Applicability comparison between Chinese dry eye questionnaire and ocular surface disease index questionnaire among college students / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the applicability of Chinese dry eye questionnaire in college students using the ocular surface disease index(OSDI)questionnaire as a reference.METHODS: Cross-sectional study. A total of 711 college students from Nanyang Medical College were enrolled in the study and assessed for dry eye condition using OSDI questionnaire and Chinese dry eye questionnaire. The response rate of each question in the two questionnaires was counted. Cronbach α was calculated to evaluate the internal consistency of both questionnaires. Correlation between the total scores of the two questionnaires was analyzed to evaluate the criterion validity. Based on OSDI scores, the discriminant validity of Chinese dry eye questionnaire was evaluated; receiver operating characteristic(ROC)curves was plotted for Chinese dry eye questionnaire scores, area under the ROC curve(AUC)was calculated, and diagnostic thresholds and corresponding sensitivity and specificity were also analyzed.RESULT: The response rates of the 12 questions on the OSDI questionnaire were 33.2%-100.0%, while it was 100.0% for each question on the Chinese dry eye questionnaire. The Cronbach α values of OSDI questionnaire and Chinese dry eye questionnaire were 0.905 and 0.789, respectively. The Chinese dry eye questionnaire score was positively correlated with the OSDI score(rs=0.712, P<0.001). According to OSDI questionnaire scores, dry eye severity was divided into normal group, mild dry eye group, moderate dry eye group and severe dry eye group. The scores of Chinese dry eye questionnaire in these groups were 4.00(2.00, 6.00), 9.00(7.00, 11.00), 12.00(9.00, 14.00)and 16.00(13.50, 22.00), respectively, which increased with the severity of dry eye, and the overall difference was statistically significant(P<0.001), as well as pairwise comparison between groups(P<0.05). The AUCs of Chinese dry eye questionnaire in distinguishing normal population from dry eye population, mild dry eye from moderate dry eye, moderate dry eye from severe dry eye were 0.862, 0.661 and 0.769, respectively, and the diagnostic thresholds were 6.5, 11.5 and 14.5, respectively.CONCLUSION:Chinese dry eye questionnaire has an equivalent reliability, validity, discriminant ability and better response rate for dry eye screening and epidemiological survey among college students in China compared with OSDI questionnaire.

Association of Serine/Threonine Phosphoprotein Phosphatase 4C Expression With Prognosis of Gastric Cancer / 中国医学科学院学报

Objective To investigate the expression level of serine/threonine phosphoprotein phosphatase 4C(PPP4C)in gastric cancer,and analyze its relationship with prognosis and the underlying regulatory mechanism.Methods The clinical data of 104 gastric cancer patients admitted to the First Affiliated Hospital of Bengbu Medical College between January 2012 and August 2016 were collected.Immunohistochemical staining was employed to determine the expression levels of PPP4C and Ki-67 in the gastric cancer tissue.The gastric cancer cell lines BGC823 and HGC27 were cultured and transfected with the vector for PPP4C knockdown,the vector for PPP4C overexpression,and the lentiviral vector(control),respectively.The effects of PPP4C on the cell cycle and proliferation were analyzed and the possible regulatory mechanisms were explored.Results PPP4C was highly expressed in gastric cancer(P<0.001),and its expression promoted malignant progression of the tumor(all P<0.01).Univariate and Cox multivariate analysis clarified that high expression of PPP4C was an independent risk factor affecting the 5-year survival rate of gastric cancer patients(P=0.003).Gene ontology and Kyoto encyclopedia of genes and genomes enrichment analysis suggested that PPP4C may be involved in the cell cycle.The correlation analysis showed that the expression of PPP4C was positively correlated with that of Ki-67 in gastric cancer(P<0.001).The up-regulation of PPP4C expression increased the proportion of tumor cells in the S phase,alleviated the G2/M phase arrest,and promoted the proliferation of gastric cancer cells and the expression of cyclin D1 and cyclin-dependent kinase 6(CDK6)(all P<0.05).The down-regulation of PPP4C decreased the proportion of gastric cancer cells in the S phase,promoted G2/M phase arrest,and inhibited cell proliferation and the expression of cyclin D1,CDK6,and p53(all P<0.05).p53 inhibitors promoted the proliferation of BGC823 and HGC27 cells in the PPP4C knockdown group(P<0.001,P<0.001),while p53 activators inhibited the proliferation of BGC823 and HGC27 cells in the PPP4C overexpression group(P<0.001,P=0.002).Conclusions PPP4C is highly expressed in gastric cancer and affects the prognosis of the patients.It may increase the proportion of gastric cancer cells in the S phase and alleviate the G2/M phase arrest by inhibiting p53 signaling,thereby promoting cell proliferation.

ALDH3B1 expression is correlated with histopathology and long-term prognosis of gastric cancer / 南方医科大学学报

OBJECTIVE@#To investigate the expression of aldehyde dehydrogenase 3B1 (ALDH3B1) in gastric cancer and explore its correlation with the pathological parameters and long-term prognosis of the patients.@*METHODS@#We analyzed the clinical data of 101 patients who underwent radical gastrectomy for gastric cancer in our hospital between January, 2013 and November, 2016, and examined the expression of ALDH3B1 in paraffin-embedded samples of gastric cancer tissues and adjacent tissues from these cases by immunohistochemical staining. We evaluated the correlation between ALDH3B1 expressions and histopathological parameters and assessed the predictive value of ALDH3B1 expression for long-term survival of the patients. We also examined the effect of lentivirus-mediated interference and overexpression of ALDH3B1 on the malignant behaviors of MGC-803 gastric cancer cells.@*RESULTS@#The expressions of ALDH3B1 and Ki67 were significantly higher in gastric cancer tissues than in adjacent tissues (P < 0.05). In gastric cancer patients, ALDH3B1 expression was positively correlated with peripheral blood CEA and CA19-9 levels (P < 0.01). The proportion of patients with CEA ≥5 μg/L, CA19-9 ≥37 kU/L, T stage of 3- 4, and N stage of 2-3 was significantly greater in high ALDH3B1 expression group than in low expression group. Kaplan-Meier survival analysis showed that the 5-year survival rate was significantly lower in gastric cancer patients with high ALDH3B1 expressions (P < 0.01). Univariate and Cox multiple regression analyses identified a high expression of ALDH3B1 (P < 0.05, HR= 0.231, 95% CI: 0.064-0.826), CEA≥5 μg/L (P < 0.01, HR=4.478, 95% CI: 1.530-13.110), CA19-9≥37 kU/L (P < 0.01, HR=3.877, 95% CI: 1.625-9.247), T stage of 3-4 (P < 0.01, HR=4.953, 95% CI: 1.768-13.880), and N stage of 2-3 (P < 0.05, HR=2.152, 95% CI: 1.152-4.022) as independent risk factors affecting 5-year survival after radical gastrectomy. The relative ALDH3B1 expression level, at the cut-off point of 4.66, showed a sensitivity of 76.47% and a specificity of 76% for predicting 5-year postoperative death (P < 0.01). In the cell experiment, overexpression of ALDH3B1 obviously promoted the proliferation, migration and invasion of MGC-803 cells.@*CONCLUSION@#As an independent risk factor affecting 5-year survival after radical gastrectomy, ALDH3B1 is highly expressed in gastric cancer and correlated with pathological parameters of the tumor, and a high ALDH3B1 expression may promote proliferation, invasion and metastasis of gastric cancer cells.

DKK3 Regulates Melanogenesis in Melanocytes of Alpaca / 中国生物化学与分子生物学报

Dickkopf-3 (DKK3) , as a critical inhibitor of the Wnt/p-catenin signaling pathway, may he involved in melanogenesis.In the current study, we investigated the effects of DKK3 on melanogenesis in melanocytes of alpaca.Overexpression of DKK3 in alpaca melanocytes, the expression of Wntl, Lefl , Myc and the major target genes termed microphthalmia-associated transcription factor (M1TF) and its downstream genes, including tyrosinase (TYR), tyrosinase-related protein 1 (TYRP1) and tyrosinase- related protein 2 (TYRP2) were significantly decreased at both mRNA and protein levels (P<0.05); total alkali melanin, pheomelanin and eumelanin were decreased by 80.30%, 72.17% and 64.60% (P <0.05), respectively.In contrast, in the melanocytes transfected with siRNA-DKK3 (a small interference RNA targeting DKK3) , the expression of Wntl, Lefl, Myc, MITF, TYR, TYRPl and TYRP2 were significantly increased at both mRNA and protein levels (P<0.05) ; total alkali melanin, pheomelanin and eumelanin were significantly increased by 1.65 folds, 1.25 folds and 1.21 folds (P< 0.05) , respectively.These results indicate that DKK3 regulates melanogenesis in alpaca melanocytes via the Wnt/p-catenin signaling pathway and down-regulates MITF.

Interferon-Gamma Release Assay is Not Appropriate for the Diagnosis of Active Tuberculosis in High-Burden Tuberculosis Settings: A Retrospective Multicenter Investigation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Interferon-gamma release assay (IGRA) has been used in latent tuberculosis (TB) infection and TB diagnosis, but the results from different high TB-endemic countries are different. The aim of this study was to investigate the value of IGRA in the diagnosis of active pulmonary TB (PTB) in China.</p><p><b>METHODS</b>We conducted a large-scale retrospective multicenter investigation to further evaluate the role of IGRA in the diagnosis of active PTB in high TB-epidemic populations and the factors affecting the performance of the assay. All patients who underwent valid T-SPOT.TB assays from December 2012 to November 2015 in six large-scale specialized TB hospitals in China and met the study criteria were retrospectively evaluated. Patients were divided into three groups: Group 1, sputum culture-positive PTB patients, confirmed by positive Mycobacterium tuberculosis sputum culture; Group 2, sputum culture-negative PTB patients; and Group 3, non-TB respiratory diseases. The medical records of all patients were collected. Chi-square tests and Fisher's exact test were used to compare categorical data. Multivariable logistic analyses were performed to evaluate the relationship between the results of T-SPOT in TB patients and other factors.</p><p><b>RESULTS</b>A total of 3082 patients for whom complete information was available were included in the investigation, including 905 sputum culture-positive PTB cases, 914 sputum culture-negative PTB cases, and 1263 non-TB respiratory disease cases. The positive rate of T-SPOT.TB was 93.3% in the culture-positive PTB group and 86.1% in the culture-negative PTB group. In the non-PTB group, the positive rate of T-SPOT.TB was 43.6%. The positive rate of T-SPOT.TB in the culture-positive PTB group was significantly higher than that in the culture-negative PTB group (χ2 = 25.118, P < 0.01), which in turn was significantly higher than that in the non-TB group (χ2 = 566.116, P < 0.01). The overall results were as follows: sensitivity, 89.7%; specificity, 56.37%; positive predictive value, 74.75%; negative predictive value, 79.11%; and accuracy, 76.02%.</p><p><b>CONCLUSIONS</b>High false-positive rates of T-SPOT.TB assays in the non-TB group limit the usefulness as a single test to diagnose active TB in China. We highly recommend that IGRAs not be used for the diagnosis of active TB in high-burden TB settings.</p>

Study on the efficacy evaluation of real-time fluorescence assay of RNA isothermal amplification in the treatment of patients with positive pulmonary tuberculosis / 天津医药

@#Objective To investigate the value of real-time fluorescence detection technique of RNA (SAT) constantamplification in monitoring the effect of chemotherapy on patients with sputum positive pulmonary tuberculosis. Methods Sixty-two patients were selected, who were clinically diagnosed as the first-time retreatment for sputum smear-positive pulmonary tuberculosis and were hospitalized in our department from June 2015 to December 2016. After two-month standard anti-tuberculosis treatment, sputum samples were detected by Peng’s vessel acid-fast staining, BACTEC MGIT- 960 culture and strain identification, SAT detection. The BACTEC MGIT-960 culture and strain identification were used as gold standards, the value of SAT during the monitoring the therapeutic effect of the anti-tuberculosis drugs was assessed. Results After the treatment, 49 cases out of 62 showed positive results in mycobacterium tuberculosis culture test, among them 42 patients were diagnosed as human type mycobacterium tuberculosis, 7 patients were diagnosed as nontuberculous mycobacteria infection, and 13 cases showed negative results in mycobacterium tuberculosis culture. Thirty-two cases showed positive results in sputum Peng’s vessel acid-fast staining test, and 30 cases showed negative results. Forty-one cases showed positive results in SAT test and 21 cases showed negative results in SAT. SAT results were well concordant with sputum culture results (Kappa value=0.964), and the sensitivity, the specificity, the positive predictive value and the negative predictive value of SAT were 97.62%, 100%, 100% and 95.24% respectively. Peng’s vessel acid-fast staining results were badly concordant with MGIT-960 culture results (Kappa value=0.086), and the sensitivity, the specificity, the positive predictive value and the negative predictive value of Peng’s vessel acid-fast staining were 54.76%, 55.00%, 71.88% and 36.67% respectively. Conclusion SAT results can be used as good indices during the monitoring therapeutic effects of drugs used for the first-time retreatment in patients with sputum smear-positive pulmonary tuberculosis, which is worth promoting.

Clinical Observation of Staging Treatment with Various Acupuncture Therapies Mainly on Yifeng Point for Peripheral Facial Paralysis / 广州中医药大学学报

Objective To investigate the clinical efficacy of staging treatment with various acupuncture therapies mainly on Yifeng (TE17) point for the treatment of peripheral facial paralysis. Methods One hundred and two peripheral facial paralysis patients were randomly divided into trial group and control group, 51 patients in each group. The trial group was given acupuncture mainly on Yifeng point, by Yang needling(plum-blossom needling) for acute stage, Qi needling(concentrated triple-needling) for resting stage and Bang needling(lateral needling) for recovery stage. The control group was given conventional acupuncture. The treatment for the two groups was performed once a day, 5 continuous days constituted a course, and the treatment lasted 3 courses. Before treatment and after treatment for 1, 2, 3 course (s), facial nerve function scores were evaluated with House-Brackmann Grading Scale (HB) and the scores of pain in head and face were evaluated with Visual Analogue Scale (VAS). And the clinical efficacy of the two groups was assessed after treatment. Results (1) After treatment for 3 courses, the cure rate and total effective rate of the trial group were 82.35％, 100.00％, and those of the control group were 60.78％, 86.27％, respectively. The differences between the two groups were significant (P <0.05). (2) After treatment, HB scores and VSA scores of patients with facial pain and headache in the two groups were improved after treatment (P < 0.05 compared with those before treatment), and the improvement in the trial group was superior to that in the control group (P < 0.05). Conclusion Staging treatment with various acupuncture therapies mainly on Yifeng point is more effective for the treatment of peripheral facial paralysis than conventional acupuncture.

Therapeutic Observation of Stage-based Treatment of Peripheral Facial Paralysis with Yifeng (TE 17) as the Major Point Treated by Different Acupuncture Methods / 上海针灸杂志

Objective To observe the clinical efficacy of stage-based treatment of peripheral facial paralysis with Yifeng (TE 17) selected as the major point treated by different acupuncture methods.Method A total of 102 patients with peripheral facial paralysis were randomized into a treatment group and a control group, 51 cases each. The treatment group was intervened by selecting Yifeng (TE 17) as the major point, treated with centro-square needling in the acute stage, triple needling in the resting stage, and proximal needling in the remission stage; the control group was intervened by ordinary acupuncture. The two groups were treated once a day, 5 d as a course of treatment. Before and after 3 treatment courses, the House Brackmann (HB) facial nerve grading scale and Visual Analogue Scale (VAS) in those patients complicated with pain were observed, and the clinical efficacies were compared.Result The total effective rate and recovery rate were respectively 100.0％ and 82.3％ in the treatment group versus 86.3％ and 60.8％ in the control group, and the between-group differences were statistically significant (P<0.05). The HB scores were significantly changed respectively after 1, 2 and 3 treatment courses in the two groups compared with the pre-treatment scores (P<0.05). The HB scores in the treatment group were significantly different from those in the control group respectively after 1, 2 and 3 treatment courses (P<0.05). The patients complicated with facial pain or headache presented significant differences in VAS score respectively after 1, 2 and 3 treatment courses in the two groups (P<0.05). In comparing the VAS score in the patients complicated with facial pain or headache, there were significant differences between the two groups respectively after 1, 2 and 3 treatment courses (P<0.05).Conclusion Stage- based treatment with Yifeng (TE 17) selected as the major point treated with different acupuncture methods can produce valid efficacy in treating peripheral facial paralysis.

Clinical analysis of high resolution CT semi quantitative evaluation of glucocorticoid in the treatment of idiopathic interstitial pneumonia / 中国生化药物杂志

Objective To evaluate the short-term effect of glucocorticoid therapy in patients with idiopathic interstitial pneumonia by high resolution CT semi quantitative score. Methods 32 cases of idiopathic interstitial pneumonia were treated with conventional treatment, combined with glucocorticoids, the use of high resolution CT semi quantitative score, the short-term efficacy of its accurate judgement. Results The analysis shows that high resolution CT semi quantitative score below 20％ idiopathic interstitial pneumonia patients with hospital mortality period is only 5.26％, and the high resolution CT semi quantitative score during the high fatality rate of 38.46％ hospitalized patients with 20.00％ or more, the difference was statistically significant (P<0.05). Conclusion The application of high resolution CT semi quantitative score of received corticosteroid therapy for idiopathic interstitial pneumonia patients with curative effect to give accurate judgment to the doctor for the future development of drug treatment and guarantee its prognosis are of positive significance.

Comparison of the histological morphology between normal skin and scar tissue / 华中科技大学学报（医学）（英德文版）

Skin wound healing is a complex event, and interrupted wound healing process could lead to scar formation. The aim of this study was to examine the morphological changes of scar tissue. Pathological staining (HE staining, Masson's trichrome staining, methenamine silver staining) was used to evaluate the morphological changes of regenerating epidermis in normal skin and scar tissue, and immunofluorescence staining to detect the expression of collagen IV, a component of basement membrane (BM), and the expression of integrinβ4, a receptor for BM laminins. Additionally, the expression of CK14, CK5, and CK10 was measured to evaluate the proliferation and differentiation of keratinocytes in normal skin and scar tissue. The results showed that the structure of the skin was histologically changed in scar tissue. Collagen IV, expressed under the epidermis of normal skin, was reduced distinctly in scar tissue. Integrinβ4, expressed in the basal layer of normal skin, was found absent in the basal layer of scar tissue. Additionally, it was found that keratinocytes in scarring epidermis were more proliferative than in normal skin. These results indicate that during the skin wound healing, altered formation of BM may affect the proliferation of keratinocytes, reepithelial and tissue remodeling, and then result in scar formation. Thus, remodeling BM structure during wound repair may be beneficial for improving healing in cutaneous wounds during clinical practice.

Isoprenaline Induces Periostin Expression in Gastric Cancer

PURPOSE: Periostin mediates critical steps in gastric cancer and is involved in various signaling pathways. However, the roles of periostin in promoting gastric cancer metastasis are not clear. The aim of this study was to investigate the relevance between periostin expression and gastric cancer progression and the role of stress-related hormones in the regulation of cancer development and progression. MATERIALS AND METHODS: Normal, cancerous and metastatic gastric tissues were collected from patients diagnosed with advanced gastric cancer. The in vivo expression of periostin was evaluated by in situ hybridization and immunofluorescent staining. Meanwhile, human gastric adenocarcinoma cell lines MKN-45 and BGC-803 were used to detect the in vitro expression of periostin by using quantitative real-time polymerase chain reaction (PCR) and western blotting. RESULTS: Periostin is expressed in the stroma of the primary gastric tumors and metastases, but not in normal gastric tissue. In addition, we observed that periostin is located mainly in pericryptal fibroblasts, but not in the tumor cells, and strongly correlated to the expression of α-smooth muscle actin (SMA). Furthermore, the distribution patterns of periostin were broader as the clinical staging of tumors progressed. We also identified a role of stress-related signaling in promoting cancer development and progression, and found that isoprenaline upregulated expression levels of periostin in gastric cancer cells. CONCLUSION: These findings suggest that the distribution pattern of periostin was broader as the clinical staging of the tumor progressed and found that isoprenaline upregulated expression levels of periostin in gastric cancer cells.

Comparison of the histological morphology between normal skin and scar tissue / 华中科技大学学报（医学）（英德文版）

Skin wound healing is a complex event, and interrupted wound healing process could lead to scar formation. The aim of this study was to examine the morphological changes of scar tissue. Pathological staining (HE staining, Masson's trichrome staining, methenamine silver staining) was used to evaluate the morphological changes of regenerating epidermis in normal skin and scar tissue, and immunofluorescence staining to detect the expression of collagen IV, a component of basement membrane (BM), and the expression of integrinβ4, a receptor for BM laminins. Additionally, the expression of CK14, CK5, and CK10 was measured to evaluate the proliferation and differentiation of keratinocytes in normal skin and scar tissue. The results showed that the structure of the skin was histologically changed in scar tissue. Collagen IV, expressed under the epidermis of normal skin, was reduced distinctly in scar tissue. Integrinβ4, expressed in the basal layer of normal skin, was found absent in the basal layer of scar tissue. Additionally, it was found that keratinocytes in scarring epidermis were more proliferative than in normal skin. These results indicate that during the skin wound healing, altered formation of BM may affect the proliferation of keratinocytes, reepithelial and tissue remodeling, and then result in scar formation. Thus, remodeling BM structure during wound repair may be beneficial for improving healing in cutaneous wounds during clinical practice.

A modified method for locating parapharyngeal space neoplasms on magnetic resonance images: implications for differential diagnosis / 癌症

The parapharyngeal space (PPS) is an inverted pyramid-shaped deep space in the head and neck region, and a variety of tumors, such as salivary gland tumors, neurogenic tumors, nasopharyngeal carcinomas with parapharyngeal invasion, and lymphomas, can be found in this space. The differential diagnosis of PPS tumors remains challenging for radiologists. This study aimed to develop and test a modified method for locating PPS tumors on magnetic resonance (MR) images to improve preoperative differential diagnosis. The new protocol divided the PPS into three compartments: a prestyloid compartment, the carotid sheath, and the areas outside the carotid sheath. PPS tumors were located in these compartments according to the displacements of the tensor veli palatini muscle and the styloid process, with or without blood vessel separations and medial pterygoid invasion. This protocol, as well as a more conventional protocol that is based on displacements of the internal carotid artery (ICA), was used to assess MR images captured from a series of 58 PPS tumors. The consequent distributions of PPS tumor locations determined by both methods were compared. Of all 58 tumors, our new method determined that 57 could be assigned to precise PPS compartments. Nearly all (13/14; 93%) tumors that were located in the pre-styloid compartment were salivary gland tumors. All 15 tumors within the carotid sheath were neurogenic tumors. The vast majority (18/20; 90%) of trans-spatial lesions were malignancies. However, according to the ICA-based method, 28 tumors were located in the pre-styloid compartment, and 24 were located in the post-styloid compartment, leaving 6 tumors that were difficult to locate. Lesions located in both the pre-styloid and the post-styloid compartments comprised various types of tumors. Compared with the conventional ICA-based method, our new method can help radiologists to narrow the differential diagnosis of PPS tumors to specific compartments.

Nasopharyngeal adenoid cystic carcinoma: magnetic resonance imaging features in ten cases / 癌症

Nasopharyngeal adenoid cystic carcinoma (NACC) is a rare malignancy with high local invasiveness. To date, there is no consensus on the imaging characteristics of NACC. To address this, we retrospectively reviewed 10 cases of NACC and summarized the magnetic resonance imaging (MRI) features. MR images of 10 patients with histologically validated NACC were reviewed by two experienced radiologists. The location, shape, margin, signal intensity, lesion texture, contrast enhancement patterns, local invasion, and cervical lymphadenopathy of all tumors were evaluated. Clinical and pathologic records were also reviewed. No patients were positive for antibodies against Epstein-Barr virus (EBV). The imaging patterns of primary tumors were classified into two types as determined by location, shape, and margin. Of all patients, 7 had tumors with a type 1 imaging pattern and 3 had tumors with a type 2 imaging pattern. The 4 tubular NACCs were all homogeneous tumors, whereas 3 (60%) of 5 cribriform NACCs and the sole solid NACC were heterogeneous tumors with separations or central necrosis on MR images. Five patients had perineural infiltration and intracranial involvement, and only 2 had cervical lymphadenopathy. Based on these results, we conclude that NACC is a local, aggressive neoplasm that is often negative for EBV infection and associated with a low incidence of cervical lymphadenopathy. Furthermore, MRI features of NACC vary in locations and histological subtypes.

Imaging features and clinicopathological manifestations of solitary fibrous tumors / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the imaging features, clinical manifestations and pathological characteristics of solitary fibrous tumors (SFT).</p><p><b>METHODS</b>The clinicopathological manifestations and medical imaging findings were analyzed retrospectively in 27 patients with surgically confirmed SFT.</p><p><b>RESULTS</b>The SFTs originated from different parts of the body, including 18 in the chest, 4 in the abdomen, 1 in the lumboscral area, 3 in the pelvis, and 1 in the left shoulder. Twenty-three cases were found by CT scan, among which there were 16 benign diseases, presented with well-defined round or elliptic margins, with homogeneous attenuation and clearly surrounding; 6 malignant cases with unclear demarcations, invasive surrounding, heterogeneous attenuation due to calcification and/or irregular necrosis, and 1 junctional case with well-defined margins, which was enlarged during follow-up. There were 4 SFTs scanned by MRI with clear margin and homogeneous or heterogeneous signal intensity. All of the 4 cases were isointense or hyperintense to muscle on T1-weighted images, and were hyperintense on the T2-weighted images. All tumors showed heterogeneously intense enhancement with geographic pattern. Immunohistochemical staining showed that CD34-positive was 81.5%, vimentin (100.0%), CD99 (100.0%) and bcl-2 (96.3%), as well as negative CK (100.0%) and S-100 (96.3%).</p><p><b>CONCLUSION</b>The location of SFT is varying. Though its clinical manifestations vary, the diagnosis is depended on pathology and immunohistochemistry. There are certain specific features related to SFTs on CT or MRI. These imaging techniques may serve to provide helpful information as to the location and vicinal anatomic structure of the tumor, which is of substantial importance for planning surgery.</p>

Diagnostic value of ADC and rADC of diffusion weighted imaging in malignant breast lesions / 中华肿瘤杂志

<p><b>OBJECTIVE</b>The aim of this study was to evaluate the value of diffusion weighted imaging (DWI) in the diagnosis of patients with breast diseases.</p><p><b>METHODS</b>Fifty-three consecutive patients were scanned with GE signa HDx 1.5 T magnetic resonance system equipped with 8-channel breast coil. DWI was scanned by SE-EPI sequence in b values of 500 s/mm(2) and 800 s/mm(2), respectively. The apparent diffusion coefficients (ADC) of these lesions were measured. The mean apparent diffusion coefficients (ADC) of these lesions were calculated in b values of 500 s/mm(2) and 800 s/mm(2), respectively. These lesions' ADC value (rADC) was counted respectively and the result of the rADC was equal to the lesion's ADC divided by the ADC of the ipsilateral normal breast tissue. Threshold of ADC and rADC for differential diagnosis was acquired by ROC (receiver operating characteristic curve) analysis. Different imaging technologies were evaluated emphasizing their sensitivity, specificity and accuracy.</p><p><b>RESULTS</b>Sixty-six lesions of 53 cases were confirmed by pathology, including 39 malignant lesions and 27 benign lesions. (1) b = 500 s/mm(2), the threshold of ADC value was 1.435 x 10(-3) mm(2)/s, with a sensitivity of 82.1% and a specificity of 81.5%. The threshold of rADC value was 0.62, with a sensitivity of 76.9% and a specificity of 100%. (2) b = 800 s/mm(2), the threshold of ADC value was 1.295 x 10(-3) mm(2)/s, with a sensitivity of 79.5% and a specificity of 81.5%. The threshold of rADC value was 0.71, with a sensitivity of 89.7% and specificity of 88.9%. (3) The area under the ROC curve was increased for the four diagnostic indicators (ADC(500), ADC(800), rADC(500), rADC(800)).</p><p><b>CONCLUSION</b>DWI spends short time, and it doesn't need contrast material. ADC value and rADC value have a high sensitivity and specificity as a diagnostic indicator. DWI is helpful in improving the specificity of MR and may become one of valuable conventional procedures for breast tumor diagnosis.</p>

Validity and reliability of Chinese version of alcohol withdrawal scale(AWS) / 中华行为医学与脑科学杂志

Objective To evaluate the validity and reliability of the Chinese version of Alcohol Withdrawal Scale (AWS). Methods Totally 175 patients diagnosed as alcohol dependence according to the criteria of ICD-10 were studied. Intraclass correlation coefficient (ICC) analysis was applied for examining interrater consistency and Cronbach' s α for internal consistency. Factor analysis was used to examine the construct validity. Correlation analysis between AWS and CGI,Revised Clinic Institute Alcohol Withdrawal Syndrome Scale(CIWA-Ar) were conducted to evaluate the criterion validity. Based on clinical criteria,ROC curve was calculated so as to test the discriminative ability and establish the cut-off point of the scale. Results ( 1 ) Reliability: ICC value was 0.93,and Cronbach's α was 0.83,which indicated good interrater and internal consistency. (2) Validity:the correlation coefficients of the two subscale with the total scale score were 0.78,0.83 respectively. The correlation coefficients between the subscale were 0. 81 and factor analysis revealed that each item of the scale had relatively high load on the primary factor (0.409 ～0.926). At the time of admission,the total score of the AWS was positively correlated with that of CGI ( r = 0.71, P < 0.05 ). The total score of the AWS also was positively correlated with that of CIWA-Ar ( r = 0. 86, P<0. 05). As treatment went on,total score of the AWS showed a downward trend,at the end of the first week,the total score of the AWS was positively correlated with that of CGI ( r = 0.62, P<0.05). (3)The cut-off point of AWS for mild alcohol withdrawal state was determined as ≥3. With this cut-off point,AWS had both high sensitivity (92.1% ) and specificity (73.5% ) ,and the area under curve (AUC) was 0. 91. The cut-off point of AWS for moderate withdrawal state was determined as ≥7, and the sensitivity and specificity of AWS were 94.3 % and 89.7 % respectively, with the AUC of 0.94. The cut-off point of AWS for severe withdrawal state was determined as ≥ 10. With this cut-off point AWS had both high sensitivity (94. 9% ) and high specificity (92.6% ) .with the AUC of 0.93. Conclusion AWS has good reliability and validity and can reflect the change of the disease and the efficacy of treatment.

Preventive effect of transcutaneous electro-acupuncture on the intratracheal extubation stress response in general anesthesia of patients with breast cancer undergoing modified radical mastectomy / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the regulatory effect of transcutaneous electro-acupuncture (TCEA) for preventing intratracheal extubation stress response (IESR) in general anesthesia.</p><p><b>METHODS</b>Sixty patients with breast cancer scheduled to receive mastectomy were numbered according to their sequence of hospitalization, patients of odd number were assigned to the control group and those of even number to the treated group, 30 in each group. They were anesthetized by the same anesthesia approach, but TCEA was applied on patients in the treated group in the narcotic process by stimulating at Hegu (LI4) and Neiguan (PC6) of the diseased side for 20 min before induction; then on bilateral points of Hegu, Neiguan, Chize (LU5) and Lieque (LU7) all through the whole course of operation, but at time of 30 min before ending operation, stimulus at Chize and Lieque points stopped and turned to bilateral Shuitu (ST10) and Qishe (ST11) points. No management other than conventional anesthesia was applied on patients in the control group. Changes of blood pressure (MAP), heart rate (HR), plasma catecholamine and cortisol as well as the respiratory tract response occurred after extubation were observed and compared.</p><p><b>RESULTS</b>HR, MAP, plasma levels of catecholamine and cortisol increased after extubation in both groups (P < 0.05), but the changes were more obvious in the control group than in the treated group (P < 0.05). Besides, the adverse reaction of respiratory tract occurred in the treated group was milder (P < 0.05).</p><p><b>CONCLUSIONS</b>TCEA can alleviate the IESR to attenuate the adverse reaction of respiratory tract. It is definitely valuable in clinical practice.</p>

Auditory cortical responses evoked by pure tones in healthy and sensorineural hearing loss subjects: functional MRI and magnetoencephalography / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Blood oxygen level dependent functional magnetic resonance imaging (fMRI) and magnetoencephalography are new techniques of brain functional imaging which can provide the information of excitation of neurons by measure the changes of hemodynamics and electrophysiological data of local brain tissue. The purpose of this study was to study functional brain areas evoked by pure tones in healthy and sensorineural hearing loss subjects with these techniques and to compare the differences between the two groups.</p><p><b>METHODS</b>Thirty healthy and 30 sensorineural hearing loss subjects were included in this study. In fMRI, block-design paradigm was used. During the active epoch the participants listened to 1000 Hz, sound pressure level 140 dB pure tones at duration 500 ms, interstimulus interval 1000 ms, which presented continuously via a magnetic resonance-compatible audio system. None stimulus was executed in control epoch. In magnetoencephalography study, every subject received stimuli of 1000 Hz tone bursts delivered to the bilateral ear at duration 8 ms, interstimulus intervals 1000 ms. Sound pressure level in healthy subjects was 30 dB; in sensorineural hearing loss subjects was 20 dB above everyone's hearing threshold respectively. All subjects were examined with 306-channel whole-scalp neuromagnetometer.</p><p><b>RESULTS</b>In fMRI, all subjects showed significant activations in bilateral Heschl's gyri, anterior pole of planum temporale, planum temporale, precentral gyri, postcentral gyri, supramarginal gyri, superior temporal gyri, inferior frontal gyri, occipital lobes and cerebellums. The healthy subjects had more intensive activation in bilateral Heschl's gyri, anterior pole of planum temporale, inferior frontal gyri, left superior temporal gyri and right planum temporale than the hearing loss subjects. But in precentral gyri, postcentral gyri and occipital lobes, the activation is more intensive in the hearing loss subjects. In magnetoencephalography study, both in the hearing loss and the healthy subjects, the most evident audio evoked fields activated by pure tone were N100m, which located precisely on the Heschl's gyrus. Compared with the hearing loss subjects, N100m of the healthy subjects was stronger and had longer latencies in right hemisphere.</p><p><b>CONCLUSIONS</b>Under proper pure tone stimulus the activation of auditory cortex can be elicited both in the healthy and the sensorineural hearing loss subjects. Either at objective equivalent stimuli or at subjectively perceived equivalent stimuli, the auditory responses were more intensive in healthy subjects than hearing loss subjects. The tone stimuli were processed in a network in human brain and there was an intrinsic relation between the auditory and visual cortex. Blood oxygen level dependent fMRI and magnetoencephalography could reinforce each other.</p>