Purpose To explore the value of window width adjustment in diagnosing the invasiveness of lung adenocarcinoma manifested as ground glass opacities on high-resolution CT, and to provide guidance for the diagnosis of lung adenocarcinoma in different types. Materials and Methods The preoperative CT data of 102 preinvasive lesions and 107 invasive lesions of lung adenocarcinoma were analyzed retrospectively. Among 102 cases of preinvasive lesions, 25 were atypical adenomatous hyperplasia (AAH), 77 were adenocarcinoma in situ (AIS). Among 107 cases of invasive lesions, 78 were minimally invasive adenocarcinoma (MIA), and 29 were invasive adenocarcinoma. The lesions were ground glass opacity (GGO) on lung window while were invisible on mediastinal window. The window width was adjusted constantly until the lesions were invisible with the fixed mediastinal window level (40 HU). When the lesions became invisible, the window width was compared and the best cut-off was found on ROC curve in the two groups. Results The window width of lesions between preinvasive lesions and invasive lesions was different (Z= - 6.203, P<0.05). Window width was a good indicator for the invasiveness of pulmonary adenocarcinoma (area under the ROC was 0.748, P<0.05), and the window width of 1303 HU was the best cut-off for preinvasive lesions and invasive lesions (sensitivity was 56.9%, specificity was 86.0%. Conclusion Window width may be useful for the diagnosis of the invasiveness of the GGO of lung adenocarcinoma on HRCT. The lesion disappearing when the window width is larger than 1303 HU is more likely to be preinvasive; while the lesion disappearing when the window width is smaller than 1303 HU is more likely to be an invasive one.

BACKGROUNDLive attenuated hepatitis A vaccine (H2 strain) is widely applied in prevention of hepatitis A epidemic in China and other countries now. It is essential to observe and confirm the vaccine immune efficacy, population antibody level and its persistent efficacy after mass immunization.

METHODSA total of 220 children with negative anti-HAV antibody (aged 1 - 3 years) were taken for follow-up assay to observe seroconversion and geometric mean titre (GMT) level 2 months, 12 months, 6 years, and 10 years after inoculation. Another survey sampled from subjects of different age groups (3, 6, 9, 15, 18, 25 and 35 years) to compare anti-HA antibody positive rate before and after inoculation performed 10 years previously. Epidemiological observations were taken for 10 years to evaluate the relationship between vaccine coverage and hepatitis A morbidity. Serum antibody to HAV was detected by enzyme linked immunoassay (ELISA, calibrated by WHO international reference) and ABBOTT Axsym HAVAB microparticle enzyme immunoassay.

RESULTSSeroconversion in follow-up assay 2 months and 10 years after inoculation was 98.6% and 80.2% respectively. For children, the vaccination anti-HA antibody positive rates were significantly different before and after 10 years, 7.69% cf 70.45% (aged 3 years) and 52.58% cf 71.78% (aged 18 years). When vaccine coverage rose from 57% to 74%, there were no any HA epidemics. When vaccine coverage reached 85%, there were no any HA cases. With vaccine coverage between 85% and 91%, there were no any HA cases in cohorts from the age of 1 year to 15 years during the 10 years.

CONCLUSIONSLive attenuated hepatitis A vaccine has an obvious long-term effectiveness in prevention and control of HA epidemics through mass vaccination.

Adolescent ; Adult ; Child ; Child, Preschool ; Enzyme-Linked Immunosorbent Assay ; Follow-Up Studies ; Hepatitis A ; prevention & control ; Hepatitis A Vaccines ; immunology ; Hepatitis Antibodies ; blood ; Humans ; Immunoglobulin G ; blood ; Mass Vaccination ; Vaccines, Attenuated ; immunology

Objective To evaluate the long-term immunogencity and effectiveness of live attenuated hepatitis A (HA) vaccine (H2 strain) after one dose injection, through a 15 years' follow up observation. Methods A total of 220 children with negative anti-HAV antibody (aged 1-3 y)were involved and followed up in Jiaojiang district, Taizhou city, Zhejiang province. Indicators would include seroconversion and geometric meantiter(GMT) levels after inoculation the vaccine with single dose at 2 m, 12 m, 6 years, 10 years and 15 years. Epidemiological observation was carried out within the 15 years to evaluate the relationship between vaccine coverage, the incidence of HA and the overall effectiveness. In the studied population, serum was tested by ELISA(calibrated by WHO international reference) and ABBOTT Axsym HAVAB mEIA. Results Seroconversion rates were found to be 98.6% and 81.3% after 2 months and 15 years of inoculation and slowly decreased. GMT level was 128 mIU/ml after 15 years, significantly higher than the required protective level of 20 mIU/ml,recommended by WHO experts. Effectiveness through the 15-year follow up program showed a significant correlation between vaccine coverage and incidence of HA in 1-15 years aged group (Kendall-Rank test, t =-0.931, P＜0.01). There was no HA case seen among the observed accumulated 236 413 person-year vaccines, compared to 4 HA cases discovered in the 27 206 personyear of the non-vaccinees. The overall protective rate reached 100%. Through a mass vaccination program on children, the whole population established an immune-defence to enable the incidence of HA decreased by 96.7%. Conclusion The long-term immunogencity and effectiveness of live attenuated hepatitis A vaccine (H2 strain) after one dose injection could last as long as 15 years.

CD40/CD40L interactions play a pivotal role in T cell activation, and take part in many physiologic and pathologic procedures and different levels. In this article, stable CHO transformants secreting human CD40-Ig fusion protein were established through transfection and selection with Lipofectamaine and G418, respectively. In order to obtain great valume of recombinant protein, big batch serum-free cultures of engineered CHO cells were performed in roller-bottle using CHO-II-SFM medium. After cultures, the cell-culture supernatants were harvested, concentrated through ultra-filtration, and finally purified by affinity choromatography with Protein G Sepharose Fast Flow. Human peripheral bloods were collected freshly and seperated with Ficoll, CFU-T was cultured in semi-solid culture system with peripheral blood mononuclear cells (PBMNC). Effect of human CD40-Ig fusion protein on the formation of CFU-T was observed in vitro. The results showed that the yield of human CD40-Ig fusion protein was 30 mg in total 3 liter CHO-II-SFM culture supernatant, and it supposed that the expression level of CD40-Ig in CHO cells was more than 10 micro g/ml. The purity of purified fusion protein is above 95%. Furthermore, compared with human IgG, human CD40-Ig fusion protein significantly inhibited the formation of CFU-T at dose 0.25, 1.0, 4.0, and 10 micro g/ml, it lays a good foundation to evaluate its potential functions in vivo.

OBJECTIVETo evaluate the effectiveness and safety of endovascular stent insertion for non-small cell lung cancer patients with superior vena cava syndrome.

METHODSWe retrospectively studied 123 patients referred to our hospital for the treatment of non-small cell lung cancer presenting with superior vena cava syndrome. Patients were devided in two groups according to the use of endovascular stent insertion in superior vena cava syndrome or not. 64 patients underwent endovascular stent insertion was designed as the stenting group and 59 without stenting as control group. The differences between the two groups in complete response, complication and survival were analyzed.

RESULTSThe complete response rate of superior vena cava obstruction was 92.0% for the stenting group, and 42.0% for the control group, showing a significant difference between the two groups (P < 0.001). The median time to complete response was (3.76 ± 2.83) days in the stenting group, significantly shorter than that of the control group (28.08 ± 16.06) days (P < 0.001). The relapse rate after complete response was 12.0% in the stenting group and 16.0% in the control group, showing a non-significant difference between the two groups (P = 0.607). The median time to relapse was 2.7 months in the stenting group and 1.1 months in the control group (P = 0.533). In the stenting group, stent stenosis occurred in 1 case and thrombosis was observed in 3 cases. The incidence rate of complications was 6.3%. Thrombosis occurred in 1 case of the control group, with an incidence rate of complications of 1.7%, showing a non-significant difference between the two groups (P = 0.201). Seven among the 123 patients were still alive at the endpoint of following up. The median survival time was 8.0 months (stenting group) and 5.5 months (control group) (P = 0.382).

CONCLUSIONSEndovascular stent insertion is effective and safe for non-small lung cell cancer patients with superior vena cava syndrome, and it may be recommended as the first choice for palliative treatment of superior vena cava obstruction.

Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; complications ; surgery ; Female ; Humans ; Lung Neoplasms ; complications ; surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Palliative Care ; Remission Induction ; Retrospective Studies ; Stents ; Superior Vena Cava Syndrome ; complications ; surgery ; Thrombosis

This study was purposed to investigate the influence of inflammatory microenvironment on mesenchymal stem cells (MSCs) and regulatory effect of MSCs on osteoblast formation. The MSCs were isolated from synovial fluid of patients with rheumatoid arthritis (RASF-MSCs) and were cultured, the immunotypes of RASF-MSCs were detected by flow cytometry, the ability to differentiate RASF-MSCs into osteoblasts and adipocytes was determined by means of osteogenic and adipogenic induction, the regulatory effect of RASF-MSCs on osteoblast formation was assayed by co-culturing RASF-MSCs whth CD14(+) monocytes and in situ tartrate-resistant acid phosphatase staining. The results showed that RASF-MSCs highly expressed CD105, CD73, CD29, CD44, CD166 and HLA-ABC. Meanwhile, they lowly expressed CD34, CD45, CD31, HLA-DR, CD80 and CD86. However, RASF-MSCs decreased multi-differentiation capability as compared with BM-MSCs. More interestingly, RASF-MSC significantly promoted osteoclasts formation (p < 0.05) when co-cultured with monocytes. It is concluded that MSCs from rheumatoid arthritis synovial fluid exert typical MSC phenotypes but displayed decline of multi-differentiation capability. RASF-MSCs especially show promoting effect on osteoclastogenesis. The findings of this study may contribute to the understanding biological behavior of MSCs in pathological microenvironment.
Arthritis, Rheumatoid ; Bone Marrow Cells ; cytology ; Cell Differentiation ; Cells, Cultured ; Humans ; Mesenchymal Stromal Cells ; cytology ; Osteoblasts ; cytology ; Synovial Fluid ; cytology

This study was aimed to investigate the effect of activated T cell on the ability of MSC to differentiate into osteoblasts. The activated T cells with MSCs were co-culture for 14 days, then the osteoblast formation was tested by alkaline phosphatase staining. Furthermore, the supernatant of activated T cell was added in culture system of MSCs, the expression of molecules related with immune regulation of activated T cells was detected by RT-PCR, so as to determine what kinds of cytokine displayed the important function in MSC differentiation. The result showed that activated T cell could promote differentiation of MSC into osteoblasts, and IL-1beta played an important role in the effect of activated T cells on MSCs, while TNF-alpha, TGF-beta1 were not. It is concluded that the activated T cells promote the differentiation of MSCs to osteoblasts. The interactive influence between MSCs and immune cells can be mediated through cytokines.
Cell Differentiation ; Cells, Cultured ; Coculture Techniques ; Culture Media, Conditioned ; Humans ; Interleukin-1beta ; biosynthesis ; Mesenchymal Stromal Cells ; cytology ; Osteoblasts ; cytology ; T-Lymphocytes ; metabolism

OBJECTIVETo explore the significance of damage control surgery (DCS) in the treatments of severe pancreaticoduodenal injuries.

METHODSClinical data of 19 patients with severe pancreaticoduodenal injuries managed with DCS approach in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine and the First Affiliated Hospital of Wenzhou Medical College from March 2005 to January 2013 were analyzed retrospectively.

RESULTSThree cases were cured after damage control operation and postoperative ICU resuscitation treatment. Twelve cases underwent definite operations (distal pancreaticojejunal Roux-en-Y anastomosis, proximal duodenojejunal Roux-en-Y anastomosis or pancreaticoduodenectomy) after damage control operation and postoperative ICU resuscitation treatment and cured. Four cases died after damage control operation due to multiple organ failure and the mortality was 21.1%.

CONCLUSIONApplication of DCS approach can improve the prognosis of patients with severe pancreaticoduodenal injuries.

Adult ; Duodenum ; injuries ; surgery ; Female ; Humans ; Male ; Middle Aged ; Pancreas ; injuries ; surgery ; Pancreaticoduodenectomy ; Retrospective Studies ; Young Adult

In an attempt to study the immunoregulatory effect of osteoblasts derived from mesenchymal stem cells (MSC), MSC was induced to differentiate into osteoblasts for one week. The growth pattern and the phenotype were evaluated by MTT and flow cytometry respectively. The immunoregulatory effect was tested by the inhibitory effect on T cell proliferation. The result showed that during the differentiation cells grew fast and there was no significant change in the phenotypes but keeping CD73, CD105, CD44, CD29 positive and CD34, CD45, HLA-DR, CD86 negative. Osteocyte derived from MSC also showed immunosuppressive effect on T cell proliferation in adose-dependent manner. It is concluded that osteoblasts derived from MSC also harbored immunoregulatory effect.
Bone Marrow Cells ; cytology ; immunology ; Cell Differentiation ; immunology ; Cell Lineage ; Cell Proliferation ; Cells, Cultured ; Humans ; Mesenchymal Stromal Cells ; cytology ; immunology ; Osteoblasts ; cytology ; immunology ; T-Lymphocytes ; cytology ; immunology

This study was aimed to investigate if human heart harbored a population of primitive undifferentiated cells with the characteristics of MPC. Cells were isolated from human fetal heart and were cultured under conditions appropriate for bone marrow-derived MPCs. Their morphology, phenotypes and functions were tested by methods developed for MPC from other sources. The results showed that morphologically, cells were spindle shaped and resembled fibroblasts. In their undifferentiated state, cells were CD73, CD105, CD29, CD44, HLA-ABC, CD166 positive and CD45, CD34, CD86, HLA-DR negative. When cultured in adipogenic, osteogenic or chondrogenic media, cells differentiated into adipocytes, osteocytes and chondrocytes respectively. They could be extensively expanded in vitro and exhibited very low immunogenicity as evaluated by T cell proliferation assays. It is concluded that cells isolated from fetal heart possess similarity to their adult and fetal bone marrow counterparts in morphologic, immunophenotypic, and functional characteristics.
Bone Marrow Cells ; cytology ; Cell Adhesion ; Cell Differentiation ; Cells, Cultured ; Fetal Heart ; cytology ; Fetus ; Humans ; Mesenchymal Stromal Cells ; cytology ; immunology ; Multipotent Stem Cells ; physiology