Child ; Clinical Laboratory Techniques ; Humans ; Microbiological Techniques ; Viral Load ; Virus Cultivation ; Virus Diseases ; diagnosis

Objective To evaluate the clinical significance of 18F-FDG PET/CT in localization and etiologic diagnosis of suspected pacemaker-related infection(SPRI).Methods Fifteen SPRI patients (10males,5 females,age range:45-86 years) were included in this retrospectively study.18F-FDG uptake in device-related region and abnormal 18F-FDG uptake out of the device region were visually interpreted.Final diagnosis was decided according to modified Duke's criteria and imaging interpretation.Diagnostic efficiency of 18 F-FDG PET/CT on SPRI was evaluated.Results Of 7 patients with suspected pocket infection,5 patients had hot spot of 18F-FDG in the pocket site,either in superficial skin and/or deep soft tissue.Of 9 patients with suspected infective endocarditis,a diffuse FDG uptake was demonstrated in 3 patients in the area of left atrium,right atrium,and right ventricle;another 3 patients had abnormal FDG uptake in other sites rather than in the implantation regions,and the rest 3 showed negative PET/CT results.In patients with SPRI,18F-FDG PET/CT diagnosed 7 cases of pocket infection,8 cases of infective endocarditis,14 cases of pacemaker-related infection.Conclusions 18F-FDG PET/CT imaging is useful in localization and etiologic diagnosis in SPRI patients.It might guide the clinical SPRI management.

Objective To investigate the value of 99Tcm-MDP imaging for the differential diagnosis between infection and aseptic loosening after total hip arthroplasty.Methods During February 2008 to August 2011,74 patients (32 males,42 females,average age (64.3±11.2) years) with hip pain after arthroplasty underwent 3-phase (blood flow,blood pool and bone phases) 99Tcm-MDP imaging.All patients had measurements of serum C reactive protein (CRP) and erythrocyte sedimentation rate (ESR).Joint infection was defined as either increased peri-prosthetic soft tissue activity during perfusion and blood pool phases or increased peri-prosthetic bone activity during uptake phase,or positive in all 3 phases.Aseptic loosening was defined as having negative 99Tcm-MDP in all 3 phases.Clinical diagnosis was chosen as the gold standard.The blood flow-pool imaging was compared with the serum examinations.x2 test was used for statistical analysis.Results There were 74 symptomatic joints in 74 patients,including 24 joint infections and 50 aseptic loosening.For the detection of peri-prosthetic infection,combined perfusion-blood-pool phase was more accurate than bone uptake phase (90.5％ (67/74) vs 55.4％ (41/74) ;x2=23.159,P＜0.001),with the sensitivity of 91.7％ (22/24)vs 70.8％ (17/24) and specificity of 90.0％ (45/50) vs 48.0％ (24/50),respectively.The blood flow-pool imaging was also more accurate than CRP (73.0％ (54/74) ;x2 =7.656,P＜0.05) and ESR (71.6％ (53/74) ; x2 =8.633,P＜0.05),respectively.Conclusion 99Tcm-MDP perfusion/blood flow-pool imaging is an accurate modality for differentiating peri-prosthetic infection from aseptic loosening in patients with hip pain after arthroplasty.

Child, Preschool ; Diagnosis, Differential ; Humans ; Male ; Myositis Ossificans ; diagnosis ; diagnostic imaging ; pathology ; physiopathology ; Prognosis ; Tomography, X-Ray Computed

To investigate the status of application of Chinese Hypertension Prevention and Treatment Guideline (Guideline) by general practitioners (GPs) in Shanghai.A questionnaire survey was conducted among 260 GPs from 8 communities in Xuhui District of Shanghai during March 2011 to December 2012.Among all participants,94.2％ knew the Guideline.The overall correct rate was 56.2％; that of epidemiology,diagnosis,treatment,two-way referral and community management of hypertension was 49.2％,54.5％,60.6％,56.9％ and 32.3％,respectively.There were significant differences in correct rates of the questionnaire between GPs with different age,gender,education and community (P =0.000,0.035,0.000,0.000).The correct rates of epidemiology and treatment in GP teaching bases (58.5％ and 62.6％) were higher than those in non-teaching bases (39.2％ and 58.4％) (P =0.002,0.040).But there was no difference in overall correct rate between these two groups (P =0.095).The results indicate that the understanding and application of Hypertension Guideline by General practitioners in community is insufficient.Teaching hospitals should carry out systematic,comprehensive,sustained,targeted training course in order to improve the diagnosis and treatment levels of hypertension for general practitioners in community.

Objective To report the clinical and magnetic resonance imaging(MRI)features of 5 eases with idiopathic orbital myositis.Methods Four females and one male,aged 27 to 57 years,presented department of neurology in the First Hospital of Peking University in October 2008 to September 2009.The duration of disease Was between 3 months and 4 years.Recurrent course appeared in 3 of them.0rbital MRI Was performed in all of them.After diagnosis they underwent long.term corticosteroid treatment.Results All patients presented ocular pain,asymmetrical and incomplete ophthalmoplegia and mild proptosis.EMG revealed no significant decline in repetitive stimulation.Muscle biopsies of limb muscle were unremarkable.Creatine kinase and thyroid function test were in normal limits.MRI revealed unilateral.focal or difluse enlargement and enhancement of extraocular muscles,involving 1 extraocular muscle in 2 cases,2extraocular muscles in 2 cases,more extraocular muscles in 1 case.No evidence indicated bone destruction or cavernous sinus abnormalities.Five Cases showed improvement and remission after long-term administration of steroids.Conclusion Persistent and asymmetrical ophthalmoplegia is connnon in orbital myositis.Extraocular muscle swelling characterized the MRI changes.

Objective To evaluate skin barrier function in patients with atopic dermatitis (AD),and to assess its relationship with claudin-1 expression.Methods Totally,11 patients with AD and 11 healthy human controls were recruited in this study.A Tewameter TM210 was used to measure transepidermal water loss (TEWL) value,and high-frequency ultrasound to determine epidermal thickness and density,in lesional and non-lesional skin of the patients and normal skin of the healthy controls.A double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) was performed to determine the serum level of free claudin-1 in these subjects.One-way analysis of variance and t test were carried out to compare these parameters in different groups,and Pearson's correlation analysis to estimate the relationship between different parameters.Results The TEWL value was significantly higher in lesional skin than in nonlesional skin of patients with AD and normal skin of the healthy controls ((36.9 ± 34.2) vs.(9.1 ± 6.0) and (4.4 ± 3.1) g·m-2·h-1,both P＜ 0.05).The epidermal thickness in AD lesions was (0.23 ± 0.04) mm,significantly higher than that in nonlesional skin ((0.18 ± 0.03) mm,P ＜ 0.01) and normal control skin ((0.18 ± 0.02) mm,P ＜ 0.01).Ultrasound images revealed a characteristic subepidermal low echo-genic band in the AD lesions.The patients with AD showed a significantly lower serum level of claudin-1 compared with the healthy controls ((0.80 ± 0.88) vs.(1.73 ± 1.85) μg/L,P ＜ 0.05).Moreover,the serum level of claudin-1 was negatively correlated with epidermal thickness (r =-0.61,P ＜ 0.01),but positively correlated with the inverse of TEWL (1/TEWL,r =0.44,P ＜ 0.05).Conclusions The impaired skin barrier function,which may be evaluated by TEWL,1/TEWL and epidermal thickness,is associated with the expression of claudin-1 in patients with AD.

Objective Study the anti-tumor effects in vivo of AMH-D on S-180 cell lines, the synergistic effects of AMH-D and cyclophosphamide,and investigate the way and its strength of the effect. Provide the basis for the development of anti-cancer drug. Methods Kunming mice were transplanted with S-180 tumor cells subcutaneously in the right armpit. Intraperitoneal injection was done after randomization on the next day. Mice were killed on the eleventh day, and tumors were stripped and weighed. The tumor weight was used as indicator for analysis and evaluation. Results The results showed that AMH-D could effectively inhibit the growth of S180 cells transplanted tumor. The tumor inhibition rate was 50.45%at the dose of 150 mg/kg, with a dose-effect relationship. There were no obvious impacts on the growth of the weight of mice. The results showed that AMH-D had a synergistic effect combined with cyclophosphamide within a certain dose. Conclusion Fungus extract AMH-D has a great effect on anti-tumor in vivo of S180 cells transplanted tumor, and has a synergistic effect combined with cyclophosphamide within a certain dose.

Objective To explore the differentiation potential of bone marrow stromal cells (BMSC) to enteric neuron in vitro and to seek proper induction methods.Methods BMSC were harves- ted from male rats and cultured in DMEM supplemented with 20% fetal bovine serum,and characterized by flow cytometry.At passage 6,BMSC were pre-induced by basic fibroblast growth factor (bFGF,10 ng/ml) for 24 h,then induced in two groups:glial cell-line derived neurotrophic factor (GDNF) group, 10 ng/ml GDNF in fetal gut condition medium (FGCM) for 10 d.Vitamin A acid (VA) group,VA, zinc in FGCM for 10 d.The expressions of neuronal markers,neural specific enolase (NSE) and neu- rofilament (NF),glial cell marker,glial fibrillary acidic protein (GFAP),enteric neuronal marker,pro- tein gene production 9.5(PGP9.5),nitric oxide synthase (nNOS),enteric neural transmitter,vasoactive intestinal peptide (VIP) were detected by fluorescent immunohistochemistry method.Results The cul- tured BMSC were CD90 positive and CD45 negative on flow cytometry.After 10 d of induction,a certain number of cells adopted neuron-like morphological changes and showed the expressions of NSE,NF, PGPg.5,nNOS and VIP without the expression of GFAP by fluorescent immunohistoehemistry method in both groups.But in GDNF group,the positive rate of NF,PGP9.5,nNOS and VIP was significantly higher than that in VA group (75.6%?8.4% vs 48.5?7.5%;57.7%?6.5% vs 35.7%?7.2% 46.6%?5.4% vs 30.5%?6.6%;72.3%?6.7% vs 40.4%?7.4%;P＜0.01).Conclusion BMSC can be induced to differentate into enteric neuron in vitro by different methods.GDNF with FGCM can induce higher rate of enteric neuron like cells compared with VA etc.

Type 2 diabetes mellitus is a kind of chronic metabolic disease,accompanied by multiple organ damages and involving the skeletal system as well.Osteoporosis is the most likely bone lesions suffered by patients with type 2 diabetes.The study found that,type 2 diabetic patients,compared with the normal people,will suffer from fracture at high risk,due to the decreased of bone quality and the increased risk of falling.The decrease of bone quality are the result of the deterioration of bone architecture and the loss of bone mass.The abnormal gait as well as the impairment of cognitive and the muscle weakness of type 2 diabetes,especially for elderly patients,will reduce their balance ability and increase their risk of falling,lead to an increased prevalence of fractures.