Objective To observe the dynamic change of activated cytotoxic T lymphocyte (CTL) percentage during periopera-tive period in the patients with breast cancer and to explore the value of detecting the peripheral blood activated CTL in monitoring the perioperative condition of breast cancer patients .Methods The lymphocytes in whole blood were defined by forward scatter and side scatter (FSC/SSC) signal parameters by adopting flow cytometry (FCM ) ,the CD3 ,CD8 and CD38 antigens on lymphocyte surface were detected by CD3-FITC ,CD8-APC and CD38-PE monoclonal antibody ,respectively .The CD3+CD8+CD38+ percentage in 20 healthy people were detected with the established method to determine the reference ranges ,and the dynamic changes of CD3+CD8+ CD38+ cells percentage in total T cells and cytotoxic T cells of 33 patients with breast cancer during perioperative period were observed .Results The percentages of CD3+ CD8+ CD38+ /CD3+ and CD3+ CD8+ CD38+ /CD3+ CD8+ in healthy group were (13 .46 ± 4 .08)% and (29 .98 ± 9 .1)% ,respectively .Both the CD3+ CD8+ CD38+ /CD3+ [(10 .44 ± 6 .61)% ] and CD3+ CD8+CD38+ /CD3+CD8+ [(22 .34 ± 10 .68)% ] before operation in 33 patients with breast cancer were significantly lower than those in healthy group (P<0 .05);CD3+CD8+CD38+ /CD3+ [(9 .64 ± 6 .16)% ] on postoperative 1 d was significantly lower than that in preoperation(P<0 .01);CD3+CD8+CD38+ /CD3+ [(12 .67 ± 7 .73)% ] and CD3+ CD8+ CD38+ /CD3+ CD8+ [(27 .42 ± 10 .65)% ] on postoperative 7 d were significantly higher than those in preoperation (P<0 .05) ,the difference with the healthy control had no statistical significance(P>0 .05) .Conclusion Observing the dynamic change of CD3+CD8+CD38+ cells percentage has an impor-tant significance for monitoring the perioperative condition of the patients with breast cancer ,contributing to get the activated CTL recovery situation of the patients and to choose the correct chemotherapy occasion for the patients .

Objective We studied the clinical features and its significance of coal worker's pneumoconiosis combined with sleep apnea Methods In 40 patients with coal worker's pneumoconiosis combined with sleep apnea hospitalized from February 2006 to December 2009, polysomnography ( PSG) , blood routine, urine routine, blood pressure and biochemical indicators were measured and analyzed. Results Patients with coal worker' s pneumoconiosis combined with sleep apnea manifested mainly as duplicate hypoxemia and multi-organ dysfunction: high blood pressure, dysfunction of heart, lung and kidney, increase of serum glucose, blood lipids, blood uric acid and finally led a vicious cycle to aggravate the above mentioned damage. Conclusions In clinical, multiple-organ dysfunction resulted from severe hypoxemia and hypercapnia caused by coal worker's pneumoconiosis combined with sleep apnea, should be fully aware and give ational and effective treatment early to reverse or delay the further function damages of multiple organs, and therefore significantly improve the prognosis.

Objective To investigate the relationship between HBV genotypes and YMDD motif mutations or BCP mutations in Xiangtan of Hunan Province. Methods HBV genotypes, YMDD motif mutations and BCP mutations were analyzed in 952 HBV infected patients. Results HBV genotyping showed that 698 HBV type B patients and 115 HBV type C patients accounted for 73.32% and 12.08% respectively of all the participants. The rest 139( 14.60% )were genotype B and C mixed infection( B + C ). The analysis of YMDD motif mutations showed that 844 YMDD wild-type which accounted for 88.66% of all the subjects and the remainder were YMDD mutation types, of which 54( 5.67% ) carried YVDD, 53( 5.57% ) YIDD,and 1 YVDD and YIDD mixed infection. Basic Core Promoter mutations showed that 1762A/1764G ( wild type )accounted for 70.59% and 1762T/1764A( mutant ) accounted for 19.75%. The rest 92 patients were 1762T/1764A and 1762A/1764G mixed infection. This study showed no significant difference in the rate of YMDD mutation( 10.04% vs 10.43% ,χ2 =0.017,P＞0.05 ) ,but a significant difference in the types of YMDD mutation(χ2 = 4.836, P ＜ 0.05 )between HBV types B and C. The YVDD mutation was more commonly seen in genotype C( 9.57% ) than in genotype B( 5.88% ). The BCP mutation rate showed a significant difference( 27.36% vs 46.09%, χ2 = 16.478, P ＜ 0.01 ). Genotype C was more frequent than genotype B. The BCP mutation rate showed no significant difference between YMDD Wild-type and YMDD mutation types( 28.67% vs 35.51%, χ2 = 2.139, P ＞ 0.05 ), but most of BCP mutations happened in YVDD mutant type( 61.11% ). Conclusions ( 1 ) The predominant HBV genotypes in Xiangtan were genotype B and genotype C, the major genotype was type B, which display the characteristics of epidemiology in Southern China. ( 2 ) Determination of HBV genotypes before lamivudine therapy was probably not an important pretreatment investigation to predict antiviral responses. ( 3 ) Detection of HBV genotypes, YMDD motif mutations and BCP mutations will contribute to the correct evaluation of prognosis and timely proper management of HBV patients.

Objective To study the expression of suppressor gene PTEN in gastric cancer tissues and its relationship with tumor biologic characteristics. Methods Using EnVision immunohistochemical methods, we examined the suppressor gene PTEN expression in 116 cases of gastric cancer, 35 cases dysplasia and 56 cases normal gastric mucosa specimens. Results The positive rate of PTEN (53.4 %, 62/116) was lower in gastric cancer tissue than in dysplasia (71.4 %, 25/35) and normal gastric mucosa specimens(100 %, 56/56) (P

Objective To evaluate the feasibility of low tube voltage (80 kV)with low concentration contrast medium iodixanol (270 mg I/mL)in cerebral perfusion using 640-slice volume CT.Methods Patients who underwent CT cerebral perfusion were randomly divided into two groups.Group A:100 kV,320 mg I/mL contrast medium;group B:80 kV,270 mg I/mL contrast medium.The effective dose(ED)was record,the frontal cortex,temporal cortex and occipital cortex were selected as regions of interest(ROI),and the cerebral perfusion parameters (rCBV,rCBF,MTT,TTP)were measured separately.The CT value of the M1 segment of cerebral middle artery, the C7 segment of internal carotid artery,the basilar artery and the surrounding brain tissue were measured.The signal-to-noise radio (SNR)and the contrast-to-noise ratio(CNR)of two groups were compared and analyzed.All data will be statistically analyzed,and the consistency of two physicians for image quality evaluation was analyzed by Kappa analysis.Results The ED of group B was 4.56 mSv, which was reduced by 35.2% compared to group A(7.04 mSv).The perfusion parameters,the CT value of ROI and the SNR,CNR for two groups were of no statistical difference(P>0.05).Conclusion The feasibility of low tube voltage combined with low concentration contrast media is better,which not only meets the requirements of clinical diagnosis,but also reduces the radiation dose and the probability of contrast induced nephropathy.

Objective To compare the effect of continuous positive airway pressure (CPAP)and bilevel positive airway pressure(BiPAP)on the cardiac structure and function of patients with obstructive sleep apnea and hypopnea syndrome(OSAHS).Methods 100 patients with OSAHS were selected as the research subjects.The patients were randomly divided into two groups by digital table method,CPAP group had 50 cases,adopted the CPAP ventilation mode,BiPAP group had 50 cases,adopted the BiPAP ventilation mode.The heart rate,blood pressure, blood brain natriuretic peptide(BNP),nitric oxide(NO),endothelin -1 protease,matrix metalloprotein 9(MMP -9), C -reactive protein (CRP) and polysomnography (PSG) related indicators,cardiac structure and function and endothelial function changes before and after treatment were observed in the two groups,compared the clinical effect of the two modes.Results Before treatment,in both groups,there were no statistical differences in blood pressure,heart rate,BNP,NO,endothelin -1,MMP -9,CRP,PSG related indicators,cardiac structure and function,endothelial function.After six months of noninvasive ventilator treatment,results of the heart rate,systolic pressure,diastolic blood pressure,blood oxygen saturation,oxygen partial pressure,the BNP,endothelin -1,NO,MMP -9,CRP,body mass index,the Epworth sleepiness scale(ESS),Apnea hypoventilation index(AHI),oxygen and lowest at night,aortic di-ameter(AO),left ventricular inner diameter (LA),right ventricular(RV)inside diameter,left ventricular ejection fraction(LVEF),pulmonary artery systolic pressure(PASP)of the CPAP group were (79.83 ±11.47)times/min, (114.06 ±11.45)mmHg,(72.44 ±7.38)mmHg,(97.6 ±1.45)%,(93.17 ±1.86)mmHg,(110.78 ±38.32)ng/L, (17.58 ±2.07)ng/L,(8.55 ±0.55)μmol/L,(372.73 ±189.00)μg/L,(3.34 ±2.29)mg/L,(23.87 ±1.59), (0.98 ±0.70),(0.65 ±0.30),(94.04 ±1.62)%,(31.52 ±2.17 )mm,(31.19 ±1.09 )mm,(20.86 ± 1.69)mm,(61.13 ±5.02)%,(20.74 ±5.49)mmHg.which of the BiPAP group were (80.96 ±8.56)times/min, (114.58 ±9.34)mmHg,(71.67 ±8.57)mmHg,(96.96 ±1.43)%,(94.52 ±1.66)mmHg,(87.63 ±28.33)ng/L, (17.76 ±2.20)ng/L,(8.54 ±0.52)μmol/L,(359.63 ±268.95)μg/L,(4.96 ±2.00)mg/L,(24.15 ±1.65), (0.85 ±0.75 ),(0.58 ±0.19 ),(94.50 ±1.18)%,(31.73 ±1.57 )mm,(31.97 ±1.12)mm,(21.58 ± 2.43)mm,(62.24 ±5.79)%,(21.45 ±3.76)mmHg.In the oxygen partial pressure,the BNP,MMP -9,CRP,ESS score,AHI,LA,LVEF and other indicators,BiPAP mode were better than CPAP mode(t =2.13,4.32,2.13,4.32, 1.39,4.93,2.58,4.36,all P <0.05 ).Conclusion BiPAP mode and CPAP mode can improve cardiovascular function in patients with OSAHS,improve the symptoms of low ventilation,reduce obesity,but in terms of reducing cardiac load,improve blood vessel function,BiPAP mode is better than CPAP.

OBJECTIVETo explore the clinicopathologic features of CD30-positive sinusoidal large B-cell lymphoma (CD30 + SLBCL) and its relative correlation with Epstein-Barr virus (EBV).

METHODSTwo cases of CD30 + SLBCL, a 65-year-old men and a 85-year-old women were morphologically and immunophenotypically analyzed. EBV status was also evaluated through not only the polymerase chain reaction (PCR) amplification to the EBV Bam HIW DNA sequence, but also an immunohistochemical detection of the latent membrane protein 1 (LMP1).

RESULTSThe patients presented with similarly superficial lymphadenopathy. One of them died of the tumor within 10 months. Microscopically, both of the neoplasms were characterized by a cohesive sinus growth pattern and the monomorphic cytology of the tumor cells. Immunohistochemically, They were both positive for CD45, CD30, and CD20 or CD79alpha, whereas neither expressed EMA, ALK1, nor any histiocytic/T-lineage markers. No evidence of EBV-infection could be found either.

CONCLUSIONSCD30 + SLBCL is a morphologically and immunophenotypically distinctive variant of diffuse large B-cell lymphoma, which should be distinguished from T/null cell type anaplastic large cell lymphoma and some other nodal lesions with a predominantly sinusoidal infiltrative pattern. CD30 + SLBCL may not be correlation with EBV.

Aged ; Aged, 80 and over ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Ki-1 Antigen ; analysis ; Lymphoma, B-Cell ; diagnosis ; pathology ; Lymphoma, Large-Cell, Anaplastic ; diagnosis ; pathology ; Male ; Middle Aged

Objective To assess the CT characteristics of thoracoabdominal localized Castleman disease (LCD) in 55 cases and correlate with histopathologic features. Methods Fifty-five patients with LCD proved histopathologically in thorax ( n = 25 ) and abdomen ( n = 30 ) were collected during past 20 years. The unenhanced and contrast-enhanced CT were performed in all patients. Two radiologists reviewed CT images and the CT findings were analyzed simultaneously. Results In 54 patients with hyaline-vascular type ( n = 50 ) and mixed type ( n = 4 ) localized CD, the lesion typically presented as solitary mass (90. 7% , 49 cases), with irregular or lobular or infiltrative margin ( 83.3% , 45 cases),central calcification (38. 9%, 21 cases), marked enhancement (100% , 54 cases), focal non-necrosis low attenuation areas (72. 2%, 39 cases), lymphadenopathy (70.4%, 38 cases) and dilated feeding vessels adjacent to the mass (96.3%, 52 cases). One lesion with plasma cell type localized CD presented as a mass with irregular margin, mild enhancement and central necrosis. Four morphologic patterns wereclassified on CT, including solitary mass with well-circumscribed margin (n =4), irregular or lobular margin ( n = 30), infiltrative or halo-like margin ( n = 16 ), and multiple coalescent maasses ( n = 5 ). Conclusion CT features of thoracoabdominal localized CD are closely related to the location and pathological type. LCD with hyaline-vascular and mixed type has typical CT characteristics, while LCD with plasma cell type has no typical CT findings.

Objective To evaluate the predictive value of a dose-surface histogram (DSH) for radiation cystitis (RC) in patients with cervical cancer. Methods We retrospectively included 190 patients with cervical cancer who underwent image-guided radiotherapy (IGRT) from the HIS system of The First Affiliated Hospital of Hebei North University from May 2013 to May 2023. The patients were divided into test group (n = 100) and control group (n = 90). The dose distribution in the bladder was evaluated by using a DSH for the test group and using a dose-volume histogram (DVH) for the control group. Receiver operating characteristic curves were used to evaluate the predictive value of DSH for RC in comparison with DVH. Results There were no significant differences in baseline data and RC incidence between the two groups (all P＞0.05). All evaluation indicators were significantly different between DSH and DVH (all P＜0.05). The predictive value of S₄₅ and V₄₅ for the incidence of grade-I, -II, and -III RC was low (all P＜0.05). The predictive value of S₅₀ and V₅₀ for the incidence of grade-I, -II, and -III RC was moderate (all P＜0.05). S₅₅−S₅₇ and V₅₅−V₅₇ showed high value for predicting the incidence of grade-I, -II, and -III RC (all P＜0.05). Conclusion DSH shows basically the same predictive value for the incidence of RC caused by IGRT in cervical cancer as DVH, which is expected to become a new tool for evaluating radiotherapy plans.