Objective To develop a multiplex PCR-based reverse line blot(mPCR/RLB) hybridization assay to detect,simultaneously,seven genes encoding AR-erm(A/TR),erm(B),mef(A/ E),tet(M),tet(O),aphA-3,aad-6 and two AR-related genes,int-Tn and mreA in group B streptococcus.Methods Nine pairs of specific primers and Oligonucleotide probes targeting erm(A/TR), erm(B),mef(A/E),tet(M),tet(O),aphA-3,aad-6 int-Tn and mreA respectively were modified according to former studies or designed in this study.The primers and probes were labeled with biotin and amino,respectively.The nine genes were amplified simultaneously in the same tube.PCR product hybridized with the probes labeled in the BiodyneC nylon membrane to detect the nine genes.To detect the sensitivity and specificity of the method developed,PCR with single pair of primer targeting each gene were tested in 318 isolates tested and the results were compared with the one abtained by RLB.Results The nine resistance-related genes could be successfully detected by mPCR/RLB assay developed in this study.Based on sequencing,21 of 22 isolates with mef had mef(E)and eight of 353 with int-Tn had an atypical sequence.Except for the above 29 genes,all the others corresponded well with the results obtained by single pair primer PCR.Conclusion The mPCR/RLB assay developed in this study is simple,rapid and suitable for surveillance of antibiotic resistance in GBS.

This study examined the effect of different b values on diffusion-weighted MR imaging (DWI) of human prostate by using single-shot spin echo echo planar imaging (SE-EPI) sequences, observed the normal appearances and measured apparent diffusion coefficient (ADC) values in anatomical regions of normal prostate. Twenty-four healthy volunteers (mean age: 32 y) were studied by using a 1.5T system with a phased array surface multicoil. Two kinds of single-shot SE-EPI sequence were used to perform DWI in the prostate in volunteers, with five b values being 0, 30, 300, 500 to 1000 s/mm(2). The image quality with different imaging parameters was analyzed and the ADC values in anatomical regions of normal prostate were measured. DWI of prostate was successfully obtained in all volunteers. The images were of good quality, without artifacts containing pixels within the prostate. The contrast was good between the different anatomical regions of the prostatic gland, i.e., the peripheral zone (PZ), which exhibited higher signal intensity, and the central gland (CG). Signal intensity contrast was related to the magnitude of b values. The ADC values in PZ and CG were (1.27+/-0.22)x10(-3) mm(2)/s and (1.01+/-0.17)x10(-3) mm(2)/s, respectively. The ADC values were found to be significantly higher in PZ than in CG (P<0.05, paired t-test). Significant differences were found between the slice-selecting component and both the read-out and phase-encoding components of the ADC values. It is concluded that SE-EPI is a suitable DWI sequence for human prostate. The contrast between PZ and CG is good when b values are low, while the diffusion and ADC values are accurate when b values are high. ADC values are higher in PZ than in CG in normal prostate. Diffusional anisotropy is present in normal prostatic tissue.
Magnetic Resonance Imaging/*methods ; Prostate/*anatomy & histology

Antitumor effect of combined transfer of suicide gene and cytokine gene was evaluated in the present study. Adenoviruses expressing E. coli. cytosine deaminase (AdCD) and adenoviruses expressing murine interleukin 2 (AdTL2) were used for the treatment of tumor-bearing mice. The mice were inoculated s. c. with FBL-3 leukemia cells and 3 days later received intratumoral injection of AdCD in the presence or absence of AdIL2 followed by intraperitoneal 5-fluorocytosine (5FC) administration. The results demonstrated that tumor-bearing mice treated with AdCD/5FC in combination with AdTL2 showed more .potent inhibition of tumor growth and survived much longer as compared with mice treated with AdCD/5FC, AdEL2, AdlacZ/5FC or PBS. It was illustrated that the tumor mass showed obvious necrosis and inflammatory cell infiltration, and more CD4+ and CD8+ T cells infiltrated into the tumor after combined therapy. The splenic NK and CTL activities increased significantly in mice after combined transfer of CD gene and EH gene. Our results demonstrated that combined transfer of suicide gene and IL-2 gene could inhibit the growth of established tumor in mice significantly and induce antitumor immunity of the host efficiently.

BACKGROUNDRepair of anterior mitral leaflet (AML) prolapse is still a technical challenge for cardiac surgeons. It is an important issue to find a way to repair the AML prolapse with a reliable and reproducible technique.

METHODSBetween January 2002 and June 2009, the operation of chordal transfer based on the "edge-to-edge" technique was performed in 21 patients with serious mitral valve regurgitation because of prolapse of the anterior leaflet. After the operation, echocardiography was performed in each patient before discharge and at the time of follow-up.

RESULTSAll patients survived the operation. One patient required mitral valve replacement because of anterior leaflet perforation 3 days after the operation. The other patients were free from reoperation. At the time of follow-up, all these patients were in New York Heart Association (NYHA) functional class I. In all these patients, pre-discharge and follow-up echocardiography showed neither stenosis nor significant regurgitation of the mitral valve: the cross-sectional area of the mitral valve was 3.3 - 4.8 cm(2) (mean (3.78 ± 0.52) cm(2)), the mean regurgitation area was (0.45 ± 0.22) cm(2). At the same time, both dimension of left atrium and left ventricle reduced significantly (left atrium diameter: pre-operation (48.26 ± 11.12) mm, post-operation (37.57 ± 9.56) mm, P < 0.05; the end-diastolic diameter of the left ventricle: pre-operation (61.43 ± 8.24) mm, post-operation (42.35 ± 10.79) mm, P < 0.01).

CONCLUSION"Edge-to-edge" chordal transfer technique is a simple, reliable, and reproducible technique that can provide good results for repair of anterior leaflet prolapse of mitral valve.

Adolescent ; Adult ; Aged ; Chordae Tendineae ; surgery ; Echocardiography ; Female ; Humans ; Male ; Middle Aged ; Mitral Valve ; surgery ; Mitral Valve Prolapse ; diagnostic imaging ; surgery ; Suture Techniques

BACKGROUNDIt is still a challenge for the cardiac surgeons to achieve adequate revascularization for diffused coronary artery disease (CAD). Coronary endarterectomy (CE) offers an alternative choice of coronary artery reconstruction and revascularization. In this study, short-term result of CE combined with coronary artery bypass graft (CABG) was discussed in the treatment for the diffused CAD.

METHODSFrom January 2012 to April 2014, 221 cases of CABG were performed by the same surgeon in our unit. Among these cases, 38 cases of CE + CABG were performed, which was about 17.2% (38/221) of the cohort. All these patients were divided into two groups: CE + CABG group (Group A) and CABG alone group (Group B). All clinical data were compared between the two groups, and postoperative complications and in-hospital mortality were analyzed. The categorical and continuous variables were analyzed by Chi-square test and Student's t-test respectively.

RESULTSDiabetes mellitus, hypertension, hyperlipidemia, and peripheral vascular disease were more common in group A. In this cohort, a total of 50 vessels were endarterectomized. Among them, CE was performed on left anterior descending artery in 11 cases, on right coronary artery in 29 cases, on diagonal artery in 3 cases, on intermediate artery in 2 cases, on obtuse marginal artery in 5 cases. There was no hospital mortality in both groups. The intro-aortic balloon pump was required in 3 cases in Group A (3/38), which was more often than that in Group B (3/183). At the time of follow-up, coronary computed tomography angiogram showed all the grafts with CE were patent (50/50). There is no cardio-related mortality in both groups. All these patients were free from coronary re-intervention.

CONCLUSIONSCoronary endarterectomy + CABG can offer satisfactory result for patients with diffused CAD in a short-term after the operation.

Aged ; Coronary Artery Bypass ; adverse effects ; methods ; Coronary Artery Disease ; surgery ; Endarterectomy ; methods ; Female ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Peripheral Vascular Diseases ; surgery ; Postoperative Complications ; Treatment Outcome

OBJECTIVESTo reveal the relationship of brain motion and cerebrospinal fluid (CSF) flow by phase-contrast cine MRI, and to evaluate this technique in differentiating between arachnoid cysts and subarachnoid space enlargement.

METHODSUsing a phase-contrast cine MRI pulse sequence, we measured brain motion and CSF flow during the cardiac cycle in 10 healthy volunteers and 10 patients with MRI-suspected arachnoid cyst or subarachnoid space enlargement. CSF stroke volume curve was illustrated according to flow quantification, and time-signal intensity curve was traced. The two curves were compared.

RESULTSThis study showed that brain motion was due to the volume difference between arterial and venous blood flow during a cardiac cycle, and thus drives CSF pulsation. Arachnoid cysts and subarachnoid space enlargement carried different curve patterns, demonstrating that phase-contrast MRI and flow quantification can be a useful and reliable technique for non-invasive evaluation of brain motion and CSF flow.

CONCLUSIONArachnoid cysts can be successfully differentiated using phase-contrast cine MRI from subarachnoid space enlargement.

Adult ; Arachnoid Cysts ; diagnosis ; Diagnosis, Differential ; Female ; Humans ; Magnetic Resonance Imaging, Cine ; Male ; Subarachnoid Space ; pathology

This study examined the effect of different b values on diffusion-weighted MR imaging (DWI) of human prostate by using single-shot spin echo echo planar imaging (SE-EP1) sequences,observed the normal appearances and measured apparent diffusion coefficient (ADC) values in anatomical regions of normal prostate. Twenty-four healthy volunteers (mean age: 32 y) were studied by using a 1.ST system with a phased array surface multicoil. Two kinds of single-shot SE-EPI sequence were used to perform DWI in the prostate in volunteers, with five b values being 0, 30, 300, 500 to 1000 s/mm2. The image quality with different imaging parameters was analyzed and the ADC values in anatomical regions of normal prostate were measured. DWI of prostate was successfully obtained in all volunteers. The images were of good quality, without artifacts containing pixels within the prostate. The contrast was good between the different anatomical regions of the prostatic gland, i.e.,the peripheral zone (PZ), which exhibited higher signal intensity, and the central gland (CG). Signal intensity contrast was related to the magnitude of b values. The ADC values in PZ and CG were (1.27±0.22)× 10-3 mm2/s and (1.01±0.17)× 10-3 mm2/s, respectively. The ADC values were found to he significantly higher in PZ than in CG (P<0.05, paired t-test). Significant differences were found between the slice-selecting component and both the read-out and phase-encoding components of the ADC values. It is concluded that SE-EPI is a suitable DWI sequence for human prostate. The contrast between PZ and CG is good when b values are low, while the diffusion and ADC values are accurate when b values are high. ADC values are higher in PZ than in CG in normal prostate. Diffusional anisotropy is present in normal prostatic tissue.

OBJECTIVETo investigate the clinicopathological features and the immunohistochemical phenotype of perianal Paget's disease (PPD) associated with internal anorectal adenocarcinoma, with emphasis on the histogenesis of Paget's cells.

METHODSThe clinical and pathologic features of three cases of PPD with rectal adenocarcinoma were investigated. Periodic-acid-Schiff (PAS), alcian-blue and mucicarmine staining with and without diastase digestion were performed. The immunohistochemical study was performed on selected sections by a panel of antibodies including carcinoembryonic antigen (CEA), CK7, CK8, CK10/13, CK20 and gross cystic disease fluid protein 15 (GCDFP15).

RESULTSAll three cases occurred in middle to old age male patients complaining of anal bleeding. Digital physical examination revealed ulcerated or cauliflower-like masses in the anus just distal to the dentate line. Perianal skin erythematous patches were found in two cases, and small discrete granules in one case. Histologically, the anorectal neoplasm was either a moderately or poorly differentiated adenocarcinoma. Two types of Paget's cells were noted, namely the classical type characterized by a polygonal shape with vesicular nuclei and abundant pale cytoplasm, and the signet ring type characterized by eccentrically displaced nucleus. Both the rectal adenocarcinoma cells and Paget's cells showed strong positivity for PAS, AB and mucicarmine, which were resistant to the diastase digestion. Immunohistochemically, they were both positive for CEA, CK7, CK8 and CK20, but negative for CK10/13 and GCDFP15.

CONCLUSIONSThe CK20(+)-GCDFP15(-) type Paget's cells in PPD were derived from the direct intraepithelial Pagetoid spread of anorectal adenocarcinomas. PPD was more frequently associated with internal carcinomas than any other type of extramammary Paget's disease. It is recommended that clinicians should carefully examine the anus or rectum in the presence of PPD to ascertain if it is associated with an internal carcinoma.

Aged ; Aged, 80 and over ; Apolipoproteins ; Apolipoproteins D ; Carrier Proteins ; analysis ; Diagnosis, Differential ; Glycoproteins ; analysis ; Humans ; Immunohistochemistry ; Intermediate Filament Proteins ; analysis ; Keratin-20 ; Male ; Membrane Transport Proteins ; Middle Aged ; Paget Disease, Extramammary ; chemistry ; diagnosis ; pathology ; Rectal Neoplasms ; chemistry ; diagnosis ; pathology

OBJECTIVETo explore the clinical value of magnetic resonance (MR) imaging in the diagnosis of the complications after breast augmentation with polyacrylamide hydrogel injection.

METHODSMRI was performed in 16 patients who had breast augmentation with polyacrylamide hydrogel injection. The results of magnetic resonance imaging were compared with the clinical symptoms.

RESULTSMRI examinations of the 16 patients showed that (1) 4 breasts in 2 patients were comparatively natural; (2) a large lacteal cyst was detected in one patients in lactation; (3) breast asymmetry occurred in 3 patients (6 sides); (4) in 10 patients (20 sides), the injected gel was in irregular form. The results of MRI were in accord with the clinical symptoms.

CONCLUSIONMRI is of great diagnostic value for the complications after breast augmentation with polyacrylamide hydrogel injection.

Acrylic Resins ; administration & dosage ; Adult ; Breast ; pathology ; Female ; Humans ; Injections ; Magnetic Resonance Imaging ; Mammaplasty ; adverse effects ; methods ; Postoperative Care ; Postoperative Complications ; diagnosis ; etiology ; Sensitivity and Specificity

OBJECTIVETo compare the differences of the efficacy and different therapeutic drugs on the treatment of benign prostatic hyperplasia (BPH) in order to ensure the optimal indication for different BPH patients.

METHODSA randomized, parallel-controlled, multicenter clinical trial was conducted. From September 2002 to December 2003 906 BPH patients were enrolled into 7 therapeutic groups, including selective-adrenoceptor antagonist (terazosin, doxazosin tamsulosin and naftopidil), 5 alpha-reductase inhibitor (finasteride and epristeride) and natural product (cernilton). International Prostate Symptom Score (IPSS) and Quality of Life (QOL), uroflowmetry, total prostatic volume (TPV) and transitional zone volume and residual urine were used as efficacy criteria.

RESULTSAccording to the baseline, the IPSS and Qmax were significantly correlated to the prostatic volume and transitional zone volume (P < 0.01). At average follow-up of 6 months, significant improvements in IPSS, QOL, Qmax and residual urine volume were observed in each therapeutic group, and no difference in IPSS improvement was found among the groups. Prostatic volume and transitional zone volume were significant decreased in 5alpha-reductase inhibitor groups (P < 0.05). In patients with baseline TPV greater than 35.5 cm3, the improvement of Qmax was more significant than that in patients with TPV less than 35.5 cm3 in finasteride group (P < 0.01) (5.7 ml/s and 2.2 ml/s respectively), and more significant symptomatic improvements were also found in cernilton, doxazosin and naftopidil group. In each group, the improvement of symptom were more significant in patients with IPSS higher than 20 points (P < 0.01).

CONCLUSIONSEach drug observed in this study can improve the subjective and objective symptoms significantly for BPH patients, especially for patients with higher IPSS baseline. When using 5alpha-reductase inhibitor, prostatic volume can be decreased significantly and more obviously subjective and objective improvement can be found in the patients with TPV greater than 35.5 cm3.

5-alpha Reductase Inhibitors ; Adrenergic alpha-Antagonists ; therapeutic use ; Aged ; Aged, 80 and over ; Androstadienes ; therapeutic use ; Double-Blind Method ; Doxazosin ; therapeutic use ; Enzyme Inhibitors ; therapeutic use ; Finasteride ; therapeutic use ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Naphthalenes ; therapeutic use ; Piperazines ; therapeutic use ; Plant Extracts ; therapeutic use ; Prazosin ; analogs & derivatives ; therapeutic use ; Prostate ; drug effects ; pathology ; physiopathology ; Prostatic Hyperplasia ; drug therapy ; Quality of Life ; Secale ; Sulfonamides ; therapeutic use ; Treatment Outcome