Epistaxis ; diagnosis ; etiology ; Hemophilia B ; complications ; diagnosis ; Humans ; Male ; Young Adult

OBJECTIVETo investigate the clinicopathological features and prognosis of patients with the malignant transformation of sinonasal inverted papilloma.

METHODSThirty-two consecutive cases encountered between January 1991 and January 2008 were retrospectively reviewed. Survival rates and prognostic factors were calculated with SPSS 17.0 software using the Kaplan-Meier method and multivariate Cox model survival analysis.

RESULTSThe malignancy accounted for 8.99% of all types of sinonasal inverted papilloma. There were 25 males and 7 females, the median age was 56.5 years. The sites of tumor included 22 cases in nasal cavity and ethmoid sinuses, 10 cases in maxillary sinuses. The tumors included 21 high grade tumors, 8 intermediate grade tumors and 3 low grade tumors. Thirty-two patients were staged as T1(3/32), T2(10/32), T3(16/32), T4(3/32). According to the percentage of the malignant cell in the entire tumor tissue, 5 patients were in grade I, 5 patients were in grade II, 8 patients were in grade III, 14 patients were in grade IV. There were 3 distant metastasis in 32 patients; 19 patients underwent surgery plus postoperative radiotherapy, 10 underwent surgery alone and 3 underwent radiotherapy alone. The 5-year overall survival were 72.5%, and the median overall survival time was 62.2 months. Kaplan-Meier univariate survival analysis indicated that the clinical stages and treatment modalities were prognostic factors, and multivariate Cox model survival analysis confirmed that the clinical stages and treatment modalities were independent factors for overall survival (HR were 4.211 and 0.312, all P < 0.05).

CONCLUSIONSThe morbidity of sinonasal inverted papilloma-associated malignancy is low, the clinical features were not specificity. The clinical stages and treatment modalities may affect the prognosis. Surgery plus postoperative radiotherapy are main treatment means.

Aged ; Carcinoma, Squamous Cell ; pathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Grading ; Papilloma, Inverted ; pathology ; therapy ; Paranasal Sinus Neoplasms ; pathology ; therapy ; Retrospective Studies ; Survival Rate

Abscess ; complications ; Adult ; Brain Abscess ; complications ; Female ; Humans ; Meningocele ; complications ; Nasal Cavity ; pathology ; Nose Diseases ; complications

Objective To understand human rhinovirus (HRV) etiology of acute lower respiratory tract infection (ALRTI) in children in Shanghai area and establish a nested reverse transcription- polymerase chain reaction (nested RT-PCR) assay.Methods Three hundred and forty-two naso- pharyngeal secretion (NPS) samples from ALRTI cases who were hospitalized were collected during January 2005—December 2005.Nested RT-PCR techniques were used to detect HRV-specific RNA.The PCR products were sequenced and data of nucleotides were analyzed.The proportion of HRV infection in children with ALRTI,the distribution of gender,age and season,and clinical char- acteristics were also investigated.Results Forty-six (13.5%) of 342 samples were HRV positive detected by nested RT-PCR.The sequences of 15 positive samples shared high homology of 83%- 97% with HRV sequence in GenBank.Within the 15 positive samples,nucleotide homology varied from 64.4% to 98.4%,and the ratio of genetic variation was from 1.6% to 48.3%./00.These 15 ampli- cons attribute to the two branches of HRV cladogram.The sequences of 15 amplieons were highly varied,in which single nucleotide mutation and several nearby nueleotides mutations were found. Ribonucleotide deletion and insertion in the nucleotide sequence was also found.HRV positive sam- ples were detected in 33 boys and 13 girls,respectively.The ratio of infection cases between boys and girls was 2.5:1.Of 46 HRV infected cases,27 (58.7%) were less than 12 months of age and 38 (82.6%) were less than 3 years old.HRV infected ALRTI occured all the year round and peaked from March to May.Of the patients whose NPS samples were HRV positive detected by nested RT-PCR,45 patients were diagnosed with bronchopneumonia and 1 was diagnosed with asthmatic bronchitis.Fever of most patients was moderate.The peripheral blood leukocyte counts in thirty-nine (84.8%) patients were less than 10?10~9/L.Neutrophil percentages in thirty-seven (80.4%) patients were less than 0.50.C-reactive protein of thirty-six (78.3%) patients were less than 8 mg/L. All of these features were the characteristics of viral pneumonia.The complications were not common and conditions of most patients were not severe.All the children were cured.Conclusions This nes- ted RT-PCR technique is highly specific,rapid and convenient for the detection of HRV RNA in NPS of patients with ALRTI and the genome of HRV viruses is highly variable.The incidence of HRV infection predominates in children in Shanghai area.ALRTI of HRV is short of specificity and condi- tions of most patients are not severe and their prognoses are fine.

Archives ; China ; Humans ; Occupational Health ; Residence Characteristics

China ; epidemiology ; Humans ; Occupational Diseases ; epidemiology

Objective To study effects of low molecular weight heparin on liver fibrosis and the serum levels of TGF-?_1 in patients with chronic hepatitis B virus.Methods 45 patients with chronic hepatitis B virus were randomized into control group(the routine strategy)and trial group(the routine strategy + low molecular weight heparin).The period of treatment is 3 weeks.Serum hepatic fibrosis indices before and after heparin treatment were examined by RIA,the levels of serum TGF-?_1 before and after heparin treatment were examined by ELISA.Results Hepatic functions became significantly better in trial groups,serum PⅢP and type IV collage levels and the levels of serum TGF-?_1 in trial group decreased significantly after treatment.Conclusions The mechanism of anti-fibrosis action of LMWH may inhibited production of TGF-?_1 in patients with HBV.

Objective To evaluate the pattern of energy metabolism and nutrients intake in patients with chronic viral hepatitis and posthepatitic cirrhosis to effectively direct their nutrition therapy.Methods Resting energy expenditure (REE) was measured with open-circuit indirect Jorimetry in 60 patients with chronic viral hepatitis and 60 patients with posthepatitic cirrhosis.Their normal basal energy expenditure (BEE) was predicted by Harris-Benedict equation and energy intake (EI) was determined by diet recall. Correlation between REE and indicators for nutrition assessment was analyzed.Results REE was (77? 21) kJ?kg~(-1)?d~(-1) in 60 patients with pusthepatitic cirrhosis,significantly lower than BEE[(95?16) kJ? kg~(-1)?d~(-1)(P0.05,and their EI was (127?34) kJ?kg~(-1)?d~(-1),1.41?0.43 times as REE,in which PROI was (1.02?0.29) g?kg~(-1)?d~(-1),1.31?0.61 times as PROE (0.87?0.34) g?kg~(-1)?d~(-1),also indicating a negative nitrogen balance (-2.02?4.07).REE,EI and intake of three nutrients,serum level of albumin and prealbumin (PA) and body weight significantly decreased in patients with posthepatitic cirrhosis,as compared to those in patients with chronic viral hepatitis (P

OBJECTIVETo study the viremia formation in guinea-pigs infected with wild type and attenuated Japanese encephalitis virus (JEV).

METHODSGuniea pigs were inoculated intraperitoneally with different wild JEV strains and the attenuated vaccine strain and its parent virulent strain. Viremia was detected on different days following virus inoculation.

RESULTSAll the guinea-pigs inoculated with the wild JEV strains induced different levels of viremia (1.00-3.40 Lg pfu) on the 1st and 3rd day post inoculation. Using a virus titer of 10(4) pfu for inoculation, the animals inoculated with the SA14 parent strain induced relatively high viremia (10(2.4)-10(3.4) pfu), however no viremia coulds be detected on any tested days.

CONCLUSIONThe degree of viremia in guinea pigs can be used as a new method to evaluate the attenuation of JEV.

Animals ; Disease Models, Animal ; Encephalitis Virus, Japanese ; pathogenicity ; physiology ; Encephalitis, Japanese ; virology ; Guinea Pigs ; Humans ; Japanese Encephalitis Vaccines ; administration & dosage ; adverse effects ; Vaccines, Attenuated ; administration & dosage ; adverse effects ; Viremia ; virology ; Virulence ; Virus Replication

OBJECTIVETo analyze the computed tomography (CT) and magnetic resonance imaging (MRI) findings of small hepatocellular carcinoma to improve the accuracy in the diagnosis.

METHODSThis retrospective analysis involved 41 patients with small hepatocellular carcinoma cases confirmed by pathological examination of the biopsy samples or follow-up. These patients were assessed for CT and MRI findings including lesion size, density or signal intensity, enhancement patterns, and presence of tumor capsules.

RESULTSOn unenhanced CT images, small hepatocellular carcinomas were displayed mainly as low-density masses, and the majority of tumors presented with low signal intensity on T1-weighted unenhanced MR images with increased signal intensity on T2-weighted images in comparison with the surrounding liver parenchyma. Most of tumors showed intense enhancement during the arterial phase (CT in 15 cases and MRI in 13 cases), but some appeared isointense to the liver parenchyma (CT in 4 cases and MRI in 4 cases). In portal and delayed phases, the tumors typically had lower signal intensity than that of the surrounding liver tissues (CT in 25 cases and MRI in 12 cases) with enhancement of the tumor capsules (13 cases).

CONCLUSIONDynamic enhanced scanning can be more informative of the pathology and blood supply of small hepatocellular carcinoma. Early and late arterial phase imaging may help in detecting the small lesions and in making differential diagnosis.

Adult ; Aged ; Carcinoma, Hepatocellular ; diagnosis ; diagnostic imaging ; Diagnosis, Differential ; Female ; Humans ; Image Enhancement ; Liver Neoplasms ; diagnosis ; diagnostic imaging ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed