Objective To investigate the pulmonary imaging findings and the clinical characteristics of ANCA-associated vasculitis.Methods 16 patients with ANCA-associated vasculitis confirmed by pathology in our hospital were analyzed retrospectively,all patients underwent 1 6-sclice high resolution chest CT scans.The clinical manifestations and lung CT findings of the patients were analyzed.Results The mean age of 1 6 patients (7 male and 9 female)was 62.7 (ranged from 56 to 83).The onset time of the disease was ranged for 1 weeks to 2 years,and it was characterized as multiple organs involvement accompanied by kidney damage with different degrees.The clinical respiratory symptoms inluded fever and cough.The lung HRCT features of ANCA-associated vasculitis were as follows:patchy shadow in 14 cases (87.5%),streak one in 12 (75%),nodular one in 3 (18.8%),cavities in 4 (25%),emphysema and pulmonary bullae in 6 (37.5%),tree-in-bud in 6 (37.5%),pleural effusion in 4 (25%),mediastinal lymph nodes enlargement in 3 (18.8%), pleural thickening in 6 (37.5%),cellular-like in 5 (31.3%),bronchiectasis in 6 (37.5%),round-glass opacity in 10 (62.5%)and reticulate changes in 8 (50%).Some patients were treated by the glucocorticoid (a hormone steroid)or by it in combination with immunosuppressant, and the clinical symptoms were improved and some lesions on X-ray images were significantly reduced or disappeared.Conclusion ANCA-associated vasculitis usually occurs in the majority of middle or old age without gender difference.Multiple organs are easily involved and the lesions in lung may be misdiagnosed as infection.Early CT diagnosis and timely treatment may improve the prognosis.

Objective To analyze the possible risk factors for Parkinson's disease (PD),and to provide clues to its etiology and prevention.Methods A matched case-control study,including 91 cases of PD and 364 controls,was carried out in Shanxi Provincial People's Hospital.Subjects completed an interviewer administered questionnaire about some putative risk factors.Multivariable conditional Logistic regression model was used to analyze the associated factors for PD.SAS 8.0 was used to analyze the data.Results 6 risk factors were found significantly associated with PD.The odds ratio (OR) of Parkinson's disease was 5.421 (95％CI:1.272-23.103) for family history,3.330 (95％CI:1.268-8.741) for rural living more than 10 years,2.495 (95％CI:1.044-5.961) for maternal smoking during pregnancy,1.607 (95％ CI:1.224-2.112) for maternal age more than 37 years,3.673 (95％CI:1.766 7.643) for history of drinking alcohol,2.147 (95％CI:1.279 3.602) for less physical exercising.Conclusions PD is a disease affected by the interaction of genetic and environmental factors,and the risk factors should be intervened selectively.

Lung cancer is the leading cause of morbidity and mortality of malignant tumor.Surgery,radiotherapy and chemotherapy remain the primary means of treatment for lung cancer,while the discoveries of molecular targets and targeted agents for lung cancer are making revolutionary changes and will almost certainly propel progress in this field into the foreseeable future.Biomarker-based individualized comprehensive treatment strategy is expected to benefit the lung cancer patients' survival.Meanwhile,chemotherapy remains the major treatment of advanced non-small cell lung cancer,which requires implementing the "three combinations" dialectical therapy principles,that is,systemic with local,conventional with personalized,eliminating with supporting.

Objective: To investigate the changes of oxygen metabolic parameters and blood glucose concentrations during perioperative period of orthotopic liver transplantation. Methods: The blood gas, cardiac index (CI), mixed venous oxygen saturation (SvO2), oxygen delivery (DO2), oxygen consumption (VO2), oxygen extraction rate (O2ER), and arterial blood glucose were measured at defined time points (before anesthesia induction, 30 min before anhepatic period, 5 min after anhepatic period, 30 min after anhepatic period, 5 min of neohepatic period, 30 min of neohepatic period, and postoperation) in 50 patients receiving liver transplantation. Results: Compared with those before anesthesia induction, no significant changes in CI, SvO2, DO2, VO2, and O2ER were found in pre-anhepatic period. CI, VO2, and DO2 decreased significantly at the early 5 min of the anhepatic period (P<0.05); VO2, DO2, and O2ER decreased significantly at the 30 min of the anhepatic stage (P<0.05). SvO2, DO2, and VO2 increased, but O2ER decreased significantly at the early 5 min of the neohepatic stage (P<0.05). DO2, VO2, and O2ER increased significantly at the 30 min of the neohepatic stage (P<0.05). During preanhepatic stage the blood glucose levels increased progressively but were lower than those during anhepatic stage. During neohepatic stage, blood glucose decreased abruptly but was still higher than the normal level (P<0.05). Conclusion: It suggests that serious imbalance of oxygen metabolism exists during liver transplantation, especially in anhepatic and early neohepatic stages. Blood glucose increases during the preanhepatic stage, reaches the peak during the anhepatic stage, and then decreases gradually.

OBJECTIVETo investigate the role of RLIP76 in regulating multi-drug resistance in small cell lung cancer (SCLC), and to analyze the relationship between its expression and prognosis.

METHODSThe expressions of RLIP76 protein and gene were detected by Western blotting and real-time PCR (RT-PCR) in both the chemosensitive SCLC H69 cell line and chemoresistant H69AR cell line, respectively. siRNA was transfected into the H69AR cells to inhibit RLIP76 expression, and eGFP-RLIP76 was transfected into the H69 cells to enhance RLIP76 expression. The drug-sensitivity of cells to chemotherapeutic drugs (ADM, DDP, VP-16) were detected by CCK8 assay. The expression of RLIP76 in the SCLC tissues was detected by immunohistochemistry. The relationship of RLIP76 expression with clinicopathological features and prognosis of the patients was analyzed.

RESULTSThe expression of RLIP76 in H69AR cells was 13.675 ± 0.983, significantly higher than 1.074 ± 0.107 in the H69 cells (P < 0.01). The drug-sensitivities of H69AR cells to chemotherapeutic drugs were significantly increased when the expression of RLIP76 was down-regulated (P< 0.001). The sensitivities of H69 cells to chemotherapeutic drugs ADM, DDP and VP-16 were significantly decreased after transfection with eGFP-RLIP76 up-regulating the RLIP76 expression (P = 0.003). The positive expression rates were 61.3% and 9.4% in the SCLC tumor tissues and para-cancerous tissues, respectively (P < 0.01). The expression of RLIP76 was significantly correlated with clinical stage, chemosensitivity and overall survival of the SCLC patients (P < 0.05).

CONCLUSIONSOur results suggest that RLIP76 is involved in the regulation of small cell lung cancer multidrug resistance. RLIP76 may serve as a potential target gene to evaluate the chemosensitivity and clinical prognostic for small cell lung cancer.

ATP-Binding Cassette Transporters ; metabolism ; physiology ; Antineoplastic Agents ; pharmacology ; Cisplatin ; pharmacology ; Down-Regulation ; Drug Resistance, Multiple ; Drug Resistance, Neoplasm ; Etoposide ; pharmacology ; GTPase-Activating Proteins ; metabolism ; physiology ; Humans ; Lung Neoplasms ; drug therapy ; metabolism ; RNA, Small Interfering ; Real-Time Polymerase Chain Reaction ; Small Cell Lung Carcinoma ; drug therapy ; metabolism ; Transfection ; Up-Regulation

[Objective]To explore the potential of a novel collagen I /chitosan /Nano?-tricalcium phosphate(?-TCP)bilayered scaffold for being used in tissue engineering(TE)of osteochondral repair.[Method]Bilayered scaffolds were produced with collagen Ⅰ,chitosan and?-TCP,using a special cross-linking and freeze drying method.The pore size,porosity and interpores of the scaffold were observed by scanning electron microscopy(SEM).Rabbit bone mesenchymal stem cells(BMSC)were isolated and amplified,then inoculated onto the scaffold.By SEM scanning,the condition of the cells adhering onto the scaffold was observed.The proliferation of the cells on the scaffolds was examined using MTT method,and the growth curve was drawn.The cell-scaffold composite were then induced to differentiate towards cartilage by 3-D culturing,and then implanted into muscle pouches 2 weeks later.The result was observed 6 weeks later by HE staining,toluidine blue staining and type Ⅱ collagen immunohistochemistry.[Result]The scaffold possessed high porosity and proper pore size,the porosity was above 95%.BMSC could adhere onto the scaffold well,and the proliferation rate of the cells on the scaffolds was perfectly good.After in vitro induction,BMSC-scaffold composite can differentiate toward cartilage ectopicly.[Conclusion]The novel collagen I /chitosan /?-TCP bilayered scaffold possesses good pore structure and biocompatibility,and will possibly become a new biomaterial of TE used for osteochondral repair.

Hepatopulmonary syndrome is a pulmonary syndrome that is characterized by the clinical triad of chronic liver disease,arteriovenous shunts due to intrapulmonary vasodilatation,and arterial hypoxemia.Dwing to its complicated pathogenisis,unconspicuous behavior and lack of clinic features,it is very hard for early diagnosis,so while diagnosed,most of HPS patients are in a hard way.The clinical treatment is limited with unsatisfactory effectiveness,so does the prognosis.This article reviews the current diagnosis and therapies of hepatopulmonary syndrome.

Objective:To study the expression and clinical relevance of IRAK-M in monocytes in patients with systemic lupus erythematosus. Methods: Real-time quantitative PCR was performed for IRAK-M mRNA measurement and enzyme-linked immunosorbent assay was used for anti-double-stranded DNA antibody ( dsDNA ) and anti-single-stranded DNA antibody ( ssDNA ) . Dynamic scattering turbidimetric immunoassay was applied for complement 3(C3),complement 4(C4) and C-reactive protein(CRP), while Westergren method for erythrocyte sedimentation rate (ESR). Correlation analysis of IRAK-M with SLEDAI,dsDNA,ssDNA,C3, C4,CRP and ESR was computed by Pearson or Spearman. Results:①The result showed that the mRNA expression of IRAK-M in SLE patients was significantly lower than healthy controls (P<0. 05);and the mRNA expression of IRAK-M in active group was significantly lower than stable group ( P<0. 05 ) . ②The levels of dsDNA, ssDNA, CRP and ESR in SLE patients were significantly higher than healthy controls( P<0. 05 );and the levels of C3 and C4 in SLE patients were significantly lower than healthy controls ( P<0. 05 ) . Meanwhile,the levels of dsDNA,ssDNA,CRP and ESR in active group were significantly higher than stable group (P<0. 05),and the levels of C3 and C4 in active group were significantly lower than stable group (P<0. 05).③Correlation analysis showed that the mRNA expression of IRAK-M had a positive correlation with C3 (P<0. 05),and had a negative correlation with SLEDAI,dsDNA,CRP and ESR (P<0. 05),but had no correlation with ssDNA and C4(P>0. 05). Conclusion: This study indicated that IRAK-M play certain significant roles in the pathogenesis of SLE. We can monitor SLE disease activity and prognosis by quantitative detection of mRNA expression of IRAK-M. Meanwhile,it is very necessary to routinely test and regularly monitor the levels of dsDNA,ssDNA,C3,C4,CRP and ESR in SLE.

Music and speech may share the same neural pathway, and the role of music therapy in speech rehabilitation gradually attracts the attention from the rehabilitation medical profession in recent years. This article reviewed the effect, mechanism, and strategy of music therapy in speech rehabilitation.

Objective The incidence of breast cancer in China obviously keeps rising in recent years. The optical tomo?graphy image ultrasonography system ( OPTIMUS) is gradually applied in clinic as a new imaging diagnostic technique, but few system?atic studies are reported on its application to the diagnosis of breast tumors. The aim of this study was to assess the value of OPTIMUS in differentiating benign and malignant breast masses by measuring the maximum hemoglobin concentration ( MHC) in the lesions using OPTIMUS with the help of the results of controlled pathological study. Methods This prospective study included 380 cases of breast tumor ( 210 benign and 170 malignant ) treated from April 2009 to April 2014. We measured the MHC using OPTIMUS, detected the expressions of VEGF and PECAM?1/CD31 by immunohistochemistry, calculated the optimal threshold valve of MHC in predicting breast malignancy with the ROC curve, and analyzed the correlation of the MHC value with benign and malignant lesions, lymph node metasta?sis, and the expressions of VEGF and PECAM?1/CD31. Results The mean MHC was significantly higher in the malignant than in the benign lesions ([215.33±69.31] vs [116.50±55.31] μmol/L, P<0.01). The area under the ROC curve (AUC) was 0.836 (95%CI 0.684-0.989). The optimal threshold valve in the diagnosis of malignant breast lesions was 135.00 μmol/L, with a sensitivity of 84.7% and a specificity of 89%. When the tumor was≤2 cm, the MHC was significantly higher in the patients with lymph node metas?tasis than in those without ([207.73±66.43] vs [184.36±62.13] μmol/L, P<0.05). However, the MHC was markedly lower in the benign masses with VEGF and PECAM?1/CD31 negative than in the malignant lesions with VEGF and PECAM?1/CD31 positive ([116.50±55.31] vs [205.73±72.46] μmol/L, P<0.05) and strongly positive ([244.21±63.56] μmol/L, P<0.05). Strongly posi?tive expressions of VEGF and PECAM?1/CD31 were positively correlated with MHC ( P<0.05) . Conclusion Measurement of MHC by OPTIMUS contributes to the differential diagnosis of benign and malignant breast lesions and has a potential value for preoperative assessment of the prognosis of breast cancer.