Objective To characterize the imaging features of mediastinal cysts and gain a better understanding of atypical manifestations of various mediastinal cysts and improve the level of diagnosis. Methods The CT and/or MR images(CT n=28, MRI n=26, CT and MRI n=10), surgical information, and pathologic material in 44 histopathologically proved cases of mediastinal cyst were retrospectively reviewed. Results The mediastinal cysts were located in the anterior mediastinum(n=13), middle mediastinum(n=18), anterior-middle mediastinum (n=2) and posterior mediastinum(n=11). Bronchogenic cysts and pericardial cysts were atypically located in 7/20(35%)and 5/6 respectively. The density of 42.9% cysts on CT was close to that of water. Each of the cysts had a high signal intensity that was equal to or greater than cerebrospinal fluid on T_2-weighted MR images. One cyst showed marked loss of signal on MR hydrography. The signal intensities of the cysts were variable on T_1-weighted images. The signal intensity of MRI was not homogeneous in 5 and the reasons were different. Fourteen cases were misdiagnosed. Conclusion 1.The cysts with soft-tissue attenuation on CT in the anterior and posterior mediastinum may be easily misdiagnosed as neoplasm. Pericardial cysts located in the paratrachea may be easily misdiagnosed as bronchogenic cysts .2. MRI can be used to diagnose the cysts with high density on CT.3. Heterogeneous signal on MRI and loss of signal on MR hydrography might be the reasons for misdiagnosis.

Humans ; Forensic Medicine ; Poisoning/diagnosis*

Objective To investigate the correlation between CT perfusion parameters of pulmonary carcinoma and standardized uptake values(SUV)derived from ~(18)F-fluoro-deoxyglucose positron emission tomography(~8F-FDG PET)and tumor microvessel density(MVD),and to determine the validity of CT perfusion in assessing tumor angiagenic activity of pulmonary carcinoma.Methods Fifty patients(mean age 57.5,17 females)with pulmonary carcinoma underwent CT perfusion using 16-slice helical CT.Blood flow(BF,ml?100g~(-1)?min~(-1)),blood volume(BV,ml?100g~(-1)),mean transmit time(MTF,s)and permeability surface area product(PS,ml?100g~(-1)?min~(-1))were analyzed.SUV of PET was calculated in 14 patients.The CD34 immunohistochemical staining was used for tumor microvessel counting.CT perfusion parameters of pulmonary carcinoma were correlatively studied with SUV and tumor MVD.Pearson's correlation analysis was performed to evaluate the association between CT perfusion parameters and SUV and MVD.Results The average values of BF,BV,MTT and PS were 97.30 ml?100g~(-1)?min~(-1), 8.86 ml?100g~(-1),6.75 s and 34.52 ml?100g~(-1)?min~(-1),respectively.The average value of MVD was 61.82/FOV.The mean value of SUV was 5.96.There was positive correlation between BF and SUV(r= 0.727,P

OBJECTIVETo compare the efficacy of different points combination in the treatment of menopausal insomnia.

METHODSNinety-six cases of menopausal insomnia were randomized into 3 groups, Xinshu (BL 15), Shenshu (BL 23), Sishencong (EX-HN 1), Shenmen (HT 7), Sanyinjiao (SP 6) were chosen in the restore interaction between the heart and the kidney group (group A, 32 cases); Zhaohai (KI 6), Jiaoxin (KI 8), Shenmai (BL 62), Pucan (BL 61) were chosen in the acupuncturing qiao mai group (group B, 32 cases); auricular Shenmen (TF4) and sensitive spot at the distribution area of auricular vagus nervus were chosen in the ear acupuncture group (group C, 32 cases). Six days made one session and the treatments were finished after 4 courses. The polysomnography (PSG) and Pittsburgh sleep quality index (PSQI) were employed before and after treatment to evaluate the alleviation of insomnia.

RESULTSThe parameters of the sleep latency (SL), rapid wave sleep latency (RL) and sleep efficiency (SE) were significantly improved in the three groups, and the differences were statistically significant (P < 0.05, P < 0.01). The SL and awaking time (AT) in group C [SL (401.08 +/- 16.54) min and AT (4.87 +/- 2.64) times] were significantly superior to those in the other two groups [SL (50.36 +/- 18.47) min, (54.87 +/- 20.92) min, AT (5.98 +/- 2.11) times, (6.13 +/- 3.04) times, all P < 0.05]. The S(3+4) (%) in group C was also significantly higher than those in the other two groups (both P < 0.05). It was indicated by PSQI that the sleep quality of group C (0.78 +/- 0.12) was significantly superior to that in group B (1.32 +/- 0.29), the total score and cured and markedly effective rate in group C [(4.34 +/- 1.43), 68.8% (22/32)] were superior to those in group A [(7.48 +/- 3.09), 53.1% (17/32), both P < 0.05].

CONCLUSIONEar acupuncture has a better curative effect than the restore interaction between the heart and the kidney group and acupuncturing qiao mai group, it is worth of being promoted.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Menopause ; psychology ; Middle Aged ; Sleep ; Sleep Initiation and Maintenance Disorders ; therapy ; Treatment Outcome

OBJECTIVETo improve the diagnosis and treatment of lymphangioleiomyomatosis (LAM).

METHODSThe clinical data of four cases of lymphangioleiomyomatosis diagnosed in our hospital were analyzed and corresponding literature was reviewed.

RESULTSLymphangioleiomyomatosis, a rare disorder of unknown cause that occured almost exclusively in women of child bearing ages, was characterized microscopically by atypical smooth muscle proliferation. It could occur as a sporadic diseases or as a part of tuberous sclerosis complex (TSC). LAM was associated with progressive dyspnea, recurrent spontaneous pneumothoraces, chylous effusions, and hamartomas.

CONCLUSIONClinicians should be familiar with the characteristics of LAM so that diagnosis and treatment can be made earlier to improve the prognosis.

Adolescent ; Adult ; Biopsy, Needle ; Female ; Humans ; Lung ; diagnostic imaging ; pathology ; Lung Neoplasms ; diagnosis ; pathology ; physiopathology ; Lymphangioleiomyomatosis ; diagnosis ; pathology ; physiopathology ; Male ; Middle Aged ; Tomography, X-Ray Computed

Objective :To explore the feasibility and clinical value of real time three‐dimensional transesophageal echo‐cardiography (RT‐3D TEE) in diagnosis of congenital heart valvular disease (CHVD).Methods :A total of 135 CH‐VD patients treated in our hospital were selected .All patients received surgery ,and transthoracic echocardiography (TTE) and RT‐3D TEE inspection successively within 7d before surgery .Heart valve lesion condition was observed , and diagnostic results of two methods and surgical outcome were compared and analyzed .Results :RT‐3D TEE could display the morphological structure ,lesion degree and peripheral blood flow of heart valves in CHVD patients in a multi‐angle ,stereoscopic and clear way .It could find heart valve disease which is difficult to be identified by TTE , and corrected the diagnostic deviation .With surgical results as the gold standard ,diagnostic coincidence rate of RT‐3D TEE was significantly higher than that of TTE (97. 04% vs.91. 11%, P＝0.039).CHVD diagnosed by RT‐3D TEE and TTE possessed a intermediate consistency (Kappa＝0.477 , P＝0. 001).Conclusion :RT‐3D TEE can pro‐vide more imaging information for the diagnosis of CHVD ,which can be used as an effective supplement for preop‐erative TTE examination .

OBJECTIVETo investigate the mutational characteristics of cathepsin C (CTSC) gene in two Chinese patients with Papillon-Lefèvre syndrome (PLS), and provide molecular basis for research of the pathogenesis of PLS.

METHODSPeripheral blood samples were obtained from patients and their parents respectively. Genomic DNA were extracted after consents. Polymerase chain reaction, direct DNA sequencing and restriction enzyme reaction were performed to screen mutations of CTSC gene.

RESULTSCompound heterozygous mutations of CTSC gene were identified in the two patients. Patient I carried the G139R and S260P mutations, patient II had the R250X and C258W mutations. The parents were heterozygous carriers without the clinical feature of PLS. None of the mutations were detected in normal controls. Furthermore, the S260P and C258W changes were novel mutations of CTSC gene, which had not been reported previously.

CONCLUSIONSMutations of CTSC gene are responsible for the phenotype of Papillon-Lefèvre syndrome in two Chinese patients. The results extend the mutation spectrum of CTSC gene and also provide basis for gene diagnosis of PLS in China.

Asian Continental Ancestry Group ; genetics ; Cathepsin C ; genetics ; Child, Preschool ; Exons ; genetics ; Female ; Humans ; Male ; Mutation, Missense ; genetics ; Papillon-Lefevre Disease ; enzymology ; genetics

Structure of natural product-ursolic acid was modified for increasing its antitumor activity. Ursolic acid was acylated, esterified, hydrolized or oxidized to obtain target pentacyclic triterpenoid compounds with different substitutes. Sixteen derivatives of ursolic acid were designed and synthesized including eleven new compounds. Anti-tumor activities of ursolic acid and these derivatives against HeLa, SKOV3 and BGC-823 cells in vitro were investigated by MTT assay. The results indicated that compounds 7a and 8a were found to have stronger cell growth inhibitory than ursolic acid on HeLa cells and SKOV3 cells separately, and are worth to be intensively studied further.
Antineoplastic Agents, Phytogenic ; chemical synthesis ; chemistry ; pharmacology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; HeLa Cells ; Humans ; Triterpenes ; chemical synthesis ; chemistry ; pharmacology

OBJECTIVETo describe a form of interstitial lung disease pathologically characterized by small airway-centered interstitial fibrosis (ACIF).

METHODSWe analyzed the clinical, pulmonary functional, radiographic, and histologic characteristics of one ACIF case in Peking Union Medical College Hospital and reviewed 12 cases in literatures.

RESULTSClinically, patients presented with chronic cough and progressive dyspnea. Pulmonary function tests showed restrictive ventilatory pattern. Bronchoalveolar lavage showed a mild increase in lymphocytes in most cases. Chest radiography revealed diffuse reticulonodular infiltrates, with thickening of the bronchial walls and surrounding fibrosis. The key finding in histopathology was a distinctive pattern of ACIF centered on membranous and respiratory bronchioles.

CONCLUSIONSACIF is a disease that do not fit into any known category of interstitial lung disease. Whether it is a unique disease remains to be determined.

Adult ; Biopsy ; Bronchi ; pathology ; Diagnosis, Differential ; Humans ; Lung ; diagnostic imaging ; pathology ; Male ; Pulmonary Fibrosis ; diagnosis ; diagnostic imaging ; pathology ; Respiratory Function Tests ; Tomography, X-Ray Computed ; methods

OBJECTIVETo explore the diagnosis, treatment, and prognosis of prostatic malignant mesenchymal tumors (PMMT).

METHODSWe retrospectively analyzed the clinical and follow-up data about 20 cases of PMMT and reviewed the literature relevant to the diagnosis, treatment, and prognosis of the disease.

RESULTSBased on the results of pathology and immunohistochemistry, the 20 PMMT cases included leiomyosarcoma (n = 7), rhabdomyosarcoma (n = 5), prostatic stromal sarcoma (n = 3), chondrosarcoma (n = 1), and undifferentiated PMMT (n = 4). Twelve of the patients were treated by radical prostatectomy (3 concurrently by sigmoid colostomy and 1 by cystostomy), 2 by pelvic tumor resection following arterial embolization, 1 by total pelvic exenteration, 1 by colostomy with pelvic lymph node biopsy, and 4 by conservative therapy because of metastasis to the lung, pelvis and bone. Of the 20 patients, 9 died of systemic metastasis within 3 months after treatment, 3 died at 6, 7, and 14 months, respectively, 3 survived with tumor for 5, 11, and 12 months, respectively, 2 survived without tumor for 12 and 24 months so far, all subjected to periodic chemotherapy postoperatively, and 3 lost to follow-up.

CONCLUSIONPMMT is a tumor of high malignancy and rapid progression, for which transrectal ultrasound-guided biopsy remains the main diagnostic method. The clinical stage of the tumor is an important factor influencing its prognosis and the survival rate of the patients can be improved by early diagnosis and combined therapy dominated by radical prostatectomy.

Combined Modality Therapy ; methods ; Humans ; Immunohistochemistry ; Male ; Mesenchymoma ; mortality ; pathology ; therapy ; Prognosis ; Prostatectomy ; Prostatic Neoplasms ; mortality ; pathology ; therapy ; Retrospective Studies