OBJECTIVETo explore the diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) combined with Surepath liquid-based cytology test for lung and mediastinal lymphadenopathy.

METHODSEighty EBUS-TBNA cases in West China Hospital of Sichuan University collected from December 2011 to June 2014 were retrospectively analyzed. The conventional smears and Surepath liquid based preparations were reviewed and compared with histological biopsy. Evaluated whether liquid based preparation could improve the satisfactory rate and diagnostic accuracy.

RESULTSThis study included 53 men and 27 women, the male to female ratio was 1.96:1.00; the age ranged from 17 to 79 (mean 54) years. One to four lymph node groups were aspirated in each patient, resulting in a total of 109 lymph node groups, including 57 paratracheal, 34 subcarinal, three tracheal bronchial, seven pulmonary and four hilar lymph node groups. The definite locations of four other mediastinal lymph node groups were not known. The overall satisfactory rate of conventional smears and liquid-based cytology test was 90.0% and 92.5%, respectively. By histology, there were 37 cases diagnosed as malignant tumors, nine as tuberculosis, two as sarcoidosis, 11 as unexplained granulomatous inflammation, and 27 as other benign lesions. The sensitivity, specificity and accuracy of conventional cytological smears for tumors were 86.5%, 97.7% and 92.5% respectively; the positive and negative predictive values were 97.0% and 89.4% respectively. The sensitivity, specificity and accuracy of the liquid-based preparation were 89.2%, 97.7% and 93.8% respectively; the positive and negative predictive values were 97.1% and 91.3% respectively. Combining the conventional cytological smears and liquid based preparation, the sensitivity, specificity and accuracy were 91.9%, 97.7% and 95.0% respectively; and the positive and negative predictive values were 97.1% and 93.3% respectively.

CONCLUSIONSEBUS-TBNA is a good method to diagnose lung and mediastinal lymphadenopathy. Surepath liquid based cytology test could improve the sample satisfactory rate, the diagnostic sensitivity and accuracy. If combined with immunocytochemistry it could be useful for further tumor typing. EBUS-TBNA combined with Surepath liquid based preparation is an effective complement for the histologic biopsy.

Adolescent ; Adult ; Aged ; Biopsy, Fine-Needle ; China ; Female ; Humans ; Immunohistochemistry ; Lung ; diagnostic imaging ; Lung Neoplasms ; diagnostic imaging ; Lymph Nodes ; diagnostic imaging ; Lymphatic Diseases ; diagnostic imaging ; Male ; Middle Aged ; Needles ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography ; Young Adult

OBJECTIVEEssential hypertension may begin at childhood. The aim of this study is to identify the risk factors of hypertension and detect the evolvement tracking of blood pressure in childhood.

METHODSIn this study, we followed up blood pressure changes in 4623 school children (6 - 15 years-old) from 1987 to 2005 in Hanzhong rural area. A total of 152 children were grouped to higher blood pressure group [systolic blood pressure (P(SBP)) >or= 75(th) (P(75))] and 140 children grouped to normal blood pressure group [P(SBP) < 50(th) (P(50))] and their blood pressure were re-measure 18-years later.

RESULTSThe total follow-up rate was 70.2%. Follow-up blood pressure was significantly higher in higher blood pressure group at baseline than that in normal blood pressure group at baseline (P < 0.05). The hypertension rate at follow up was significantly higher in higher blood pressure group at baseline than that in normal blood pressure group at baseline (28.0% vs. 4.1%, P < 0.01). The risk for hypertension was 6.88 greater in higher blood pressure group at baseline than that in normal blood pressure group at baseline.

CONCLUSIONSHigher blood pressure at childhood is a risk of developing hypertension at adulthood.

Adolescent ; Blood Pressure ; physiology ; Blood Pressure Determination ; Child ; Follow-Up Studies ; Humans ; Hypertension ; etiology ; physiopathology ; Risk Factors

This study investigated the relationship between IL-33/ST2 signal pathway gene polymorphisms and myocardial infarction (MI) in Han Chinese. A case-control association analysis was performed on a total of 490 MI patients (MI group) and 929 normal subjects (NC group). Sequenom Mass Array and Taqman genotyping technique were used to analyze the tag single nucleotide polymorphisms (SNPs) in the genes encoding IL-33, ST2, and IL-1RaP (rs11792633, rs1041973 and rs4624606). The results showed that the frequencies of rs4624606 genotypes AA, TT, AT were 0.031, 0.647, 0.322 in MI group and 0.026, 0.712, 0.263 in NC group, and the allele frequencies of A and T were 0.192, 0.808 in MI group and 0.157, 0.843 in NC group. There were significant differences in rs4624606 genotypes and allele frequencies between MI group and NC group (P<0.05). For rs11792633, the allele frequencies of C and T were 0.45, 0.55 in MI group and 0.454, 0.546 in NC group with no significant differences found between the two groups. Compared with genotype CC+TC, rs11792633 genotype TT had an increased risk of hypertension (P<0.05). However, there were no significant differences in the frequencies of rs11792633 genotypes between the two groups. No significant differences were noted in the frequencies of rs1041973 genotype and allele between the two groups. Logistic regression analysis showed that rs4624606 genotypes AT and AA+AT were both significantly associated with MI (AT: OR=1.325, P=0.029, 95% CI=1.03-1.705; AA+AT: OR=1.316, P=0.028, 95% CI=1.03-1.681) after factors such as age, gender, smoking, drinking, body mass index (BMI), triglyceride (TG) and cholesterol were adjusted. Those carrying rs4624606 genotype AT or AA+AT had an increased risk of MI. No associations were found between the polymorphisms of the other two loci with MI. It was concluded that, in the IL33/ST2 signal pathway, the A allele of rs4624606 polymorphism of IL-1RaP gene is a potential independent risk factor for MI, and the genotypes AA+AT and AT are associated with the incidence of MI.
China ; Ethnic Groups ; genetics ; Female ; Humans ; Interleukin-1 Receptor-Like 1 Protein ; Interleukin-33 ; Interleukins ; genetics ; metabolism ; Male ; Myocardial Infarction ; genetics ; Receptors, Cell Surface ; genetics ; metabolism ; Signal Transduction ; genetics

BACKGROUNDA survey of early stage follicular lymphoma(FL) revealed that the rigorously staged FL patients at first diagnosis had a better outcome as compared with non-rigorous staged FL patients, but there were no similar reports in China.

OBJECTIVETo explore the relationship between the rigorous staging at first diagnosis and the prognosis of FL patients at different stages.

METHODSThe clinical data of 111 patients with newly diagnosed FL from 2008 to 2014 year were collected and analyzed. The rigorous staging included: (1) bone marrow aspiration and biopsy, (2) imaging examination of whole body including CT and ultrasounic scan, or PET/CT, either or both is defined as rigorous staging, or else as non-rigorous staging.

RESULTSThe FL patients at I-II stages by rigorous staging showed a superior progression-free survival(PFS) compared with non-rigorous staging patients(P=0.048). For all the patients, the age, serum LDH, bone marrow lesion and more than 3 foci of diameter larger than 3 cm correlated with prognosis in univariate analysis, and multivariate analysis revealed that the age, serum LDH and bone marrow imolvement were the independent prognostic factors.

CONCLUSIONRigorous staging leads to better outcomes, suggesting that accurate and appropriate testing is important for the patients at the first treatment. The close correlation of bone marrow with prognosis indicates that the evaluation of bone marrow is very important for the daily clinical practice.

OBJECTIVETo explore the effects of the shock wave on the capacity of mesenchymal stem cells(MSCs) to proliferate and differentiate into osteoblasts.

METHODSMSCs were isolated from the bone marrow of healthy donors. The human bone marrow MSCs(BM-MSCs) were divided into 3 groups including blank control group,osteoinduced group and shock wave group. The MSCs in blank control group were cultured with common mediam; the MSCs in osteoinduced group were treated with osteogenic agents and cultured; the MSCs in shock wave group were cultured with common medium and stimulated by shock wave. The morphology of MSCs in each groups were observed by micoscopy; the CCK-8 was used to detect the proliferation ability of MSCs; the alkaline phosphatase staining and von Kossa staining were used to evaluale the differentiation potential of MSCs in each groups.

RESULTSThe results of CCK-8 revealed the shock wave could promote cell proliferation as compared with blank control group. The results of alkaline phosphatase and Von Kossa staining showed that the shock wave displayed a stronger ability to promote the human BMMSC differentiation into osteoblasts cells in comparison with the osteoinduced group. The blank control group was weakly positively stainined.

CONCLUSIONThe shock wave treatment can promote proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells.

OBJECTIVE: To investigate the efficacy and safety of VDZ (Vedolizumab) in the salvage treatment of glucocorticoid resistance to gastrointestinal graft-versus-host disease (GR-GI GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children. METHODS: The clinical data of 5 patients with refractory GI GVHD who received allo-HSCT in Wuhan Children's Hospital from December 2020 to December 2021 were retrospectively analyzed with VDZ salvage therapy. RESULTS: Among the 5 children with refractory GI GVHD, there were 1 male and 4 female, including 2 cases of extremely severe aplastic anemia, 1 case of acute myeloid leukemia (M2, high-risk), 1 case of fanconi anemia and 1 case of myelodysplastic syndrome. The median age of transplant recipients was 54.4 (12-164) months. The median treatment time from transplantation to VDZ was 1.4 (0.6-6.8) months. On average, 3.5 (2-5) doses of VDZ were received. After receiving treatment, 2 patients achieved a complete response (CR), 2 patients achieved a very good partial response (VGPR), 1 patient was non-responsive (NR) after a short-term partial response (PR). Compared with that before VDZ treatment, the amount of diarrhea, stool color, blood and traits of the children after medication were effectively improved. The median follow-up time was 9.3 (7.23-12.83) months. No disseminated or severe bacterial/fungal infections occurred during VDZ treatment and follow-up, and 2 children died of leukemia recurrence and pulmonary bronchiolitis obliterans. CONCLUSION VDZ salvage treatment of refractory GI GVHD in children has obvious short-term efficacy and good safety.
Child ; Humans ; Female ; Male ; Child, Preschool ; Salvage Therapy ; Glucocorticoids/therapeutic use* ; Retrospective Studies ; Graft vs Host Disease