Plastic Bronchitis (PB) is a condition characterized by formation of plugs or casts in the tracheobronchial tree, which can induce partial or complete airway obstruction and ventilatory dysfunction.The clinical manifestations are nonspecific, usually including cough, progressive dyspnea and refractory hypoxemia.However, dyspnea and hypoxemia can be quickly improved by removing branching casts with bronchoscopy.Now, the the clinical features and differential diagnosis of PB are described in this article, in order to improve the diagnosis of the disease.

Molecular imaging technologies are newly emerging subjects in recent years, which are the medical research hotspots today. Advances of several common molecular imaging technologies in the staging of non-small cell lung cancer were reviewed in this article.

Objective To analyze the prevalence of nosocomial infections among inpatients and its influential factors.Methods The retrospective survey was performed by reviewing and analyzing the clinical data of 7788 inpatients in 2004 in Nankai Hospital of Tianjin.Results Totally 250 nosocomial infection cases were identified,which gave a prevalence of 3.21%.The all-year highest prevalence was found in September.Among all the departments,the highest rate,5.20%,occurred in Department of Gynecology.The inpatients aged more than 60-year-old showed higher prevalence than those under 60 years old.The main infection position was lower respiratory tract(41.60%).Concludes The prevalence of nosocomial infections of Nankai Hospital were within the acceptable standard range defined by Ministry of Health,China.Nevertheless,the prevalence would be reduced if measurements for surveillance and control could be properly applied.

Objective To determine the capability of quantitative low attenuation areas volume percentage(LAA%)in individual lobes to assess pulmonary function loss and disease severity in pulmonary COPD patients.Methods A total of 80 subjects (50 COPD patients;30 normal smokers),who all were smokers,underwent pulmonary function tests(PFTs)and Chest CT examination at full inspiration.For the quantitative assessment,percentage of low attenuation areas were automatically calculated for each lobe by the post processing software(Thoracic VCAR).To study the correlation between these CT parameters and lung function(FEV1% pre-dicted,FEV1/FVC,DLCO%predicted,RV/TLC),univariate linear regression analysis was performed.CT measurements were compared between the five groups with analysis of covariance(ANCOVA).Results FEV1 and FEV1/FVC had significant correla-tions with all of these CT parameters.DLCO、RV/TLC had significant correlations with these parameters,aside from the LAA% of right middle lobe and right inferior lobe.The LAA% in left upper lobe have the highest correlation with FEV1、DLCO、RV/TLC. However,FEV1/FVC have the highest correlation with the LAA% of right lower lobe.The LAA% of Right lung,right upper lobe,and whole lung were significantly different between the non-COPD group and GOLD1 group.Conclusion Whole lung and every lung lobe low attenuation areas volume percentage were reflected the lung function impairment in COPD patients.

Objective To observe the expression changes of renal tissue Bax,Bcl-2 and caspase-3,to wxamine the correlation between the ratio of Bax to Bcl-2,caspase-3 and renal tubular cells apoptosis,and to investigate the role of caspase-related signal pathway.Methods Forty-eight male Wistar rats were randomly divided into three groups: control (CN,n=8),exhaustive swimming (ES,n=24) and inula britannica (IB,n=16) group.The rats of CN were quiet without swimming.The rats of ES swam to exhaustive state and were sacrificed at immediately(ESI),6 hour (ES 6 h) and 24 hour (ES 24 h) after exhaustive swimming respectively.The rats of IB took orally inala britannica at the dose of 25 ml/kg body weight at 24 h before swimming and then swam to exhaustive state.The rats of IB group were sacrificed at 6 hour (IB 6 h) and 24 hour (IB 24 h)after exhaustive swimming.The animal model of overtraining-induced acute kidney injury was developed by exhaustive swimming.The renal cell apoptosis was measured by the method of TUNEL.The expressions of Bax,Bcl-2,caspase-3 in renal tissue were observed by immunohistochemistry.The expression of caspase-3 protein was examined by Western blotting.The correlation between the ratio of Bax to Bcl-2 and caspase-3 was analysed by Pearson method,and the correlation between the ratio of Bax to Bcl-2,caspase-3 and renal tubular cell apoptosis was analysed by Spearman method.Results The number of renal tubular apeptotic cells was increased progressively in ESI to ES 24 h rats by TUNEL (P＜0.05).Immunohistochemistry staining showed that the ratio of Bax to Bcl-2 and caspase-3 in renal tubular cells were increased progressively at 0 h,6 h and 24 h after exhaustive swimming compared with control group (P＜0.05).The change of renal tissue caspase-3 was also revealved by Western blotting analysis.The ratio of Bax to Bcl-2 and caspase-3 in renal tubular cell was correlated positively (r=0.865,P＜0.05),The ratio of Bax to Bcl-2,and caspase-3 was also correlated positively to renal tubular cell apoptosis (r=0.674,r=0.837,P＜0.05) in ES rats.Pretreatment with inula britannica inhibited the up-regulation of the ratio of Bax to Bcl-2,caspase-3 and cell apoptosis in renal tubular cell induced by exhaustive swimming.Conclusion Overtraining can induce renal tubular cells apoptosis through activating caspase-related signal pathway by impairing the balance of Bax and Bcl-2,which may be one of the important molecular mechanisms of overtraining-induceed renal tubular cells apoptosis.

Objective To study the role of endothelin-1 (ET-1) and angiotensin Ⅱ (AngⅡ) in over-exertion induced acute kidney injury (OTIAKI) by observing the changes in ET-1 and AngⅡ contents in plasma and renal tissue and their relationship with OTIAKI in exhausted rats. Methods 40 male Wistar rats were randomly divided into two groups: control group (CN, n=8) and exhaustion group (ES, n=32). The exhaustion group, depending on the recovery time after exhaustion, was further divided into 4 subgroups (8 each): immediate subgroup (ESI), 6h after exhaustion subgroup (ES 6h), 12h after exhaustion subgroup (ES 12h) and 24h after exhaustion subgroup (ES 24h). The animal model of OTIAKI was reproduced by exhausting swimming, while the rats in control group were not forced to swim. The contents of serum urea (Ur) and creatinine (Cr) in each group were serially measured. The renal specimens were observed with a light microscope to study their morphologic changes. Renal cell apoptosis was detected using terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling (TUNEL) assay. The contents of ET-1 and AngⅡ in plasma and renal tissue were measured by radio-immunoassay (RIA). The correlation between the content of ET-1 and the levels of serum Ur and Cr were was analyzed by Pearson method, and the correlation between the content of AngⅡ in renal tissue and cell apoptosis was analyzed by Spearman method. Results The levels of serum Ur and Cr were significantly increased in ESI group (P

Objective To compare the diagnostic value of PET-CT and bone scintigraphy in bone metastases. Methods Thirty-two patients with malignant neoplasm confirmed by pathology were undergone18F-FDG PET-CT and bone scan within two weeks.The sensitivity,specificity and accuracy of PET-CT and bone scan in detecting the focus were compared at the same scan filed.Results The diagnostic sensitivity,specificity and accuracy with PET-CT were 94.9%,91.7% and 94.1%,respectively,and 96.2%,54.2% and 86.3% with bone scan,respectively.18F-FDG PET-CT and99Tcm-MDP bone scan were the same in detecting metastatic tumor of bone,but the specificity of18F-FDG PET-CT was better than99Tcm-MDP bone scan in detecting bone metastasis.Conclusion Compared with99Tcm-MDP bone scan,18F-FDG PET-CT is more specific and helpful in detecting bone metastases.

Objective To investigate the renal histopathological changes of over training induced acute renal injury in human being.Methods Eight patients treated in our hospital admitted overtraining were observed retrospectively about their clinical and pathological data,including clinical features,laboratory tests and pathological examinations.Results Eight patients with acute kidney injury after overtraining,manifested as urine occult blood positive in 2 cases,3 cases of urinary protein,urinary occult blood and urine protein were positive in 3 cases.Five cases of renal dysfunction,manifested as creatinine,urea nitrogen,uric acid significantly increased; renal ultrasound non-specific changes,manifested as increased echogenicity of the cortex.2 cases of renal pathology glomerular ischemic; Two cases of renal interstitial mild edema,five cases of inflammatory cell infiltration; Three cases of renal tubular epithelial vacuolar degeneration,2 cases of tubular atrophy,4 cases of renal tubular epithelial brush border loss,see intraluminal protein casts can be seen,1 case of calcium deposition.Conclusion The acute renal injury can be induced by overtraining.Kidney pathology ischemic is the most important change and renal tubular show most sensitive features of ischemic.In addition,inflammatory response and striated muscle damage were also induced because of overtraining.

Objective: Diffuse muscular calcification was rare myopathological change due to abnormal metabolism of calcium, which was mainly found in dermatomyositis and myositis ossificans progressiva. Here we reported a case of diffuse muscular calcification that clinically mimicked myositis ossificans progressiva. The disease might be a new type of congenital calcium metabolic disease. Methods:A 15-year-old girl developed subcutaneous cysts in the wrist and ankle when she was 1 year old. At the age of 9, she developed recurrent fever with myalgia, fatigue and diffuse muscular calcification. It was difficult for her to squat, run or walk. Protuberance presented in the subcutaneous tissue of her trunk. Some nodules ruptured with outflow of chalky material. ESR, ENA, RF, CRP, PTH, CK were in normal limits. EMG was unremarkable. X-ray confirmed diffuse calcification in the muscle and subcutaneous tissues. Biceps muscle biopsy was performed. Results:Numerous inflammatory cells infiltrated around vessels in the perimyosium with perifascicular muscle fiber atrophy and degeneration. Many RRF and SDH positive fibers were also observed. EM showed tubular reticular inclusions in vascular endothelium. Conclusion: Diffuse muscular calcification indicated existence of systemic calcium metabolic abnormality. As the clinical symptoms and distribution pattern of calcification were different from dermatomyositis with subcutaneous calcification and myositis ossificans progressiva, our case might be a new type of disease. The microvascular changes might result in the lesion of muscle fibers.

Objective To investigate the effects of valsartan on the expression of connective tissue growth factor(CTGF) in rat glomerular mesangial cells incubated with high concentration of glucose.Methods We used high concentration glucose and valsartan to stimulate the cultured rat glomerular mesangial cells in vitro. The protein expressions of CTGF and the activation of P38 mitogen-activated protein kinase(P38 MAPK) and cAMP response element binding protein 1(CREB1) were tested by Western blot. CTGF and fibronectin(FN) mRNA were measured by reverse transcription and polymerase chain reaction (RT-PCR). The protein synthesis of lamanin (LN) and type IV collagen in the supernatants of the GMCs were detected by radioimmunoassay. Results Compared with low glucose control group,the expression of CTGF,p-P38 MAPK,p-CREB1,CTGF mRNA,FN mRNA,LN and type IV collagen in the supernatants were significantly increased in GMCs incubated with high concentration of glucose medium. The expression levels of CTGF,p-P38 MAPK,p-CREB1,CTGF mRNA and FN mRNA were significantlylower in the valsartan group than those in the high concentration glucose group. The concentrations of LN and type IV collagen in the supernatantsin the valsartan group were also lower than those in the high concentration glucose group. Conclusion Valsartan can inhibit expression of CTGF and ECM proteins in rat glomerular mesangial cells incubated with high concentration of glucose,partly by regulating the phosphorylation of P38 MAPK and CREB1.