Objective To investigate the clinical feature,image of CT scan pulmonary,diagnosis and treatment response in children with pulmonary cavity,and discuss the method of diagnosis and the tactics of treatment for pulmonary cavity in children.Methods A retrospective study of 6 patients with pulmonary cavity,who were diagnosed and treated from Jul. 2003 to Oct. 2009 in Department of Pediatrics of the First Hospital Affiliated to China Medical University.The clinical manifestations,laboratory tests,image of CT scan pulmonary,microbiological evidence,diagnostic procedure and treatment response were collected and evaluated.Results Six patients all didn′t have history of lung di-sease,there were 4 boys and 2 girls,8-15 years old,average age was 10.5 years old.Two cases of them had unrelated pulmonary underlying diseases,1 case had hyperthyroidism,and the other had juvenile idiopathic arthritis and had complication of macrophage activation syndrome,the other 4 cases had no obvious history.All cases had fever (38-40 ℃),3 cases had cough and 1 case had chest pain.Staphylococcus aureus were cultured in 2 cases,no bacteria was cultured in other 4 cases;the count of white blood cell decreased in 2 cases and increased in 4 cases;C-reactive protein increased in 5 cases and was normal in 1 case;plasma IgE level increased in 2 cases and was normal in other 4 cases;plasma 1,3-beta-D-glucan of all 6 cases were negative.Pulmonary cavities were found in the first CT scan of the lungs in 5 cases and only 1 case of patient′s pulmonary cavities was found in the second CT scan of the lung.Five cases were diagnosed infective causes,1 case was diagnosed noninfectious cause,5 cases of infective causes had been treated with anti-microbial drugs for at least 1 week,1 case of noninfectious cause were treated with methylprednisolone cobined cyclosporin A for 2 weeks.Pulmonary CT scan was rechecked in all cases,and the state of the cases were improved before discharged from hospital.Conclusions The causes of pulmonary cavity in children are not only infective factors,but also some non-infective disease,especially some changes of image of pulmonary CT scan has diagnostic value,detailed past medical history and appropriate rechecking of chest radiographic check are very necessary for diagnosis,according to the result of microbial inspection and evaluation of treatment effect in time and then adjust the treatment protocols.

Objective To analyze the efficacy,late complications and prognostic factors of post-op-erative radiotherapy for cervical cancer. Methods From Nov. 1999 to Feb. 2005,114 patients with cervi-cal cancer received adjuvant pelvic radiotherapy after radical hysterectomy and pelvic lymphadenectomy. The median age was 42.5 (24 to 72) years old. According to the FIGO staging system,6,51,18,26 and 13 pa-tients had stage ⅠA, Ⅰb1, Ⅰb2, ⅡA and ⅡBdisease. The pathological type was squamous cell carcinoma,ade-nocarcinoma, squamous-adenocarcinoma and undifferentiated carcinoma in 92,19,2 and 1 patients, respec-tively. The whole-pelvic external beam irradiation of 50 Gy (40 to 60 Gy) was given with 6 MV or 15 MV X-ray beams using four-field box technique. Eighty-one patients received intravaginal brachytherapy of 16 Gy (4 -30 Gy in 1 -6 fractions) 4 weeks after the beginning of radiotherapy, with the referrence point being at 0.5 cm under the vaginal mucosa. Eighty-seven patients received preoperative and/or concurrent chemother-apy. The survival and independent prognostic factors were analyzed by Log-rank method and Cox model. Results The median follow-up time was 26.0 (5 - 75) months. The overall survival rate, disease-free sur-rival rate and local control rate were 93.1%, 88.1% and 94.6% at 2-year, and 75.7%, 62.3% and 85.6% at 5-year,respectively. The independent prognostic factors were lymph node metastasis and positive surgical margin for overall survival, positive surgical margin for local control, and stage, uterine body invasion and positive surgical margin for disease-free survival. Sixteen patients ( 14% ) had distant metastasis, and the most common sites were the lung,inguinal region,bone,liver and brain. According to RTOG grading sys-tem, the incidence of late gastrointestinal side effects of grade 1,2 and 3 was 11.4%, 11.4% and 3.5%. The corresponding genitourinary side effects were 14.0% ,6.1% and 0.9%, respectively. The incidence of leg lymphedema was 7 % . Conclusions Post - operative radiotherapy can achieve good local control in cervical cancer with acceptable late side effects. Distant metastasis is the main cause of death.

Objective To analyze the medical service pricing policy of 30 provinces and autonomous regions in China and recommend on problems and challenges, for reference of medical service pricing reform in the future.Methods Literature review and policy analysis were used for summary and performance appraisal of medical service pricing of China.Results Most of the areas surveyed followed the step-by-step approach to gradually adjust pricing, while a few areas completed it in a one-time adjustment manner.2015 witnessed most areas, up to 20 (66.67%), in price adjustment;their price adjustments focused on price reduction of large-scale medical equipment inspection fees and some medical tests.On the other hand, prices of diagnosis, nursing care, and treatment which are labor-intensive were increased.Conclusions Specifications of medical services are improving, yet there exist great gaps in the convergence of medical insurance.It is advisable to expedite the convergence of the new version specifications, to achieve value regression and dynamic price adjustment of medical services.

Adenocarcinoma, Mucinous ; metabolism ; pathology ; surgery ; Carcinoid Tumor ; metabolism ; pathology ; surgery ; Chromogranin A ; metabolism ; Diagnosis, Differential ; Gastrectomy ; methods ; Gastrointestinal Stromal Tumors ; pathology ; Humans ; Male ; Middle Aged ; Neoplasms, Multiple Primary ; metabolism ; pathology ; surgery ; Stomach Neoplasms ; metabolism ; pathology ; surgery ; Synaptophysin ; metabolism

Objective To judge method performance of routine biochemistry parameters on Roche Modular PPI testing system by using westgard's method evaluation decision chart.Methods We assessed imprecision(CV)from internal quality control and inaccuracy(bias)from external quality control evaluation.Combined estimates of imprecision and inaccuracy by plotting imprecision as the x-coordinate and inaccuracy as the y-coordinate to locate an expected operating point of every item on the chart.By comparing this operating point with allowable total errors(TEa),we can decide whether the performance is acceptable or not.Results In the 27 different parameters tested,imprecision and bias of calcium were 0.08 mmol/L and 0.06 mmol/L respectively,its performance was marginal.The imprecision of creatinine,urea,glucose, sodium,chloride and phosphorus were 3.20%,2.13%,1.52%,0.89 mmol/L,1.10% and 1.55%,the bias were 4.79%,0.96%,4.63%,0.80 mmol/L,1.74% and 4.13% respectively,their performance was good.M1 other 20 items were of excellence performance.Conclusions Routine biochemistry parameters on Roche Modular PPI testing system possessed good precision and accuracy,and their performance were acceptable.To judge method performance of biochemistry testing system by using westgard' s method evaluation decision chart was easy to do and suited for clinical laboratory.

OBJECTIVETo explore the association between angiotensin-converting enzyme (ACE) and the polymorphisms of N5, N10-methylenetetrahydrofolic acid reductase (MTHFR) gene in patients with ischemic stroke (IS).

METHODSTotally 454 patients with IS (IS group) and 334 controls (control group) were recruited in our study. Their I/D polymorphisms of ACE gene and C677T polymorphisms of MTHFR gene were detected by PCR and denaturing high performance liquid chromatography.

RESULTSThe frequencies of DD, ID, II and CC, CT, TT genotype in IS group were 22.5%, 43.4%, 34.1%, and 51.8%, 40.5%, 7.7%, respectively, and were 17.4%, 45.5%, 37.1% and 56.9%, 38.3%, 4.8% in the control group, respectively. DD genotype was associated with large-artery atherosclerosis (LAA), and TT genotype and T allele were associated with LAA and cardioembolism. Synergistic effects were found between TT and DD/ID DD genotypes in the pathogenesis of ischemic stroke.

CONCLUSIONDD, TT genotype and T allele are risk factors of IS, and ACE gene and MTHFR gene have synergistic effects in the pathogenesis of IS.

Brain Ischemia ; complications ; genetics ; Genetic Predisposition to Disease ; Humans ; Methylenetetrahydrofolate Reductase (NADPH2) ; genetics ; Polymorphism, Genetic ; Renin ; genetics ; Stroke ; etiology ; genetics

This article reviews the methods, notes and evaluation of the living animal models of the medical shock wave, including directly shocked animal models, surgical implantation of stones into animal kidney models, implantation of tumor cells into animal models and animal bone models. The living animal models play an important role in studying the medical shock wave.
Animals ; Disease Models, Animal ; Dogs ; Guinea Pigs ; Kidney ; pathology ; Kidney Calculi ; pathology ; therapy ; Lithotripsy ; adverse effects ; Models, Animal ; Neoplasm Transplantation ; Neoplasms, Experimental ; pathology ; Rabbits ; Rats

OBJECTIVETo prepare a new dosage formulation of activated carbon nanoparticles adsorbing mitomycin C (MMC-ACNP) and evaluate the beneficial effects of intraperitoneally applied MMC-ACNP as a drug delivery system for lymphatic targeting in preventing metastasis and recurrence of gastric cancer.

METHODSMMC-ACNP was prepared. Acute toxicity after its intraperitoneal administration was evaluated. An experiment on nude mice model with transplanted human gastric cancer in 6 groups was completed to assess the effects of drugs on intra-abdominal carcinomatosis.

RESULTSThe LD50 of MMC-ACNP was 46.80 mg/kg (in terms of MMC) while that of MMC aqueous solution was 9.33 mg/kg. The toxicity of MMC-ACNP was much less than that of the solution form. MMC-ACNP was superior to MMC aqueous solution in controlling carcinomatosis and tumor growth by intraperitoneal administration. Despite the high dose of MMC, leukopenia and thrombocytopenia were not observed in the MMC-ACNP treated group. Fine activated carbon particles adsorbing MMC entered the nuclei of tumor cells, so that the effects of the anticancer drug were reinforced.

CONCLUSIONMMC-ACNP gives a good promise of clinical use due to its advantages such as high selectivity and low toxicity.

Adenocarcinoma, Mucinous ; pathology ; Animals ; Antibiotics, Antineoplastic ; administration & dosage ; adverse effects ; pharmacology ; Charcoal ; administration & dosage ; Drug Carriers ; Drug Delivery Systems ; Female ; Humans ; Injections, Intraperitoneal ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Mitomycin ; administration & dosage ; adverse effects ; pharmacology ; Nanoparticles ; Neoplasm Transplantation ; Stomach Neoplasms ; pathology ; Thrombocytopenia ; chemically induced

BACKGROUNDMacro- and microvascular diseases are the leading cause of morbidity and mortality in diabetic patients, but their mechanisms remain unclear. Recent reports provide evidence that the levels of CD55 and CD59 are decreased in diabetic microvascular diseases. However, very little is known about the levels of CD55 and CD59, the relationship between them and carotid artery intima-media thickness, and the effects of statins on CD55 and CD59 in diabetic macrovascular diseases.

METHODSThe mean fluorescence intensity (MFI) of CD55 and CD59 expression on peripheral blood leucocyte subsets (lymphocytes, monocytes and neutrophils) was studied using flow cytometry, and carotid artery intima-media thickness was measured using B-mode ultrasonography in 23 healthy subjects (controls), 19 patients with type 2 diabetes (T2DM), and 43 patients with type 2 diabetes and macrovascular diseases (T2DM-M). The patients with T2DM-M were assigned to two subgroups based on whether statins were used: group with statins (n = 23) and group without statins (n = 20).

RESULTSCompared with the controls and T2DM, the MFI of CD55 positive neutrophils was significantly lower in T2DM-M (P = 0.049 vs controls and P = 0.033 vs T2DM); similarly, the MFI of CD59 positive monocytes was also lower in T2DM-M (P = 0.038 vs controls and P = 0.043 vs T2DM). The MFI of CD59 positive neutrophils in T2DM-M was lower than in T2DM (P = 0.032). The levels of CD55 and CD59 were negatively associated with age and blood pressure (r = -0.245 - -0.352, P = 0.041 - 0.003), but not acute-phase reactants and carotid artery intima-media thickness. The levels of CD55 and CD59 increased after treatment with statins, but the results were not significantly different (P > 0.05).

CONCLUSIONSCD55 and CD59 expressions on peripheral blood leucocytes are decreased in T2DM patients with macrovascular diseases. The results suggest that the decreased levels of complement regulatory proteins might play an important role in diabetic macrovascular diseases.

Aged ; Aged, 80 and over ; CD55 Antigens ; immunology ; CD59 Antigens ; immunology ; Diabetes Mellitus, Type 2 ; immunology ; Diabetic Angiopathies ; immunology ; Female ; Flow Cytometry ; Gene Expression Regulation ; Humans ; Leukocytes ; immunology ; Male ; Middle Aged

OBJECTIVETo analyze the associated risk factors, clinical characteristics and laboratory abnormalities of type 2 diabetes patients with fatty liver.

METHODSThe data of type 2 diabetes cases with fatty liver were collected in our hospital. 63 cases of type 2 diabetes without fatty liver were selected randomly as control during the same period. The associated variables were analyzed by using logistic regression model. The clinical data and liver function were compared between two groups.

RESULTSThe proportion of obesity and hyperlipidemia was higher in type 2 diabetes patients with fatty liver than without fatty liver. Body mass index (BMI) (OR: 4.392) was positive correlation to fatty liver in the patients with type 2 diabetes. In contrast, insulin sensitivity index (ISI) (OR: 0.000) and regular insulin treatment (OR: 0.058) were negative correlation to it. The abnormal frequencies of aspartate aminotransferase (AST, 16.0%), alanine aminotransferase (ALT, 25.2%), the ratio of AST/ALT less than 1 (52.8%) and gamma-glutamyltransferase (GGT, 31.9%) of type 2 diabetes patients with fatty liver were significantly higher than those without fatty liver (3.2%, 6.4%, 36.5% and 11.1% respectively).

CONCLUSIONObesity and insulin resistance might increase the risk of fatty liver in the patients with type 2 diabetes. Patients of type 2 diabetes with fatty liver show higher serum lipid level and more obvious damages of liver function than those without fatty liver

Adult ; Aged ; Aged, 80 and over ; Diabetes Mellitus, Type 2 ; blood ; complications ; Fatty Liver ; blood ; etiology ; Female ; Humans ; Hyperlipidemias ; blood ; complications ; Insulin Resistance ; Logistic Models ; Male ; Middle Aged ; Obesity ; blood ; complications ; Risk Factors