Objective To evaluate the safety and accuracy of CT-guided cutting needle biopsy for the hepatic lesions near diaphragmatic dome.Methods A total of 25 cases with hepatic lesions near the diaphragmatic dome were undertaken CT-guided cutting needle biopsy using 16 gauge or 18 gauge core biopsy needles.Results Histological examination showed malignancy in 17 cases and benign in 8 with 2 false negative results(8%),and there were no false positive results.The specificities of malignant and benign lesions were 100% and 75%,respectively.Overall accuracy was 92%.Pneumothorax,needle tract hemorrhage,and subcapsular hepatic hemorrhage occurred in 2(8%),1(4%)and 1(4%),respectively.Conclusion CT-guided cutting needle biopsy for the hepatic lesions near diaphragmatic dome is a reliable and relatively safe diagnostic method.(J Intervent Radiol,2007,16:838-840)

Objective To evaluate the functional outcome,predicting response and toxicity of CT- guided permanent implanted ~(125)I seed branchytherapy for metastatic cancers in vertebrae.Methods Forty three vertebrae with metastatic cancer were treated by CT-guided percutaneous permanent implanted ~(125)I seed branchytherapy in 15 patients.There were 8 male and 7 female patients with average age of 54.6 years and 2 to 5 vertebrae involved in this group.According to the size of tumor,the optimal activity and quantity of seeds were calculated by TPS and correlative formula.~(125)I seeds were implanted percutaneous puncture under CT- guidance with coaxial needles to pass the normal osseous tissue for approaching the lesions including 3 routes of pedicnlar lateral and anterior ways.The distance between seeds and posterior border of vertebral body was over 3 nun(3-10mm).Permanent ~(125)I seed implantation brachytherapy for paraspinal metastatic lesions were also taken place.Results Mean follow-up time was 12.3 months(range 3-30 months)and outcome was evaluated clinically and radiographieally in 10 of 15 procedures,with 5 only on clinical data.No new pain occurred at 11 sites with no previous complaint.The pain was completely controlled at 18/32 sites,partial control at 14/32 sites.No complications correlated to the radiotherapy damage of nerve and spinal cord were found.Conclusion The procedure of CT-guided permanent implanted ~(125)I seeds brachytherapy for vertebral metastatic cancers is a safe effective and minimal invasive method with few complications.It is beneficial not only for pretherapeutic metastasis but also for recurrent tumors after radiotherapy;bearing rather high tolerance and safety.(J Intervent Radiol,2007,16:834-837)

Objective To evaluate enteral nutrition treatment on nutritional status of patients with esophageal cancer during radiotherapy in Chinese population. Methods We searched domestic and foreign relevant databases (PubMed, Medline, Cochrane Library, Wanfang Data, Chinese Journal Database, VMIS) by key words (esophageal cancer, chemoradiotherapy, enteral nutrition) , meeting the conditions of the clinical randomized controlled trials, and evaluated the quality of each document. We used meta-analysis method to analysis the published literatures about clinical randomized controlled trials, which were enteral nutrition treatment on nutritional status of patients with esophageal cancer during radiotherapy in Chinese population.RevMan5.1 statistical analysis software were used. Results Seven separate clinical randomized controlled trials including 503 cases were included into the meta-analysis. The following five indexes of nutritional status in enteral nutrition treatment (ENT) group were superior to routine treatment (RT) group (P<0.05): body weight, Body Mass Index (BMI), hemoglobin, serum albumin, serum prealbumin. The MD Values and 95％CI (confidence interval) were 5.54 (3.61-7.46), 2.20 (2.02-2.39), 12.46 (5.86-19.05), 4.04 (2.48-5.61), 49.53 (20.93-78.13) .The funnel plot showed no significant publication bias in each indexes. Conclusion Enteral nutrition treatment can improve the nutritional status of patients with esophageal cancer during radiotherapy compare only with routine treatment.

OBJECTIVETo investigate the role of transrectal real-time tissue elastography (TRTE) in the diagnosis of prostate cancer (PCa).

METHODSEighty-four patients with suspected PCa and scheduled for prostate biopsies underwent TRTE, digital rectal examination (DRE), transrectal ultrasonography (TRUS), and magnetic resonance imaging (MRI). The findings of TRTE were compared with those of other examinations and pathological findings.

RESULTSOf these 84 patients, 36 had benign lesions and 48 had PCa. The diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 91.7%, 72.2%, 83.3%, 81.5%, and 86.7% for TRTE and 85.4%ì63.9%ì76.2%, 75.9%, and 76.7% for TRUS (P>0.05), while its specificity (72.2%) was significantly higher than that of MRI (44.4%) (P=0.03). The TRTE findings were not significantly correlated with the pathological findings and serum total prostate specific antigen (P>0.05), and the diagnostic sensitivity of TRTE decreased along with the enlargement of prostate. However, the diagnostic specificity of TRTE was higher than MRI for nodules with soft to medium texture (P=0.04).For PCa, the diagnostic sensitivity of TRTE increased when the Gleanson scores of tumors increased (P<0.05).

CONCLUSIONTRTE can be used as a diagnostic test to supplement clinical diagnosis of PCa.

Adult ; Aged ; Aged, 80 and over ; Elasticity Imaging Techniques ; methods ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prostatic Neoplasms ; diagnostic imaging ; Rectum ; diagnostic imaging ; Sensitivity and Specificity

OBJECTIVETo investigate the outcomes of perineal urethrostomy plus secondary urethroplasty for ultralong urethral stricture and assess its influence on the patient's quality of life.

METHODSWe retrospectively analyzed 54 cases of ultralong urethral stricture treated by perineal urethrostomy from 2000 to 2010. The mean age of the patients was 40 years, and the average length of stricture was 6.5 cm. We evaluated the patients'quality of life by questionnaire investigation and the clinical outcomes based on IPSS, Qmax, the necessity of urethral dilation and satisfaction of the patients.

RESULTSThe mean Qmax of the 54 patients was (14.0 +/- 4.7) ml/min. Of the 34 cases that underwent secondary urethroplasty, 22 (64.7%) achieved a mean Qmax of (12.0 +/- 3.5) ml/min, 8 (23.5%) needed regular urethral dilatation and 4 (11.8%) received internal urethrotomy because of restenosis. IPSS scores were 5.4 +/- 2.1 and 8.5 +/- 5.8 after perineal urethrostomy and secondary urethroplasty, respectively. Fifty of the total number of patients (92.6%) were satisfied with the results of perineal urethrostomy, and 22 of the 34 (64.7%) with the results of secondary urethroplasty.

CONCLUSIONPerineal urethrostomy plus secondary urethroplasty is safe and effective for ultralong urethral stricture, and affects very little the patient's quality of life.

Adolescent ; Adult ; Aged ; Child ; Humans ; Male ; Middle Aged ; Ostomy ; Perineum ; surgery ; Quality of Life ; Retrospective Studies ; Treatment Outcome ; Urethral Stricture ; surgery ; Urologic Surgical Procedures ; methods ; Young Adult

OBJECTIVETo explore treatments of severe post-kidney-transplant lung infection by integrative Chinese and Western medicine (ICWM), in order to elevate the curing rate as well as to lower the death rate.

METHODSBased on conventional ways of Western medical treatments of 18 cases of severe post-kidney-transplant lung infection, such as putting the patients in single individual ward, antibiotics to prevent infection, respiratory machines, blood filtration, nutritional support, steroids, and maintaining electrolytes balance, we applied integrated Chinese medicinal treatments, like altering conventional prescription "pneumonia III", and conducted clinical observation of effectiveness, and indexes including white blood cell (WBC), neutrophilic granulocyte, blood urea nitrogen (BUN), blood creatinine (Cr), etc.

RESULTSOf the 18 cases studied, 7 were already cured, 8 proved the treatment effective, 3 died. All clinical indexes had statistically significant changes compared with those of before treatment (P < 0.01).

CONCLUSIONICWM can increase curing rate and lower death rate.

Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Immunocompromised Host ; Immunosuppressive Agents ; therapeutic use ; Kidney Transplantation ; Lung Diseases ; drug therapy ; immunology ; Male ; Middle Aged ; Opportunistic Infections ; drug therapy ; Respiratory Tract Infections ; drug therapy ; immunology

OBJECTIVETo examine whether the enhanced expression of CD40L cDNA on murine ovarian cancer (OVHM) cells could induce the secretion of Th1 cytokines from dendritic cells (DC).

METHODSOVHM cells were transfected with the full-length mouse CD40L cDNA by lipofectamine 2000 and then G418 resistant cells as positive cells were selected. They were examined for their expression of CD40L with flow cytometry. Bone marrow cells were firstly depleted of erythrocytes, macrophages, T and B cells with PE-conjugated magnetic beads, and then cultured in 10% FCS RPMI 1640 medium supplemented with recombinant mouse GM-CSF and IL-4 for 10 days. PKH67-labeled tumor cells were cultured with DC, and then the stained cells were analyzed for the expression of MHC-I, MHC-II, CD80, CD86, CCR7 in DC with flow cytometry. The expression of p40, p19, p35, p28, EBI3 subunits, IL-18, IFN-gamma, Mig gene in cocultured DC-tumor cells were detected by RT-PCR.

RESULTSThe CD40L cDNA was successfully transfected into OVHM cells. Bone marrow-derived DCs, when cultured with CD40L/OVHM, formed clusters with the tumors and showed an upregulated expression of MHC- I, MHC-II, CD80, CD86, CCR7. Expression of the IL-12, IL-23, IL-27, IL-18, interferon-gamma (IFN-gamma) and Mig (monokine induced by IFN-gamma) genes was induced in the DCs that were cultured with CD40L/OVHM but not with OVHM cells.

CONCLUSIONThese data directly showed that the expression of CD40L on ovarian cancer cells facilitates the interaction between DCs and tumors, enhances the maturation of DCs, induces secretion of Th1 cytokines, especially for IL-12, IL-23 and IL-27, which maybe one of the possible antitumor mechanism for CD40L-transfected ovarian cancer cell line.

Animals ; CD40 Ligand ; genetics ; metabolism ; Cell Line, Tumor ; Cells, Cultured ; Coculture Techniques ; Cytokines ; secretion ; DNA, Complementary ; genetics ; Dendritic Cells ; cytology ; metabolism ; Female ; Interleukin-12 ; secretion ; Interleukin-23 ; secretion ; Interleukins ; secretion ; Mice ; Ovarian Neoplasms ; metabolism ; pathology ; Th1 Cells ; secretion ; Transfection

OBJECTIVETo explore different microRNA expression profiles between chronic hepatitis B (CHB) patients of Pi-Wei dampness-heat syndrome (PWDHS) and Gan depression Pi deficiency syndrome (GDPDS).

METHODSBy applying gene chip technology, blood samples from CHB patients of PWDHS (3 cases), GDPDS (3 cases), and healthy volunteers (3 cases) were withdrawn and microRNA detected. The microRNA was screened and functional analyses performed by using SAS system.

RESULTSTotally 77 microRNAs with differential expression were screened from CHB patients of PWDHS and healthy volunteers, including 60 up-regulated microRNAs and 17 down-regulated microRNAs. Functions of target genes were mainly associated with transcription factors, gas exchange, adverse stimulating, regulation of enzyme activities, developing of the immune system, and the process of actin filaments. Totally 41 microRNAs with differential expression were screened from CHB patients of GDPDS and healthy volunteers, including 32 up-regulated microRNAs and 9 down-regulated microRNAs. Functions of target genes were mainly associated with binding to nucleotide or chromatin, inhibition and activation of transcription, biosynthesis, regulation of metabolic process, regulation of enzyme activities, developing of the immune system, the process of actin filaments, and IL-12. Totally 6 microRNAs with differential expression were screened from CHB patients of PWDHS and CHB patients of GDPDS, including 1 up-regulated microRNA and 5 down-regulated microRNAs. Functions of target genes were mainly associated with transmembrane transport, regulation of transcription factors, metabolism of hormones, developing of the immune system, the process of actin filaments, regulation of metabolic process, response to exterior stimulation, and so on.

CONCLUSIONThere existed differentially expressed microRNAs (spectrum) between CHB patients of PWDHS and CHB patients of GDPDS.

Depression ; Hepatitis B, Chronic ; genetics ; metabolism ; Hot Temperature ; Humans ; Interleukin-12 ; metabolism ; Medicine, Chinese Traditional ; MicroRNAs ; metabolism ; Oligonucleotide Array Sequence Analysis ; Research ; Syndrome

OBJECTIVETo investigate the relationship between the clinical character and therapeutic strategy and prognosis in severe acute pancreatitis.

METHODSFrom January 2001 to December 2005, 783 patients with SAP were treated. Therapeutic strategy was selected based on the preliminary scheme for diagnosis and treatment of severe acute pancreatitis by pancreatic surgery society of CMA. All the patients were divided into biliary group and non-biliary group, while 375 patients in biliary group, with 182 patients treated operatively and 193 patients treated nonoperatively; and 408 patients in non-biliary group, with 147 patients treated operatively and 261 patients treated nonoperatively.

RESULTSThere were 698 survivals, the overall survival rate was 89.1%. 357 survivals in the biliary SAP group, the survival rate was 95.0%, in which 171 survivals from operation treated cases, with the survival rate of 94.0%, and 186 survivals from non-operation treated cases, with the survival rate of 96.4%; 341 survivals in the non-biliary SAP group, the survival rate was 84.0%, in which 110 survivals from operation treated cases, with the survival rate of 74.8%, and 231 survivals from non-operation treated cases, with the survival rate of 88.5%. 48.3% patients of the survival group had organ dysfunction, and 18.3% patients had multiple organ dysfunctions, while 100% patients of the death group had organ dysfunction, and 97.6% patients had multiple organ dysfunction. Respiratory dysfunction was found to be the most common cause totally followed by nerve system dysfunction and shock, with the rates of 26.3%, 11.7% and 10.3%, respectively. Respiratory dysfunction, renal dysfunction and cardiac dysfunction are most commonly in death group, with the rate of 94.1%, 60.0% and 60.0%, respectively. The rate of fungi infection in the survival group and death group were 8.9% and 37.6%. The rates of alimentary tract fistula in the survival and death group were 0.9% and 14.1%, respectively.

CONCLUSIONSThe therapy aiming at the cause for biliary SAP and the operation aiming at infected pancreatic necrosis is helpful to improve curative rate; MODS is the main cause of death in severe acute pancreatitis. Respiratory dysfunction, renal dysfunction and cardiac dysfunction are high risk factors.

Female ; Humans ; Male ; Middle Aged ; Pancreatitis, Acute Necrotizing ; diagnosis ; mortality ; therapy ; Prognosis ; Retrospective Studies ; Survival Rate

OBJECTIVETo explore the causes of nonspecific chronic cough in children and relationship between transient receptor potential vanilloid 1 (TRPV1) gene polymorphisms and nonspecific chronic cough.

METHODSA total of 195 children with chronic cough were followed up half a month, one month and three months after their first visit to hospital. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to examine polymorphisms of the TRPV1 gene in the children. A total of 205 healthy or surgical children without chronic cough served as the control group.

RESULTSThe etiologic distribution of the 195 children with chronic cough was as follows: 96 (49.2%) cases of cough variant asthma (CVA), 48 (24.6%) cases of CVA complicated by upper airway cough syndrome (UACS), 34 (17.4%) cases of post-infectious cough, and 17 (8.7%) cases of UACS. Three genotypes were identified in both groups at positions rs222747 (CC, GC and GG), rs222748 (CC, TC and TT) and rs8065080 (CC, TC and TT). The frequencies of genotype and allele at position rs222747 did not accord with the law of Hardy-Weinberg. There was no significant difference in frequencies of genotype and allele at positions rs222748 and rs8065080 between the two groups.

CONCLUSIONSCVA, UACS and post-infectious cough are common causes of nonspecific chronic cough in children. TRPV1 gene polymorphisms at positions rs222748 and rs8065080 may be unrelated to nonspecific chronic cough in children.

Adolescent ; Alleles ; Child ; Child, Preschool ; Chronic Disease ; Cough ; etiology ; genetics ; Female ; Genotype ; Humans ; Infant ; Male ; Polymorphism, Genetic ; TRPV Cation Channels ; genetics