MRI-based neck imaging reporting and data systems in diagnosis of extracavity local recurrent nasopharyngeal carcinoma and posttreatment changes / 中华放射学杂志

Objective:To evaluate the diagnostic value of neck imaging reporting and data systems (NI-RADS) based on MRI in extracavity local recurrent nasopharyngeal carcinoma (ELRNPC) and posttreatment changes (PTC).Methods:From April 2015 to September 2020, 33 cases of ELRNPC and 37 cases of PTC confirmed by pathology or follow-up were retrospectively enrolled at Zhongshan City People′s Hospital. Two radiologists independently evaluated the conventional MRI findings using NI-RADS criteria in the first step, then evaluated with conventional MRI and diffusion weighted imaging (DWI) sequences in the second step. All images were re-evaluated by one senior radiologist in the same steps after three months. Inter- and intra-reader agreements were assessed with Cohen′s Kappa test. Receiver operating characteristic curves were generated to assess the diagnostic values of NI-RADS categories between ELRNPC and PTC. The area under the curve (AUC) was compared by Delong test.Results:Inter- and intra-reader agreements of Kappa value were 0.742 and 0.909 for conventional MRI and 0.807 and 0.934 for conventional MRI with DWI. In the differential diagnosis of ELRNPC and PTC, the AUC, sensitivity, and specificity of NI-RADS categories based on conventional MRI were 0.932 (95%CI 0.846-0.978), 87.9% (95%CI 71.8%-96.6%), 94.6% (95%CI 81.8%-99.3%), and of NI-RADS based on conventional MRI with DWI were 0.991 (95%CI 0.933-1.000), 93.9% (95%CI 79.8%-99.3%), 97.3% (95%CI 85.8%-99.9%), respectively. There was a statistical difference between the AUCs of the two categories ( Z=2.20, P=0.028). Conclusions:For both the NI-RADS based on MRI with or without DWI, the differential diagnostic value of ELRNPC and PTC is excellent, while the consistency and diagnostic performance are more substantial when combined with DWI.

Effects of pre-injection of pressors on pressor response and bispectral index of patients receiving lower abdominal surgery under total intravenous anesthesia

Surgery in the lower abdomen can cause many adverse reactions in nervous system, metabolic and endocrine systems. Conventional intravenous anesthesia applied for lower abdominal surgery can cause the drop in blood pressure leading to hypoperfusion of vital organs. Hence, an ideal anesthesia state is required to make patients unconscious, unaware and have no postoperative memory during anesthesia. In this study, we investigated the effects of pre-injection of different pressors on the pressor response and bispectral index (BIS) of patients receiving lower abdominal surgery under total intravenous anesthesia. For this, 300 patients undergoing lower abdominal surgery under total intravenous anesthesia were divided into normal saline (Gr. A), ephedrine (Gr. B) and phenylephrine groups (Gr. C) (n=100). Hemodynamics indices were recorded before anesthesia induction (T0) and 1, 3, 5, 7 and 9 min after drug injection (T1-T5, respectively). We observed the following reactions and recorded. BIS values at T0-T5 as well as the time points when the values rose to 65, 75, 85 and 95 and those for respiratory recovery, consciousness recovery and extubation after stopping target-controlled infusion were recorded. Compared with Gr. A, Gr. B had significantly higher systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR) and cardiac output (CO) at T1-T5 (P <0.05), and Gr. C had higher SBP, DBP, MAP and lower HR (P <0.05). Adverse reactions viz., intraoperative hypotension, hypertension, postoperative bradycardia, tachycardia, nausea and vomiting were also observed. The incidence rates of hypotension and total adverse reactions in groups B and C were significantly lower than those of Gr. A (P <0.05). Group B had significantly higher BIS values at T1-T5 than those of Gr. A (P <0.05). The time when BIS values recovered to 65 and 75 in group B was significantly shorter than that of Gr. A (P <0.05). Pre-injection of ephedrine and phenylephrine to patients undergoing lower abdominal surgery under total intravenous anesthesia elevated the blood pressure and reduced the incidence rate of adverse reactions without affecting the recovery time.

Tumor volume of resectable gastric adenocarcinoma on multidetector computed tomography: association with N categories

OBJECTIVE: To determine whether the gross tumor volume of resectable gastric adenocarcinoma on multidetector computed tomography could predict the presence of regional lymph node metastasis and could determine N categories. MATERIALS AND METHODS: A total of 202 consecutive patients with gastric adenocarcinoma who had undergone gastrectomy 1 week after contrast-enhanced multidetector computed tomography were retrospectively identified. The gross tumor volume was evaluated on multidetector computed tomography images. Univariate and multivariate analyses were performed to determine whether the gross tumor volume could predict regional lymph node metastasis, and the Mann-Whitney U test was performed to compare the gross tumor volume among N categories. Additionally, a receiver operating characteristic analysis was performed to identify the accuracy of the gross tumor volume in differentiating N categories. RESULTS: The gross tumor volume could predict regional lymph node metastasis (p<0.0001) in the univariate analysis, and the multivariate analyses indicated that the gross tumor volume was an independent risk factor for regional lymph node metastasis (p=0.005, odds ratio=1.364). The Mann-Whitney U test showed that the gross tumor volume could distinguish N0 from the N1-N3 categories, N0-N1 from N2-N3, and N0-N2 from N3 (all p<0.0001). In the T1-T4a categories, the gross tumor volume could differentiate N0 from the N1-N3 categories (cutoff, 12.3 cm3), N0-N1 from N2-N3 (cutoff, 16.6 cm3), and N0-N2 from N3 (cutoff, 24.6 cm3). In the T4a category, the gross tumor volume could differentiate N0 from the N1-N3 categories (cutoff, 15.8 cm3), N0-N1 from N2-N3 (cutoff, 17.8 cm3), and N0-N2 from N3 (cutoff, 24 cm3). CONCLUSION: The gross tumor volume of resectable gastric adenocarcinoma on multidetector computed tomography could predict regional lymph node metastasis and N categories.

Comparison of the efficacy of IMRT and conventional radiation therapy combined with chemotherapy in ad-vanced nasopharyngeal carcinoma / 局解手术学杂志

Objective To observe the curative effect and adverse reactions of IMRT and conventional radiotherapy combined with chem-otherapy in treating patients with advanced nasopharyngeal carcinoma. Methods The patients were divided into the IMRT group (46 cases) and conventional radiotherapy combined with chemotherapy group ( 50 cases ) . Making the IMRT and conventional radiotherapy combined with chemotherapy treatment plan, and analyze the curative effect and adverse reaction of the two groups. Results Compared with the con-ventional radiotherapy combined with chemotherapy group, IMRT group has a significantly increase in complete remission rate and overall re-sponse rate, but there is no significant difference in long-term efficacy. The skin, dry mouth ( parotid) ,and oral mucositis response is lower in IMRT group, and the neutropenia incidence, prevalence of anemia, liver and kidney function damage rate is also significantly lower than conventional radiotherapy combined with chemotherapy. Conclusion The IMRT can significantly improve the curative effect in treatment of advanced nasopharyngeal carcinoma and reduce the adverse reactions compared with the conventional radiotherapy combined with chemotherapy.

Prognostic significance of the 2004 WHO classification compared with the 1973 WHO classification for organ-confined invasive bladder cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To compare the 2004 and 1973 WHO classifications for predicting tumor recurrence for organ-confined (T stage ≤ pT2b) invasive urothelial carcinoma of the bladder treated with radical cystectomy.</p><p><b>METHODS</b>From February 2000 to August 2011, the 173 consecutive cases of organ-confined invasive urothelial carcinoma of the bladder were treated with radical cystectomy. The data of clinical and follow-up information was collected. The Kaplan-Meier plots with Log-rank test were used to estimate recurrence-free survival (RFS). Univariate and multivariate analysis using the Cox proportional hazard regression model were performed to evaluate the impact of any clinicopathological prognostic factors (tumor grade, tumor stage, lymph node status, lymphovascular invasion, preoperative hydronephrosis, and non-pure urothelial carcinoma) on RFS.</p><p><b>RESULTS</b>The 5-year RFS was 84.7% for the entire cohort. Univariate and multivariate analysis demonstrated that when using the 2004 WHO classification, lymph node status (RR = 4.573, 95% CI: 1.469-14.237), tumor grade (RR = 9.993, 95% CI: 1.325-75.390) and preoperative hydronephrosis (RR = 3.207, 95% CI: 1.209-8.508) presented independent predictors for RFS; while using the 1973 WHO system, lymph node status (RR = 9.484, 95% CI: 3.450-26.074) and lymphovascular invasion (RR = 3.009, 95% CI: 1.062-8.526) were independent predictors.</p><p><b>CONCLUSIONS</b>The 2004 WHO classification, as an independent factor, is superior to the 1973 classification for predicting RFS in patients with organ-confined invasive bladder cancer treated with radical cystectomy. However, a further perspective study is needed to validate its role in prognosis.</p>

Protective effect of brain-derived neurotrophic factor for rat hippocampal neurons cultured with high glucose concentrations / 中国医师杂志

Objective To investigate the effect of brain-derived neurotrophic factor on protection of rat hippocampal neurons after cultured with high glucose concentrations.Methods Hippocampal neurons of neonatal SD rat were cultured in serum-free medium and divided into normal group,high glucose group and high glucose BDNF group.The morphological changes of the neurons were observed under inverted fluorescence microscope.Immunofluorescence stain for Map2 was performed to identify the purity of neurons.The survival of the neuron were tested by PI/Hoechest33342 staining.Results Compared with the normal group [survival rate (96.11 ± 1.63) ％],the number of PI positive neurons were significantly increased in the high glucose group [survival rate (76.29 ± 6.74) ％].Treatment with BDNF [survival rate (93.47 ±2.43) ％] significantly reduced the number of PI positive cells.Conclusion BDNF can protect rat hippocampal neurons from apoptosis induced by high glucose.

Diagnostic and application value of 64-slice spiral CT scanning in preoperative staging of esophageal cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the diagnostic and application value of pre-operative 64-slice spiral CT evaluation in operation selection for esophagus cancer.</p><p><b>METHODS</b>Multi-slice computed tomography (MSCT) was conducted in 50 patients with esophageal cancer before operation, using the work station for after-treatment to get CT virtual endoscopy (CTVE), multiplanar reconstruction (MRP), shaded surface display (SSD) and Raysum images, and combined with the transect images to record the preoperative MSCT staging and to predict the operation scheme, and compared with the postoperative pathological staging and the actual operational plan.</p><p><b>RESULTS</b>The diagnostic sensitivity of MSCT for preoperative T staging was 100.0% (50/50), while the N staging was 80.0% (16/20). According to the MSCT prediction, the resection rate of esophageal cancer was 96.0% (48/50). Through the preoperative MSCT evaluation, the accuracy of CT-TNM stage was 90.0%, highly consistent with the pathological TNM stage (Kappa = 0.811, P < 0.05).</p><p><b>CONCLUSIONS</b>MSCT can effectively display the shape, size and position of the tumor, determine the tumor invasion range, lymph node metastasis and distant metastasis, etc., make preoperative evaluation for esophagus cancer patients and provide evidence for clinicians to predict the operation scheme for esophagus cancer.</p>

An analysis of the characteristics and etiology of hand, foot and mouth disease in a Guangzhou sentinel hospital from May to December, 2008 / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze the characteristics and etiology of hand, foot and mouth disease (HFMD) in a sentinel hospital of Guangzhou.</p><p><b>METHODS</b>The epidemiological data and clinical specimens were collected from May to December, 2008 for virological investigations (viral isolation, RT-PCR and molecular identification) and phylogenetic analysis.</p><p><b>RESULTS</b>A total of 309 clinical cases were reported, and the incidence was the highest in 2-4-year-old children, among whom only 15 developed complications, with human enterovirus 71 (HEV71) as the main pathogen (64.7%). Phylogenetic analysis indicated that ten Guangzhou EV71 isolates belonged to Cluster C4a.</p><p><b>CONCLUSION</b>HFMD is an important infectious disease in children resulting from infections by HEV71 as the main pathogen in 2008, and the Guangzhou C4a strains co-evolved with the isolates from other provinces in China and the neighboring countries.</p>

Construction of pNTAP-MK2 eukaryotic expression plasmid and establishment of a cell line for its stable expression / 南方医科大学学报

<p><b>OBJECTIVE</b>To construct pNTAP-MK2 eukaryotic expression plasmid and establish a HEK293 cell line stably expressing tandem affinity purification (TAP)-tagged MK2.</p><p><b>METHODS</b>The MK2-encoding region was subcloned into the vector pNTAP to construct the recombinant plasmid pNTAP-MK2, which was subsequently transformed into DH5 alpha.E.coli. After identification by PCR, digestion with restriction endonuclease and sequencing, the recombinant expression plasmid was transfected into HEK293 cells via liposome, and the cell line with stable expression of exogenous TAP tag-MK2 gene was selected by antibiotic G418. The expression and localization of the fusion protein TAP tag-MK2 were detected by Western blotting and immunofluorescence assay.</p><p><b>RESULTS</b>The results of PCR, restriction endonuclease digestion and sequencing all confirmed the correct construction of the recombinant eukaryotic expression plasmid pNTAP-MK2. Western blotting showed that the recombinant plasmid was expressed stably in HEK293 cells after transfection with G418 selection. Immunofluorescence assay identified the expression product TAP tag-MK2 mainly in the cell nuclei.</p><p><b>CONCLUSION</b>The eukaryotic expression vector pNTAP-MK2 has been successfully constructed, and in the established cell line with stable expression of TAP tag-MK2, TAP tag does not influence the localization of exogenous MK2.</p>

Application of fluorescence in situ hybridization to prenatal diagnosis of aneuploidy in 110 uncultured amniotic fluid samples / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To optimize the prenatal diagnosis platform by using domestically made fluorescence in situ hybridization(FISH) kit and to explore the clinical application of FISH to rapid prenatal diagnosis of a wide range of chromosomal abnormalities.</p><p><b>METHODS</b>Amniotic fluid samples from 110 pregnant women were studied with the rapid prenatal diagnosis method of FISH and the conventional cell culture method of karyotyping, the results from both methods were compared.</p><p><b>RESULTS</b>Four cases of trisomy 21, 1 case of trisomy 18, 58 cases of 46, XX, and 47 cases of 46, XY were detected by FISH in the 110 amniotic fluid samples. It is concordant with the results from conventional karyotype analysis. The concordance rate is 100%.</p><p><b>CONCLUSION</b>Domestically made FISH kit can be used to rapidly and accurately detect the most common chromosome aneuploidies by using less sample volume while the price is relatively low. FISH can be a reliable and rapid prenatal diagnostic tool as an adjunct to classical cytogenetic study. It can be used for rapid and accurate prenatal diagnosis of women with high risk of maternal serum screening.</p>

Follow-up of 3 605 cord blood donors after 6 months of cord blood donation in Guangzhou cord blood bank / 中国实验血液学杂志

To study the program of evaluating mothers and infants after 6 months of cord blood donation, from June 1998 to February 2004, all mothers after 6 months of cord blood donation were followed-up by phone calls or letters to report on the health condition. The results showed that when 3 195 mothers were visited by phone calls, 18 mothers declined to answer. 392 letter were send to those who could not be found by phone, 15 of whom wrote back. The average time to talk with each mother was approximately 12 minutes. Follow-up on the baby donors showed two cases with chromosome abnormality, one with hypothyroidism, one with neutropenia, one with albinism and 5 dead with unclear reasons. The cord blood components from all these abnormal donors found were discarded. In conclusion, the programs to evaluate mother and baby after 6 months of cord blood donation seems important in quality control of the components stored in cord blood bank.

The mechanisms of p21WAF1/Cip-1 expression in MOLT-4 cell line induced by TSA / 中国实验血液学杂志

To investigate the function and molecular mechanism of p21(WAF1/Cip-1) expression in MOLT-4 cells induced by HDAC inhibitor TSA, the expression pattern of p21(WAF1/Cip-1) and the distribution of cell cycle in TSA treated cells were analyzed. The results showed that TSA could effectively induce G(2)/M arrest and apoptosis of MOLT-4 cells. Kinetic experiments demonstrated that p21(WAF1/Cip-1) were upregulated quickly before cell arrested in G(2)/M and began decreasing at the early stage of apoptosis. Meanwhile, the proteasome inhibitor MG-132 could inhibit the decrease of p21(WAF1/Cip-1) at the early stage of apoptosis, which showed that proteasome pathway involved in p21(WAF1/Cip-1) degradation during the TSA induced G(2)/M arrest and apoptosis responses. This study also identified that the protein level of p21(WAF1/Cip-1) was highly associated with the cell cycle change induced by TSA. Compared to cells treated by TSA only, exposure MOLT-4 cells to TSA meanwhile treatment with MG-132 increased the protein level of p21(WAF1/Cip-1) and increased the numbers of cell in G(2)/M-phase, whereas the cell apoptosis were delayed. It is concluded that p21(WAF1/Cip-1) plays a significant role in G(2)/M arrest and apoptosis signaling induced by TSA in MOLT-4 cells.

Use of capillary electrophoresis to determine hemoglobin A2 in healthy adults and alpha- and beta-thalassemia carriers / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To evaluate the capillary isoelectric focusing (CIEF) method for the estimation of blood hemoglobin A2 (Hb A2) concentrations in routine thalassemia screening.</p><p><b>METHODS</b>A total of 105 samples from healthy adults and 93 samples with positive phenotypes were collected by routine thalassemia screening. CIEF was compared with Helena spife combo electrophoresis system for Hb A2 measurement and its precision and reproducibility were tested by analyzing intra-assay or inter-assay coefficient of variations(CVs). The reliability and veracity of Hb A2 measurement by CIEF for the detection of alpha- and beta- thalassemia including Hb E were evaluated by genotyping of 93 consecutive samples for routine thalassemia screening.</p><p><b>RESULTS</b>By us e of CIEF for measurement of Hb A2 in a local healthy adult population, the range of reference value(3.59%-5.23%) was obtained. The results of CIEF showed good linearity relation to that of conventional Hb electrophoresis assay. All thalassemia carriers (43 cases of alpha-thals and 44 of beta-thals) or Hb E carriers (6 cases) presumptively identified by the present CIEF for the quantification of Hb A2, combined with routine RBC parameters for indicating microcytosis and hypochromia were confirmed to be the heterozygous or compound heterozygous defects of alpha- or beta- globin gene by molecular diagnosis, without any false positive or false negative results.</p><p><b>CONCLUSION</b>The measurement of Hb A2 by CIEF method is rapid, precise and reproducible; it could be used in routine screening for alpha- or beta- thalassemia.</p>