Objectives To study the incidence of Trichomonas vaginalis(TV)infection in Chinese male patients with nongonococcal urethritis(NGU),to evaluate the sensitivity and specificity of urine-based and urethral swab polymerase chain reaction(PCR)detection,and to set up a method of non-invasive detection for male TV infection.Methods One hundred and five male NGU patients were collected from the STD clinic.Two urethral swabs were obtained from each patient,one for InPouch TV culture system,the other for PCR;one urine specimen(first-void urine or first-catch urine)was also collected for PCR detection.Culture was considered as the"gold standard".Compared with the culture,the sensitivity,specificity,positive predictive value(PPV)and negative predictive value(NPV)of two PCR detection were calculated.Results The positive rate of InPouch TV system detection was4.76%(5/105);the positive rate of urine-based PCR and urethral swab PCR detection was3.81%(4/105)and4.76%(5/105),respectively.In comparison with the culture,the sensitivity,specificity,PPV and NPV were80%,100%,100%and99%for urine-based PCR and80%,99%,80%and99%for urethral swab PCR.Conclusions TV is one of the etiological agent for male NGU,the positive rate of TV is4.76%in our study.The urine-based PCR detection has a higher sensitivity and specificity and provides a noninvasive method which is feasible in practice.

Objective To evaluate the performance of ligase chain reaction(LCR) in the detection of Chlamydia trachomatis(Ct) from urethral or cervical samples in STD patients. Methods Ct was detected by LCR in urethral or cervical swabs from 276 cases with urethritis or cervicitis attending our STD clinic. All 276 urethral or cervical swab specimens were pooled by 4 into 69 pools for detection. Chlamydial cell culture was performed in 56 cases with nongonococal urethritis or cervicitis. Discrepant results were analyzed by PCR with primers targeting Ct major outer membrane protein gene. Results The sensitivity and specificity of LCR assay were 96.7% and 100% respectively. Two LCR approaches, pooling or individual testing, yielded 100% of consistency in the detection of Ct in urethral or cervical specimens. Conclusions LCR provides a highly sensitive and specific assay for detection of Ct from urethral and cervical samples, and could be recommended for the diagnosis of genital chlamydial infection. Pooling LCR is suitable for screening of urethral or cervical Ct infection in population study.

Objective To compare the difference of decreasing radiation-induce lung injure among CT scans including active breathing control (ABC), slow CT scan and general axial CT scan under free breathing (FB) in precise radiotherapy of peripheral non-small cell lung cancer (NSCLC). Methods Ten patients of peripheral NSCLC were included. For each patient, three CT scans were obtained: (1) the general axial CT scans under FB;(2) the fast spiral CT scans under ABC;(3) the slow CT scans under FB. Three treatment plans based on three CT scans were optimized. Gross tumor volume (GTV), clinical target volume (CTV) and planning target volume (PTV) along with V20 (lung volume accepted > 20 Gy/all lung volume ×100%) and Dmean (average dosage accepted irradiation of all lung)of three treatment plans were calculated and compared. Results The GTV and CTV of the slow CT plan seem in largest, and those of ABC plan in smallest, but no statistics signification among the three plans (F = 1.513, P = 0.238;F = 1.376, P = 0.270). However, The PIV of the FB plan was largest, and the difference of PTV between plans of ABC and FB, plans of slow CT scans and FB were statistics significant (F = 26. 148, P = 0.000). The differences of V20 and Dmean between plans of FBand ABC, plans of FB and slow CT scans were statistics significant yet (F = 7.623, P = 0.002;F = 18.217, P = 0.000). Conclusion Compared with FB conditions, ABC or the slow CT scan method in precise radiotherapy of peripheral NSCLC can decrease radiation volume and dose to normal tissues as well as the probability of decreasing radiation-induce lung injure.

Objective:To evaluate the effectiveness of Minqing Ao dental desensitizer in the treatment of early childhood caries (ECC).Methods:41 0 teeth with ECC in 1 1 0 cases were divided into 3 groups.Minqing Ao dental desensitizer,fluoride toothpaste and ordinary toothpaste without fluoride were respectively used in group A,B and C.The laser fluorescence value(LFV)was meas-ured and compared before treatment,2,4,6 weeks and 6 months after treatment.Results:2 weeks after treatment,the LFV was not significantly changed in the 3 groups.4 weeks after treatment LFV in group A was decreased(P<0.01 ),the LFV in group A was lower than that in group B(P<0.05)and in group C(P<0.01 ).While there was no significant difference between group B and C(P>0.05).6 weeks after treatment LFV in group A and B was decreased(P<0.01 and P<0.05),there was significant difference be-tween each 2 groups(P<0.05).6 weeks and 6 months after treatment LFV in group A was lower than that in group B(P<0.01 ),and in group B was lower than that in group C(P<0.01 ).Conclusion:Minqing Ao is effective for treatment of early childhood caries.

Objective To investigate causes and treatments for a fracture of the contralateral femoral neck in the elderly with prosthetic replacement for femoral neck fractures.Methods A retrospective analysis was conducted on 85 cases undergone prosthetic replacement for femoral neck fractures between March 2005 and May 2012,including 12 cases in secondary replacement group due to fractures of the contralateral uninjured femoral neck after primary prosthetic replacement and 73 cases in primary replacement group.Variables were compared between the two groups including causes of injury,age,sex,bone density,complications,quality of life,Harris score of the contralateral hip joint,surgical choice.Refracture reasons were evaluated and treatment plans were proposed.Results Immediate cause of injury in all cases was falling.Primary and secondary replacement groups showed mean age of (68.82 ± 5.18) yearsvs (76.83 ± 3.64) years (P＜0.05),male to female ratio of 0.66:1 vs 0.09:1 (P＜0.05),and bone mineral density of (0.507 ± 0.062) g/cm2 vs (0.461 ± 0.095) g/cm2(P ＜0.05).Moreover,cases in the two groups suffered from the associated complications (hypertension,diabetes mellitus,cataract,stroke,rheumatoid arthritis,and Parkinson' s disease).Except for the diabetes mellitus,incidence of the other five basic diseases presented significance differences between the two groups (P ＜ 0.05).Of primary and secondary replacement groups,quality of life was (76.26 ±14.17) points vs (67.86 ± 16.74) points (P ＜ 0.05) ; Harris score of the contralateral hip was (98.66 ±1.39) points vs (90.75 ± 5.39) points (P ＜ O.05).For treatment choice,32 total hip arthroplasty (THA) and 41 femoral head arthroplasty (FHA) with cement fixation in 44 cases and cementless fixation in 29 cases were performed in primary replacement group; two total hip arthroplasty and 10 femoral head arthroplasty with cement fixation in 11 cases and cementless fixation in one were performed in secondary placement group (P ＜ 0.05).Conclusions Fall remains the immediate cause of the contralateral fractures following prosthetic replacement of femoral neck fractures in the elderly.Aging,females,bone density reduction,high-incidence of complications,decreased quality of life,and joint function impairment after the primary prosthetic replacement are unfavorable factors.Prosthetic replacement is still the preferred choice of treatment and surgical procedure is more likely to be the simple cemented FHA.

Objective To investigate the value of 18 F-fluorodeoxyglucose FDG) positron emission tomography (PET)-computed tomography (CT) in predicting the progression-free survival (PFS)and overall survival (OS) of patients with esophageal squamous cell carcinoma (ESCC) after threedimensional (3D) radiotherapy.Methods A retrospective analysis was performed on 98 ESCC patients,who underwent FDG PET-CT before 3D radiotherapy from 2004 to 2010,to investigate their 1-,3-,and 5-year PFS and OS rates.The relationship of maximum standard uptake value (SUVmax),mean SUV (SUVmean),metabolic target volume (MTV),length of primary tumor on PET-CT before radiotherapy,and number of tumors on PET with PFS and OS were analyzed.The SUVs and clinical data were analysed by independent samples t-test or Hotelling T2 test; the Kaplan-Meier method was used for calculating PFS and OS rates,and the Logrank test was used for survival difference analysis;the prognostic factors were analysed using the Cox proportional hazard model.Results The follow-up rate was 100％ ;56 patients were followed up for at least 3 years,and 27 for at 5 years.The SUVmax SUVmean and MTV of primary tumor,length of primary tumor on PET-CT before radiotherapy,and number of tumors on PET were correlated with PFS and OS (x2 =8.99-41.82,all P ＜ 0.01).The Cox regression analysis showed that PFS could be well predicted based on SUVmean (x2 =4.41,P =0.036,RR =1.398) and number of tumors on PET (x2 =6.79,P =0.009,RR =3.650) and that OS could be well predicted based on number of tumors on PET (x2 =5.03,P =0.025,RR =3.740).Conclusions When estimating the long-term response to precise radiotherapy in patients with ESCC,SUV mean and number of tumors on PET may be used to predict PFS,and number of tumors on PET may be used to predict OS.

ObjectiveTo investigate the efficacy of rapamycin combined with CsA/Tacrolimus (Tac) in chronic allograft nephropathy (CAN).MethodsFifty-three cases of CAN accepted the quadruple immunosuppressive drug program,which contained rapamycin combined with CsA/Tac and MMF and prednisone,and CsA/Tac and MMF were reduced to the original amount of 25％ to 50％.After treatment for 12 months,more relevant indicators,including serum creatinine,glomerular filtration rate,serum cholesterol,triglycerides,urinary protein,GPT and bilirubin and other changes were observed.ResultsIn the patients receiving quadruple regimen of rapamycin during 12 months,the blood Ccr was decreased from (161.51 ± 106.48)μmol/L before treatment to (126.51 ± 56.2)μmol/L after treatment for 6 months (P＜0.05) and to (123.43 ± 54.18)μmol/L after for 12 months (P＜0.01).The GFR was increased from (0.754 ± 0.302) ml/s before treatment to (0.952 ± 0.347)ml/s after treatment for 6 months (P＜0.05) and to (1.007 ± 0.394) ml/s after treatment for 12 months (P＜0.01).Cholesterol and triglycerides in patients had no significant change before and after treatment.The positive rate of proteinuria after treatment showed an increasing trend from 9.4％ before treatment to 26.4％ after treatment for 12 months.ConclusionThe quadruple program of rapamycin combined with CsA/FK506 and MMF can significantly improve Ccr and GFR in patients with CAN,but it can increase the incidence of proteinuria in patients:

Objective To discuss the value of dual-time-point 18FDG PET-CT imaging on involved field radiotherapy for hilar and mediastinal metastatic lymph nodes in patients with non-small cell lung cancer (NSCLC).Methods Fifty-four patients with NSCLC were included in this analysis,including 34 men and 20 women with mean age of 59(34-76)years.Two sequential PET-CT scans given 3-5 days before surgery were standard single-time-point imaging for the whole body and delayed imaging for the thorax.The pathologic data were used as golden standard to determine the difference between the standard single-time-point and dual-time-point FET-CT imaging in the definition of gross target volume(GTV)of involved-field radiotherapy for metastatic lymph nodes. Results For hilar metastatic lymph nodes,the GTV defined by single-time-point imaging was consistent with pathologic GTV in 21 patients(39%),comparing with 31 patients(57%) by dual-time-point imaging.Using pathologic data as golden standard,GTV alteration defined by single-time-point imaging had statisticaly significant difference comparing with that defined by dual-time-point imaging(u=519.00,P=0.023).For mediastinal metastatic lymph nodes,the GTV defined by single-time-point imaging was consistent with pathologic GTV in 30 patients(56%),comparing with 36 patients(67%)by dual-time-point imaging.Using pathologic data as golden standard.GTV alteration defined by single-time-point imaging had no statisticaly significant difference comparing with that defined by dual-time-point imaging(u=397.50,P=0.616).Conclusions For patients with NSCLC receiving involved-field radiotherapy,GTV definition for hilar and mediastinal metastatic lymph nodes by dual-time-point imaging is more consistent with that by pathologic data.Dual-time-point imaging has a larger value in terms of target delineation for hilar and mediastinal metastatic lymph nodes.

Objective:To investigate distribution characteristics of Treponema pallidum (Tp) in secondary syphilis lesions, and to analyze its correlation with histopathological findings. Methods:Totally, 41 patients were collected from Department of Dermatology and Venereology, Peking Union Medical College Hospital from January 2008 to December 2018, who were confirmedly diagnosed with secondary syphilis according to clinical manifestations and serological examinations, and had undergone histopathological examinations. Immunohistochemical results of skin tissue sections were analyzed, and differences in clinical and histopathological characteristics were analyzed between immunohistochemically Tp-positive and Tp-negative sections. Continuous data were compared by using t test or Kruskal-Wallis test, and categorical data were compared by using Chi-square test or Fisher′s exact test. Results:Immunohistochemical examination showed that Tp was detected in 68.3% of the 42 secondary syphilis tissue sections, and Tp was mainly distributed in the lower epidermis and superficial and middle dermis. The positive rate of Tp was significantly higher in secondary syphilis lesions mainly manifesting as maculae (80% [16/20]) than in those mainly manifesting as papules (50% [11/22], P < 0.05) . Among 10 pathological characteristics, extended rete ridges, basal cell liquefaction degeneration, neutrophil infiltration in the stratum corneum, lichenoid pattern of infiltration and punctate keratinocyte necrosis were observed more frequently in immunohistochemically Tp-positive sections than in Tp-negative sections (all P < 0.05) . Immunohistochemical study revealed that tissue sections with a larger number of Tp showed more pathological features ( H = 17.914, P < 0.001) . Immunohistochemical staining showed that there were 8, 7 and 6 syphilis-specific histopathological characteristics on average in 8 tissue sections with a larger number of Tp, 14 with a medium number of Tp and 5 with a small number of Tp, respectively; while only 4 syphilis-specific histopathological characteristics were observed on average in 15 immunohistochemically Tp-negative tissue sections. Conclusion:Immunohistochemical staining could show the distribution of Tp in secondary syphilis lesions, and it seems that tissue sections with a larger number of Tp present with more syphilis-specific histopathological characteristics.

Objective To report a pedigree with X?linked dominant protoporphyria(XLDPP), and to detect 5?aminolevulinic acid synthetase 2(ALAS2)gene mutations in this pedigree. Methods A clinical investigation was performed in a pedigree with XLDPP, and relevant data were collected from family members. A next?generation sequencing method was applied to screen possible mutation sites, and Sanger sequencing was performed to determine pathogenic gene mutations. Dermoscopy was conducted to observe skin lesions in the patients with XLDPP, and the Fotofinder system and very high frequency (VHF) ultrasound system were utilized to assess the severity of photodamage. Liver and gallbladder ultrasonography as well as blood examination were performed for all the family members. Results A deletion mutation, c.1706?1709ΔAGTG, was detected in the ALAS2 gene on the X chromosomes of all the patients in this family, which led to replacement or loss of 19-20 C?terminal residues through transcriptional frameshifting, and eventually caused an increase in ALAS2 activity. In the patients with XLDPP, skin photodamage was relatively severe;protoporphyrin?induced hepatobiliary damage was observed and aggravated with age;anemia and iron deficiency occurred sometimes. Conclusion The deletion mutation c.1706?1709ΔAGTG of the ALAS2 gene may be the underlying cause of XLDPP in this pedigree.