Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Societies, Medical ; United States

Objecfive To analyze the relationship between aortic root dimension(ARD)and anterior circulation infarction(ACI)by measuring ARD of ACI patients.Methods The ARD of 110 ACI patients(56 men and 54 women)were measured with 2-dimensional uhrasonography during ventricular systole.66 control subjects(32 men and 34 women)without the clinical signs of cerebral infarction or organic heart disease and cardiac insufficiency were selected after carrying out detailed cage history inquiring.physical examination,CT or MRI and ultrasonic examination.ResultsARD in men and women Was respectively(29.80±2.35)mm and(28.88±3.06)mm in the ACI group.While it was(27.64±1.70)mm and(26.98±1.60)mm respectively in the control subjects.ARD in men and women was significantly higher in the ACI group as compared with the control subjects(P＜0.01).Logistic regression analysis indicated that the odds ratio(confidence interval)associated with ARD Was 1.630(1.205-2.204)in men and 1.494(1.098-2.033)in women for ACI.Conclusions There is a close relationship between ARD and ACI.ARD is an important risk factor of ACI.

Objective To study the effect of platelet-derived growth factor(PDGF)and lysosomes on lung injury in macaque with early-phase endotoxie shock.Method Eleven macaques were randomly divided into two groups,namely,control group(Co group,n=5)iand endotoxic group(En group,n=6).The macaque of the Co group injected with 1 ml/kg normal saline and the macque of the En group received a dose of 2.8 mg/kg Lipopolysaccharides(LPS)i.v.The blood gas was detected at 120 minutes after LPS challenging. Uhrastructure,cytochemistry of acid phosphatase(ACPase)detection by electronic microscopy and immunohistochemical assay of PDGF were completed in hmgs of all the macaque .Results Administration of LPS did not change the parameters of gas exchange,namely,PaO_2,PaO_2/Fi and PaCO_2.In the early phase,of endotoxic shock,ACPase activity products increased and lysosome destroyed in the alveolar cells.The pathologic changes of alveolus,such as degeneration of vessel endothelium,injury of alveolar epithelium and damage of basement membrane,and transudation of blood component were observed by electron microscopy in the En group. However,no pathological changes were found in the control group.By immunohistochemical staining,PDGF on alveolar wall in the En animals was observed,whereas no PDGF protein in the Co macaques was noticed. Conclusions Administration of LPS induced the expression of PDGF in the alveolar wall and lysosome injury in the alveolar cells,as a result of alveolar damage in early-phase endotoxin shock.In the meantime,the parameters of gas exchanges did not change.The PDGF may play an important role in the pathogenesis of lung during the early-phase of endotoxin shock.

Objective:To explore the clinical pathological characteristics and initial 131I curative responses of familial differentiated thyroid cancer (FDTC) and sporadic differentiated thyroid cancer (SDTC). Methods:A total of 66 FDTC patients (19 males, 47 females, age (39.8±11.7) years) and 1 701 SDTC patients (442 males, 1 259 females, age (40.9±11.3) years) who underwent 131I therapy in Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology between January 2010 and August 2018 were retrospectively enrolled. The clinical pathological characteristics, preablative stimulated thyroglobulin (ps-Tg), preablative stimulated thyroglobulin antibody (ps-TgAb) and response to initial therapy (excellent response, indeterminate response, biochemical incomplete response, structural incomplete response) of two groups were analyzed and compared. The clinical pathological parameters included age, gender, pathological type, tumour maximum diameter, bilateral, multifoci, nodules goiter, thyroiditis, thyroid membrane invasion, lymph node metastasis (LNM), invasion of the surrounding soft tissues, distant metastasis, TNM staging and American Thyroid Association (ATA) risk stratification (low-risk, intermediate-risk, high-risk). χ2 test or Fisher exact test and independent-sample t test were used to compare the data between two groups. Results:Comparing with SDTC group, FDTC group showed higher proportion of bilateral foci (45.5%(30/66) vs 31.2%(530/1 701); χ2=5.999, P=0.010), thyroid membrane invasion (43.9%(29/66) vs 26.6%(452/1 701); χ2=9.672, P=0.002) and distant metastasis (15.2%(10/66) vs 6.2%(105/1 701); χ2=8.418, P=0.004). There was a statistical difference in risk stratification between two groups (high-risk: 18.2%(12/66) vs 9.2%(156/1 701); intermediate-risk: 68.2%(45/66) vs 72.7%(1 237/1 701); low-risk: 13.6%(9/66) vs 18.1%(308/1 701); χ2=6.898, P=0.030). But the tumor maximum diameter of FDTC group was smaller than that of SDTC group ((1.24±0.74) vs (1.50±0.92) cm; t=-2.275, P=0.020). There were no significant differences in other clinical pathological parameters between FDTC group and SDTC group ( t=-0.804, χ2 values: 0.101-5.359, all P>0.05). There were no significant differences between two groups in the postoperation ps-Tg, ps-TgAb levels and the response to initial therapy after 131I treatment ( χ2 values: 0.059-1.915, all P>0.05). Conclusions:The FDTC group displays distinct characteristics as increased aggressiveness at diagnosis. But after accurately treatment, there is no significant difference in the response to therapy between two groups.

Introduction:The 2010 targets of the China Hepatitis B Prevention Programme were a prevalence of hepatitis B surface antigen (HBsAg) less than 1.0% for children less than five years old and less than 6.0% for the total population. This survey assessed the prevalence of Hepatitis B infection in Lianyungang, Jiangsu province, China in 2009–2010.Methods:Multistage sampling was used with 2372 subjects among 17 selected villages. Blood specimen collection and testing by enzyme-linked immunosorbnet assay (ELISA) were completed using the following markers for hepatitis infection: HBsAg and antibody to HBsAg (anti-HBs); hepatitis B e antigen (HBeAg) and antibody to HBeAg (anti-HBe); and hepatitis B core antibody (total anti-HBc). The data were analysed with Epi Info, version 3.3.2.Results:The prevalence of HBsAg was 2.4% (95% Confidence Interval [CI]: 1.8–3.0; Adjusted Prevalence [AP] 2.9%); anti-HBs prevalence was 51.1% (95% CI: 49.1–53.1; AP 49.2%) and total anti-HBc prevalence was 41.7% (95% CI: 39.8–43.7; AP 45.5%). The prevalence of HBsAg and total anti-HBc positivity increased from young to older age groups, yet the prevalence of anti-HBs positivity decreased from young to older age groups (P< 0.001 for all). There was no difference in the prevalences of HBsAg and anti-HBs among females and males (P= 0.108 and 0.089), but females had a higher prevalence than males for total anti-HBc positivity (P< 0.001). Discussion: This survey showed that in 2010 the prevalence of HBsAg among children aged less than five years was lower than the national target of 1.0% and that the prevalence of HBsAg for the total population was lower than the national target of 6.0%.

BACKGROUNDAccurate knowledge of the spinal structural functions is critical to understand the biomechanical factors that affect spinal pathology. Many studies have investigated the human vertebral motion both in vitro and in vivo. However, determination of in vivo motion of the vertebrae under physiologic loading conditions remains a challenge in biomedical engineering because of the limitations of current technology and the complicated anatomy of the spine.

METHODSFor in vitro validation, a human lumbar specimen was imbedded with steel beads and moved to a known distance by an universal testing machine (UTM). The dual fluoroscopic system was used to capture the spine motion and reproduce the moving distance. For in vivo validation, a living subject moved the spine in various positions while bearing weight. The fluoroscopes were used to reproduce the in vivo spine positions 5 times. The standard deviations in translation and orientation of the five measurements were used to evaluate the repeatability of technique. The accuracy of vertebral outline matching with metallic marks matching technology was compared.

RESULTSThe translation positions of the human lumbar specimen could be determined with a mean accuracy less than 0.35 mm and a mean repeatability 0.36 mm for the image matching technique. The repeatability of the method in reproducing in vivo human spine six degrees of freedom (6DOF) kinematics was less than 0.43 mm in translation and less than 0.65° in rotation. The accuracy of metallic marks and vertebral outline matching did not show significant difference.

CONCLUSIONSCombining a dual fluoroscopic and computerized tomography imaging technique was accurate and reproduceable for noninvasive measurement of spine vertebral motion. The vertebral outline matching technique could be a useful technique for matching of vertebral positions and orientations which can evaluate and improve the efficacy of the various surgical treatments.

Biomechanical Phenomena ; Fluoroscopy ; methods ; Humans ; In Vitro Techniques ; Lumbar Vertebrae ; anatomy & histology ; physiology ; Middle Aged ; Spine ; anatomy & histology ; physiology

Objective: To survey the prevalence and distribution of sleep disorders in patients with Parkinson disease (PD) and to analyze the influencing factors. Methods: The prevalence and distribution of sleep disorders were surveyed with Parkinson Disease Sleep Scale (PDSS) among 206 PD patients. The association of sleep disorders with age, course of disease, cognitive function, motor function, depression, and the equivalent dose of levodopa (LED) was analyzed. Results: The overall PDSS score in 206 patients was (116.9±21.4). The three most frequent items of sleep disorders were the overall sleep quality(181/206, 87.9%), difficulty in maintaining sleep(160/206, 77.7%)and nocturnal enuresis(151/206, 73.3%); the three least frequent items were early awaking(87/206, 42.2%), urinary incontinence(56/206, 27.2%)and hallucination(44/206, 21.4%). The three items with the lowest average scores were nocturnal enuresis(6.9±3.1), difficulty in maintaining of sleep(7.1±2.7)and overall sleep quality(7.1±2.0); three items with the highest average scores were audiovisual illusion(9.3±1.8), incontinence caused by motion disability(9.0±2.1) and early awaking with upper and lower limb pain(8.7±2.1). PD patients were divided into group 1 [Hoehn-Yahr(H&Y) stage 1.0-1.5], group 2 (H&Y stage 2.0-2.5) and group 3 (H&Y stage 3.0-4.0). One-way analysis of variance or non-parametric test showed that there were significant differences in the course of disease(F=21.91, P=0.00), total score and the subscale scores of Unified Parkinson Disease Rating Scale(UPDRS, UPDRS Ⅰ-Ⅳ) (F=90.67, χ²=12.86, F=31.20, F=60.17, χ²=24.01, all P<0.01), the Hamilton Rating Scale for Depression(HAMD) scores (χ²=11.06, P=0.00), LED (F=14.93, P=0.00) and Minimum Mental State Examination(MMSE) scores (χ²=9.81, P=0.01) among three groups. There was no significant difference in age and PDSS scores among three groups. The results showed that there were significant differences in terms of restless state and nocturnal dysphoria (F=5.12, P=0.01; F=3.27, P=0.04) between group 1 and group 3. The linear regression analysis showed that the HAMD and the LED scores had the greatest influence on PDSS score (R²=0.142, 0.196). Conclusion PD patients have a variety of sleep symptoms. The treatment of large doses of dopamine and depression contribute to the occurrence of PD sleep disorders.

Objective To discuss the experience of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) for the treatment of hepatocellular carcinoma (HCC). Methods Clinical data of one patient with HCC undergoing ALPPS in Tangdu Hospital of the Forth Military Medical University in March 2015 were retrospectively analyzed. The patient was male, aged 31 years, was hospitalized at 2 weeks after interventional therapy of HCC. Hehadahistory of hepatitis B forover 20 years. No yellow skin or sclera was observed. Percussion pain of hepatic region was positive. HBsAg was positive and the level of AFP was 10 196μg/L. A massive HCC in the right lobe was observed by computer tomography (CT) scan, approximately 15 cm in diameter. The admitting diagnosis was HCC of the right lobe. Preoperative evaluation: Child-Pugh classification A. The liver volume was 3 464 ml, the right lobe was 2 693 ml and the left lobe was 771 ml assessed by CT scan. After resection of the right lobe and partial inferior left lobe, the remnant liver volume accounted for 35%of the standard liver volume (SLV). The standard remnant liver volume (SRLV) was 328 ml/m2. The patient was unable to tolerate one-stage operation and ALPPS was performed subsequently. The informed consents of the patient was obtained and the local ethical committee approval was received. Results During the ifrst-stage ALPPS, liver separation, removal of portal vein tumor thrombosis, ligation of the right branch of portal vein, partial resection of the inferior left lobe were performed. During the second-stage surgery, right hemihepatectomy was performed and chemotherapy pump was implanted in portal vein. CT scan revealed that the SRLV was 610 ml/m2, and the volume of left liver lobe grew to 1 245 ml, accounting for 86%of SLV 2 weeks after the ifrst-stage of ALPPS. The patient developed massive abdominal hemorrhage following the second-stage surgery and bleeding was stopped after receiving digital subtraction angiography (DSA) of the hepatic artery+embolization. The patient was discharged in stable condition on April 17th, 2015. Conclusions ALPPS is suitable for patients with middle- and advanced-stage HCC who are intolerable of one-stage hepatectomy. For those requiring comprehensive therapy, ALPPS can prolong the survival time of patients to provide the opportunity of receiving subsequent comprehensive treatments.

OBJECTIVETo establish a fluorescent polymerase chain reaction (F-PCR) method for detecting the coronavirus related to severe acute respiratory syndrome (SARS) and to evaluate its value for clinical application.

METHODSThe primers and the fluorescence-labeled probe were designed and synthesized according to the published sequence of the SARS-associated coronavirus genes. A F-PCR diagnosis kit for detecting the coronavirus was developed, and 115 clinical nasopharyngeal gargling liquid samples were tested.

RESULTSThe sequence of PCR amplified products completely matched the related sequence of the SARS-associated coronavirus genome. Forty-nine out of 67 samples from identified SARS patients and 8 of 18 samples from persons having close contact with SARS patients showed positive results. All 30 samples from healthy controls were negative.

CONCLUSIONThe F-PCR method established may be a rapid, accurate and efficient way for screening and for the early diagnosis of SARS patients.

Fluorescence ; Humans ; Polymerase Chain Reaction ; methods ; SARS Virus ; genetics ; isolation & purification ; Severe Acute Respiratory Syndrome ; virology

OBJECTIVETo explore the feasibility and safety of conditioning regimen containing fludarabine (Flud) for haploidentical hematopoietic stem cell transplantation (HSCT).

METHODSPreparative regimen containing Flud 40 mgxm(-2)xd(-1) on day -7 to -3 in place of cyclophosphamide (CTX) for haploidentical HSCT was given to 35 patients with hematologic malignancies (4 standard risk, 16 high risk, 15 relapse with no remission). All donors received rhG-CSF followed by HSC harvest. One patient received peripheral blood HSCT (PBSCT), one bone marrow transplantation (BMT), and the others BM combination with PBSCT. The regimen-associated side effect, engraftment, incidence of graft-versus-host disease (GVHD) and disease-free survival (DFS) probabilities were observed.

RESULTSAll patients achieved sustained, full donor-type engraftment. Thirty-four patients obtained primary durable engraftment, and 1 who rejected graft from his mother obtained successful durable engraftment after the second graft from his father. The cumulative incidence of grade III-IV acute GVHD and chronic GVHD was 12.1% and 31.7%, respectively. With a follow-up duration of 8-25 months, 6 patients were dead, in which 3 died of relapse, 2 of acute GVHD, 1 of fungal infection, none died of regimen-associated side effect. The other 29 patients remained alive and DFS probability was 79.7%.

CONCLUSIONFlud based conditioning regimens for haploidentical HSCT is safe and feasible, which reduces regimen-associated side effect, with no increasing the rate of relapse and infection, and decreases the incidence of aGVHD.

Adolescent ; Adult ; Child ; Child, Preschool ; Cyclophosphamide ; Feasibility Studies ; Female ; Graft vs Host Disease ; prevention & control ; Hematopoietic Stem Cell Transplantation ; Humans ; Male ; Middle Aged ; Transplantation Conditioning ; adverse effects ; methods ; Transplantation, Homologous ; Vidarabine ; adverse effects ; analogs & derivatives ; therapeutic use ; Young Adult