significantly decreased in the BMSCs group compared with those in culture medium treated group.</p><p><b>CONCLUSIONS</b>BMSCs transplantation can significantly improve heart function and attenuate LV remodeling in rats with ISO-induced heart failure mediated by reducing myocardial fibrosis and downregulation of myocardial MMP-2 and MMP-9 expressions.</p>

The studies on early warning of Lens culinaris-reactive alpha-Fetoprotein (AFP-L3) detecting in primary hepatocellular carcinoma / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To explore the significance of Lens culinaris-reactive alpha-Fetoprotein (AFP-L3) detection in primary hepatocellular carcinoma.</p><p><b>METHODS</b>AFP-L3 was isolated by using microspin column coupled with lens culinaris agglutinin (LCA), AFP and AFP-L3 were detected with chemiluminescent immunoassay, the proportion of AFP L3 levels were calculated, and the relationship between the elevated AFP-L3 (%) levels and benign and malignant liver disease was analyzed.</p><p><b>RESULTS</b>There were significant differences in positive rate between the patients of HCC, suspected HCC and other liver disease (81.80%, 73.68%, 11.80%, respectively, P < 0.05). Among the undetermined HCC (suspected HCC, liver disease) patients, 12 out of 21 cases of AFP-13 positive were diagnosed to be HCC within 6 months, and 6 of them were diagnosed to be the single small HCC at the early stage through B-Ultrasonic Diagnosis or CT. Among 62 cases of AFP-L3 negative, 3 cases were diagnosed to be HCC within 6 months and the risk of occurrence of HCC for AFP-L3 positive increased 11.9 times.</p><p><b>CONCLUSION</b>AFP-L3 has no correlation with AFP value, and it can be used as an independent HCC diagnosis factor. The detection of AFP-L3 has a significant implication for the identification of benign or malignant liver disease and the early stage predictive diagnosis of HCC while AFP increases.</p>