OBJECTIVETo study characteristic presentations of Brucellar spondylitis on MRI in order to improve the diagnostic level.

METHODSFrom October 2009 to December 2010,15 patients with Brucellar spondylitis were evaluated by MRI. They included 11 males and 4 females ranging in age from 31 to 64 (mean 49) years. The major clinical manifestations were different degrees of fatigue,fever and low back pain. All patients underwent MRI and treated with antibiotic drugs.

RESULTSBrucellar spondylitis was mostly localized at the lumbar spine with obvious bony hyperostosis in the vertebral periphery. Most foci were in the edge, anterior and middle parts of the vertebral body, with low signals on T1WI and mixed low signals on T2WI, and high signals on T2 fat suppression, mostly without significant changes in intervertebral space. Paraspinal abscess was observed in 5 cases. Thirteen cases involved the lumbar vertebrae, 1 case involved the thoracic and lumbar vertebrae, and 1 case involved the lumbar and sacral vertebrae. Two vertebrae were affected in 14 cases, and 3 vertebrae were affected in 1 case.

CONCLUSIONMRI can provide imaging clues for diagnosis and differential diagnosis of Brucellar spondylitis, and has a high clinical value.

Adult ; Brucellosis ; diagnosis ; Diagnosis, Differential ; Female ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Spondylitis ; diagnosis

Objective To investigate the correlations of serum neuregulin 4(NRG4)level with sex hormone and metabolism level in patients with polycystic ovary syndrome(PCOS).Methods A total of 87 PCOS patients were selected as the study subjects(PCOS group),and 90 healthy women(no reproductive system diseases,normal menstruation and normal sex hormone examination)were selected as the control group.Enzyme-linked immunosorbent assay(ELISA)was used to detect ser-um NRG4 level,glucose and lipid metabolism indexes and sex hormone indexes.Pearson method and multiple linear regression were used to analyze the correlation between serum NRG4 and various inde-xes in PCOS patients.Results The serum NRG4 level in PCOS group was(24.41±7.31)ng/mL,which was significantly higher than(15.43±4.26)ng/mL in the control group(P＜0.001).Com-pared with the control group,the levels of BMI,hypersensitive C-reactive protein(hs-CRP),fasting blood glucose(FBG),fasting insulin(FINS),insulin resistance index(HOMA-IR),triglyceride(TG),luteinizing hormone(LH),luteinizing hormone/follicle stimulating hormone(LH/FSH),prolactin and total testosterone in PCOS group were significantly increased(P＜0.05).Serum NRG4 levels in PCOS patients were positively correlated with BMI,hs-CRP,FBG,FINS,HOMA-IR,TG,LH,LH/FSH and total testosterone(P＜0.05);the BMI,FBG and TG were the influencing factors of serum NRG4 level(P＜0.05).Conclusion The increase of serum NRG4 level in PCOS patients is associated with abnormal glucose and lipid metabolism and sex hormone indexes.

Objective To investigate the correlations of serum neuregulin 4(NRG4)level with sex hormone and metabolism level in patients with polycystic ovary syndrome(PCOS).Methods A total of 87 PCOS patients were selected as the study subjects(PCOS group),and 90 healthy women(no reproductive system diseases,normal menstruation and normal sex hormone examination)were selected as the control group.Enzyme-linked immunosorbent assay(ELISA)was used to detect ser-um NRG4 level,glucose and lipid metabolism indexes and sex hormone indexes.Pearson method and multiple linear regression were used to analyze the correlation between serum NRG4 and various inde-xes in PCOS patients.Results The serum NRG4 level in PCOS group was(24.41±7.31)ng/mL,which was significantly higher than(15.43±4.26)ng/mL in the control group(P＜0.001).Com-pared with the control group,the levels of BMI,hypersensitive C-reactive protein(hs-CRP),fasting blood glucose(FBG),fasting insulin(FINS),insulin resistance index(HOMA-IR),triglyceride(TG),luteinizing hormone(LH),luteinizing hormone/follicle stimulating hormone(LH/FSH),prolactin and total testosterone in PCOS group were significantly increased(P＜0.05).Serum NRG4 levels in PCOS patients were positively correlated with BMI,hs-CRP,FBG,FINS,HOMA-IR,TG,LH,LH/FSH and total testosterone(P＜0.05);the BMI,FBG and TG were the influencing factors of serum NRG4 level(P＜0.05).Conclusion The increase of serum NRG4 level in PCOS patients is associated with abnormal glucose and lipid metabolism and sex hormone indexes.

CAR-T cell therapy that targets surface antigens to kill tumor cells specifically has recently become another cornerstone in tumor immunotherapy. In this study, a lentiviral expression plasmid of CAR targeting human epidermal growth factor receptor 2 (HER2) was constructed by genetic engineering. The recombinant plasmid was co-transfected with other packaging plasmids into HEK293T cells by calcium phosphate precipitation to generate lenti-car, which are CAR lentiviral particles. HER2-specific CAR-T cells were obtained by transducing human peripheral blood mononuclear cells with lenti-car. Their specific inhibitory effects on HER2-positive and HER2-negative tumor cells were analyzed in vitro. The constructed CAR-T cells were specifically activated by HER2-expressing tumor cells as indicated by secretion of IFN-γ and IL-2. The inhibitory rate on HER2-positive SK-OV-3 cell line was (58.47±1.72)%, significantly higher than that on the mock-treated control group (P<0.05). The inhibitory rate on HER2-negative K562 cell lines was (11.74±2.37)%, which was not significantly different from that on the control group (P>0.05). Furthermore, when we transfected a HER2-expressing vector into K562, the inhibitory rate increased to (30.41±7.59)%, which was higher than that on HER2-negative K562 (P<0.05). Thus, the constructed second-generation HER2-specific CAR-T cells specifically suppressed growth of tumor cells overexpressing HER2 protein, suggesting that HER2-specific CAR-T cells might prove useful for immunotherapy of HER2-positive cancer.

Objective: To improve the recognition of ectopic adrenocorticotropic hormone syndrome. Methods: The diagnosis and treatment of a 43 years old female patient with multiorgan involvement mimic dermatomyositis was analyzed and discussed. Results: The patient presented with fatigue, edema, skin pigmentation, neuropsychiatric abnormalities, hypertension, hypokalemia, hyperglycemia and other systemic involvement, was finally diagnosed with ectopic adrenocorticotropic hormone syndrome caused by paraganglioma of the anterior mediastinum. After surgical removal of the tumor, her clinical symptoms immediately relieved, meanwhile related hormone levels returned to normal. Conclusion Although paraganglioma-induced ectopic adrenocorticotropic hormone syndrome is rare in clinical practice, more attention should be paid to this specific situation.