To study the clinical feature of pulmonary tuberculosis with sputum M. tuberculosis negative and L form of M. tuberculosis positive, the sputum of 204 patients with pulmonary tuberculosis with negative smear and culture results was cultured for L form of M. tuberculosis. A comparative study of major clinical manifestations, X ray, and therapeutic effect was carried out in 60 cases of L form positive and 144 cases of L form negative pulmonary tuberculosis. The detection rate of L form positive in patients with pulmonary tuberculosis was 29 4%. The incidence of caseous lesion and cavitation in the L form positive patients was higher than those with L form negative, and the incidence of focal absorption was higher in L form negative patients than those with L form positive. The existence of L form of M. tuberculosis suggested activity of the tuberculous lesion. The treatment of pulmonary tuberculosis must be persisted with a reasonable regimen with whole therapeutic period until L form of M. tuberculosis is eliminated from sputum.

Objective To explore the characteristics of clinic and epidemiology of neonatal respiratory syncytial virus(RSV) pneumonia in newborn infants.Methods Three hundred and nine neonates(male 196,female 113) who were admitted to children's hospital of Fudan University and identified as having RSV pneumonia from Jan.2004 to Dec.2008 were enrolled.RSV antigen was detected in exfoliated respiratory cells by direct immunofluorescence.All the clinical data were collected and subjects and they were divided into different groups based on path of infection,gestational age and RSV status.Results From case notes over the 5 years,309 eligible neonates with RSV infection were identified.Male term neonates were more likely to acquire infection,as compared to female,1.71.0.The incidence of RSV infection peaked in winter and spring.Compared with community acquired infection group,hospital acquired infection group had more premature infants(23.2% vs 8.7%,P=0.002),lower birth weight[(3 010.8?852.8) g vs(3 153.2?943.4) g,P=0.026],much longer mean length of hospital stay[(19.0?8.0) d vs(12.2?4.5) d,P=0],more expensive cost[(5 646.4?3632.2) RMB vs(4 175.8?2 879.2) RMB,P=0] and later occurrence day[(21.3?8.6) d vs(15.8?6.0) d,P=0].Compared with simple RSV infection group,mixed infection group had more expensive cost[(6 063.1?3 085.4) RMB vs(4 513.2?3 860.8) RMB,P=0.047] and more oxygen use(40.0% vs 25.7%,P=0.006).The clinical characteristics of patients with RSV pneumonia varied.Preterm group compared with term group more frequently exhibited apnea and cyanosis(20.0% vs 0.7%,42.9% vs 22.7%),respectively.Forty-two percent of them had bacterial infection,while 13.3% of them had infection of other part of body.The prognosis of most RSV(99.0%) infections was good.Conclusions RSV was an important cause of respiratory tract infections during the last five years.Clinical characteristics of RSV infections were atypical.Hospital acquired RSV infection was more severe than the community acquired infection in neonates.There are no specific,effective interventions for treating RSV infections,so preventive measures are most important.

Objective To evaluate the effectiveness, the influence on cellular immune function and the side-effect of bacillus of Calmette-Guerin polysaccharide nucleic acid(BCG-PSN)combined with antituberculous chemotherapy in the treatment of pulmonary tuberculosis. Methods A total of 60 pulmonary tuberculosis patients were divided into treatment group(30 patients)and control group(30 patients)by random digits table. All patients accepted the same standard antituberculous chemotherapy, meanwhile patients in treatment group were injected with BCG-PSN. Observed and compared the clinical symptom,the size of the focas nidus,the change of toxic response and immunity. Results The symptoms were significantly relieved in both groups after treatment(P＜0.05), but it was significantly better in treatment group(P＜0.05), the effective rate and control rate in treatment group[36.7%(11/30),96.7%(29/30)]were significantly higher than those in control group[23.3%(7/30), 86.7%(26/30)](P ＜ 0.05). After treatment,the levels of CD3,CD4 and IL-2 were higher, and the level of CD8 was lower, but the treatment group improved significantly better than control group(P ＜ 0.05). The rate of leukopenia was lower in treatment group than that in control group[10.0%(3/30)vs. 33.3%(10/30),P ＜0.05]. As to the safety,no other toxicities were observed in the treatment group. Conclusions BCG-PSN combined with antituberculous chemotherapy in the treatment of pulmonary tuberculosis contributes to relieve the symptom, reduce size of the nidus, decrease leukopenia incidence and enhance the cell immunity. It is safe.

Objective To investigate the effect of hyperoxia on the expressions of cysteinyl aspartate specific proteinase -3(Caspase -3)and proliferating cell nuclear antigen (PCNA)in bone marrow mesenchymal stem cells (BMSCs).Methods Primary BMSCs from SD rats were cultured in vitro,BMSCs grew to 70% -80% degrees of fu-sion and then were randomly divided into room air group and hyperoxia exposure group.Each group was divided into 5 sub -groups,and cultured for 0,3,6,1 2,and 24 h respectively.Morphology investigation with inverted phase contrast microscope was adopted.The expressions of Caspase -3 and PCNA protein levels were detected by Western blot. Results (1 )As time wenty by,compared with room air group,the gap between cells increased,some of the cells be-came circular,and cell detachment and floating appeared in the hyperoxia -exposure group (>1 2 h)compared with room air group.(2)As time went on,compared with the room air group,the expression levels of Caspase -3 protein in the hyperoxia -exposure group were increased,and the difference was significant after 6 hours of culture (0.27 ± 0.04 vs 0.1 4 ±0.02,t =5.03,P =0.007).(3)Compared with room air group,the PCNA levels of the hyperoxiaexpo-sure group(6 h)decreased,and the difference in PCNA protein expression levels was significant after 6 hours of culture (0.27 ±0.04 vs 0.38 ±0.04,t =3.37,P =0.028).Conclusions Hyperoxia exposure increases Caspase -3 expres-sion levels and decreases PCNA expression,which may affect the proliferation and apoptosis of BMSCs.

In recent years,along with the deepening study of bone marrow mesenchymal stem cells (BMSCs),the repair effect of BMSCs in various tissue injury have been gradually revealed.And in recent years,except the ability of differentiate to the target cells,its paracrine effect,for example,a variety of cyto-kines secreted by BMSCs,also plays an important role in the process of repairing.

Objective To study the expression of intercellular adhesion molecule-1 ( ICAM-1 ) and vascular cell adhesion molecule-l(VCAM-L) on human mesangial cells (HMC) after stimulation by endothelin-1 (ET-1). Methods The ex-pression of ICAM-1 and VCAM-1 was detected at mRNA and protein levels by using Northern bolt and cell ELISA respectively. Results There was basic mRNA and protein expression of ICAM-1 and VCAM-1 on HMC in the control groups without ET-1. ET-l(10-7mol)augmented the mRNA expression of ICAM-1 and VCAM-1 with the maximum at 4 -8 hr. Increased protein expression of ICAM-1 and VCAM-1 was followed thereafter in a time-depended manner. Conclusion The upregulated expression of ICAM-1 and VCAM-1 by ET-1 may have an important role in the development of glomerulonephritis.

Objective To cvaluate the efficacy and safety of HabibTM VesOpen intravascular radiofrequency catheter percutaneous radiofrequency ablation combined with TACE in the treatment of portal vein tumor thrombus of primary hepatocellular carcinoma.Methods Thirty-nine patients with primary hepatocellular carcinoma complicated with portal vein thrombosis were treated with HabibTM VesOpen intracavitary catheter ablation combined with TACE.The postoperative success rate,complication,blood index,α-fetoprotein (AFP),portal vein patency and tumor thrombus imaging changes were assessed.Results All of 39 patients underwent surgery successfully without occurrence of perforation,infection,hepatapostema,intra-abdominal hemorrhage nor other complications associated with surgery.Blood routine examinations (WBC,RBC,PLT) after 2 weeks and 4 weeks of surgery had no statistical difference compared with those of preoperation.Liver function indexes including ALT,AST,ALB had statistical difference before and after the surgery except for TBIL.AFP had statistical difference before and after surgery.Doppler ultrasonography after 4 weeks showed blood flow in original blocked portal vein.Enhanced CT or MR examinations after 8 weeks on the abdomen,suggested that tumors were shrinked or disappeared.Conclusion Radiofrequency catheter ablation with intracavitary radiofrequency catheter of HabibTM VesOpen is an effective method in the treatment of portal vein tumor thrombus in primary hepatocellular carcinoma.

Objective To compare the prognostic value of the 7th edition of AJCC cancer staging system in nasopharyngeal carcinoma (NPC) patients treated with conventional radiotherapy (CRT) and intensity-modulated radiotherapy (IMRT).Methods From January 2004 to December 2006,totally 1138 NPC patients were treated with CRT (790 patients) and IMRT (348 patients) in Cancer Hospital of Fujian province.The median ages were 47 and 45 years old for two groups ( x2 =1.49,P =0.222 ),respectively.There were 0,41,488,261 and 5,65,176,102 patients in stage Ⅰ,Ⅱ,Ⅲ,Ⅳ of the two groups after restaged with 7th edition of AJCC cancer staging system,respectively (x2 =64.78,P =0.001 ).The 3-year survival was analyzed according to T-category,N-category and overall stage.Results The follow-up rate at 3 years is 96.0％.The median follow-up were 32 months and 33 months for CRT and IMRT groups.N-category was found to be the prognostic factors for overall survival (OS,x2 =6.50,P =0.038 and x2 =13.60,P =0.004) and metastasis free survival ( MFS,x2 =7.78,P =0.009 and x2 =15.30,P =0.002) for CRT and IMRT groups.The clinical stage was prognostic factor for OS in conventional group ( x2 =6.70,P=0.035),and for MFS in IMRT group (x2 =9.12,P=0.028).Conclusions The T-calegory of 7th AJCC staging system shows poor predictive value for the long-term survival of NPC patients.The N-calegory of 7th AJCC staging system can well estimate the OS and MFS for NPC.

Background and purpose: Cervical nodal metastasis in nasopharyngeal carcinoma plays an important role in the definition of radiotherapy area and clinical staging, it is also one of the main factors influencing prognosis. So this study was designed to explore the pattern of metastatic lymph nodes for patients with nasopharyngeal carcinoma, which may provide a basis for clinical treatment and research. Methods: From Jun. 2005 to Sep. 2007,779 histologically diagnosed nasopharyngeal carcinoma patients had routine MRI scan before radiation therapy at Fujian Provincial Cancer Hospital. Diagnostic radiologists and radiation oncoiogists together assessed the nodal distribution according to the guideline CT-hased delineation of lymph node levels. Then, Chi-sqnare test was used to analyze the correlation between T stage and nodal metastasis rate and between nodal diameter and nodal extracapsular invasion. Results: Of 779 patients, 592(76.0%) had nodal involvement. The distribution was as follows: 1 in level Ⅰ,384 in level Ⅱa, 499 in level Ⅱ_b, 184 in level Ⅲ, 33 in level Ⅳ, 67 in level V_a, 21 in level V_b, 597 in retropharynx.In these patients, a total of 1 479 postive nodes, including 973 (65.79%) extracapsular spread nodes, were detected.The rate of nodal extracapsular invasion was higher when the axial diameter increased. Leap metastasis rate was 1.0%. No significant correlation was found between T stage and nodal involvement. Conclusion: The level Ⅱ and retropharyngeal node were the most frequently involved regions, they had similar metastatic rate and were both the first echo node to metastases of nasopharyngeal carcinoma. Level Ⅰ metastasis was lower. The proportion of extracapsular spread of metastatic lymph nodes increased with axial diameter of lymph nodes-dependent. The cervical node involvement of nasopharyngeal carcinoma was spread orderly down the neck, and the incidence of skip metastasis is rare. The relationship between T stage and nodal involvement has no statistical significance.

Adult ; Aged ; Breast Neoplasms ; blood ; pathology ; Carcinoembryonic Antigen ; blood ; genetics ; Carcinoma, Ductal, Breast ; blood ; secondary ; Female ; Fibroadenoma ; blood ; Fibrocystic Breast Disease ; blood ; Humans ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Staging ; RNA, Messenger ; blood ; genetics