1.Endoscopic balloon dilation combined with brush cytology in diagnosis of ductal cholangiocarcinoma
Pingxiao HUANG ; Qilong SONG ; Shujie DI ; Yan FAN ; Jian WANG ; Yusheng LIAO ; Heng ZHANG ; Jie WU
Chinese Journal of Hepatobiliary Surgery 2021;27(3):202-205
Objective:To study the combined use of endoscopic balloon dilation with endoscopic biliary brushings in diagnosis of bile duct strictures.Methods:A prospective single center study was conducted at the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology. All patients with suspected malignant bile duct strictures shown on CT or MRI imaging from January 2018 to January 2020 were reviewed. All patients gave informed consent to the endascopic retrograde cholangiopancreatography procedures. Their clinical and follow-up data were analyzed. All patients underwent endoscopic balloon dilation of bile duct strictures. Before and after balloon dilation, biliary brush cytology was performed, and the results were used to classify the patients into the control group and the experimental group. Pathological examination of the brush cytology samples was carried out by a single chief pathologist. Presence of cancer cells or significant heterogeneous cells indicated a positive brush cytology test. Negative patients who still highly consider cholangiocarcinoma and agree to surgery and whose gross specimen is confirmed to be malignant after surgery should be considered as false negative by brush examination; it is difficult to judge that patients with cholangiocarcinoma have progress after 2 months of follow-up should be considered as false negative by brush examination. Any progression of disease indicated that the brush test was wrong and the test was again classified as false negative. Only when there was no progression of strictures was the possibility of a benign biliary stricture being considered. The advantage test (McNemar test) was used to analyze the difference between the two diagnostic methods.Results:Of 39 patients who were included in this study, there were 26 males and 13 females, with an age of (68.0 ± 5.2) years. Cholangiocarcinoma was diagnosed by histopathology, surgery or at 2 months follow-up in 35 patients. In the control group, 17 patients had a positive brush test (sensitivity rate was 48.6%, 17/35). In the experimental group, 26 patients had a positive brush test (sensitivity rate was 74.2%, 26/35). In addition, 2 patients in the control group had a positive brush test, while in the experimental group, a negative brush test. A total of 28 patients were positive in the two groups. The sensitivity rate of the brush test was 80.0% (28/35). There were significant differences between the two groups ( P<0.05). Conclusion:Endoscopic balloon dilation combined with endoscopic biliary brushings improved the sensitivity of pathological diagnosis of cholangiocarcinoma, and endoscopic biliary brushings before and after balloon dilation improved the sensitivity of diagnosis.
2.Association of polymorphisms of cytochrome P450 2C9 exon 4 and -65G>C with warfarin sensitivity.
Zan-xin WANG ; Lei HUANG ; Heng CAI ; Jian-long MEN ; Min-xin WEI
Chinese Journal of Medical Genetics 2010;27(4):428-432
OBJECTIVETo investigate the association of the polymorphisms of cytochrome P450 2C9 (CYP2C9) exon 4 608T/G, 561A/C, 537A/C and 527A/C, and -65G/C with warfarin sensitivity.
METHODSA total of 102 patients under warfarin anticoagulant therapy were selected. During follow-up, warfarin dosage and associated Prothrombin Time-International Normalized Ratio (P-INR) values were recorded. Simultaneous monitoring of incidence of bleeding and thrombosis adverse effect was recommended. Genetic polymorphisms of the above mentioned loci were identified by polymerase chain reaction and DNA sequencing.
RESULTSThe average age of the 102 patients was (62.1+/-10.5) years. The body mass index (BMI) was (24.7+/-3.8) kg/m2. Mean daily warfarin requirement was from 1.250 to 5.077 mg/day when therapeutic PT-INR (1.5-2.5) was maintained. DNA sequencing showed no polymorphisms of 608T/G, 561A/C, 537A/C, 527A/C in CYP2C9 exon 4. Warfarin daily dosage in CYP2C9 exon 4 -65C carriers was 3.106+/-0.619 mg/d, while it was (2.555+/-0.708) mg/d in individuals with wild-type -65G (P=0.020). Receiver operating characteristic (ROC) analysis showed that warfarin daily dosage of more than 2.5 mg/d can be used to predict the CYP2C9 exon 4 -65GC genotype (AUC: 0.770, P=0.005, 95%CI:0.626-0.915). Logistic regression indicated that BMI was an independent factor of bleeding during anti-coagulation therapy (OR=0.794, 95%CI: 0.651-0.970, P=0.024).
CONCLUSIONThe Chinese population are, generally, warfarin-sensitive. Exon 4 of the CYP2C9 gene is highly conserved in this population. The warfarin maintenance dosage in CYP2C9 exon 4 -65CG carriers was significantly higher than those with wild-type -65GG. The clinical significance needs further investigation with more large-scale, multi-center trials.
Adult ; Alleles ; Anticoagulants ; pharmacology ; therapeutic use ; Aryl Hydrocarbon Hydroxylases ; genetics ; Cytochrome P-450 CYP2C9 ; Exons ; genetics ; Female ; Genetic Predisposition to Disease ; Genotype ; Humans ; Male ; Middle Aged ; Point Mutation ; Polymorphism, Genetic ; Thrombosis ; drug therapy ; Warfarin ; pharmacology ; therapeutic use
3.Application of FICTION technique to the detection of genetic aberrations in multiple myeloma.
Di WANG ; Liang HUANG ; Heng ZHANG ; Zhe GENG ; Zhen SHANG ; Jian-feng ZHOU ; Chun-rui LI
Chinese Journal of Hematology 2011;32(4):226-230
OBJECTIVETo investigate the diagnostic value of FICTION (Fluorescence Immunophenotyping and Interphase Cytogenetics as a Tool for the Investigation of Neoplasms) technique, combining immunofluorescence and fluorescence in situ hybridization (FISH), to detect genetic aberrations in multiple myeloma (MM).
METHODSBone marrow samples were collected from 18 MM and 2 plasma cell leukemia (PCL) patients. Probes targeting IgH and MMSET were prepared using a Nick Translation Kit from Bacterial artificial chromosome (BAC) clones. The immunophenotyping was achieved via the CD138 tyramide signal amplification (TSA)-mediated immunofluorescence, followed by FISH with the prepared probes \[t(4;14), t(11;14), t(14;16)\] and the commercial deletion probes (13q and p53) to detect common genetic aberrations in MM.
RESULTSAll the 20 samples were assayed with the probes mentioned above, and revealed 4 cases with t(4;14), 6 with t(11;14), 1 with t(14;16), 3 with p53 deletion; and 8 with 13q deletion. The remaining 4 cases had none of the 5 aberrations.
CONCLUSIONFICTION technique facilitates the detection of genetic abnormalities of MM in situ; enhances both efficiency and sensitivity of positive detection, thus, could be used as the screening test of molecular diagnosis of MM to guide coming-up risk-adapted therapy and evaluate prognosis.
Adult ; Aged ; Aged, 80 and over ; Cytogenetics ; Female ; Fluorescent Antibody Technique ; Humans ; Immunophenotyping ; In Situ Hybridization, Fluorescence ; Male ; Middle Aged ; Multiple Myeloma ; diagnosis ; genetics
4.Mutant thiopurine S-methyltransferase alleles among Jing Chinese in Guangxi province.
Jian-ping ZHANG ; Min HUANG ; Yong-yuan GUAN ; An-long XU ; Jue-heng WU
Chinese Journal of Medical Genetics 2003;20(4):303-306
OBJECTIVETo investigate the mutant alleles of thiopurine S-methyltransferase (TPMT) among Jing Chinese.
METHODSPolymerse chain reaction-single strand conformation polymorphism (PCR-SSCP) techniques were developed for assaying exons 5, 7 and 10 of the TPMT gene respectively and were used to detect mutant TPMT alleles among Jing Chinese.
RESULTSTwo cases of TPMT*3C (A719G) heterozygotes were identified in 103 Jing Chinese; other deleterious alleles such as TPMT*2 (G238C), TPMT*3A (G460A/A719G) and TPMT*3B (G460A) were not found; 27 cases of silent mutant allele TPMT*1S (T474C) were also identified (5 homozygotes and 22 heterozygotes).
CONCLUSIONThe PCR-SSCP assay established and adopted in this study was sensitive and reliable, which could be used to detect mutant TPMT alleles. Allele frequency of TPMT*3C is low among Jing Chinese (1.0%), and TPMT*3C appears to be the most prevalent deleterious allele in this population.
Adolescent ; Alleles ; Asian Continental Ancestry Group ; genetics ; China ; Exons ; genetics ; Female ; Gene Frequency ; Genotype ; Humans ; Male ; Methyltransferases ; genetics ; Mutation ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational
5.Management of postoperative chyle leak after surgery for digestive malignancies.
Yong-heng HUANG ; Yuan-sen CHEN ; Jian-dong YU ; Dong-jia ZHONG ; Yun-le WAN ; Jie WANG
Chinese Journal of Gastrointestinal Surgery 2012;15(4):360-362
OBJECTIVETo investigate the treatment of postoperative chyle leak after surgery for digestive malignancies.
METHODSFrom December 2008 to February 2012, in the Sun Yat-sen Memorial Hospital of Sun Yat-sen University, clinical data of 19 patients with chyle leak after digestive system cancer surgery were retrospective analyzed.
RESULTSNineteen cases of chyle leak were all identified between the second and the fourth postoperative day and were all initially managed with conservative treatment including early fasting, parenteral nutrition(PN), 24-hour continuous infusion of somatostatin, and low pressure suction drainage. Eight patients were treated successfully for 6 to 10 days with a significant reduction of the daily drainage volume. Ten patients had enteral nutrition(EN) and their drain tubes were repeatedly washed with 30 ml of compound meglumine diatrizoate injection every day until the drainage volume decreased to 200 ml/day. The time to resolution of chyle leak in these ten patients ranged from 12 to 24 days. One patient had no significant decrease in fluid drainage and developed abdominal distension after one week of conservative treatment. Surgical closure of chyle leak was performed on the 11th postoperative day, abdominal cavity drainage tube was removed on the 4th postoperative day. The patient was discharged home in good condition.
CONCLUSIONMost postoperative chyle leak after surgery for digestive malignancies can be successfully managed with conservative treatment. Somatostatin and the drainage are the main therapeutic approaches. When chyle leak is not resolved with conservative treatment, surgical treatment should be considered to prevent serious complications.
Adult ; Aged ; Anastomotic Leak ; therapy ; Chyle ; Digestive System Neoplasms ; surgery ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; therapy ; Retrospective Studies
6.MRI diagnosis of central neurocytoma
Jing LI ; Xian-Yue QUAN ; Jian-Ming YANG ; Fan-Heng HUANG ; Chun-Tang YU ; Hong-Shun JIA
Chinese Journal of Neuromedicine 2011;10(4):417-420
Objective To evaluate the MRI features of central neurocytoma (CNC). Methods Thirteen patients with CNC (7 males and 6 females, aged 18-28), admitted to our hospital fiom January 2007 to January 2010, were chosen; preoperative plain and contrast enhanced MRI scans were performed on these 13 patients and 1 also received CT scan. The clinical and imaging data and pathological features of these patients were retrospectively analyzed. Results The largest tumor enjoyed its maximum diameter of 3.2-8.5 cm; the CNC in 12 patients located at the lateral ventricle and that in 1 patient at the parenchyma of the left frontal and temporal lobes. Lobulated solid tumors were noted in these lesions,showing T1 isointense and T2 hyperintense in MRI; some multiple, scattered cystic lesions showed stronger T1 and T2 signal than the former ones; vascular "flow void" signal was shown in 6 patients in T2WI, and slightly weak T1 signal was shown in 8. All the tumors demonstrated inhomogeneous enhancement and the tumor vessels in 6 patients were noted under contrast MRI. Focal calcification was found. Conclusion CNC in the lateral ventricle enjoys typical location; considering the age of patients, non-contrast and contrast MRI findings, correct diagnosis of CNC can be made; however, CNC outside the lateral ventricle is hard to diagnose.
7.Effect of siRNA targeting HER-2/neu on proliferation of human glioma cells and its related gene expression
Heng ZHANG ; Xin-Jian WU ; Zhen-Hua YU ; Chao YANG ; Zheng-Song HUANG
Chinese Journal of Neuromedicine 2011;10(6):552-556
Objective To investigate the effect of HER-2/neu siRNA on proliferation of human glioma cell lines U251MG and T98G which over-express HER-2/neu, and explore its mechanism.Methods Liposome-mediated HER-2/neu siRNA was transfected into human glioma cell lines U251MG and T98G;lipofectin group was established as controls. The mRNA and protein levels of HER-2/neu were detected by real-time PCR and Western blotting 3 d after the transfection. The proliferation of glioma cells was investigated using methyl thiazolyl tetrazolium (MTT) assay 3 and 4 d after the transfection. The effects of HER-2/neu siRNA on AKT/FOXO1 pathway and protein expression of p27 and Cyclin D1 were studied using Western blotting. Results HER-2/neu mRNA and protein expressions in the transfected U251MG cells were decreased to (28.833±4.174)% and (22.167±1.955)% while those in cells of the lipofectin group were (92.067±5.698)% and (96.100±1.682)%, respectively,with significant differences (P=0.000, 0.001). HER-2/neu mRNA and protein expressions of the transfected T98G cells were decreased to (28.067 ±6.165)% and (12.433 ±8.864)% while those in the untransfected cells were (96.000 ±5.110)% and (94.333 ±3.215)%, respectively, with significant differences (P=0.001, 0.008). Three d after the transfection, the rates of proliferation in the transfected T98G and U251MG cells were (58.467±5.561)% and (63.933±5.363)%, respectively;4 d after the transfection, the rates of proliferation in the transfected T98G and U251MG cells were (57.500±4.770)% and (60.167±3.253)%, respectively;an obvious decrease was noted as compared them with cells of the lipofectin group (P=0.020, 0.023, 0.021, 0.008). Cyclin Dl expression was decreased, while p27 protein expression was up-regulated in the transfected cells as compared with those in cells of the lipofectin group (P<0.05). Moreover, the levels of phosphorylated AKT and phosphorylated FOXO1 were decreased in the transfected cells as compared with those in cells of the lipofectin group (P<0.05).Conclusion The specific siRNA targeting HER-2/neu in human glioma cell lines U251MG and T98G could inhibit the cell proliferation, which might relate to the suppression of AKT/FOXO1 pathway and the regulation of expresion of thier downstream molecules such as p27 and Cyclin D1.
8.Dynamic changes of inflammation parameters in patients after neurosurgery
Zhi-Heng JIAN ; Xi-An ZHANG ; Song-Tao QI ; Guang-Long HUANG ; Jun-Xiang PENG
Chinese Journal of Neuromedicine 2013;12(4):415-418
Objective To observe the postoperative dynamic changes of body temperature (BT),C-reactive protein (CRP) and white blood cell (WBC) count.Methods One hundred and two consecutive patients with surgically treated intracranial or spinal lesions,admitted to our hospital from July 2011 to February 2012,were chosen and divided into group A (non infection) and group B (infection) depending on whether postoperative bacterial infections (POBIs) were occurred.Evaluation of postoperative BT and CRP levels,as well as WBC count,was performed.Results WBC and BT levels would elevate in majority of patients with or without POBIs one day after the operation; the difference between the two groups showed no significant difference (P>0.05).Elevation of BT and WBC levels was noted in 23.8% and 21.4% patients from group A and in 88.9% and 83.3% patients from group B five days after the operation,with significant difference between the two groups (P<0.05).Similar results were seen seven day after the operation.Five and seven days after the operation,78 patients (92.8%) and 68 patients (80.9%) still had abnormal CRP level in group A.ROC curve revealed that better diagnostic performance five and seven days after the operation could be found as compared with that one and three days after the operation.Conclusion Elevation of serum CRP,WBC and BT levels can occur in patients with or without POBIs on the first three days of neurosurgical operation; persistent anomalies or secondary elevation could indicate ongoing infection,which needs attention from clinic.
9.Epidemiological survey on a family aggregation COVID-19 in Y County, Chenzhou City, Hunan
Hong ZHOU ; Han wu ZHU ; Bai tang CHEN ; Wen HENG Z ; De biao HENG HE ; Jian HENG HUANG ; Shao feng HENG OUYANG ; Jun xiao HENG HUANG ; Hui HENG TAN
Shanghai Journal of Preventive Medicine 2020;32(2):E009-E009
Objective To investigate epidemic characteristics of a family aggregation COVID-19, and to provide scientific basis for prevention and control of family aggregation epidemic. Methods] Field epidemiological methods were used to investigate the cases and close contacts of a family aggregation COVID-19 in Y County, Chenzhou City, Hunan Province. Descriptive statistical analysis was used on epidemiological data . The 2019-nCoV nucleic acid was detected by real-time fluorescence quantitative RT-PCR. Results It was found that Ms. Deng was infected with COVID-19 and became the infectious source of the family aggregation epidemic , who had lived in Wuhan Hubei Province. Her boyfriend Mr. Cao became a second-generation case of COVID-19..Another two asymptomatic but infected persons were family members living with Ms.Deng . Conclusion COVID-19 easily spreads within families. The awareness of family members' protection, the education of new coronavirus pneumonia prevention and control in key groups should be strengthened to avoid the occurrence and spread of family aggregation epidemic.
10.Evaluation of four kits for screening HIV antibody.
Hui ZHOU ; Chu-wen JIANG ; Shi-jian LI ; Heng LI ; Mei-qun HUANG ; Jian-qun LIANG ; Wei-huan XIAO
Chinese Journal of Preventive Medicine 2010;44(3):247-250
OBJECTIVETo Evaluate four kits for screening HIV antibody by comparing and analyzing the HIV antibody screening positive results and Western Blot (WB) test results.
METHODSFrom January 2004 to June 2009, three ELISA kits (Zhongshan, Biomérieux and Livzon) were used for initial screening HIV antibody. The reactive positive samples were reexamed by initial ELISA kit and a rapid kit (Abbot Determine HIV-1/2). All repeatedly reactive positive screening results were followed by WB test.
RESULTSA total of 193 (0.094%) WB confirmed positive results were obtained from 206 151 specimens. The sensitivities and predictive values of negative test result (PVN) of three ELISA kits were all 100% and those of Abbot Determine HIV-1/2 were 93.93%, and 91.67% respectively. All false negative results from Abbot were WB indeterminate. The specificities of Zhongshan, Biomérieux, Livzon and Abbot were 99.88%, 99.89%, 99.96% and 89.38%; the study predictive values of a positive test result (PVP) were 35.58%, 46.46%, 76.61% and 92.20%; the efficiencies were 99.88%, 99.89%, 99.96% and 91.98%; the areas under ROC curve of the three ELISA kits were 0.93, 0.99, and 0.95 respectively. PVP of Livzon was obviously higher than those of Zhongshan (chi(2) = 45.804, P = 0.000), Biomérieux (chi(2) = 25.231, P = 0.000) and Biomérieux was higher than Zhongshan (chi(2) = 2.488, P = 0.115). PVP of Abbot was highest (chi(2) = 18.633, P = 0.000, vs Livzon). There were some specimens with S/CO (optical density of sample/cut off) ratio < 6 or > or = 6 in all three groups with positive, indeterminate and negative WB results. The S/CO ratio from Zhongshan in confirmed positive group (14.29 + or - 2.63) was higher than in positive-negative group (2.80 + or - 3.25) (t = 17.652, P = 0.000). The S/CO ratio from Biomérieux in confirmed positive group(16.09 + or - 2.35) was higher than in positive-negative group (2.14 + or - 1.91) (t = 31.622, P = 0.000). The S/CO ratio from Livzon in confirmed positive group (11.54 + or - 1.95) was higher than in positive-indeterminate group (5.54 + or - 3.57) (t = 6.386, P = 0.000), positive-negative group (3.25 + or - 2.41) (t = 21.772, P = 0.000) and positive-indeterminate group was higher than positive-negative group (t = 2.301, P = 0.033).
CONCLUSIONThe performances of four HIV antibody screening kits are good but estimating WB confirming result in line with S/CO ratio is not available. All repeated screening positive results should be followed by confirmatory tests.
AIDS Serodiagnosis ; methods ; Blotting, Western ; methods ; Enzyme-Linked Immunosorbent Assay ; methods ; statistics & numerical data ; HIV Antibodies ; blood ; HIV Seropositivity ; diagnosis ; Humans ; Indicators and Reagents ; Mass Screening ; Reagent Kits, Diagnostic ; Sensitivity and Specificity