Objective To study the abdominal CT findings of the penicilliesis marneffei in patients with AIDS.Methods Abdominal CT imaging features of the the penicilliesis mameffei in 35 patients with acquired immunodeficiency syndrome (AIDS) were retrospectively analyzed.Results Abdominal lymph adenopathy was observed in 27 (77.1%) cases.Hepatosplenomegaly was observed in 18 (51.4%) cases.Lesions in the liver and spleen were found in 11 (31.4%) cases which included 3 cases of low density nodules in the liver (8.6%) and 5 cases of low density nodules in the spleen (14.3%).5 cases of diffuse low density in the liver (14.3%) and 5 cases of heterogeneous enhancement in the liver (14.3%) .Thickening of the intestinal wall was observed in 3 cases (8.6%). Ascites was observed in 4 cases (11.4%).Pancreatitis was found in 1 case(2.9%).Conclusions Penicilliosis marneffei in patients with AIDS usually involves multiple organs in the abdomen.Abdominal lymphadenopathy, hepatosplenomegaly and parenchymai lesions in the liver and spleen are the most common CT findings in the abdomen.

Objective To study the clinical characteristics, diagnostic methods and therapeutic efficacy of pneumocystis pneumonia (PCP) in patients with acquired immunodeficiency syndrome (AIDS). Methods Sixty-nine AIDS cases of PCP were diagnosed according to the criteria of USA Centers for Disease Control and Prevention revised in 1993. The clinical symptoms and signs of the patients were observed. The peripheral blood lymphocyte counts, blood gas analysis and bronchoalveolar lavage fluid (BALF) were checked and transbronchoscopic lung biopsy was performed. Results All studied patients were in the late stage of AIDS. The main clinical manifestations included fever (100.0%), cough (97.1%), and dyspnea (92.80%). Pulmonary rales could be heard in 42 cases (60.9% ). Peripheral CD4+ T lymphocyte counts ranged from 1 × 106 -88 × 106/L. Fifty-two cases (75.4% ) had low arterial partial pressure of oxygen value of less than 10.7 kPa (1 kPa = 7.5 mm Hg). Sixty-one cases (88.4 %) had elevated serum lactate dehydrogenase (LDH) level. Bilateral diffused interstitial change (46.4%) and ground-glass shadow (29.0%) were the most common abnormal chest radiological findings. Pneumocystis organisms were detected in the BALF from 2 patients and in the transbronchial biopsy (TBB) tissue from 35 patients. All patients were treated with compound sulfamethoxazole. Thirty-three were treated with corticosteroid simultaneously and 27 were assisted with mechanical ventilation. Fifty patients recovered or got improved, eleven died, and eight left hospital because of deteriorated condition. Conclusions When an AIDS patient represents with fever, cough, dyspnea, hypoxemia, elevated serum I.DH level, CD4+ T lymphocyte count below 100 × 106/L, and interstitial pneumonia or ground-glass shadow in chest images, the diagnosis of PCP could be made presumptively. It is difficult to make a nosogenic diagnosis of PCP, but TBB considerably increases the positive rate of pneumocystis. Compound sulfamethoxazole is recommended as the first selected drug. In severe cases, corticosteroid and assisted mechanical ventilation combined with compound sulfamethoxazole could remarkably improve the prognosis of PCP.

Objective: To study the relationship between dilated cardiomyopathy and nuclear lamina protein (LMNA) gene mutation in Kazak ethnics at Xinjiang area.
Methods: A Kazak familial dilated cardiomyopathy (FDCM) with 31 members was studied. In addition, 160 patients with idiopathic dilated cardiomyopathy (IDCM) with 160 healthy controls were enrolled in our study, and they were divided into 4 groups: IDCM-Kazak, IDCM-Han and Control-Kazak, Control-Han.n=80 in each group. Peripheral blood DNA were extracted, 12 exons with nearby introns of LMNA gene were detected by PCR and the ampliifed products were sequenced and compared with the standard template of CHROMAS and BLAST software to identify mutation sites. LMNA mutation in both Kazak and Han IDCM patients were investigated.
Results: A novel LMNA mutation (insC, CGG→CCG) at exon 7 was identiifed in a FDCM proband, it caused an amino acid substitution as Arg to Pro, and a known LMNA polymorphism loci rs4641 (c.1362C>T His454His) was fund at exon 10. In addition, LMNA polymorphism loci rs4641 genotype distribution (χ2=5.16,P=0.036) and allele frequency (χ2=4.50,P=0.034) were statistically different between IDCM-Kazak group and Control-Kazak group; while such differences were no statistic meaning between IDCM-Han group and Control-Han group. Logistic regression analysis indicated that LMNA polymorphism loci rs4641 was related to IDCM occurrence in Kazak ethnics (P=0.025, OR=0.412, 95% CI 0.189-0.896).
Conclusion: LMNA polymorphism loci rs4641 was related to IDCM in Kazak ethnics at Xinjiang area, which might be susceptible loci for IDCM occurrence.

Objective To evaluate CT features of pulmonary tuberculosis in the patients with HIV infection and AIDS(HIV/AIDS).Methods CT findings of pulmonary tuberculosis were retrospectively analyzed in 48 patients with HIV/AIDS.Results The CT features of pulmonary tuberculosis in HIV/AIDS included: secondary pulmonary tuberculosis in 19 cases(39.6%), mostly showing patchings shadows,10 cases with large confluent consolidation; hematogenous pulmonary tuberculosis in 17 cases(35.4%), including 7 cases of acute miliary tuberculosis(showing miliary lesions evenly distributed in both lungs), and 10 cases of sub-acute disseminated tuberculosis(showing nodular patterns diffusely distributed in both lungs, asymmetrical in size and distribution); complex lesions in 10 cases(20.8%, showing patchy, nodular and miliary lesions). Among all the patients, 36 (75.0%) showed enlarged mediastinal lymphnodes, 13(27.1%) pleural effussion, 10(20.8%) pericardial effusion.Conclusion The characteristics of pulmonary tuberculosis in the patients with HIV/AIDS were mostly diffuse distribution.

Objective To evaluate the etiology and CT features of thoracic lymphadenopathy in patients with acquired immunodeficiency syndrome (AIDS).Methods CT features of thoracic lymphadenopathy in 178 AIDS patients were retrospectively analyzed.Results Of 668 AIDS patients with thoracic lymphadenopathy,174 were proved to be infections including Penicilliosis marneffei (n =117),tuberculosis (n =42),cryptococcosis (n =10) and non-tuberculous mycobacteria (n =5).Four were proved to be tumors including 3 Kaposi's sarcomas and 1 lymphoma.The enlarged mediastinal and hilar lymph node presented as homogeneous soft-tissue density in 140 patients,with central low attenuation in 29 patients,as extreme low attenuation in 9 patients on plain CT scan and showed homogeneous enhancement in 28 patients,rim enhancement in 19 patients,non enhancement in 2 patients on enhanced CT scan.Accompanied CT findings included diffuse pulmonary micro-nodules (n =45),primary complex or similar primary complex (n =13),pleural effusion (n =59),pericardial effusion (n =24),sandwich sign in the small bowel mesentery (n =31).The CT findings of penicilliosis marneffei and tuberculosis were compared with chisquare test.There were significant differences on homogeneous soft-tissue density,central low attenuation,homogeneous enhancement,rim enhancement,diffuse pulmonary micro-nodules,primary complex or similar primary complex,sandwich sign,pleural effusion (x2 =32.62,43.82,12.13,15.72,11.76,11.06,5.44,4.07,P ＜ 0.05).Conclusions Thoracic lymphadenopathy can be caused by infections and tumors in AIDS.CT plays an important role for the differential diagnosis.

Objective To study the CT findings of abdominal tuberculosis in patients with AIDS.Methods CT imaging features of abdominal tuberculosis in 33 patients with AIDS were retrospectively analyzed. Results Abdominal lymph adenopathy were observed in 23 cases (69. 7%, 23/33 ).Hepatosplenomegaly were observed in 10 cases (30. 3%, 10/33). Multiple low density nodes in spleen were observed in 14 cases(42. 4%, 14/33)including 9 cases of diffuse, low density nodes (27. 3% ,9/33). Low density lesions in liver were observed in 7 cases (21.2%, 7/33 ) including a case of tuberculous abscess (3.0%, 1/33 ) . Peritoneum and epiploon involvements were found in 5 cases ( 15.2%, 5/33 ) with associated ascites in 2 cases ( 6. 1%, 2/33 ) . Thickening of intestines wall were observed in 4 cases ( 12. 1% ,4/33). Destruction of lumbar vertebra with cold abscess was observed in 1 case (3.0% ,1/33).Abscess in psoas was observed in 1 case (3.0%, 1/33). Conclusion Abdominal tuberculosis in patients with AIDS usually involves multiple organs in the abdomen. CT has an important role in the detection and following up examination of these lesions.

Objective: To explore the relationship between atrial MMP-9 with its inhibitor (TIMP-1), anti-apoptosis gene (BCL-2) with apoptosis gene (BAX) and the aging with atrial remodeling in experimental dog model during atrial ifbrillation (AF), in order to better deal with the aging caused AF.
Methods: The experimental dogs were divided into 4 groups: ①Adult with sinus rhythm (ASR) group, ②Elder with sinus rhythm (ESR) group and③Adult with AF (AAF) group,④Elder with AF (EAF) group. n=7 in each group. Chronic AF model was induced by rapid and persistent atrial pacing. The mRNA and protein expressions of MMP-9, TIMP-1 and BCL-2, BAX were measured by real time quantitative RT-PCR and Western blot analysis. The cellular ultra structural remodeling was examined by optical/electron microscopy, and the apoptosis index was determined by TUNEL method,
Results: Compared with adult dogs, the elder dogs showed obviously increased expressions of MMP-9, BAX, and decreased expressions of TIMP-1, BCL-2, all P<0.05. Compared with SR gods, the AF dogs presented up-regulated expressions
of MMP-9, BAX, all P<0.05, and down-regulated expressions of TIMP-1, BCL-2, all P<0.05, such changes were most obvious in elder AF dogs. Accompanying with the aging and AF, the degree of atrial ifbrosis, cellular ultra structure and the apoptosis index were changed with the statistic meaning.
Conclusion: The abnormal expressions of MMP-9/TIMP-1 and BCL-2/BAX might be one of the molecular mechanisms for aging caused AF in experimental dog model.

Objective To study the imaging appearances of Rhodococcus equi pneumonia in three patients with acquired immunodeficiency syndrome ( AIDS). Methods Thoracic imaging appearances of Rhodococcus equi pneumonia in three patients with AIDS were retrospectively analyzed. Results The chest radiograph showed patchy consolidations and small nodules ( n = 3 ), large consolidations with multiple cavitations ( n = 2). CT showed large lobar or segmental consolidations with multiple cavitations (n=2),patchy consolidations (n=2), bronchiectasis (n=1), multiple small centrilobular nodules ( n = 2) and tree-in-bud patterns (n = 2). Conclusion The most common radiological findings in AIDS patients with Rhodococcus equi pulmonary infection are large consolidations with multiple cavitations and multiple centrilobular nodules.

Objective To study the chest radiographic appearances of the non-tuberculous mycobacterial(NTM) pulmonary infection in patients with acquired immune deficiency syndrome (AIDS).Methods Ten patients with AIDS and NTM underwent chest X-ray radiography and 7 patients performed high-resolution CT (HRCT) scan. Chest radiographic features of NTM in patients with AIDS were retrospectively analyzed. Results The chest radiograph showed bilateral pulmonary involvement in 6 cases and single lung involvement in 4 cases (3 cases in the right, 1 case in the left). Patchy air space consolidation (6 cases), large consolidation (5 cases), cavitation (5 cases), small nodules (3 cases),military nodules (2 cases), linear opacity ( 1 cases) were demonstrated on radiography. On HRCT, air space consolidation (7 cases), small nodules (6 cases), large consolidation (5 cases) with cavitation and cylindric bronchiectasis after the absorption of consolidation, enlarged hilar and mediastinal lymph nodes (4 cases), ground-glass opacities (3 cases), military nodules and "tree-in-bud" sign (2 case), pleural effusion ( 1 case), pericardial effusion ( 1 case) and fibrotic band ( 1 case) were found. Conclusion The most common radiographic appearances of NTM in patients with AIDS are bilateral small nodules, large consolidation with cavitation and cylindric bronchiectasis, enlarged hilar and mediastinal lymph nodes.

Objective To manifest the imaging appearances of the pulmonary mucormycesis in patients with acquired immunodeficiency syndrome(AIDS).Methods The radiographic and hiish resolution computed lomography(HRCT)features of the pulmonary mucormycosis in 13 patients with AIDS were retrospectively analyzed.Results On radiography,the infiltrative lesions were found in 5 patients,7 cases had reticular pattem,4 cages had pleural effusion,4 cages had enlarged hilar and mediagtinal lymph nodes,3 cases had diffuse milliary lesions,3 Cages had masses,2 cases had ground-slags shadows,2 cages had cystic lesions,cavity,pleural thickening,pericardia]effusion and focal pneumothorax Wag presented in 1 cage respectively.On HRCT,7 cages had enlarged mediagtinal lymph nedes,7 cages had interlobular septal thickening,the infiltrative lesion were found in 6 patients,5 cages had diffuse milliary lesions,4 cages had pleural effusion,3 cases had inasses,2 cages had ground-glass shadows,2 cases had cystic lesions,cavity,pleural thickening,focal bronchiectagis,pericardial effusion and focal pneumothorax was presented in 1 case respectively.Conclusion The main imaging appearances of the pulmonary mucormycesis in patients with AIDS include diffuse milliary lesion,enlarged hilar and mediagtinal lymph node,interiobular septal thickening,infiltrative lesion,pleural effusion and mass.