OBJECTIVETo explore the features of various mediastinal lymphadenopathies using computed tomography perfusion (CTP).

METHODSCTP parameters (CTPs) of the selected mediastinal nodes from 59 patients with pathology-proven malignant lymph nodes and of those from 29 patients with clinically diagnosed or pathology-proven inflammatory lymphadenopathies were collected. Patients were divided into subgroups by etiology and phase of primary disease, including different pathological malignant nodes and diverse inflammatory nodes. CTPs were defined as blood flow (BF), blood volume (BV), mean transit time (MTT), permeability (PMB), and time to peak (TTP). Differences of CTPs were compared between malignant and benign nodes, and among subgroups, respectively.

RESULTSIn the mediastinum, no significant differences of CTPs were found between malignant and benign groups (all P>0.05), the same for subgroups of malignant nodes (all P>0.05). Acute lymphadenitis had higher BF and BV than chronic inflammatory, lymphoid tuberculosis, sarcoidosis and malignant nodes. The BF of malignant nodes was markedly slower than that of acute lymphadenitis (P=0.01), but faster than chronic inflammatory nodes (P=0.04) and sarcoidosis (P=0.03), with no significant difference compared with lymphoid tuberculosis. Pneumonia-complicated lymphoid tuberculosis showed the longest MTT while sarcoidosis displayed the shortest MTT, and inflammatory nodes, lymphoid tuberculosis without complicated pneumonia and malignant nodes had moderate MTT.

CONCLUSIONCTPs show promising potential in distinguishing various lymphadenopathies in the mediastinum, but more studies are needed to improve their specificity.

Adult ; Female ; Humans ; Lymph Nodes ; diagnostic imaging ; Lymphatic Diseases ; diagnostic imaging ; Male ; Mediastinal Diseases ; diagnostic imaging ; Perfusion ; Retrospective Studies ; Tomography, X-Ray Computed ; methods

Objective To explore the risk factors for infection following percutaneous nephrolithotomy(PCNL), and provide the basis for prevention of postoperative infection.Methods 96 patients who were performed PCNL in a hospital between August 2010 and August 2013 were chosen,clinical data of patients were retrospectively analyzed, the occurrence of postoperative infection,risk factors and isolated pathogens were analyzed.Results 35 patients (36.46%[35/96])developed infection following PCNL.Univariate analysis revealed that risk factors for postopera-tive infection were the size and shape of stone,duration of operation,and intraoperative perfusion (all P <0.05). 96 patients before operation and 18 patients after operation were performed bacterial culture for urine,a total of 39 strains were isolated,the main isolated pathogens was Escherichia coli (n=12),followed by Pseudomonas aerugi-nosa (n=8),Streptococcus viridans (n =5 ),Klebsiella pneumoniae (n =4)and Enterobacter cloacae (n =3 ). Conclusion Infection rate following PCNL is high,duration of operation and intraoperative perfusion should be re-duced,antimicrobial agents should be used rationally.

Monolithic silica spin column extraction （MonoSpin-SPE） was developed as a simple, sensitive, and eco-friendly pretreatment method which combined with ultra-fast liquid chromatography-mass spectrometry （UFLC-MS） to determine the levels of six phthalate esters, dimethyl- （DMP）, diethyl- （DEP）, dipropyl- [ DPrP], butyl-benzyl- （BBP）, dicyclohexyl- （DcHP）, and di-n-octyl-（DOP） phthalate in physiological saline samples. Under optimized experimental conditions, the method was linear in the following ranges： 0.2- 50 μg/L for DMP, DEP, DPrP, DcHP and DOP; 5- 100 μg/L for BBP. The correlation coefficients （R2 ） were in the range of 0. 9951 - 0. 9995 for all the analytes and the limits of detection （LODs） and limits of quantification （LOQs） were in the ranges of 0.02 - 0.9 μg/L and 0.08 - 2.7μg/L, respectively. The pretreatment process showed good reproducibility with inter-day and intra-day relative standard deviations （RSDs） below 8.5% and 11.2%, respectively. This method was used to determine the levels of six phthalate esters in physiological saline samples and the recoveries ranged from 71.2% to 107.3%. DMP and DEP were found in actual physical saline samples （brand A and brand B）.

Corynebacterium glutamicum SA001 is a mutant with lactate dehydrogenase (ldhA) deletion. In order to increase metabolic flux from isocitrate to succinate, and to improve the production of succinate under anaerobic conditions,we transducted the gene aceA coding isocitrate lyase (ICL) from Escherichia coli K12 into Corynebacterium glutamicum SA001 (SA001/pXMJ19-aceA). After 12 h aerobic induction by adding 0.8 mmol/L of IPTG, the recombinant strain was transferred to anaerobic fermentation for 16 h. Succinate reached 14.84 g/L, with a productivity of 0.83 g/(L x h). Compared to C. glutamicum SA001, the activity of ICL of the recombinant strain was increased 5.8-fold, and the succinate productivity was increased 48%. Overexpression of isocitrate lyase will increase the metabolic flux of glyoxylate bypass flowing to succinate.
Corynebacterium glutamicum ; genetics ; metabolism ; Escherichia coli ; enzymology ; genetics ; Gene Deletion ; Industrial Microbiology ; Isocitrate Lyase ; biosynthesis ; genetics ; L-Lactate Dehydrogenase ; genetics ; Succinic Acid ; metabolism ; Transduction, Genetic

Objective To observe and compare the clinical characteristics of colorectal related multiple primary carcinoma (MPC) and colorectal carcinoma (CRC) for promoting early diagnosis and treatment of colorectal related MPC. Methods Pathological and clinical documents of clearly staged CRC and colorectal related MPC cases from Jul. 1997 to Nov. 2007 were retrospectively analyzed. Results 573 colorectal carcinoma cases were analyzed, including 45 MPC (7.85 %). Parenteral multiple carcinoma originated most frequently from stomach, and then breast, ovary, lung, small intestine and other sites. Among all multiple primary colorectal carcinomas (MPCC), ascending colon carcinoma was most frequent (34.0 %).While among CRC cases, rectal cancer cases was most frequent(36.5 %). Comparing CRC and MPCC, there were no significant difference in terms of tumor family history. Median morbidity age was 57 years and 63 years respectively. Cases with previous colonic polyps accounted for 20.0 % of all MPC cases, while only 0.9 % of all CRC cases. The mOS of CRC and MPC was 93.7 month and 64.8 month respectively. Most frequent pathological type of CRC and MPC were both well-moderately differentiated adenocarcinoma, but more mucinous adenocarcinoma cases were observed in MPC. Conclusion Colorectal related MPC are relatively common among colorectal carcinoma patients. More patients with MPC especially MPCC has colonic polyp. mOS of MPC is shorter than that of CRC, indicating the poor prognosis of MPC compared with CRC.MPCC has multiple colonic polyps, shorter interval of secondary carcinomas, and shorter mOS, worse prognosis than MPC with parenteral tumor.

10.3969/j.issn.1007-3969.2013.04.009

Objective:Influence of clinicopathological characteristics and different therapy patterns on the overall survival of patients with gastric cancer with bone metastasis was investigated. Methods:A total of 146 gastric cancer patients with bone metastasis were enrolled from December 1996 to December 2014. Data of clinicopathological characteristics, treatment methods, and overall survival were collected. Univariate and multivariate analyses were performed using log-rank tests and Cox's proportional hazard model, respec-tively. Results:A total of 51 (34.9%) patients had synchronous metastasis, while 95 (65.1%) had metachronous metastasis. Moreover, 35 (24.0%) patients only had bone metastasis, while 111 (76.0%) patients were complicated with other organ metastases, such as liver (30.0%), peritoneal (24.0%), lung (15.1%), and bone marrow (7.5%). After diagnosis of bone metastasis, bisphosphonates, bone radio-therapy and bone surgery were applied in 99 (67.8%), 34 (23.3%), and 5 (3.4%) patients, respectively. Additionally, 96 (65.6%) patients received palliative chemotherapy. The median overall survival was 5.8 months (95%CI:4.284-7.316). Multivariate analysis revealed that KPS<80 (P=0.030), bone marrow metastasis (P<0.001), elevated serum CA199 (P<0.001), and without palliative chemotherapy (P<0.001) were independent poor prognostic factors. Conclusion:The outcome of gastric cancer with bone metastasis is very poor, espe-cially in patients with bone marrow metastasis, worse KPS, and elevated CA199. Palliative chemotherapy may be beneficial for the sur-vival of these patients.

Objective To explore the serum level of Glucagon like peptide-1 in late-onset Alzheimer′s patients and its clinical significance.Methods Case control study.Collecting cerebral vascular disease fifty-five cases, diagnosed with late-onset Alzheimer′s disease sixty-one cases, type 2 diabetes mellitus fifty-one cases , type 2 diabetic patients combined with late-onset Alzheimer′s disease thirty-seven patients from the Shanghai East Hospital and partly Pudong area elderdly hospital during October 2013 to March 2014, and forty healthy persons as normal control from physical examination center of Shanghai East Hospital during September 2013 to February 2014.Measuring the concentrations of GLP-1,β-amyloid, Tau protein and other routinely used clinical tests in the serum of patients from the normal controls , cerebrovascular disease , late-onset Alzheimer′s disease, type 2 diabetes and type 2 diabetes mellitus combined with late-onset Alzheimer′s disease by ELISA method developed in our laboratory.The blood samples were also collected at three fixed time including fasting time ,1 hour after taking glucose , 2 hour after taking glucose, the concentrations of GLP-1 were determined in the LOAD group , T2DM group and the T2DM combined with LOAD group and normal control group.The concentrations of serum GLP-1 among groups were compared with single factor analysis of variance , and the concentrations of serum GLP-1 between the two groups were compared using LSD-t test.Analysing the correlation between GLP-1 and other indicators with Pearson analysis.Results The fasting GLP-1 levels of LOAD group were ( 123.4 ±20.8 ) nmol/L, and they were highest between the normal control group (78.6 ±6.0) nmol/L and the cerebral blood vessel disease group(89.0 ±8.7)nmol/L (F values were 3.46 and 1.98, P<0.05).The fasting GLP-1 levels of T2DM combined with LOAD group (157.9 ±28.6) nmol/L were higher than the LOAD group (123.4 ± 20.8) nmol/L (t =1.63,P <0.05), but there were no difference of the fasting GLP-1 levels between T2DM combined with LOAD group (157.9 ±28.6) nmol/L and T2DM group(153.8 ±18.0)nmol/L(t=0.96,P>0.05).Deficient secretion of GLP-1 after taking glucose 1 hour in most of the patients of T2DM combined with LOAD group (99.1 ±14.2) nmol/L, LOAD group(73.9 ±6.6 ) nmol/L and T2DM group (96.3 ±7.0 ) nmol/L could be concluded .The GLP-1 levels of T2DM combined with LOAD group after taking sugar 2 hour were (115.4 ±18.6)nmol/L ,and were higher than that of normal levels (63.3 ±6.2) nmol/L after taking sugar 2 hour(t=4.49,P<0.05).There were no difference between the GLP-1 levels of the LOAD group (73.6 ±5.8 )nmol/L and the GLP-1 levels of the normal group(63.3 ±6.2)nmol/L after taking sugar 2 hour (t=0.94,P>0.05).Pearson correlation analysis showed that the relationship of the levels of GLP-1 with Aβ( 1-42 ) and the levels of GLP-1 after taking glucose 1 h and 2 h were positively relative, and its coefficients of correlation were 0.401,0.436,0.722.Conclusions LOAD and T2MD are similar, and they have GLP-1 secretion shortage phenomenon after taking glucose , so monitoring dynamic change of GLP-1 after taking glucose may contribute to the auxiliary diagnosis of LOAD.

Objective To compare the difference of kidney function evaluated by using 3 different estimated glomerular filtration rate(GFR) equations in populations .Methods Retrospectively analyzed 65 856 patients who measured serum creatinine and Cysta‐tin C at the same time ,and come from the outpatients or inpatients of the hospital .The estimated GFR (eGFR) were calculated through 3 equations ,then compared the eGFR in the population and among different groups according to different kidney functions , and then grouped the people enrolled in the study again according to the eGFR calculated by using the 3 different equations and compared the differences among groups .Results Compared with the eGFR calculated by using Creatinine equation ,the correlation coefficients of the eGFRs calculated by using the other two equations were 0 .81 and 0 .90 ,respectively ,both P<0 .05 ;The differ‐ence between the means of eGFR were 6 .19 and 1 .79 mL/(min × 1 .73 m2 ) respectively with obvious significance (P<0 .01) ,in consistency analysis .There were obvious overestimation of kidney function when using Creatinine equation to calculate eGFR .Con‐clusion There is consistence and obvious difference by using the 3 CKD‐EPI′s eGFR equations .Physicians should choose suitable equations to evaluate kidney function in different populations .

Objective:To determine whether ox-LDL (oxdized low-density lipoprotein) is highly deposited on the uremic vessel wall and its influence on the vascular remodeling. Methods: Segments of radial arteries were obtained from 21 uremic subjects during the operation of A-V fistula prior to hemodialysis. Segments of internal thoracic arteries of similar diameter were obtained from patients with benign chest tumors as control.The vascular lesions and ox-LDL, CD68,MCP-1, eNOS,ET-1, PCNA,FN on the vessel wall were determined by means of H-E stain and immunohistochemistry. Results： With H-E stain,atherosclerotic plaques were found in the radial arteries of 4 uremic patients. The middle layer of the arteries in uremic patients were obviously thickened, and the T/D　(thickness of the wall/external diameter) ratio was significantly higher than those in control group(P<0.01). ox-LDL,CD68,MCP-1, ET-1, PCNA,FN on the vessel wall in uremic patients were much higher than those in control group (P<0.01). Moreover, ox-LDL on the vessel wall was positively related to the expression of other above mentioned substances on the vessel wall (P<0.01). Whereas the expression of eNOS on the vessel wall was lower than control group (P<0.01),and was negatively related to ox-LDL on the vessel wall(P<0.01). Conclusion: ox-LDL is an important factor contributing to uremic vascular remodeling by increasing the migration,adhesion and infiltration of monocyte,the proliferation of vascular smooth muscle cell and dysfunction of endothelia.