Objective To investigate the possible role of mycobacterial infection in the pathogenesis of sarcoidosis.Methods DNA fragments of mycobacterial16S rRNA gene and the complex-specific insertion sequence IS6110of M.tuberculosis were detected by polymerase chain reaction(PCR)in formalin-fixed,paraffin-embeded skin biopsy specimens from12patients with sarcoidosis.Results Mycobacterial common sequence16S rRNA gene was found in6patients,among which5were further confirmed as M.tuberculosis,the other one was atypical mycobacteria.The IS6110DNA fragment amplified by PCR was confirmed by DNA sequencing.Conclusion The above findings suggest an aetiological role of mycobacterial infection,especially M.tuberculosis,in some patients with sarcoidosis.

Objective: To establish a rapid approach to the detection and identification of Mycobacteria from lesions of patients with suspected Mycobacterial infections. Methods: Specimens were obtained from five patients suspected to have Mycobacterial infections. DNA extracted from clinical samples was amplified by nested PCR. The PCR products were digested with Hha Ⅰ, MboⅠ, and BstUⅠ restriction enzymes and applied to PAGE. The species of Mycobacteria were determined by restriction fragment length polymorphism (RFLP) analysis. Identification of Mycobacteria culture was also performed in 3 patients. Results: M. marinum was found in two patients diagnosed as swimming pool granuloma. M. tuberculosis was found in one patient diagnosed as infectious skin granuloma. All these 3 Mycobacteria were confirmed by Mycobacteria culture. A strain of M. tuberculosis and a strain of M. fortuitum were detected in remain two patients. Conclusion: The results above indicate that PCR-RFLP analysis is rapid and reliable in detection and identification of different Mycobacteria species from skin tissues. Application of this method will be helpful for early diagnosis and treatment of Mycobacteria skin infections.

Objective To understand the RHD gene profiles of RhD negative individuals in Hainan Han population,and provide reference to establish the right method for RHD genotyping.Methods RhD was tested by anti-globulin test, and RhDel and genuine RhD-negative phenotype were identified by absorption/elution method. RhD negative samples were further tested for RHD exons by PCR-SSP.The RhD negative samples with intact RHD genes were further analyzed by PCR-SSP for RHD introns 2, 10 and RHD?gene. Results Thirty-one (29.25%)cases of RhDel individuals were identified among 106 apparent RhD-negative individuals. All RhDel samples had RHD genes;67 cases of genuine RhD-negative had no RHD genes and 8 cases were partial D. All 31 RhDel samples had Din2 and Din10 but none had RHD?. Additionally, We detected exons 1,3,4,6,7,9 and 10 in one case of ccdEe sample. Conclusion The proportion of RhDel phenotype is high among apparent RhD-negative Hainanese, and total RHD exons can be detected in all RhDel samples. Polymorphisms of RHD gene are present among genuine RhD-negative Hainanese. There is no exon 5 in all 8 cases of partial D, which suggests that exon 5 specific amplification may be very important in RHD genotyping for Hainan Han population.

Objective Study the value of clinical application of BaiJi and absorbable Gelatin in embolizing uterine myoma together with its effecty, side effect and complication.Methods 21 women with uterine myoma undergoing selective uterine arterial embolization by Seldinger's technique were studied. After retrograde transfemoral introduction of a 5 french catheter, the uterine arteries were successively catheterized. Bai Ji and absorbable Gelatin sponge particles were injected through free flow until devasculariztion. Results Uterine myoma's blood supply came from bilaterial uterine arteries demonstrated by angiography. All the supplying artering images disappeared after the embolization. 3～6 months follow up study showed: a marked reduction in the size of myomata by 38%～90%. Clinical symptoms were improved. There was one failure cas and then underwent uterotomy due to infection. Conclusions The short term effect of using Bai Ji and absorbable Gelatin for embolizing uterine myoma is clinically significant, while long term effects is still wating for research.

Objective To observe the expressions of antimicrobial peptides LL-37,human beta defensin2 (HBD-2) and HBD-3 in the lesions of lupus vulgaris and tuberculosis verrucosa cutis,and to speculate the pathogenesis of cutaneous tuberculosis.Methods Tissue specimens were collected from the lesions of 18 patients with lupus vulgaris or tuberculosis verrucosa cutis and 15 patients with psoriasis,as well as from the normal skin of 10 healthy controls.The specimens were embedded by paraffin and subjected to an immunohistochemical analysis for the detection of antimicrobial peptides LL-37,HBD-2 and HBD-3.Statistical analysis was performed by using the SPSS 13.0 software package,and t test was carried out to compare the expressions of LL-37,HBD-2 and HBD-3 between these groups.Results LL-37 and HBD-2 were observed mainly in the upper and middle layer of the epidermis,appendages and vascular endothelial cells in cutaneous tuberculosis lesions.The expression levels of LL-37 and HBD-2 were significantly higher in tuberculosis lesions than in the normal skin (t =2.632,2.399,both P ＜ 0.05).Psoriatic and tuberculosis lesions shared a similar expression pattern for LL-37 and HBD-2.HBD-3 was absent in the lesions of cutaneous tuberculosis,but present in both psoriatic lesions and normal skin.Conclusions Both LL-37 and HBD-2 may participate in the immune response in cutaneous tuberculosis,while the absence of HBD-3 may contribute to the pathogenesis of cutaneous tuberculosis.

Objective To observe the expression of Toll-like receptors (TLRs) 2,4 and 9 in lesions of lupus vulgaris and tuberculosis verrucosa cutis,and to evaluate the possible roles of these receptors in the pathogenesis of cutaneous tuberculosis.Methods Skin specimens were obtained from the lesions of 18 patients with clinically and pathologically diagnosed lupus vulgaris or tuberculosis verrucosa cutis,15 patients with plaque-type psoriasis (positive control),and from perilesional normal skin of 10 patients with pigmented nevi (negative control).Immunohistochemistry was used to detect the expression of TLRs 2,4 and 9 in these specimens,and the expression intensity was expressed as absorbence values.Data were analysed by using the SPSS 13.0 software,and t test was conducted to assess the differences between the three groups of specimens.Results TLR-2 was observed mainly in the middle and upper layer of epidermis in lesions of cutaneous tuberculosis and psoriasis,and in the whole epidermis except the basal layer in normal skin,with no significant difference in the expression intensity between the three groups of specimens (0.25 ± 0.04 vs.0.25 ± 0.05 vs.0.28 ± 0.03,P ＞ 0.05).TLR-4 was weakly expressed in cutaneous tuberculosis lesions,absent or slightly expressed in normal skin and psoriatic lesions,and the expression level of TLR-4 was significantly higher in cutaneous tuberculosis lesions than in normal skin and psoriatic lesions (0.16 ± 0.07 vs.0.07 ± 0.09 and 0.02± 0.05,t =2.58,6.24,P ＜ 0.01 and 0.05).TLR-9 was expressed in the whole epidermal layer,including appendages and vascular walls,of cutaneous tuberculosis and normal skin,with a significant increase in cutaneous tuberculosis than in the normal skin (0.25 ± 0.05 vs.0.19 ± 0.05,t =2.88,P＜ 0.05).Conclusions TLRs 2,4 and 9 are all expressed in cutaneous tuberculosis losious,and the expression intensity of TLR-4 and TLR-9 is higher in cutaneous tuberculosis lesions than in normal skin,hinting that TLR-4 and TLR-9 play a certain role in the immune response of cutaneous tuberculosis.

Objective:To explore the relationship among clinical manifestations ,SⅠ QⅢ TⅢ feature of ECG ,plasma level of D‐dimer (DD) and diagnosis of pulmonary embolism (PE) .Methods :Clinical data of 212 inpatients ,who received pulmonary CT angiography (CTA) in our hospital from Jun 2012 to May 2014 ,were retrospectively ana‐lyzed .According to pulmonary CTA results ,patients were divided into PE group (n=56) and non‐PE group (n=156) .Basic hospitalization data ,including clinical manifestations ,ECG features and plasma DD level ,were collect‐ed and compared between two groups .Results:Compared with non‐PE group ,there were significant rise in percent‐ages of dyspnea (44.87% vs .75% ) and prolonged bedridden time (3.85% vs .14.29% ) ,significant reduction in percentage of no clinical manifestations (38.46% vs .3.57% ) in PE group , P<0.01 all .Percentage of ECG SⅠQⅢTⅢ feature in PE group was significantly higher than that of non‐PE group (50% vs .23.08% ) , P<0.01. Compared with non‐PE group ,percentage of plasma DD>10μg/ml significantly rose (19.23% vs .32.14% ) in PE group ,P<0.05 .Conclusion:Patients with dyspnea and/or prolonged bedridden time ,that cannot be explained by other car‐diopulmonary diseases ,and SⅠ QⅢ TⅢ feature of ECG ;plasma DD level significant rising (> 10 μg/ml) should be considered to be PE .

Objective To explore the optimum exposure factors in digital chest radiography.Methods Chest phantom was exposed under auto exposure control model with 73, 90, 125kV and S200,400,800 plus or minor 4 micro-adjust for each sensitivity grade. Meanwhile dose area product (DAP) was recorded and the value of IQFinv was analyzed automatically by Artinis CDRAD Analyzer 1.1. Ten volunteers were exposed with 73 kV, S800 - 2; 90 kV, S800 + 2 and 125 kV, S400 + 2. Two radiologists evaluated and scored image quality. Statistical analysis was performed using one way ANOVA test by SPSS 12. 0. Results ( 1 ) The quality scores of volunteers' images obtained with three combinations of exposure factors were 2. 7 ± 0. 5 for 73 kV group, 2. 9 ± 0. 3 for 90 kV group and 2. 8 ± 0. 4 for 125 kV group. The difference among them was not statistically significant ( F = 0. 587, P ＞ 0. 05 ). Whereas the DAP values were (29. 1 ± 7.9) mGy · cm2 for 73 kV group, ( 30. 5 ± 4. 5 ) mGy ·cm2 for 90 kV group and (40. 4 ±7.6) mGy · cm2 for 125 kV group, with statistically significant difference among them ( F = 9. 803, P ＜0. 01 ). (2) In all three kV conditions, DAP value of phantom declined when sensitivity increased. There was a difference of DAP value by 11％ between two successive sensitivity grades. Under the condition of same sensitivity, DAP value changed with kV in the following order: 73 kV ＞90 kV ＞ 125 kV. (3) The value of IQFinv decreased when sensitivity increased. Under the condition of same sensitivity, IQFinv changed with kV as follow: 73 kV ＞90 kV ＞ 125 kV. Conclusion The combination of exposure factors of 90 kV and S800 + 2-S800 +4 is optimum for digital chest radiography.

Objective To investigate the radiation doses for the patients undergoing interventional radiology and to analyze the dose - influencing factors.MethodsThe clinical data of 461 patients undergoing interventional radiology,including cerebral angiography ( CEA ),cerebral aneurysm embolism ( CAE ),superselective hepatic arterial chemoembolization ( SHAG ),coronary angiography ( COA ),percutaneous intracoronary stent implantation ( PIS1 ),cardiac radiofrequency catheter ablation ( RFCA ),and permanent cardiac pacemaker implantation(PCPI) were collected to observe the cumulative air kerma (CAK),dose area product (DAP),and fluoroscopy time,and effective dose was estimated using the conversion factors.Results The effective doses for CEA,CAE,SHAG,COA,PISI,RFCA,and PCPI were (0.33 ±0.20),(0.49 ±0.35),(6.92 ±4.19),(0.76 ±0.91),(2.35 ± 1.47),(0.50 ±0.74),and (0.67 ±0.70) Sv,respectively.In 126 of the 416 patients (26%),the effective doses were greater than 1 Sv,and the effective doses of 10 person-times were greater than 10 Sv,all of which were observed in the patients undergoing SHAG.The CAK values for CEA,CAE,SHAG,COA,PISI,RFCA,and PCPIwere (0.55 ±0.43),(1.34 ± 1.11),(0.95 ±0.57),(0.32 ±0.31),(0.91 ±0.33),(0.16 ±0.22),and (0.15 ±0.14) Gy,respectively.The CAK values were greater than 1 Gy in 59 of the 461 patients ( 12.8% ),greater than 2 Gy in 11 cases (2.4%) ,and greater than 3 Gy in 1 CEA cases and 1 CEA case,respectively.Conclusions There is a wide variation range in radiation dose for different procedures.As most interventional radiology procedure can result in clinically significant radiation dose to the patient,stricter dose control should be carried out.

Objective To explore the prognostic effect of fluid-attenuated inversion recovery imaging vascular hyperintensity (FVH)on intravenous thrombolysis of acute ischemic stroke.Methods We retrospectively reviewed the clinical and imaging data of intravenous thrombolytic patients with acute anterior circulation infarction admitted from May 2009 to December 2013.The presence of FVH was evaluated,and its associations with reperfusion and clinical outcome after thrombolysis were assessed.Results Ninety-three patients were analyzed.FVH was detectable in 55 (59.1％) cases.Patients with FVH had higher NIHSS scores (11.8 ± 6.0 vs 7.2 ± 4.5,P ＜ 0.01),larger initial DWI lesions (5.5 ml vs 2.0 ml,Z =-3.030,P=0.002) and perfusion lesions (42.0 ml vs 3.0 ml,Z=-6.104,P =0.005),compared with those without FVH.The history of hyperlipidemia (OR =0.264,95％ CI 0.07-0.90,P =0.048) and proximal large vessel occlusion(OR =48.874,95％ CI 11.6-205.924,P ＜ 0.01) were independently associated with the presence of FVH.The presence of FVH independently predicted the poor neurological outcome at 3 months (OR =4.143,95 ％ CI 1.440-11.919,P =0.008).However,early reperfusion was associated with favorable outcome in patients with FVH after intravenous thrombolysis (OR =8.500,95％ CI 1.964-36.790,P =0.004).Conclusions The presence of FVH is associated with proximal large vessel occlusion,which predicts poor outcome in patients with intravenous thrombolysis.However,early reperfusion among patients with FVH can improve the outcome.