Efficacy and safety of LY01005 versus goserelin implant in Chinese patients with prostate cancer: A multicenter, randomized, open-label, phase III, non-inferiority trial / 中华医学杂志(英文版)

BACKGROUND@#LY01005 (Goserelin acetate sustained-release microsphere injection) is a modified gonadotropin-releasing hormone (GnRH) agonist injected monthly. This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer.@*METHODS@#We conducted a randomized controlled, open-label, non-inferiority trial across 49 sites in China. This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections. The primary efficacy endpoints were the percentage of patients with testosterone suppression ≤50 ng/dL at day 29 and the cumulative probability of testosterone ≤50 ng/dL from day 29 to 85. Non-inferiority was prespecified at a margin of -10%. Secondary endpoints included significant castration (≤20 ng/dL), testosterone surge within 72 h following repeated dosing, and changes in luteinizing hormone, follicle-stimulating hormone, and prostate specific antigen levels.@*RESULTS@#On day 29, in the LY01005 and goserelin implant groups, testosterone concentrations fell below medical-castration levels in 99.3% (142/143) and 100% (140/140) of patients, respectively, with a difference of -0.7% (95% confidence interval [CI], -3.9% to 2.0%) between the two groups. The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3% and 97.8%, respectively, with a between-group difference of 1.5% (95% CI, -1.3% to 4.4%). Both results met the criterion for non-inferiority. Secondary endpoints were similar between groups. Both treatments were well-tolerated. LY01005 was associated with fewer injection-site reactions than the goserelin implant (0% vs . 1.4% [2/145]).@*CONCLUSION@#LY01005 is as effective as goserelin implants in reducing testosterone to castration levels, with a similar safety profile.@*TRIAL REGISTRATION@#ClinicalTrials.gov, NCT04563936.

CTCs Detection and Whole-exome Sequencing Might Be Used to Differentiate Benign and Malignant Pulmonary Nodules / 中国肺癌杂志

BACKGROUND@#Low-density computed tomography (LDCT) improved early lung cancer diagnosis but introduces an excess of false-positive pulmonary nodules data. Hence, accurate diagnosis of early-stage lung cancer remains challenging. The purpose of the study was to assess the feasibility of using circulating tumour cells (CTCs) to differentiate malignant from benign pulmonary nodules.@*METHODS@#122 patients with suspected malignant pulmonary nodules detected on chest CT in preparation for surgery were prospectively recruited. Peripheral blood samples were collected before surgery, and CTCs were identified upon isolation by size of epithelial tumour cells and morphological analysis. Laser capture microdissection, MALBAC amplification, and whole-exome sequencing were performed on 8 samples. The diagnostic efficacy of CTCs counting, and the genomic variation profile of benign and malignant CTCs samples were analysed.@*RESULTS@#Using 2.5 cells/5 mL as the cut-off value, the area under the receiver operating characteristic curve was of 0.651 (95% confidence interval: 0.538-0.764), with a sensitivity and specificity of 0.526 and 0.800, respectively, and positive and negative predictive values of 91.1% and 30.3%, respectively. Distinct sequence variations differences in DNA damage repair-related and driver genes were observed in benign and malignant samples. TP53 mutations were identified in CTCs of four malignant cases; in particular, g.7578115T>C, g.7578645C>T, and g.7579472G>C were exclusively detected in all four malignant samples.@*CONCLUSIONS@#CTCs play an ancillary role in the diagnosis of pulmonary nodules. TP53 mutations in CTCs might be used to identify benign and malignant pulmonary nodules.

Pulmonary nodules localization via microcoil and anchor with scaled suture guided by CT in thoracoscopic surgery: A retrospective cohort study / 中国胸心血管外科临床杂志

@#Objective    To compare the effectiveness and safety of preoperative lung localization by microcoil and anchor with scaled suture. Methods    A total of 286 patients underwent CT-guided puncture localization consecutively between October 2019 and December 2020 in our hospital. According to the different methods of localization, they were divided into a microcoil group (n=139, including 49 males and 90 females, aged 57.92±10.51 years) and an anchor group (n=147, including 53 males and 94 females, aged 56.68±11.31 years). The clinical data of the patients were compared. Results    A total of 173 nodules were localized in the microcoil group, and 169 nodules in the anchor group. The localization success rate was similar in the two groups. However, the anchor group was significantly better than the microcoil group in the localization time (8.15±2.55 min vs. 9.53±3.08 min, P=0.001), the pathological receiving time (30.46±14.41 min vs. 34.96±19.75 min, P=0.029), and the hemoptysis rate (10.7% vs. 30.1%, P=0.001), but the pneumothorax rate was higher in the anchor group (21.3% vs. 11.0%, P=0.006). Conclusion    Preoperative localization of small pulmonary nodules using anchor with suture is practical and safe. Due to its simplicity and convenience, it is worth of promotion in the clinic.

Establishment and application of sandwich ELISA for detection of specific antigen of Seoul virus L99 strain / 中华微生物学和免疫学杂志

Objective:To establish a double antibody sandwich ELISA for detecting the specific antigen of Seoul virus (SEOV) L99 strain and to provide a means for antigen detection in the development, production and verification of vaccine against hemorrhagic fever with renal syndrome (HFRS).Methods:Monoclonal antibodies (McAbs) aganist L99 virus were induced in mice using four hybridoma cell lines and purified by Protein-A affinity chromatography. The purity, titer and specificity of McAbs were determined by SDS-PAGE, indirect ELISA and Western blot, respectively. Four McAbs were paired with each other and the additivity indices of paired McAbs were analyzed. After labeling McAbs with horseradish peroxidase (HRP), the concentrations of the coated and labeled antibodies were optimized by orthogonal test, and then a double antibody sandwich ELISA for virus antigen detection was established. Type Ⅱ HFRS inactivated vaccine standard was used as a quantitative standard to verify the sensitivity, linearity, specificity, accuracy and precision of the developed method. The applicability of the method was verified by testing three batches of vaccine stock solutions.Results:Four McAbs were at titers of greater than 1∶10 6 and their purity was all greater than 98%. The McAbs secreted by 1D5, 3A4 and 5B7 cells could specifically recognize the nucleocapsid protein of SEOV L99. There was cross-reaction between McAb secreted by 1D5 cells and Hantaan virus PS-6. The McAbs secreted by 3A4 and 1D5 were used as coating and labeling antibodies based on the results of antibody pairs. The working concentrations of the coating antibody and the horseradish peroxidase (HRP)-labeled antibody were 20 μg/ml and 1∶4 000, respectively. The minimum detection limit of the established method for the detection of SEOV L99 antigen was 0.078 1 μg/ml, and the linear range was 0.078 1-2.500 0 μg/ml with a R2 value of more than 0.99. There was no cross reaction with other HFRS vaccine. The virus antigen recovery rate was between 95.8% and 108.7%, and the coefficients of variation of precision was less than 10%. Three batches of Type II HFRS inactivated vaccine stocks were detected by this method and the results was dose-dependent. Conclusions:This study successfully established a double antibody sandwich ELISA method for specific detection of SEOV L99 strain antigen in the production of bivalent HFRS vaccines produced from hamster kidney cells.

Different preoperative examinations could be considered for small lung adenocarcinoma with different CT findings / 中华胸心血管外科杂志

Objective:To analyze the law of distant metastasis in patients with small lung adenocarcinoma with different CT findings, and to explore the feasibility of different preoperative examination methods for small lung adenocarcinoma with different imaging characteristics.Methods:Clinicopathological data of cT1a-cN0 lung adenocarcinoma patients admitted to the respiratory center of China-Japan Hospital from January 2017 to December 2018 were retrospectively collected. A total number of 785 patients were included, including 289 males and 496 females. SPSS 22.0 was used for statistical analysis.Results:A total number of 785 patients were included in this study, including 287 pure ground-glass nodule (GGN) patients, 111 GGN predominant patients, 221 solid predominant patients and 166 solid nodule patients. Among the included patients, 8 had distant metastasis, including 6 with bone metastasis, 1 with brain metastasis and 1 with brain and adrenal metastasis. No distant metastasis was observed in the patients with pure GGN and GGN predominant nodule, while 1 solid predominant patients had distant metastasis, and 7 patients with solid nodules had distant metastasis. The probability of distant metastasis was 0.5% for the solid predominant patients and 4.2% for the solid nodule patients. Univariate analysis results showed that CEA level ( P=0.030), the largest diameter of the lung window tumor ( P=0.003), the largest diameter of the solid component of the lung window tumor ( P<0.001), the largest area of the lung window tumor ( P=0.002), mediastinal window tumor maximum area ( P<0.001), CTR ( P<0.001), TDR ( P<0.001), and pleural indentation sign ( P=0.037) were risk factors for distant metastases. Multivariate analysis showed that CEA ( OR=1.019, 95% CI: 1.002-1.037, P=0.028) and TDR ( OR=0.000, 95% CI: 0.000-0.310, P=0.001) were independent risk factors of distant metastasis. Conclusion:For patients with pure GGN and GGN predominant nodule, preoperative examination could not be required, but for pure solid nodules, it is necessary to perform relevant preoperative examination including skull MRI before surgery to exclude distant metastasis.

A study on intervention strategies for patients′ stereotyping of nurses / 中国实用护理杂志

Objective:To explore strategies of improving patients' stereotyping of nurses, by analyzing patients′ stereotypes of nurses.Methods:The phenomenological analysis method in qualitative research was used to conduct semi-structured interviews with 12 inpatients by objective sampling method.Results:The patients′ stereotype of nurses could be summarized into three topics, it mainly consisted of three aspects: patients′ cognition of the role of nurses, patients′ stereotype of nurse-patient relationship and factors affecting nurse-patient relationship from patients′ perspective, among which factors affecting nurse-patient relationship included doctors′ attitude towards nurses, public opinion effect of media reports and patients′ negative psychological experience.Conclusions:The prejudice of patients to the relationship between nurses and patients is not optimistic, it is suggested to improve patients′ stereotyping of nurses by reconstructing the ideal role of nurses, building harmonious trusting relationships and providing friendly support from the "others".

Predictive value of radiological features on spread through air spaces in stage cⅠA lung adenocarcinoma with predominant ground-glass opacity / 中国胸心血管外科临床杂志

@#Objective    To investigate the predictive value of preoperative radiological features on spread through air spaces (STAS) in stage cⅠA lung adenocarcinoma with predominant ground-glass opacity, and to provide a basis for the selection of surgical methods for these patients. Methods    The clinical data of 768 patients with stage cⅠA lung adenocarcinoma undergoing operation in our hospital from 2017 to 2018 were reviewed, and 333 early stage lung adenocarcinoma patients with predominant ground-glass opacity were selected. There were 92 males and 241 females, with an average age of 57.0±10.0 years. Statistical analysis was performed using SPSS 22.0. Results    STAS-positive patients were mostly invasive adenocarcinoma (P=0.037), and had more micropapillary component (P<0.001) and more  epidermal growth factor receptor (EGFR) gene mutations (P=0.020). There were no statistically significant differences between the STAS-positive and STAS-negative patients in other clinicopathological features. Univariate analysis showed that the maximum diameter of tumor in lung window (P=0.029), roundness (P=0.035), maximum diameter of solid tumor component in lung window (P<0.001), consolidation/tumor ratio (CTR, P<0.001), maximum area of the tumor in mediastinum window (P=0.001), tumor disappearance ratio (TDR, P<0.001), average CT value (P=0.001) and lobulation sign (P=0.038) were risk factors for STAS positive. Multivariate logistic regression analysis showed that the CTR was an independent predictor of STAS (OR=1.05, 95%CI 1.02 to 1.07, P<0.001), and the area under the receiver operating characteristic (ROC) curve was 0.71 (95%CI 0.58 to 0.85, P=0.002). When the cutoff value was 19%, the sensitivity of predicting STAS was 66.7%, and the specificity was 75.2%. Conclusion    CTR is a good radiological feature to predict the occurrence of STAS in early lung adenocarcinoma with predominant ground-glass opacity. For the stage cⅠA lung adenocarcinoma with predominant ground-glass opacity and CTR ≥19%, the possibility of STAS positive is greater, and sublobar resection needs to be carefully considered.

Impact of interstitial lung disease on postoperative morbidity and 60 day mortality after pulmonary resection for lung cancer / 中华胸心血管外科杂志

Objective:To evaluate the effect of interstitial lung disease(ILD) on postoperative morbidity and mortality in pulmonary resection for lung cancer patients.Methods:We retrospectively analyzed 971 patients undergoing pulmonary operation from January 2010 to January 2018 in our hospital. Clinical data including age, sex, history of chronic obstructive pulmonary disease(COPD), smoking history, smoking index, American Society of Anesthesiologists(ASA) classification, forced expiratory volume in 1 s(FEV1) % predict, surgical procedure, video assisted thoracoscopic surgery(VATS) or not, intraoperative blood transfusion, anesthesia time, operation time/one-lung ventilation time, blood loss, histology, postoperative morbidity, 60-days mortality, onset of acute exacerbation of interstitial lung disease(AE-ILD), drainage, extubation time, and postoperative stay were collected and analyzed.Results:There were 80(8.2%) and 891(91.8%) patients in ILD and non-ILD group, respectively. AE-ILD occurred in 5 patients, with a 60-day mortality of 80%. A multivariate regression analysis identified that the sex( P=0.023), ILD( P=0.001), COPD( P=0.027) were independent risk factors for postoperative morbidity. ILD( P=0.023) and postoperative morbidity( P=0.001) were independent risk factors for 60-day mortality in multivariate analysis. Conclusion:Patients with ILD had a higher incidence of postoperative morbidity and 60-day mortality. Based on the obvious postoperative morbidity and mortality, special attention and management should be taken in ILD patients.

Countermeasure research on cultivation of humanistic care ability of nursing interns / 中国实用护理杂志

Objective:Through analyzing the influencing factors of nursing humanistic care ability, this paper discusses the countermeasures of cultivating the humanistic care ability of nursing interns.Methods:Nursing interns between September 2018 and April 2019 in Dalian Maternal and Child Health Hospital, the First Affiliated Hospital of Dalian Medical University and the Second Affiliated Hospital of Dalian Medical University were chosen, two questionnaires were conducted at the beginning of the internship and at the end of the internship after the cultivation of humanistic care ability, 344 of them participated in the initial survey, 331 people took part in the end of the survey.Results:The overall average score of nursing interns at early stage of nursing interns was 181.31±22.81, while the score at the final stage was 187.73±18.23, the difference was statistically significant ( t value was 4.03, P<0.05); the score of each dimension which included understanding, courage and patience was 71.66±8.83, 59.49±9.59, 56.59±5.33 respectively, lower than the standard of foreign countries which were respectively 80.22±7.56, 65.25±11.57, 63.11±4.19. The abilities of humanistic care of Chinese nursing interns were lower than those at abroad. Gender (X 1) , relationship with mother (X 3) and relationship with classmates (X 4) are influential factors of humanistic care abilities for nursing interns ( t value was 2.448, 2.784, 3.189, P<0.05). Conclusions:The implementation of cultivating humanistic care abilities for nursing interns can be based on creating medical humanities atmosphere in hospital, improving teachers′ humanistic are abilities and strengthening nurse′ professional identity and sense of responsibility.

Comparison of different drugs in the treatment of retinopathy caused by type 2 diabetes / 实用医学杂志

Objective Exploration of the efficacy of different drugs in the treatment of retinopathy caused by type 2 diabetes. Methods 120 type 2 diabetic retinopathy patients were randomly divided into treatment group of 60 patients and the control group of 60 patients based on random number table method, the control group were selected intravitreal injection with triamcinolone aetonide, and the treatment group were selected intravitreal injection with conbercept, all treatments were done three times and visual acuity, retinal and macular leakage of two groups were observed. Results The best corrected visual acuity after treatment in the treatment group and the control group were 40.45 ± 14.38 and 45.33 ± 12.89 respectively and that were significantly higher than the value before treatment, the statistically significant differences also happened between the two (P < 0.05). The CRT and TMV values of the two groups after treatment were significantly lower than that before treatment (P < 0.05) , while the CRT and TMV values in the treatment group were also significantly lower than the control group (P < 0.05). The typing leakage before and after treatment were mostly with diffuse and there were also no statistically significant differences in intra-group or inter-group. Conclusion Intravitreal injection of conbercept in the treatment of type 2 diabetic retinopathy can effectively recover vision and retinal conditions, it can stable patients' macular edema, thereby improve prognosis.

Investigation report on education organizations status of doctor-patient communication courses in medical colleges and universities of China / 中华医学教育探索杂志

In order to understand the educational organization status of doctor-patient communication courses, 114 medical colleges and universities of China were investigated, including course offerings, teaching methods and teacher condition. The survey showed that the ratio of offering doctor-patient communication courses was 64.9%, but only 51.3% courses were compulsory. The setting of class hours was arbitrary. The target objects were mainly concentrated on medical students before entering clinical practice and the large-class teaching was a main mode. The average number of teachers was three to four, half of whom were part-time teachers. Therefore, we suggest attaching great importance to doctor-patient communication course by setting it as a compulsory course, emphasizing the practicability of the course in teaching content, and properly handling the relationship between full-time teachers and part-time teachers.

Investigation report on education organizations status of doctor-patient communication courses in medical colleges and universities of China / 中华医学教育探索杂志

In order to understand the educational organization status of doctor-patient communication courses,114 medical colleges and universities of China were investigated,including course offerings,teaching methods and teacher condition.The survey showed that the ratio of offering doctor-patient communication courses was 64.9％,but only 51.3％ courses were compulsory.The setting of class hours was arbitrary.The target objects were mainly concentrated on medical students before entering clinical practice and the largeclass teaching was a main mode.The average number of teachers was three to four,half of whom were part-time teachers.Therefore,we suggest attaching great importance to doctor-patient communication course by setting it as a compulsory course,emphasizing the practicability of the course in teaching content,and properly handling the relationship between full-time teachers and part-time teachers.

The CT differences in cavitation between primary lung adenocarcinoma and squamous cell carcinoma / 实用放射学杂志

Objective To analyze the CT features of cavitation between primary lung adenocarcinoma and squamous cell cancer.Methods The CT findings of cavity of primary lung adenocarcinoma and squamous cell carcinoma were evaluated in 57 patients,including 33 of squamous cell carcinoma and 24 of adenocarcinoma.The clinical data and CT features were analyzed retrospectively using the independent samples t-test,Pearson Chi-square test or Fisher's exact test.Results The mean age of ptients with squamous cell carcinoma was higher than that of patients with adenocarcinoma (65.57-4-9.26 vs 58.75 ± 11.12,P =0.015).Statistical differences were found in distribution of gender and smoking habit between the two kinds of carcinomas (P =0.014 and P =0.029).The T stages were also different between the two carcinomas (P=0.003).In addition,the maximum diameter of tumor (P =0.003),the maximum diameter of cavity (P =0.029) and the maximum thickness of the cavity wall (P=0.001) of squamous cell carcinoma were higher than those of adenocarcinoma.Moreover,the presence of ground-glass opacity (P =0.010),vessel passing through the cavity (P =0.001),septum inside the cavity (P＜0.001) and tumoral bronchogram (P =0.027) in adenocarcinoma were higher than those in squamous cell carcinoma.Conclusion There are significant differences between adenocarcinoma and squamous cell carcinoma in the population distribution and image features,comprehensive analysis helps the differential diagnosis.

Intravoxel incoherent motion imaging for predicting pathological complete response of locally advanced rectal cancer after neoadjuvant chemotherapy / 中国医学影像技术

Objective To explore the value of intravoxel incoherent motion (IVIM) analysis in evaluation of pathological complete response (pCR) in patients with locally advanced rectal cancer (LARC) after neoadjuvant chemotherapy.Methods Totally 61 patients with pathologically proven rectal adenocarcinoma were retrospectively analyzed.All patients underwent MR scan,including multi-b DWI IVIM sequence scanning before and after neoadjuvant chemotherapy.ADC values and IVIM parameters (slow diffusion coefficient [D],fast diffusion coefficient [D*] and perfusion fraction [f]) were measured by two radiologists independently.Then the patients were divided into pCR group (n=14) and non-pCR group (n=47).Independent-samples t test was used to compare all the parameters before and after therapy,as well as the percentage changes (△ratio) between pCR and non-pCR group.Area under the curve (AUC) was used to evaluate the diagnostic performance.Results ADC (P=0.002) and D (P=0.007) values were significantly lower before therapy,while △ratio ADC (P＜0.001) and △ratio D (P =0.002) were significantly higher in pCR group compared with those in non-pCR group.D*,f and their △ratio value were not statistically different pre-chemotherapy and post-chemotherapy in both two groups (all P＞0.05).△ratio D had the highest AUC (0.786,P＜0.01).Conclusion IVIM-derived D values can help to predict and differentiate pCR of LARC after neoadjuvant chemotherapy.

Study on the Intervention to Birth Defects under the Vision of Care Ethics / 中国医学伦理学

The condition of birth defects in our country is very serious,which impose an enormous burdenon the families and society.Under the vision of care ethics,this paper emphasizes understanding and caring,analyzes the ethical dilemma in the prevention of birth defects and puts forward the prevention measures in line with the codes of ethics,aiming at strengthening the practical effect of birth defects prevention work,caring about the physical and mental health of child-bearing female,and promoting social development.

Reflection on the Cultivation of Humanistic Practice Ability of Obstetricians and Gynecologists / 中国医学伦理学

Obstetrics and gynecology is concerned with the gestation,birth and healthy development of human life and related to the happiness and joy of all families.Physicians need to have good medical humanistic practice ability.This paper analyzed the connotation of the physician's humanistic practice ability,investigated the current status of humanistic practice ability of obstetricians and gynecologists through in-depth interviews,and put forward the countermeasures of cultivating the humanistic practice ability of obstetricians and gynecologists,including strengthening the foundation of medical humanistic knowledge,carrying out the training of the humanities skills of obstetricians and gynecologists,integrating the evaluation of humanistic practice ability into the work of medical ethics,and integrating the new medical humanistic view into the construction of hospital culture.

Medical imaging findings and pathological characteristics of hepatic inflammatory myofibroblastic tumor / 中华肝胆外科杂志

Objective To study the medical imaging findings and the pathological features of hepatic inflammatory myofibroblastic tumor (HIMT) using CT,MRI and histopathology.Methods The CT and MRI findings of 31 patients with HIMT which were confirmed by histopathology on surgically resected specimen were analyzed retrospectively.The location,size,shape,edge,density or signal,and contrast enhancement of these tumors were analyzed.Results The tumors were located in the right liver in 26 patients,in the left liver in 5 patients,and under the hepatic capsule in 27 patients.The tumors were solitary in 28 patients and multiple in 3 patients.The maximum diameter of the tumor ranged from 2.1 cm to 12.5 cm.The average diameter was (3.6 ± 1.2) cm.The tumors were round or oval in 21 patients and irregular in 10 patients.19 patients underwent CT examination and all tumors showed low density,with a CT value which ranged from 5 to 35HU.The average value was (27.6 ±5.3) HU.The density of tumors was homogeneous in 6 patients and inhomogeneous in 13 patients,and among these 13 patients,3 were alveolate.Twenty-one patients underwent MRI scan and all showed a low signal on T1WI,12 patients showed an equal signal and 9 patients showed a slightly higher signal on T2WI.In 6 patients the signals were homogeneous and in 15 patients they were inhomogeneous.On CT and MRI enhanced scans the whole tumor was enhanced in 12 patients,the edge was enhanced in 9 patients,the septum was enhanced in 8 patients and no enhancement was observed in 2 patients.Pathological examination under microscopy observed the presence of proliferation of spindle cells,chronic inflammatory cells which included the proliferation of lymphocytes,plasma cells and collagen fiber formation.The spindle cells had the characteristics of fibroblasts and myofibroblast cells.Immunohistochemical examination showed the wave type protein (Vimentin) was positive in 23 patients,the smooth muscle actin (SMA) was positive in 18 patients,the muscle actin (MSA) and the specificity of junction protein (Desmin) were positive in 12 patients,CD68 was positive in 4 patients,and the ALK,S-100 protein,CDll7 and CD35 were all negative.Conclusions The radiological features of CT and MRI plain scan varied.The patterns of contrast enhancement included full tumor filling,marginal enhancement,compartment enhancement,and no enhancement.The enhanced features varied from mild to moderate enhancement in the arterial phase,further enhancement in the portal phase and mild enhancement in the delayed phase.

Clinical features and imaging findings of interstitial lung disease in antisynthetase syndrome / 中华放射学杂志

Objective To investigate the clinical features and imaging findings of interstitial lung disease in antisynthetase syndrome(AS-ILD)and to compare the characteristics among AS specificities. Methods A total of 59 cases with AS-ILD at our hospital during the last 5 years were retrospectively reviewed, including anti-Jo1 positive in 37 cases and anti-PL7 positive in 6 cases and anti-PL12 positive in 6 cases and anti EJ positive in 10 cases. There were 14 males and 45 females aged (51 ± 12) years. The clinical features including myositis, arthritis, fever,"mechanic's hands", rash, proximal dysphagia, raynaud phenomenon were identified. Two radiologists evaluated the pattern, distribution and the ILD pattern of the lung abnormalities on HRCT findings. Based on the anti synthetase antibody positive subtype, 59 patients could be divided into four groups;then the differences of clinical features and HRCT findings between different subtypes were analyzed. X2 test was performed for the comparison of the differences between anti-Jo1 antibody positive and the other 3 group. Results (1)Myositis and arthritis were the most common AS manifestations, which were 61.02%(36/59)and 50.85%(30/59) respectively.(2)The lung abnormalities were predominantly basal(91.53%, 54/59) and peripheral(59.32%, 35/59). Ground-grass opacities(79.66%, 47/59)and reticulations(76.27%, 45/59) were found most frequently. Non-specific interstitial pneumonia (NSIP) was the most common HRCT pattern(64.41%, 38/59).(3)As compared with anti-Jo1 positive AS patients, anti-PL12 positive AS patients showed a high rate of traction bronchiectasis at diagnosis(83.33%, 5/6), while the difference was statistically significant(χ2=7.206, P=0.015). The prevalence of pericardial effusion(40.00%, 4/10) was significantly higher in the group of the anti-EJ positive AS patients than that with anti-Jo1 antibody AS(χ2=6.317, P=0.044). Conclusions Myositis and arthritis are the predominant clinical features. NSIP is the most common HRCT pattern in AS-ILD patients. There are some differences of signs among various subtypes, indicating that the difference of fibrosis in the lung and inflammatory reaction in the body being correlated with the AS specificities.

Medical imaging findings and pathological characteristics of hepatic inflammatory myofibroblastic tumor / 中华肝胆外科杂志

Objective To study the medical imaging findings and the pathological features of hepatic inflammatory myofibroblastic tumor (HIMT) using CT,MRI and histopathology.Methods The CT and MRI findings of 31 patients with HIMT which were confirmed by histopathology on surgically resected specimen were analyzed retrospectively.The location,size,shape,edge,density or signal,and contrast enhancement of these tumors were analyzed.Results The tumors were located in the right liver in 26 patients,in the left liver in 5 patients,and under the hepatic capsule in 27 patients.The tumors were solitary in 28 patients and multiple in 3 patients.The maximum diameter of the tumor ranged from 2.1 cm to 12.5 cm.The average diameter was (3.6 ± 1.2) cm.The tumors were round or oval in 21 patients and irregular in 10 patients.19 patients underwent CT examination and all tumors showed low density,with a CT value which ranged from 5 to 35HU.The average value was (27.6 ±5.3) HU.The density of tumors was homogeneous in 6 patients and inhomogeneous in 13 patients,and among these 13 patients,3 were alveolate.Twenty-one patients underwent MRI scan and all showed a low signal on T1WI,12 patients showed an equal signal and 9 patients showed a slightly higher signal on T2WI.In 6 patients the signals were homogeneous and in 15 patients they were inhomogeneous.On CT and MRI enhanced scans the whole tumor was enhanced in 12 patients,the edge was enhanced in 9 patients,the septum was enhanced in 8 patients and no enhancement was observed in 2 patients.Pathological examination under microscopy observed the presence of proliferation of spindle cells,chronic inflammatory cells which included the proliferation of lymphocytes,plasma cells and collagen fiber formation.The spindle cells had the characteristics of fibroblasts and myofibroblast cells.Immunohistochemical examination showed the wave type protein (Vimentin) was positive in 23 patients,the smooth muscle actin (SMA) was positive in 18 patients,the muscle actin (MSA) and the specificity of junction protein (Desmin) were positive in 12 patients,CD68 was positive in 4 patients,and the ALK,S-100 protein,CDll7 and CD35 were all negative.Conclusions The radiological features of CT and MRI plain scan varied.The patterns of contrast enhancement included full tumor filling,marginal enhancement,compartment enhancement,and no enhancement.The enhanced features varied from mild to moderate enhancement in the arterial phase,further enhancement in the portal phase and mild enhancement in the delayed phase.

Clinical features and imaging findings of interstitial lung disease in antisynthetase syndrome / 中华放射学杂志

Objective To investigate the clinical features and imaging findings of interstitial lung disease in antisynthetase syndrome(AS-ILD)and to compare the characteristics among AS specificities. Methods A total of 59 cases with AS-ILD at our hospital during the last 5 years were retrospectively reviewed, including anti-Jo1 positive in 37 cases and anti-PL7 positive in 6 cases and anti-PL12 positive in 6 cases and anti EJ positive in 10 cases. There were 14 males and 45 females aged (51 ± 12) years. The clinical features including myositis, arthritis, fever,"mechanic's hands", rash, proximal dysphagia, raynaud phenomenon were identified. Two radiologists evaluated the pattern, distribution and the ILD pattern of the lung abnormalities on HRCT findings. Based on the anti synthetase antibody positive subtype, 59 patients could be divided into four groups;then the differences of clinical features and HRCT findings between different subtypes were analyzed. X2 test was performed for the comparison of the differences between anti-Jo1 antibody positive and the other 3 group. Results (1)Myositis and arthritis were the most common AS manifestations, which were 61.02%(36/59)and 50.85%(30/59) respectively.(2)The lung abnormalities were predominantly basal(91.53%, 54/59) and peripheral(59.32%, 35/59). Ground-grass opacities(79.66%, 47/59)and reticulations(76.27%, 45/59) were found most frequently. Non-specific interstitial pneumonia (NSIP) was the most common HRCT pattern(64.41%, 38/59).(3)As compared with anti-Jo1 positive AS patients, anti-PL12 positive AS patients showed a high rate of traction bronchiectasis at diagnosis(83.33%, 5/6), while the difference was statistically significant(χ2=7.206, P=0.015). The prevalence of pericardial effusion(40.00%, 4/10) was significantly higher in the group of the anti-EJ positive AS patients than that with anti-Jo1 antibody AS(χ2=6.317, P=0.044). Conclusions Myositis and arthritis are the predominant clinical features. NSIP is the most common HRCT pattern in AS-ILD patients. There are some differences of signs among various subtypes, indicating that the difference of fibrosis in the lung and inflammatory reaction in the body being correlated with the AS specificities.