Objective To investigate the value of the dynamic susceptibility contrast enhanced MRI (DSC-MRI) in differential diagnosis of glioblastoma,solitary cerebral metastatic tumors and cerebral lymphoma.Methods Seventeen patients with glioblastoma,15 cases with solitary cerebral metastatic tumor and 17 cases with cerebral lymphoma were analyzed retrospectively.All patients underwent conventional MR imaging,contrast enhancement and DSC-MRI preoperatively.Pseudo color pictures of cerebral blood volume (CBV) and the time signal intensity curve were obtained from the raw data of DSC MRI.The relative CBV (rCBV)were measured from regions of enhanced solid parts of the tumors,peritumoral region and contralateral normal white matter regions respectively.The percentage of signal intensity recovery (PSR) of enhanced solid parts of the tumors were measured.ROC curve analysis was performed to determine optimum indicator in differential diagnosis of three types of tumors,and the sensitivity and specificity were calculated.Results Three types of tumors all showed enhancement of solid area with obvious peritumoral edema.Besides the no difference between glioblastoma and metastasis in rCBV of solid parts of the tumors,there were statistically significant differences in comparisons of two types of tumors (all P＜0.05).Besides the no difference between single brain metastases and lymphoma in rCBV of peritumoral regions,there were statistically significant differences in comparisons of two types of tumors (all P＜0.05).The PSR of the solid parts of the tumors had no difference between glioblastoma and single brain metastases,while there were statistically significant differences in comparisons of two types of tumors (all P＜0.05).ROC curve analysis showed sensitivity and specificity of the PSR values of solid parts of the tumors in differentiating lymphoma and non lymphoma were 100 ％and 81.3 ％.The rCBV of peritumoral regions was the optimum indicator for differentiating glioblastoma and solitary brain metastasis,the sensitivity and specificity were respectively 94.1％ and 86.7％.Conclusion The combination of rCBV and PSR can improve the efficiency for diagnosing the three types of brain tumors.

Objective To study the incidence of vitamin K deficiency in low-birth weight premature infants and its relationship with intraventricular hemorrhage.Methods We use emzymoimmunoelectrophoresis to detect prophrombin protein precursors(PIVKA-Ⅱ) in vein blood in premature infants

Objective To study the effect of positive lymph node number on the survival of patients with esophageal carcinoma. Methods From July 1995 to July 2005, a total of 11,447 resected lymph nodes were obtained from 1140 patients who underwent curative resection of the primary tumor with systematic lymphadenectomy at Shanxi cancer hospital. The survivals were analysed by life tables and Kaplan-Meier methods, the related factors of lymph node metastasis were assessed by Chi-square test. Results The number of positive lymph nodes was negatively related to survival rates of esophageal carcinoma. According to the number of lymph nodes resected (≥8 nodes versus <8 nodes), there was significant difference in metastatic lymph node ratio. Conclusion The number of positive lymph node can reflect the prognosis of patients better. The authors suggest that the modification of the tumor-lymphnode-metastasis (TNM) staging classification (TNM) to include the number of positive lymph nodes in the N1 category.

Objective To investigate the effect of tumor length and number of positive lymph nodes and the ratio of positive lymph nodes on survival in patients with esophageal squamous cell carcinoma.Methods From July 1995 to July 2005, a total of 6,691 resected lymph nodes were obtained from 526patients who underwent curative resection of the primary tumour with systematic lymphadenectomy. The survivals were analysed by life tables and Kaplan-Meier methods. Results Among patients with regional disease, the number of positive lymph nodes (＞3) was related to an increasing risk. The proportion of positive lymph nodes compared with the number of lymph nodes dissected (20 %) conferred an increased risk. The tumor length (≤5 cm, 5 cm ＜ length ＜ 7 cm, ＞7 cm) was related to an increasing risk (84.74 %, 47.79 %,36.90 %, 35.52 %; 73.41%, 46.29 %, 23.87 %, 20.64 %; 64.44 %, 13.92 %, 0, 0). Conclusion Tumor length,the number of positive lymph nodes, and the ratio of positive lymph nodes are important prognostic factors for survival in patients with esophageal carcinoma. The PTNM classification system for patients with esophageal carcinoma might consider adding number of positive lymph nodes as an important prognostic factor.

OBJECTIVETo introduce the concept, methods for calculation and application of "number needs to be exposed (NNE)" in Epidemiological studies.

METHODSData was analyzed from a study on the association between diaspirin cross-linked hemoglobin (DCLHb) with 28-day mortality in patients with severe traumatic hemorrhagic shock.

RESULTSThe crude "number needed to be exposed for one additional person to be harmed" (NNEH) was 3.7 (95% CI: 2.2-11.5) for the exposure to DCLHb. After controlling the confounding bias of the baseline mortality risk, the adjusted NNEH became 2.6 (95% CI: 1.6-8.0) id., on average, among 2.6 patients exposed to DCLHb, one additional case of death would have developed within 28 days after initial hospitalization if the distribution of baseline mortality risk in exposed group had been equal to that in the unexposed group.

CONCLUSIONNNE could be expressed as the estimated average number of persons needed to be exposed for contributing (either developing or preventing for) one additional case of disease or death in a prospective study when compared with the unexposed persons. As a new index for measuring the absolute effect of an exposure, NNE presented the results on epidemiological studies in a more intuitive and understandable manner. Consequently, this method could be favorably accepted by clinicians, health policy makers and the public.

Epidemiologic Studies ; Hemoglobins ; therapeutic use ; Humans ; Logistic Models ; Randomized Controlled Trials as Topic ; Risk ; Shock, Hemorrhagic ; complications ; drug therapy ; mortality ; pathology ; Software ; Wounds and Injuries ; complications

OBJECTIVETo evaluate the contribution of individual risk factor to a disease on someone with several risk factors.

METHODSA method based on epidemiological theory and Bayes' theorem was established to measure the contribution of individual risk factor, using the relative risk (RR) or odds ratio (OR) value obtained from population-based cohort studies or meta-analysis.

RESULTSThe proportional contribution for individual risk factor to disease in one person can be measured or estimated.

CONCLUSIONThis method can be applied to risk assessment in a patient with more than one risk factor, and the results also contribute to our etiological study and clinical decision-making strategy.

Bayes Theorem ; Data Interpretation, Statistical ; Disease ; etiology ; Epidemiologic Methods ; Epidemiologic Studies ; Humans ; Proportional Hazards Models ; Risk Assessment ; Risk Factors

OBJECTIVETo investigate the effect of ANGPTL4 gene silencing on the migration of human colon cancer cells in vitro.

METHODSThe expression of ANGPTL4 in human colorectal cancer cell lines was detected by semi-quantitative RT-PCR. Following stable transfection with a short-hairpin RNA (shRNA) targeting ANGPTL4 gene in HT29 cells, ANGPTL4 mRNA and protein expressions were detected by semi-quantitative RT-PCR and direct ELISA, respectively, and the changes in cell migration ability and cell morphology were observed with transwell and immunofluorescence assays.

RESULTSANGPTL4 was expressed in most of the colorectal cancer cell lines. Compared with the control groups, HT29 cells with shRNA-mediated ANGPTL4 gene silencing showed significantly decreased expression of ANGPTL4 mRNA and protein (P<0.05) and lowered cell migration ability possibly due to decreased pseudopodia formation.

CONCLUSIONANGPTL4 was expressed in most colorectal cancer cell lines. Decreased ANGPTL4 gene expression can inhibit the cell migration and pseudopodia formation in HT29 cells.

Angiopoietin-like 4 Protein ; Angiopoietins ; genetics ; Cell Movement ; Colorectal Neoplasms ; genetics ; pathology ; Gene Silencing ; HT29 Cells ; Humans ; RNA, Small Interfering ; genetics

OBJECTIVETo introduce the concept, methods for calculation and application of "number needed to be screened" (NNBS) in epidemiologic studies.

METHODSThe concept of "number needed to treat" (NNT) was extended for disease screening strategies. For the purpose of illustration, the values of number needed to invite for screening (NNI) and number needed to be screened (NNBS) were calculated on the basis of the results from two randomized controlled screening trials--Nottingham randomized controlled trial of faecal-occult-blood screening for colorectal cancer and Swedish mammographic screening trial for breast cancer in two counties.

RESULTSIn order to prevent one death from the colorectal cancer among local people aged from 45 to 74 during the 14 years of follow-up, the NNI and NNBS for faecal-occult-blood screening program were 1220 and 665, respectively. In addition, in order to prevent one death from breast cancer among local women aged 40-74 during 8 years of follow-up, the NNI and NNBS for mammographic screening program were 1961 and 1494, respectively.

CONCLUSIONCompared with the traditional indices, NNBS can evaluate the overall effectiveness of a screening program in an intuitively understandable manner so as to facilitate the communication among medical researchers, health workers, health policy makers and the public.

Breast Neoplasms ; diagnosis ; epidemiology ; prevention & control ; Colorectal Neoplasms ; diagnosis ; epidemiology ; prevention & control ; Epidemiologic Studies ; Humans ; Mass Screening ; statistics & numerical data ; Sample Size

Objective:To investigate the feasibility of targeted imaging and therapy of prostate cancer using nanocomposite probes composed of fluorescent magnetic nanoparticles(FMCNPs) and single chain Fv(ScFv) antibody specific for gama-seminoprotein.Methods:The nanocomposite probes(FMCNPs-ScFv) were prepared by conjugating fluorescent magnetic nanoparticles with singlegama-chain Fv antibody specific gama-seminoprotein,and were characterized by high resolution transmission electron microscopy,fluorescent spectrum and magnetic spectrum.Nanocomposite probes were incubated with prostate cancer LNCaP cells,and the targeting results of nanocomposite probes were observed by fluorescent microscopy.The cytotoxicity effect of the nanocomposite probes was measured by MTT.Nude mice models of prostate cancer were established and identified by immunohistochemistry method.The nanocomposite probes were injected into nude mice via tail vein.The distribution of nanocomposite probes in the nude mice was observed by Micro-animal imaging system,targeted imaging of the prostate cancer was observed by MR instrument.The nude mice with prostate cancer were irradiated with 100 W magnetic field for 30 min,and the changes of tumor sizes were observed.Results:The FMCNPs-ScFv nanocomposite probes were successfully prepared.Nanocomposite probes entered into the cytoplasm of cancer cells and exhibited low cytotoxicity effect.Nude mice model with prostate cancer were successfully fabricated;the nanocomposite probes distributed quickly in the main organs of mice,and gradually concentrated on the tumor tissues within 24 h.MR images showed that the tumor images were gradually enhanced from 6 h to 24 h after injection of the nanocomposite probe.Four days after magnetic irradiation,the tumors in the nude mice grew slower compared with the control nude mice(P

Objective To explore the clinical value of serum procalcitonin (PCT)-based antibiotic therapy in the second-classedexacerbations of chronic obstructive pulmonary disease (AECOPD). Methods 240 patients diagnosised as AECOPD were randomized to the PCT group and the control group. Serum PCT levels of patients from the PCT group were measured 1 h after hospitalized and the third, fifth, eighth day respectively. When PCT < 0.1 μg / L, patients will stop taking antibiotics and initiated while PCT≥0.1 μg / L. Antibiotic treatment in the control group was based on guidelines of COPD diagnosis and treatment. Results Duration of antibiotic therapy and hospitalization were respectively 5.6 ± 1.4 and 8.2 ± 1.1 days in the PCT group, 9.2 ± 2.2 and 11.4 ± 2.5 days in the control group (both P < 0.05). Mean costs of hospitalization expensesand antibiotic therapy were 5700 ± 201 and 1650 ± 189) yuan in the PCT group, 6210 ± 220 and 2350 ± 210 yuan in the control group (both P < 0.05). The clinical effective rate, times of exacerbation, one-year ΔFEV1, the 1-year hospitalization rate and time to next exacerbation all showed no significant differences between the two groups. Conclusion PCT-guided antibiotic treatment reduces antibiotic use inthe second-classed acute exacerbations patients.