Objective To evaluate the diagnostic evaluation of isotropic scanning and Lung Care soft- ware in solitary pulmonary nodules,and to improve the diagnostic accuracy.Methods 52 patients suffered from SPN were included in our study.Two experts in CT analyzed the films.First,they read the axial images and made diagnosis.Then isotropic scanning and lung care software approaches were used on 16 spiral CT and another analysis were made again.The results were compared with pathological diagnosis respectively. Results Spiculated sign,lobulated sign,vessel convergence were found more on isotropic scanning approach, that had significant difference with axial images analysis(P

To establish reference values of various immunophenotypic markers in B lymphocyte population in healthy Chinese adults and build background information for accurate interpretation of B cell immunophenotyping data in clinical practice, peripheral blood from 41 healthy adults were collected separately into test tubes containing EDTA-K(2) and stored in room temperature no more than 24 hours before analysis. Whole blood lysis technique and multiparameter flow cytometry were applied to immunophenotype B cells gated on CD19/SSC dot-plot. The results showed that CD22, CD20, CD62L, CD40, CD24, CD79b, CD79a, and FMC-7 were almost positive in the circulating B cell population, whereas CD11a, CD80, CD103, CD10, CD40L, CD54, CD95L, CD86, and CD95 were almost negative in the peripheral blood B lymphocytes. CD18, CD44, CD23, CD5, CD11c and CD43 were positive in different B cell subpopulations. 78% of B cells were IgD positive and ratio kappa/lambda was 1.26. The significance of all these markers in the differential diagnosis of lymphoproliferative diseases was discussed. The conclusion is that it is necessary to consider the qualitative and quantitative levels of expression of various markers in normal B cell population in order to accurately interpret the pathological immunophenotypic data in clinical practice. It is also important to note the immunotypic differences of B cells between Chinese and Western populations.
Adult ; Aged ; B-Lymphocytes ; immunology ; CD5 Antigens ; analysis ; Female ; Flow Cytometry ; methods ; Humans ; Immunophenotyping ; Intercellular Adhesion Molecule-1 ; analysis ; Leukemia, Lymphocytic, Chronic, B-Cell ; immunology ; Lymphoma ; immunology ; Male ; Middle Aged ; Receptors, IgE ; analysis

BACKGROUND: Mechanical ventilation is a double-edged sword to acute respiratory distress syndrome (ARDS) including lung injury, and systemic inflammatory response high tidal volumes are thought to increase mortality. The objective of this study is to evaluate the effects of dynamic ventilatory factors on ventilator induced lung injury in a dog model of ARDS induced by hydrochloric acid instillation under volume controlled ventilation and to investigate the relationship between the dynamic factors and ventilator-induced lung injuries (VILI) and to explore its potential mechanisms. METHODS: Thirty-six healthy dogs were randomly divided into a control group and an experimental group. Subjects in the experimental group were then further divided into four groups by different inspiratory stages of flow. Two mL of alveolar fluid was aspirated for detection of IL-8 and TNF-α. Lung tissue specimens were also extracted for total RNA, IL-8 by western blot and observed under an electronic microscope. RESULTS: IL-8 protein expression was significantly higher in group B than in groups A and D. Although the IL-8 protein expression was decreased in group C compared with group B, the difference was not statistically significant. The TNF-α ray degree of group B was significantly higher than that in the other groups (P<0.01), especially in group C (P>0.05). The alveolar volume of subjects in group B was significantly smaller, and cavity infiltration and cell autolysis were marked with a significant thicker alveolar septa, disorder of interval structures, and blurring of collagenous and elastic fiber structures. A large number of necrotic debris tissue was observed in group B. CONCLUSION: Mechanical ventilation with a large tidal volume, a high inspiratory flow and a high ventilation frequency can cause significant damage to lung tissue structure. It can significantly increase the expression of TNF-α and IL-8 as well as their mRNA expression. Furthermore, the results of our study showed that small tidal ventilation significantly reduces the release of pro-inflammatory media. This finding suggests that greater deterioration in lung injury during ARDS is associated with high inspiratory flow and high ventilation rate.

Objective To describe a novel surgical technique for male long-segment urethral stric- ture after pelvic trauma using the intact and pedieled pendulous urethra to replace the bulbar and membra- nous urethra,and then reconstructing anterior urethra.Methods Three patients with long-segment post- traumatic bulbar and membranous urethral strictures with short left pendulous urethras who had undergone several failed previous surgeries were treated with staged pendulous-prostatic anastomotic urethroplasty fol- lowed by reconstruction of the anterior urethra.This procedure was divided into 3 stages.The first-stage sur- gery was mobilization of anterior urethra down to the coronary sulcus and then re-routing the prostatic urethra followed by pendulous-prostatic anastomotic urethroplasty with transposition of penis to perineum.The sec- ond-stage surgery was transecting the anterior urethra at the site of coronary sulcus 6 months later when it was re-vaseularized,then straightening the penis and performing urethroperineostomy.The third-stage surgery was reconstruction of anterior urethra 6 months later.Results Case 1 reported satisfactory voiding postopera- tively.Retrograde urethrography showed that the urethra was patent with no post-voiding residual urine (PVR),and bilateral vesicoureteral reflux almost disappeared.The Qmax was 18.8ml/s,and 18ml/s after the third stage surgery and at 2-year follow-up.Case 2 also had satisfactory voiding.A 22F urethral catheter could smoothly pass through the urethra,and Qmax was 19.5 ml/s with no PVR at 2-year follow-up.Case 3 underwent the first stage surgery through perineal and pubic routes.The urethrorectal and urethroperineal fis- tulas were excised and repaired simultaneously.After operation the fistulas healed,but the stenostomia resul- ting from wound infection needed further treatment.Conclusions This procedure is effective for men with complex long-segment post-traumatic bulbar and membranous urethral strictures,especially for those undergo- ing failed previous surgical treatment.

Abstract: Objective （ ） To evaluate the internal exposure levels and risk in nuclear medicine workers NMWs engaged in Methods radionuclide therapy in Guangdong Province. A total of 61 NMWs from eight hospitals in Guangdong Province were selected as the study subjects using the convenient sampling method. The 0.364 MeV full energy peak efficiency was detected in （ ） in vitro ， - deltoid muscle of right upper arm as background and thyroid gland by direct measurement method and the iodine 131 （131 ） Results ，131 I activity in thyroid gland was calculated to evaluate the internal irradiation level. Among the 61 NMWs I was ， detected in the thyroid gland of four nuclear medical staffs in three hospitals and the detection rate was 6.6%. The median and - ［M（ P-P ）］ 131 （ - ） 0 100 percentile 0 100 of thyroid I activity were 42.9 35.1 47.1 Bq. When assuming that the monitoring period was ， M（ P-P ） （ - ） ， 30 days the 0 100 of single committed effective dose in thyroid gland was 0.014 0.011 0.015 mSv and the annual dose （ - ） Conclusion of internal irradiation was 0.162 0.132 0.180 mSv/a. The internal exposure of NMWs in the eight hospitals in （ ） ， Guangdong Province meets the annual effective dose limits ≤20.000 mSv/a . However it is necessary to pay attention to the internal radiation protection of NMWs and take reasonable protective measures to reduce the internal exposure risk of NMWs.

OBJECTIVETo explore the role of hypoxia-inducible factor 1alpha (HIF-1α) in early lung fibrosis of rats with acute paraquat (PQ) poisoning.

METHODSForty eight healthy SD rats were randomly divided into control group (6 rats) and paraquat poisoning group (42 rats). Control group was exposed to 1 ml normal solution by gastric gavage. The paraquat group was exposed to 1 ml paraquat solution (50 mg/kg) by gastric gavage for 2, 6, 12, 48, 72 and 120 h, respectively. The arterial blood gas analysis (PaO(2)) was detected. The pathological examinations of lung tissues were performed by HE and Mason staining. HIF-1α in lung tissues were measured by immunofluorescence. Western blot assay was used to detect the expression levels of HIF-1α protein in lung tissues.

RESULTSPaO2 of rats exposed to paraquat for 72 h was (62.33 ± 0.22) mm Hg, which was significantly lower than that (96.00 ± 5.20) of control group (P < 0.05). Pathological examination by HE staining indicated that the acute diffuse lesion appeared in the alveolar capillary endothelium, epithelia and interstitial tissues, and there was the inflammatory cell infiltration in the alveolar of rats exposed to paraquat at 2 h after exposure. At 12 h after exposure, the interstitial edema in lung tissues of rats decreased and the alveolar space became narrow. At 120 h after exposure, there were the alveolar structure derangement, abundant cicatrix, more fibroblasts and peripheral inflammation absorption. Pathological examination by Masson staining showed that there was obvious collagen deposition in the alveolar epithelia at 2h after exposure, the increased collagen fibrosis at 24 and 48 h after exposure and the obvious damage of alveolar tissues or much more fibrous connective tissue deposition at 120 h after exposure. The results of western blot and immunofluorescence assays exhibited that the expression levels of HIF-1α in lung tissues at 2, 24 and 48 h after exposure significantly increased, as compared with control group (P < 0.05), but there were no significant differences of HIF-1α expression among sub-groups at different time points after exposure.

CONCLUSIONThe results of present study shown that there were the pulmonary fibrosis and increased expression of HIF-1α in acute PQ poisoning rats at the early stage, and HIF-1α may be associated with pulmonary fibrosis.

Acute Lung Injury ; chemically induced ; complications ; metabolism ; Animals ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Male ; Paraquat ; poisoning ; Pulmonary Fibrosis ; etiology ; metabolism ; pathology ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo evaluate the diagnosis and management of adrenal myelolipoma.

METHODSThe clinical data of 26 cases were analyzed retrospectively and the selected articles were reviewed. There were no specific clinical symptom and endocrine abnormality, except increasing catecholamine in 2 cases. All cases but two were diagnosed by B-model ultrasound scanning (B-US), CT or magnetic resonance imaging (MRI).

RESULTSTwenty-six cases were surgically treated, the diameter of the tumor was 5 - 10 cm, simple tumor resection was performed in 16 cases, and complete adrenal resection was performed in 10 cases. All the operated cases were proved by pathologists. The duration of follow-up was from 6 - 28 months after surgery. No recurrence was observed.

CONCLUSIONSThe diagnosis of adrenal myelolipoma could be established based on B-US, CT or MRI. The tumors whose diameter is larger than 5 cm in size should be removed.

Adrenal Gland Neoplasms ; diagnosis ; surgery ; Adrenalectomy ; Adult ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Myelolipoma ; diagnosis ; surgery ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVETo compare a side-to-side esophagogastric anastomosis with conventional hand-sewn or stapled esophagogastrostomy for prevention of anastomotic stricture by randomized clinical trial.

METHODSBetween November 2007 and September 2008, 160 patients with esophageal carcinoma or gastric cardia cancer were consecutively admitted and underwent surgical treatment. After excluding 5 patients (2 refused to participate in and 3 did not meet inclusion criteria), the remaining 155 patients were completely randomized to receive either a side-to-side esophagogastric anastomosis (SS group), or the conventional hand-sewn (HS group), or a circular stapled (CS group) anastomosis, after the removal of esophageal tumor. The primary outcome measured the incidence of anastomotic stricture at 3 months after the operation (defined as the diameter of the anastomotic orifice

RESULTSThere was 1 operative death (in HS group) and 1 simple exploration (in SS group). The anastomotic leakage was observed in 4 patients (2 cervical and 1 intrathoracic leaks in HS group, and 1 intrathoracic leak in CS group). The follow-up rate was 96.1% (1 patient in SS group, 3 in HS group, and 2 in CS group were lost). Finally 45 patients in SS group, 52 in HS group, and 47 in CS group were included in the analysis. The 3 groups were preoperative similar. The anastomotic stricture rate was 0% (0/45) in SS group, 9.6% (5/52) in HS group, and 19.1% (9/47) in CS group, respectively (Fisher exact probability test, P = 0.005). The reflux/regurgitation score among 3 groups was similar (chi(2) = 1.681, P = 0.432).

CONCLUSIONThe side-to-side esophagogastric anastomosis could prevent stricture formation, without increasing gastroesophageal reflux.

Adult ; Aged ; Aged, 80 and over ; Anastomosis, Surgical ; adverse effects ; methods ; Cardia ; Constriction, Pathologic ; etiology ; prevention & control ; Esophageal Neoplasms ; surgery ; Esophagus ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Stomach ; surgery ; Stomach Neoplasms ; surgery

OBJECTIVETo elucidate whether ZFP580 is involved in the cardioprotective effects of intermittent hypobaric hypoxia (IHH) against myocardial ischemia/reperfusion (I/R) injury.

METHODSThirty two male Wistar rats were randomly divided into 2 groups (n = 16): normoxia control group and IHH preconditioning group. Rats in IHH group were exposed in a hypobaric chamber (equivalent to an altitude of 5 000 m) for a 6 h period each day for 42 d. Plasma was collected and lactate dehydrogenase (LDH) and creatine kinase-MB (CK-MB) were measured after 2 h of myocardial I/R injury. ZFP580 protein expression in myocardial tissue was assayed by Western blot. Other 8 rats in each group were used to evaluate I/R-induced cardiac infarction by TTC staining. Lentivirus-mediated gene transfection was performed in H9c2 cells 72 h prior to simulated ischemia/reperfusion (SI/R) exposure. The degree of cell apoptosis was determined by annexin V/7-AAD staining and flow cytometry analysis.

RESULTSCompared with normoxia control group, adaptation to IHH attenuated infarct size and plasma leakage of LDH and CK-MB. In addition, ZFP580 expression in the myocardium was up-regulated by IHH. The results of gene transfection showed that ZFP580 overexpression significantly inhibited cells apoptosis induced by SI/R.

CONCLUSIONOur findings demonstrate that the cardioprotective effect of IHH against I/R injury is mediated via ZFP580, a novel transcription factor, with anti-apoptotic roles in myocardial cells.

Animals ; Apoptosis ; Cell Line ; Creatine Kinase, MB Form ; metabolism ; Hypoxia ; physiopathology ; L-Lactate Dehydrogenase ; metabolism ; Male ; Myocardial Reperfusion Injury ; physiopathology ; Myocardium ; metabolism ; Myocytes, Cardiac ; cytology ; Rats ; Rats, Wistar ; Transcription Factors ; metabolism

OBJECTIVETo investigate the effect of phenyl-hexyl isothiocyanate (PHI) on acetylation and methylation of histone in acute lymphoblastic leukemia cell line Molt4.

METHODSThe inhibition of cell proliferation was observed by MTT method and clone suppression test. Apoptosis and cell cycle arrest were measured by flow cytometry. The alterations in histone acetyltransferase and acetylation and methylation of histones were detected by Western blot.

RESULTSPHI could up-regulate the expression of acetyltransferase (P300/CBP), markedly induced the accumulation of acetylated histone H3, H4 and methylated histone H3 lysine 4 (H3K4), and inhibited methylation on lysine 9 of H3 (H3K9). The epigenetic regulation resulted in cell cycle arrest at G0/G1 phase, and induction of apoptosis.

CONCLUSIONSPHI can modulate both histone methylation and acetylation. It may serve as a histone deacetylase inhibitor, and might be a potential novel anti-leukemia agent.

Acetylation ; drug effects ; Apoptosis ; drug effects ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Epigenesis, Genetic ; Histone Deacetylases ; metabolism ; Histones ; metabolism ; Humans ; Isothiocyanates ; pharmacology ; Methylation ; drug effects