Child ; Child Health Services ; trends ; Delivery of Health Care ; organization & administration ; Education, Medical ; Hospitals, Pediatric ; economics ; organization & administration ; Humans ; Pediatrics ; trends ; Specialization ; Urban Population

Adrenal Cortex Hormones ; therapeutic use ; Antitubercular Agents ; therapeutic use ; Diagnosis, Differential ; Humans ; Sarcoidosis ; drug therapy ; epidemiology ; microbiology ; pathology ; Tuberculosis ; drug therapy ; epidemiology ; microbiology ; pathology

Background:Blood oxygenation level-dependent magnetic resonance imaging (BOLD-MRI) is a functional MRI technique which involves using the paramagnetic properties of deoxyhemoglobin to image the local tissue oxygen concentration.The purpose of this study was to investigate whether BOLD-MRI could evaluate hypoxia and angiogenesis of breast invasive ductal carcinoma (IDC).Methods:Ninety-eight female patients with IDC were retrospectively included in this research.All patients underwent breast BOLD-MRI at 3.0 T before surgery.R2* values of BOLD-MRI were measured.The expression of carbonic anhydrase IX (CA IX) and vascular endothelial growth factor (VEGF) was analyzed by immunohistochemistry.Spearman's correlation analysis was used to correlate R2* value with CA IX and VEGF levels.Results:Heterogeneous intensity on BOLD-MRI images was the main finding of IDCs.The mean R2* value was 52.8 ± 18.6 Hz.The R2* values in patients with axillary lymph node metastasis were significantly higher than the R2* values in patients without axillary lymph node metastasis (t =2.882,P =0.005).R2* values increased with CA IX level and positively correlated with the level of CA IX (r =0.616,P ＜ 0.001);however,R2* value had no significantly correlation with the level of VEGF (r =0.110,P =0.281).Conclusion:BOLD-MRI could noninvasively evaluate chronic hypoxia of IDC,but not angiogenesis.

To study the expression of HCV non-structure 5 antigen in vitro, a human HepG2 cell line was incubated with a HCV RNA positive serum. The S ABC i mmunological techniques and gold-labeled colloid electron microscopy method wer e employed to examine for the viral proteins in those cells. The HCV non-struct ure 5 antigen was first detected in the HepG2 cells at 72 hours post incubation. The antigen was continuously observed in the cytoplasm or on the membrane as we ll on the cell wall of the HepG2 cells even after 1, 2, 3 and 4 weeks post incub ation. The observation of HCV non-structure 5 antigen continuously expressed in the HepG2 cells strongly indicates that the cells may have been infected by HCV virus and the virus may have replicated in the cells. Therefore, the HepG2 cell line may be served as a potential host for establishment of HCV infection and p ropagation in vitro.

Objective To evaluate the feasibility of dual-source computed tomography(DSCT)coronary angiography in a population with premature heart-beats.Methods Seventy patients with suspected coronary artery disease and premature heart-beats were routinely imaged on a DSCT scanner(Somatom Definition,Siemens AG,Germany).The images were reconstructed before and after ECG editing.Two readers independently assessed image quality of all coronary segments using a four-point grading scale from excellent(1)to non-assessable(4).The results ofthe two groups were compared with a paired t-test,and a P value of less than 0.05 Was considered significant.Results The mean heart rate during examination ranged from 49 to 111 bpm[mean(70.7±12.4)bpm].Twenty-eight of 70 patients with relatively small variability of the heart rate[(41.0±18.4)bpm]got diagnostic image quality without ECG editing.In other 42 patients with larger variability of the heart rate[(71.4±28.7)bpm],the meal image quality scores were 2.09±1.27 and 1.50±0.79 before and after ECG editing,there Was a significant difference(t=13.764,P＜0.01).The proportion of non-assessable segments Was reduced from 24.8%(154/620)to 3.4%(21/620)through ECG editing(X2=121.846,P＜0.01).Finally,the diagnostic image accounted 98.0%(1014/1035)in all segments of 70 patients.Conclusion DSCT can provide diagnostic images for patients with premature heart-beats.The image quality in patients with larger variability of the heart rate can be significantly improved through ECG editing.

In this paper, the domestic varieties and quality standard of Leguminosae medicinal plants used in Tibetan medicine were analyzed. The results showed that there were 36 genera and 142 species (including varieties), as well as 64 medicinal materials varieties of Leguminosae plants were recorded in relevant literatures. In relevant Tibetan standards and literatures, there are great differences in varieties, sources, used parts, and efficacy of medicinal plants. Among them, about 38.0% (including 54 species) of the endemic plants, about 25.4% (including 36 species) of the original plants have medicinal standard legal records, except 9 kinds of traditional Chinese medicine general quality standard more fairly completed, the most varieties have only description about characters, identification, etc. Therefore it is necessary to reinforce study for the herbal textual, resources and the use present situation, chemical components and biological activity, quality standard, medicinal terms specification, to promote establishment of quality standard system for variety-terminologies-sources of Tibetan medicinal plants.
Fabaceae ; Medicine, Tibetan Traditional ; standards

In this paper, the popular domestic varieties and quality standard of Scrophulariaceae plants used in Tibetan medicine were analyzed. The results showed that there were 11 genera and 99 species (including varieties), as well as 28 medicinal materials varieties of Scrophulariaceae plants were recorded in the relevant literatures. In relevant Tibetan standards arid literatures, there are great differences in varieties, sources, parts, and efficacies of medicinal plant. Among them, about 41.4% (including 41 species) of endemic plants, about 15.2% (including 15 species) of the original plants have medicinal standard legal records, except the medicinal materials of Scrophalaria ningpoensis, Lagotis brevituba, Picrorhiza scrophulariiflora, Veronica eriogyne general, most varieties have not completed quality standard. Consequently it is necessary to reinforce the herbal textual, resources and the use present situation investigation, the effects of the species resources material foundation and biological activity, quality standard, specification the medical terms of the plants, and promote Tibetan medicinal vareties-terminologies-sources such as the criterion and quality standard system for enriching the varieties of Tibetan medicinal materials and Chinese medicinal resources.
Drugs, Chinese Herbal ; chemistry ; pharmacology ; Humans ; Medicine, Tibetan Traditional ; standards ; Plants, Medicinal ; chemistry ; classification ; Scrophulariaceae ; chemistry ; classification

OBJECTIVETo study the clinicopathologic features of pure mucinous carcinomas of the breast with diffuse micropapillary pattern.

METHODSTwenty-six cases of micropapillary variant of pure mucinous carcinoma of the breast were retrospectively reviewed by light microscopy, immunohistochemistry and clinical data analyses.

RESULTSThe age of 26 female patients ranged from 30 to 77 years old, of which 12 cases with clinical details available were mean 54 years old. The tumor diameter ranged from 0.8 to 9.0 cm (mean 3.2 cm). Ipsilateral axillary nodal metastases were identified in 3 cases. Cutaneous involvement was also found in 2 cases. The tumor cells showed the similar architectural arrangement as in invasive micropapillary carcinoma, with peripheral borders of the cell clusters highlighted by epithelial membrane antigen. Various amount of mucin occupied the retraction spaces around the tumor cells. Compared with conventional pure mucinous carcinoma of the breast, mucinous carcinomas with micropapillary pattern showed different nuclear grades (19 cases of grade I, 2 cases of grade II, 5 cases of grade III). The micropapillary cell clusters varied in size (22 cases of big micropapillary and 4 cases of small). Intraductal carcinoma was observed in 12 cases. Calcification and psammoma bodies were observed in 8 cases. Immunophenotyping, the tumor cells were with higher expression of hormone receptors, but HER2 were negative. Ki-67 positive index was 1% ∼ 70%. Neuroendocrine differentiation was observed in 6 cases.

CONCLUSIONSThe micropapillary variant of pure mucinous carcinoma of the breast, which mainly occurs in younger women, may carry the similar propensity for angioinvasion and nodal metastasis as infiltrating micropapillary carcinoma at least in cases with high nuclear grade. This morphologic subtype needs to be distinguished from conventional pure mucinous carcinoma of the breast and treated properly.

Adenocarcinoma, Mucinous ; metabolism ; pathology ; surgery ; Adult ; Aged ; Breast Neoplasms ; metabolism ; pathology ; surgery ; Cadherins ; metabolism ; Carcinoma, Papillary ; metabolism ; pathology ; surgery ; Catenins ; metabolism ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Ki-67 Antigen ; metabolism ; Lymph Node Excision ; Lymphatic Metastasis ; Mastectomy, Modified Radical ; methods ; Middle Aged ; Mucin-1 ; metabolism ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Retrospective Studies

BACKGROUNDPulmonary capillary hemangiomatosis (PCH) is a rare disease and no Chinese case has been reported yet. The disease is often misdiagnosed and its clinical characteristics are incompletely described. The aim of this study was to describe two Chinese cases and to clarify the clinical and radiographic parameters of patients with PCH.

METHODSTwo PCH cases were presented and other cases were searched from the English literature. All available clinical and radiographic data were collected from 62 literature reported PCH cases. A pooled analysis of total 64 cases was made.

RESULTSDyspnea and hemoptysis were the most common clinical symptoms of PCH. Pulmonary hypertension (PH) was found in 78% of the reported cases. PCH typically showed characteristic diffuse or patchy ground-glass opacities (GGOs) and/or multiple ill-defined centrilobular nodules in the computed tomography.

CONCLUSIONSThe diagnosis of PCH requires a high clinical suspicion. However, both clinical presentations and radiographic studies often provide clues to the diagnosis, which may prompt early lung biopsy for a definite diagnosis.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Hemangioma, Capillary ; complications ; diagnosis ; Humans ; Lung Neoplasms ; complications ; diagnosis ; Male ; Middle Aged ; Tomography, X-Ray Computed

OBJECTIVETo study the clinical features and histopathology of the neuroendocrine carcinoma (NEC) of the breast.

METHODSTwenty-two cases of NEC of the breast were analysed by morphology and immunohistochemistry using synaptophysin, chromogranin A, NSE, CD56, estrogen receptor (ER), progesterone receptor (PR), HER2, EGFR, CK5/6, CK14, p63, E-cadherin, p120, p53 and Ki-67 staining. HER2 gene amplification was detected by fluorescence in situ hybridization (FISH) for cases with HER2 protein expression 2+. The diagnosis of breast NEC relies on the expression of neuroendocrine markers expression in more than 50% of tumor cells, and no evidence of neuroendocrine carcinoma in any other parts of the body at the same time.

RESULTSThe patients aged from 31 to 96 years (mean 65.2 years), and all were female but one. Amongst the 22 patients studied, the NECs were in the left breast in 15 cases (68.2%) and in the right breast in seven cases (31.8%); the tumor size was 0.5 to 5.5 cm (mean 2.7 cm). Lymph node metastasis was found in six cases. Basing on the morphologic features, these 22 cases were categorized into six subtypes including nine cases of solid cohesive, six of mucinous, three of solid papillary, two of small cell, one of large cell and one of alveolar variants. Immunohistochemically, the expression rate of markers was 100% (22/22) for synaptophysin, 12/13 for NSE, 54.5% (12/22) for chromogranin A, and 5/16 for CD56. Also, 90.5% (19 of 21) of cases expressed ER, 81.0% (17 of 21) of cases expressed PR, and none expressed EGFR, CK5/6, CK14 and p63. HER2 protein over-expression (3+) and gene amplification was not detected in any case. All cases (19/19) were positive for membrane staining for E-cadherin and p120. p53 expression was seen in 6 of 17 cases. Ki-67 labeling index was less than 3% in 9.5% (2/21) of the cases, 3% to 20% in 66.7% (14/21) of the cases and more than 20% in 23.8% (5/21) of the cases. Both cases of HER2 (2+) did not show gene amplification by FISH. On the basis of immunophenotypes, most of the breast NECs were of the luminal molecular subtype, but not HER2-overexpression or basal-like subtypes.

CONCLUSIONSNEC of breast more likely occurs in elderly patients and in the left breast than the right breast. The most common morphology is the solid cohesive subtype, followed by the mucinous variant.

Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; classification ; metabolism ; pathology ; surgery ; Breast Neoplasms, Male ; classification ; metabolism ; pathology ; surgery ; Cadherins ; metabolism ; Carcinoma, Neuroendocrine ; classification ; metabolism ; pathology ; surgery ; Chromogranins ; metabolism ; Female ; Follow-Up Studies ; Humans ; Lymphatic Metastasis ; Male ; Mastectomy ; methods ; Middle Aged ; Phosphopyruvate Hydratase ; metabolism ; Prognosis ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Synaptophysin ; metabolism