Objective To further elucidate the CT characteristics and diagnostic approaches to non-acquired immune deficiency syndrome patients with pulmonary cryptococcosis. Methods The histories of forty-two pulmonary cryptococcosis (PC) patients diagnosed in Zhongshan Hospital from 2003 -2008 were collected and analyzed for demography data, underlying conditions, clinical symptoms, chest CT and diagnostic studies. Results None of the 42 PC patients had avian or its feces contacting history, and 71.4% (30/42) of them were immunocompetent. The most frequent CT lesions were multiple nodules (67. 9% ) with peripheral predominance (67. 9% ), and cavitations (50%) often presented within them. Masses/consolidation (31.4%) and patching lesions (2. 9% ) could exist occassionally. Positive detection rates of non-aggressive examinations including sputum, bronchoalveolar lavage fluid and bronchofibroscope aspiration were 4. 3%, 8. 3% and 6. 3% respectively, while those of aggressive approaches including transbrunchial lung biopsy (TBLB), thin needle aspiration biopsy (TNAB) and pneumonectomy by surgery were 64. 7%, 64. 3% and 100% respectively. Non-aggressive serum cryptococcus antigen test was performed in 14 patients who had been diagnosed by histopathology or pathogen culture, and all of them were positive. Conclusion Our study suggests that PC is common in immunocompetent population. Avian or its feces contacting is not so important as used opinion to PC differential diagnosis. CT characteristics of PC are diversiform and always change very slowly. Besides the most frequent multiple nodules with subpleural predominance, pulmonary lesions can present as masses, consolidation or patchings. Aggressive techniques such as TBLB and TNAB are benefit to clinical diagnosis of PC, and non-aggressive serum cryptococcus antigen test may be promising for its early diagnosis as well as clinical course follow-up and therapeutic effect evaluation.

Objective To explore the value of quantitative chest CT in early diagnosis of chronic obstructive pulmonary disease(COPD).Methods The clinical data of 138 cases of COPD high-risk patients in Shanghai community and COPD high-risk respondents in outpatient clinic of Zhongshan Hospital,Fudan University from September 20,2013 to May 20,2014 were retrospectively analyzed.All high-risk participants underwent pulmonary function and chest CT examination at baseline and 1 year later.Chest CT images were imported into quantitative CT analysis software to collect quantitative CT data.These participants were divided into COPD group(n=40)and non-COPD group(n=98)based on their lung functions after 1 year.The differences in baseline lung function and quantitative CT measurements between the two groups were compared.Binary logistic regression was used to analyze the predictors of COPD in high-risk individuals after 1 year of follow-up,and the efficacy of the logistic regression model was evaluated by ROC curve.Results There were no significant differences in gender,body mass index(BMI),the percentage value of forced expiratory volume in 1 second predicted(FEV1%pred),airway wall area ratio(WA%),total airway count(TAC),and airway wall thickness(WT)between the two groups at baseline.Compared to the non-COPD group,the square root of the tracheal wall area at 10 mm from the inner circumference of the airway(Pi10),(3.43[3.30,3.54]vs 3.23[3.15,3.36],P＜0.001),and the percentage area of low attenuation regions below ﹣950 HU(LAA%﹣950),(2.06[0.32,6.29]vs 0.57[0.25,1.89],P=0.015)were significantly higher in the COPD group.The mean lung density(MLD)in the COPD group was lower than that in the non-COPD group([﹣799.89±35.62]vs[﹣783.60±43.52],P=0.038).Binary logistic regression analysis indicated that age and Pi10 were risk factors for COPD(P＜0.05),with an area under the ROC curve of 0.791(95%CI 0.714-0.868).Conclusions In the COPD high-risk population with normal lung function,patients with elevated Pi10 and LAA%﹣950 have a higher incidence of COPD one year later,suggesting that quantitative chest CT measurements such as Pi10 and LAA%﹣950 can assist clinicians in identifying early-stage COPD.

Objective To investigate the relationship between the expression of miR-141-3p,miR-149-3p and proliferative genes,clinicopathological features and prognosis in endometrial carcinoma tissues.Methods From February 2017 to February 2019,98 patients with endometrial cancer were selected as the study objects.Real-time fluorescence quantitative PCR was used to detect the relative mRNA expression levels of miR-141-3p,miR-149-3p and proliferating genes[proliferating cell nuclear antigen(PCNA),cyclin D1,cyclin dependent kinase 4(CDK4)]in cancer tissues of patients with endometrial cancer.The correlation between the expres-sions of miR-141-3p,miR-149-3p and PCNA,cyclin D1 and CDK4 mRNA in cancer tissues of patients with en-dometrial cancer was analyzed by Pearson correlation analysis.The expression of miR-141-3p and miR-149-3p in cancer tissues of endometrial carcinoma patients with different clinicopathological characteristics was com-pared.Kaplan-Meier curve was used to analyze the influence of miR-141-3p and miR-149-3p expression on prognosis of patients with endometrial carcinoma.Univariate and multivariate Cox regression analysis of prog-nostic factors in patients with endometrial cancer.Results The relative expression levels of miR-141-3p,miR-149-3p,PCNA mRNA,cyclinD1 mRNA and CDK4 mRNA in cancer tissues of patients with endometrial carci-noma were higher than those in adjacent tissues,with statistical significance(P＜0.05).The expressions of miR-141-3p and miR-149-3p were positively correlated with the expressions of PCNA mRNA,cyclinD1 mR-NA and CDK4 mRNA in cancer tissues of patients with endometrial carcinoma(all P＜0.05).The relative ex-pression levels of miR-141-3p and miR-149-3p in cancer tissues of endometrial cancer patients with stage Ⅲand lymph node metastasis according to International Federation of Gynecology and Obstetrics(FIGO)were higher than those of endometrial cancer patients with stage Ⅰ-Ⅱ and no lymph node metastasis,respective-ly,and the difference was statistically significant(P＜0.05).The 3-year overall survival rate of miR-141-3p high expression group was significantly lower than that of miR-141-3p low expression group,and the differ-ence was statistically significant(Log-rank x2=7.043,P=0.008).The 3-year overall survival rate of patients with high miR-149-3p expression group was significantly lower than that of patients with low miR-149-3p ex-pression group,with statistical significance(Log-rank x2=7.094,P=0.007).FIGO stage Ⅲ,lymph node me-tastasis,miR-141-3p elevation and miR-149-3p elevation were independent risk factors for prognosis of pa-tients with endometrial cancer(P＜0.05).Conclusion Detecting the expression of miR-141-3p and miR-149-3p in cancer tissues of patients with endometrial carcinoma is helpful to evaluate the survival and prognosis of patients.