Objective To explore the feasibility and value of low dose CT scan for the diagnosis of pulmonary tuberculosis.Methods 150 patients with pulmonary tuberculosis underwent three doses CT scan (standard dose:150 mA;low-dose:15 mA and 30 mA) using GE dual slices helical CT.Besides the different tube current,other scan parameters including tube voltage,scan cycle,pitch,and collimation were the same in three dose groups.The scanned extent was from apexes to bases of lung.Image quality in standard group was compared with that in other two low dose groups and analyzed statistically by three radiologists.Results CT characteristics of pulmonary tuberculosis could be detected efficiently using low dose CT scan(30 mA) program,which was no significant as compared with the CT image using standard CT sose(P＞0.05).Howere,CT scan at 15 mA obviously affected on the diagnosis for both active and inactive pulmonary tuberculosis,the difference was significant (P＜0.05).Conclusion Low dose CT scan can replace totally the standard dose CT scan in diagnosing pulmonary tubercrulosis.

Electrocardiography ; methods ; Heart Conduction System ; physiopathology ; Heart Diseases ; diagnosis ; Humans

This study was to investigate the influnce of 4 weeks of living high-training low on exercise performance of rowers. Twenty rowers were divided into two groups: ten subjects spent 8-10h per night in a tabernacle simulated at an altitude of 2500m in normobaric hypoxia; 10 control subjects slept at near sea level. During the 4-week periods, all rowers were trained at the same relative or at the same intensity of work in normoxia state. The red cell volume (RCV) , haemoglobin mass (Hb) and hematocrit (HCT) were measured before test, 15th and 30th day of study,and measurements were done on a rowing ergometer at sea-level, which included an ergometer test at 4 mmol/L lactate anaerobic threshold and performance in exercise tasks of 2km, 5km, and a Wingate Anaerobic Test before test and 30th day of study. The results showed that adaptation to simulated moderate altitude can stimulate red cell production sufficiently: increase in red cell volume (RCV) , haemoglobin mass (Hb) and hematocrit (Hct). And there were significant increases in all important parameters at 4 mmol/L lactate anaerobic threshold as well as performance of 5km, while the performance of 2km showed no significant improvement, the mean values of both mean power per kilogram body weight and peak power per kilogram body weight were not increased significantly. In the control group, there were no significant changes in the all abovementioned parameters. The results of this study indicate that living high-training low can improve the aerobic energy-supply systems. We conclude that 4-week of living high and training low can improve sea level endurance performance in rowers.

Objective To compare the efficacy of retroperitoneal laparoscopy with open pyeloplasty for ureteropelvic junction obstruction(UPJO).Methods Retroperitoneal laparoscopy was performed under general anesthesia with the patients placed in lateral position.Three trocars were inserted at the midaxillary line above the iliac crest,and the pre- and post-axillary lines beneath the 12th rib.A fourth port was placed at the preaxillary line above the iliac crest.Over the medial margin of the psoas major,Gerota’s fascia was opened to expose the ureter.And then,the tissues around the ureter were cut to show the lower pole of the kidney.Afterwards,the redundant renal pelvis and the strictured segment of the ureter were resected,pelvi-ureteric anastomosis was completed with absorbable sutures,and a double-J stent was inserted.Open pyeloplasty was also carried out under general anesthesia with the patients in lateral position.An incision was made beneath the 12th rib to expose the ureteropelvic junction,and then the renal pelvis was cut at 2 cm away from the renal parenchyma,and the strictured segment of the ureter was resected.Double-J stent was indwelled after pelvi-ureteric anastomosis.The patient was placed in a lateral position under general anesthesia or epidural anesthesia.Subcostal incision was made.The lower pole of the kidney,the dilated renal pelvis and the upper ureter were mobilized in front of the psoas major.Cut the pelvis 2 cm away from the parenchyma and the PUJ was dismembered.The pelvi-ureteric anastomosis was completed with absorbable sutures and then a D-J stent was inserted.Results Compared with the open surgery group,the laparoscopy group experienced significantly longer operation time [(156.9?69.2) min vs(111.9?78.1) min,t=2.514,P=0.014],but less blood loss [mean:35(20-70)ml vs 110(60-175)ml,t=7.502,P=0.000],and shorter analgesic treatment and postoperative hospital stay [(0.7?0.3) d and(8.5?6.1) d vs(1.3?0.5) d and(15.5?10.8) d;t=-5.842,and -3.193;P=0.000 was found and 0.002].No significant difference in the occurrence of postoperative complications and hydronephrosis between the 2 groups was found [laparoscopy vs open surgery:urinary leakage:3 cases vs 3 cases,?2=0.000,P=1.000;incisional infection:0 vs 1,?2=0.000,P=1.000;and recurrence of UPJO:1 vs 0,?2=0.000,P=1.000;hydronephrosis:?2=5.192,P=0.182].Conclusions The efficacy of retroperitoneal laparoscopic pyeloplasty is comparable to open surgery.The procedure results in less blood loss and quicker recovery.

The establishment of induced pluripotent stem (iPS) cells is considered as one of the most important progresses in science and technology nowadays. In recent years, the iPS cells have been used in the construction of cellular model for hereditary heart disease, and the successful treatment in animal model of myocardial infarction, which brings a bright future for exploring the pathogenesis and therapy of hereditary heart disease.

BACKGROUND:Leukocytic infiltration induced by release of inflammatory cytotkines and up-regulation of adhesion molecules is closely associated with the formation of cerebral infarcted focus. The related factors have been widely studied.OBJECTIVE: To explore influence of estrogen on inflammatory reaction in rats after focal ischemia/reperfusion injury.DESIGN: Randomized controlled experiment.SETTING: Nanjing General Hospital, Nanjing Military Area Command of Chinese PLA.MATERIALS:The experiment was performed at the Department of Neurology, Department of Pathology, Nanjing General Hospital, Nanjing Military Area Command of Chinese PLA. Adult male SD rats were selected to establish cerebral ischemic models, with the body mass of 280-350 g.METHODS:The rats were assigned into 3 groups: control group,ovariectomized group and estrogen treatment group (estradiol, 200 μg/kg,subcutaneous injection, once a week for 4 weeks). Four weeks later, models with right middle cerebral artery occlusion (MCAO) for 1 hour and 2 hours as well as reperfusion for 0, 1, 3, 6, 22 and 70 hours were established with thread embolism method. Mean number of infiltrative neutrophils in brain tissue was calculated under microscope with 10 high power fields in ischemic hemisphere with hematoxylin and eosin staining. Expression of nuclear factor-κB was determined with immunohistochemical method.MAIN OUTCOME MEASURES:Infiltration of neutrophils and expression of nuclear factor-κB in brain parenchyma.RESULTS: ①Expression of nuclear factor-κB: There was expression of nuclear factor-κB in the ovariectomized group at hour 1 after ischemia.Positive cells appeared at hour 2 after ischemia in the control group and estrogen treatment group. The expression was in the peak at ischemia for 2hours and reperfusion for 3 hours in the three groups, and decreased gradually. There was slight expression at reperfusion for 70 hours in the ovariectomized group, while there was no clear factor-κB positive cell at reperfusion for 22 hours in the control group and estrogen treatment group.②Infiltrative neutrophils in cerebral ischemic region in the ovariectomized group significantly increased at ischemia for 2 hours and reperfusion for 22 hours. Compared with the estrogen treatment group, there was significant difference (P=0.045). At ischemia for 2 hours and reperfusion for 70 hours,infiltrative neutrophils in the ovariectomized group were more than those in the control group and estrogen treatment group, but there were significant differences only between ovariectomized group and control group.CONCLUSION: Estrogen can inhibit inflammatory reaction after cerebral ischemia/reperfusion injury.

Objective To study the expression of skin aspartic protease (SASPase) in lesions of cutaneous lupus erythematosus (CLE) and its role in the pathogenesis of CLE.Methods Skin samples were resected from the lesions and normal skin of 9 patients with CLE,including 3 cases of subacute cutaneous lupus erythematosus (SCLE),4 cases of discoid lupus erythematosus (DLE) and 2 cases of acute cutaneous lupus erythematosus (ACLE).Keratinocytes were isolated from the tissue samples and cultured in serum-free medium.Total proteins were extracted from the keratinocytes and separated by two-dimensional gel electrophoresis.ImageMaster 2D analysis software was used to assess differentially expressed proteins in keratinocytes between the lesional and normal skin,which were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS).The expression levels of SASPase were further determined by Western blot.The data were analyzed statistically by Student's t test.Results Keratinocytes were isolated from the tissue samples and successfully cultured in vitro.Two-dimensional electrophoresis profiles of proteins from the keratinocytes were obtained with high resolution and reproducibility,and the average matching protein spots were about 1200 with the matching rate higher than 80％.As Western blot showed,the relative expression level of SASPase was 0.463 ± 0.018 in keratinocytes from the lesional skin,and 0.145 ± 0.011 in those from the normal skin (P ＜ 0.05).The Western blot results were consistent with those of two-dimensional electrophoresis.Conclusion The initiation and progression of CLE seem to be associated with the abnormal activation and overexpression of SASPase.

Objective The aim of this study is to evaluate clinical application of BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) index in patients with chronic obstructive pulmonary disease (COPD). Methods Forty patients with stable COPD in Xuanwu Hospital of Beijing during September 2003 to December 2007, were recruited in the study, including 25 men and 15 women, aged 38 to 85 years (with a mean of 62 ± 13 years). BODE index was measured for each patient, one year and three years after recruitment, respectively. Severity of COPD, including number and duration of episodes, length of each hospital stay and times of hospitalization due to acute exacerbation of COPD (AECOPD), were recorded. All data were statistically analyzed with SPSS 13.0 software for windows. Results ①There was a remarkable difference in COPD severity between patients with BODE score equal to or greater than five and these with less than five (P <0.01 ). ①BODE score inversely correlated with forced expired volume at the first second ( FEV1 ) in COPD patients (P < 0.01 for those with BODE score equal to or greater than five and P <0.05 for these with BODE score less than five, respectively). ③BODE score positively correlated with number and duration of acute exacerbation, length of hospital stay and times of hospitalization due to AECOPD (P <0. 01 for those with BODE score equal to or greater than five and P < 0. 05 for those with BODE score less than five, respectively). For patients with COPD, their BODE score in the first year positively correlated with that in the third year ( r = 0.834, P < 0.01 ). Conclusions BODE index is a better indicator to evaluate their condition severity in patients with COPD.

Objective To investigate the relationship between gastrin expression and the development of coloreetal neoplasm and cell proliferation.Methods 15 samples of normal coloreetal mucosal tissue,21 samples of coloreetal adenomas and 70 samples of colorectal cancer were selected for evaluation of the expression of gastrin and Ki67 with immunohistochemieal method.Results In normal colorectal mucosal tissues.colorectal adenomas and coloreetal cancer,the positive rates of gastrin expression were 0.28.6%and 25.7%,respectively-which were signff-ieantly hisher in coloreetal cancer and adenomas groups than in the normal colorectal mucosal tissues(P<0.05).But there was no significance between colorectal cancer and adenomas(P>0.05).The positive expression rate of Ki67 with the obove samples were 40.0%,76.2%and 82.8%-respectively,with statistical results identical with results of gastrin(P<0.05).There was significant correlation between gastrin and Ki67[P<0.05).Conclusion Gastrin and Ki67 are highly expressed in eolorectal neoplasm.Gastrin miight play an important role in the carcinogen-esis and development of colorectal neoplasm,and might promote tumor cell proliferation.

Objective To investigate the effect of hyperbaric oxygen therapy on T-lymphocyte subpopulations in rats with acute pancreatitis. Methods 56 rats were randomly divided into three groups the sham group ( n = 8 ),control group( n = 24) and hyperbaric oxygen therapy group( treatment group, n = 24), then the control group and treatment groups were divided into three subgroups of 8 rats each undergoing euthanasia on days 1,3,7 after the acute pancreatitis induction. The CD4+ ,CD8+ subpopulations of T-lymphocytes in peripheral blood were detected respectively at the fist day and each day of the euthanasia. The sham group was used to make sure that the model was successfully induced. After euthanasia the pancrea was examined using electron microscopy. Results In the control group, the CD4+ cells in AP rats was significantly decreased and the ratio of CD4+/CD8+ also decreased. After 7days of HBO therapy,compared with the control group, the CD4+ lymphocytes of peripheral blood in the treatment group markedly increased( P ＜0.01 ). The CD8+ lymphocytes also increased to a certain extent. And the CD4+/CD8+ ratio of peripheral blood was obviously increased(P ＜0. 01 ). Also more severe pathological changes appeared in the untreated group than in the treatment group. Conclusion Hyperbaric oxygen therapy could improve the oxygen supply in acute panereatitis, regulate T cell immune function.