Clinical data of 28 cases of childhood bronchiolitis obliterans treated from September 2008 to November 2010 were retrospectively analysis.Pulmonary high-resolution CT (HRCT) showed that bronchial wall thicken was seen in all 28 patients,the mosaic pattern in 26 cases,patchy shadows in 18 cases,bronchiectasis with typical signet ring sign in 2 cases,atelectasis in 2 cases without pleural effusion.Pulmonary function tests and flexible bronchofiberscopy were performed in 6 cases,which showed the inflammation in bronchial tunica intima and obstruction of small airway.Blood routine,blood sedimentation,c-reaction protein,TORCH,hepatic function,renal function and immune function were normal.Patients received comprehensive treatment with methylprednisolone,clarithromycin and montelukast.The clinical conditions of 28 cases were improved with varying degrees after treatment and no significant side effects were observed.

Objective To assess the diagnostic value of CT and MRI findings of toxoplasma encephalitis among AIDS patients.Methods CT and MRI findings of toxoplasma encephalitis were retrospectively studied in 17 AIDS cases.Results The lesions were bilateral and multiple,involving basal nuclei in 12 cases,thalamus in 3 cases,bilateral cerebral hemispheres near corticomedullary junction in 1 case,and cerebellum and brain stem in 1 case.The lesions showed weak hypodensity on CT,and long T 1 and long T2 signal intensity on MRI,with marked peripheral edema effect.After contrast administration,the small ring or twist and target enhancement was seen in 12 cases,large ring enhancement-in 1 case.multiple focus in 15 cases and single focus in 2 cases;MRI was more sensitive in detecting a largest number of cerebral lesions than CT.Conclusion More small ring and twist,nodular,target enhancement are highly suggestive of toxoplasma encephalitis in the basal nuclei.Both CT and MRI are effective in diagnosing toxoplasma encephalitis,but MRI imaging without and with gadolinium is more sensitive than CT in the detection of toxoplasma encephalitis;MRI imaging may reveal a greater number of lesion when it is positive and so the detection rate of MRI is higher than that of CT.

Objective To study the effects of diacylglycerol(DG)on body weight of rats and its possible metabolic mechanism. Method (1) SD rats (n=30) were randomly divided into 3 groups. They were given free access to diets containing 7% (wt) triacylglycerol (TG, control group), 20% (wt) TG or 20% (wt) DG diets, respectively for 8 w. The changes of body weight, height, food intake, and feces were recorded. At the end of experiment, abdominal fat weight (including perirenal fat and epididymal fat), blood lipids were detected. (2) 13 w male Wistar rats (n=50) were divided into 2 groups(administrated with 10% TG or DG emulsion, respectively)in postprandial blood fat profile experiment. Blood lipids of 5 rats were analyzed at desired interval. (3) 6 w male Wistar rats (n=30) were randomly divided into 3 group, control group, DG group and TG group, administrated with glucose solution, 20%DG emulsion and 20%TG emulsion respectively for 6 d. Urine in 144 hr was collected continuously and analyzed for total ketone bodies. Results High DG diet resulted in a significant reduction in both body weight gain, ratio of abdominal fat to body weight and serum TG levels compared with the high TG diet. DG group have higher FFA level in portal vein and lower TG level in jugular vein than those of high TG group. But urine ketone body level of high DG group was higher than high TG group. Conclusion Dietary DG reduced fat accumulation inabdominal region, body and blood, and these effects may be involved with different metabolic ways of DG compared with TG.

Objective To investigate the therapeutic effects of microwave ablation combined with dendritic cell (DC) tumor vaccine on a murine breast cancer model and to explore its immunological mechanism.Methods Forty-eight Balb/c mice were used to establish models of mouse mammary carcinoma,and then randomly divided into a sham-operation group,a microwave ablation treated group,a DC tumor vaccinated group and a microwave ablation plus DC tumor vaccinated group.Microwave ablation was conducted with the microwave ablation group on day 14 after establishing the model.DC tumor vaccination was performed on day 7 in the vaccinated group.In the microwave ablation plus DC tumor vaccinated group,DC tumor vaccination and microwave ablation were consecutively performed on days 7 and 14,respectively.Tumor growth,lung metastasis and survival were observed.The proportion of CD3+ and CD4+ T cells in splenocytes were analyzed by fluorescence Activated Cell Sorter (FACS) on the 14th day after microwave ablation.Serum levels of interferon-γ (IFN-γ) and interleukin-4 (IL-4) were also detected using ELISA.Results The survival time (56.4 ± 4.3 days),tumor size (67.3 ± 6.1 mm2) and lung metastasis index (0.6 ± 0.4) in the microwave ablation plus DC tumor vaccinated group were all significantly lower than the corresponding averages in the microwave ablation and DC tumor vaccinated group.The proportions of splenic CD3 + T cells (27.8 ±10.3 ％) and CD4+ T cells (16.7 ± 8.3 ％) in the microwave ablation plus DC tumor vaccinated group were significantly larger than in the control group.Average serum levels of IFN-γ (41.8 ± 22.9 pg/ml) in the microwave ablation plus DC tumor vaccinated group were also significantly larger than in the control group,while the average serum level of IL-4 (15.4± 6.4 pg/ml) was significantly lower.Conclusions Microwave ablation and DC tumor vaccination together could have synergistic effects in treating experimental breast cancer,which might be closely related to the enhanced immune response.

Objective The aim of the study was to explore the difference between the expression of CDg7 in peripheral blood and bone marrow on acute myeloid leukemia (AML n=30). Methods A flow cytometric quantitative analysis of expression levels for CD87 was performed on fresh blast cells in peripheral blood and bone marrow from patients with acute myeloid leukaemia using CD87, monoclonal antibodies. Analysis the difference between the expression of CD87 using matched t -test. Results The values of CD87 expression in bone marrow of 14 M5 cases are from 9.47 %～80.32 %, and from 11.49 %～87.46 % in peripheral blood. The values of CD87, expression in bone marrow of 8 M4 cases are from 14.27 %～46.28 %,and from 14.79 %～47.19 % in peripheral blood. The values of CD87 expression in bone marrow of 6 M2 cases are from 4.67 %～34.26 %, and from 8.96 %～39.78 % in peripheral blood. The values of CDs, expression in bone marrow of 2 MI cases are from 3.56 %～7.69 %, and from 5.21 %～8.96 % in peripheral blood.The expression of CD87 in peripheral blood and bone marrow from patients with acute myeloid leukaemia had statistical difference (t =3.13, P<0.05). Conclusion The levels of CD87 expression had difference between peripheral blood and bone marrow. The level in peripheral blood was higher than bone marrow. So when we performed quantitative analysis of expression levels for CD87, peripheral blood instead of bone marrow was commended.

Objective:To investigate the correlation between lumbar bone mineral density (BMD), musculoskeletal perfusion andmuscle mass.Methods:From May 2019 to August 2020, totally 91 patients who applied for CT perfusion (CTP) examination of abdomen (the scan range included the vertebral body of L1－L3) in Shanghai Tenth People′s Hospital of Tongji University were retrospectively analyzed. The mean BMD of L1－L3 vertebral body was measured by quantitative CT (QCT) at the same time of CT plain scan. According to BMD, the subjects were divided into normal BMD group ( n=33), osteopenia group ( n=41) and osteoporosis (OP) group ( n=17). The L3 level perivertebral muscle mass index and fat fraction were calculated based on QCT examination. The lumbar vertebral and perivertebral muscle perfusion parameters were measured based on CTP images. The parameters of QCT and CTP among three groups were analyzed by Kruskal-Wallis H test or one-way ANOVA. The correlation analysis was conducted between these parameters using Pearson or Spearman analysis. Results:The differences of the perivertebral muscle mass index and fat fraction among three groups were statistically significant ( P<0.05). The differences of the lumbar vertebral perfusion parameters including blood flow (BF), blood volume (BV) and flow extraction product (FE) among three groups were statistically significant ( P<0.05), and BF, BV and FE were positively correlated with BMD ( r=0.444, 0.312 and 0.266 respectively, all P<0.05; adjusted for age and gender r=0.437, 0.340 and 0.337 respectively, all P<0.05). There was no statistically significant difference in perivertebral muscle perfusion parameters among three groups ( P>0.05). Perivertebral muscle mass index was negatively correlated with fat fraction ( r=-0.599, P<0.001; adjusted for age and gender r=-0.404, P<0.001), and there was no correlation between perivertebral muscle mass index and muscle perfusion parameters, as well as perivertebral muscle fat fraction and muscle perfusion parameters. Conclusions:With the changes of BMD, bone mass and perivertebral muscle mass at L3 level are synchronous. Decreased vertebral bone mass is accompanied with reduced perivertebral muscle mass, increased muscle fat and decreased bone perfusion. The changes of vertebral perfusion and perivertebral muscle perfusion at L3 level are asynchronous, which implies that reduced perfusion in OP patients may be confined to the bone.

Objective To investigate the factors which may affect the secretions of human leptin and free fatty acids (FFA) by measuring plasma glucose, serum insulin, leptin and FFA levels during reduced sample number intravenous glucose tolerance tests (IVGTT) in the subjects with different status of insulin resistance and ? cell function. Methods According to oral glucose tolerance test, 7 normal, 10 overweight/obese individuals, 12 subjects with impaired glucose tolerance (IGT) and 11 with type 2 diabetes mellitus (DM) were recruited. During IVGTT, serum insulin, leptin and FFA levels at 12 time points were simultaneously measured. Results Compared to the stable secretion of leptin, during 180 min in the IVGTT, the FFA secretion showed a "U" shape profile. The correlation analysis showed that the average serum leptin and FFA levels in 3 h were independent to fasting plasma glucose concentration. The partial correlation coefficient of leptin and insulin decreased after being adjusted for FFA (before r=0.77, P0.05). Conclusion The changes of serum FFA levels in IVGTT are more significant than those of leptin after glucose loading. Fasting plasma glucose levels do not significantly affect the average serum levels of leptin and FFA. On the contrary, insulin manifests such action but does not affect the secretion profile of these parameters.

Objective To evaluate the sensitivity and specificity of various assays in diagnosing Cushing′s syndrome. Methods The plasma cortisol, urinary free cortisol (UFC), circadian rhythm in cortisol secretion and dexamethasone suppression test were assessed in 173 patients clinically diagnosed Cushing′s syndrome. The data were compared with the postoperative pathologic diagnosis. Results The normal diurnal rhythm of cortisol secretion was lost in 92.9% patients with Cushing′s syndrome. The loss of normal diurnal rhythm of cortisol secretion of 2 time points occurred in 85.1% (8:00, 16:00) and 91.8% (8:00, 24:00), and that of 3 time points (8:00, 16:00, 24:00) in 94.7% of the cases. The excretion of UFC was increased in 91.7% of patients with Cushing′s syndrome. Low-dosedexamethasonedidnotsuppressthe excessive secretion of glucocorticoid in 79.7% (1 mg) and 84.3% (2 mg) patients with Cushing′s syndrome. The basal level of plasma cortisol was raised in 75.6% patients. The sensitivity of 8 mg dexamethasone suppression test was 50%-70% as the standard was set at 50% suppression, and specificity was more than 95%. Conclusion The most sensitive tests for Cushing′s syndrome are the loss of normal circadian rhythm of cortisol secretion and increased UFC. The method of 3 time points is more sensitive than that of 2 time points in the assessment of circadian rhythm. The 8 mg dexamethasone suppression test is the most useful method in differentiating Cushing′s disease from adrenal adenoma.

Objective To observe non-displaceable binding potential (BPND) changes of striatal dopamine D2 receptors(SDDR) in patients with first-episode major depressive disorder (MDD) using 11C-Raclopride PET/CT,and to analyze the relationship between BPND and Hamilton rating scale for depression (HAM-D).Methods From December 2014 to December 2015,patients with first-episode MDD and age/gender-matched healthy controls underwent brain MRI and 11C-Raclopride PET/CT in this prospective study.BPND of bilateral SDDR was calculated by molecular imaging and kinetic analysis toolbox (MIAKAT).BPND changes of bilateral SDDR and their relationship with HAM-D score were analyzed.Paired t test,two-sample t test and Pearson correlation analysis were used.Results A total of 20 MDD patients (8 males,12 females,average age: (32.80±9.76) years) and 20 healthy controls (9 males,11 females,average age:(29.25±6.93) years) were enrolled in this study.The 11C-Raclopride uptake in brain tissue of the MDD group and control group were mainly distributed in bilateral striatum,and very few 11C-Raclopride was distributed in bilateral cerebral cortex and cerebellum.In MDD group,the BPND level of bilateral SDDR had no statistical differences(t values: 0.69,0.35,both P>0.05),and similar results were found in the control group(t values: 0.28,0.24,both P>0.05).Compared with the control group,however,the MDD group had lower BPND level of bilateral SDDR(t values: 3.13-4.41,all P<0.05).The BPND of bilateral caudate nucleus and/or putamen D2 receptors was correlated with HAM-D total score,anxiety/somatization factor score,cognitive impairment factor score,retardation factor score and sleep disturbance factor score(r values: from-0.688 to-0.453,all P<0.05).Conclusions The binding potential of SDDR in patients with first-episode MDD is declined,and the BPND level of SDDR is correlated with symptoms of depression.The abnormality of SDDR may be an important molecular mechanism of the abnormality of midbrain-striatal dopamine reward circuits in MDD patients.

Objective To detect the mutations of RET proto-oncogene in patients with medullary thyroid carcinoma (MTC). Methods Twelve patients with MTC confirmed by pathology and two clinically suspected patients were recruited. Total genomic DNA was extracted from peripheral blood for PCR. PCR products of exon 10, exon 11 and exon 16 of the RET proto-oncogene were purified and direct gene sequencing was performed. Results The genomic mutations were detected in 8 patients, in which direct gene sequencing analysis detected a mutation of TGC to CGC at codon 618 in exon 10 in 1 patient, a mutation of TGC to TAC at codon 634 in exon 11 in 2 cases, a mutation of TGC to CGC at codon 634 in exon 11 in 3 patients and a mutation of ATG to ACG at codon 918 in exon 16 in the remaiming 2 cases. Conclusion MTC can be diagnosed at gene level by direct gene sequencing analysis. It is possible to diagnose MTC before operation by means of molecular genetic analysis.