Background: Early diagnosis and staging of liver fibrosis are important for the prognosis and evaluating the survival of patients.Aims: To systematically assess the diagnostic value of transient elastography (TE) for staging of liver fibrosis in patients with chronic liver disease.Methods: PubMed,Embase,Cochrane Library,CNKI,Wanfang and VIP from Jan.2001 to Dec.2015 were retrieved to collect the articles with staging of liver fibrosis in patients with chronic liver disease by TE.Data extraction was conducted.Article quality was evaluated by quality assessment of diagnostic accuracy studies 2 (QUADAS2).Meta-analysis was conducted by Stata 12.0 software.Results: Twenty articles involving 5 748 patients were included.Meta-analysis showed that the combined sensitivity,specificity and AUC of TE for diagnosing significant fibrosis (≥F2) were 0.78 (95％ CI: 0.73-0.82),0.85 (95％ CI: 0.80-0.88) and 0.88 (95％ CI: 0.85-0.91),respectively.The combined sensitivity,specificity and AUC for advanced fibrosis (≥F3) were 0.89 (95％ CI: 0.86-0.91),0.88 (95％ CI: 0.85-0.91) and 0.94 (95％ CI: 0.92-0.96),respectively.The combined sensitivity,specificity and AUC for cirrhosis (F4) were 0.91 (95％ CI: 0.86-0.95),0.89 (95％ CI: 0.87-0.92) and 0.95 (95％ CI: 0.93-0.97),respectively.Conclusions: TE technique has a good diagnostic value in assessing significant fibrosis,advanced fibrosis and cirrhosis in patients with chronic liver disease,especially for advanced fibrosis and cirrhosis.

ObjectiveTo study the imaging characteristics of SPN of adenocarcinoma (ASPNs) on 18F-FDG PET/CT.MethodsThe morphological and metabolic features of 35 ASPNs on FDG PET/CT were retrospectively reviewed.SUVmax (SUV) was measured and ΔSUVmax was calculated according to ΔSUVmax =(SUVmax on delay imaging - SUVmax on early imaging)/SUVmax on early imaging × 100％.Statistical analysis was performed by software SPSS 11.5 using t-test,analysis of variance and Fisher exact test.Results( 1 ) Fifteen ASPNs (42.86％,15/35) presented as nodular pattern on FDG PET imaging,while 20 (57.14％,20/35) as lamellar,cloudy or ill-defined patterns.The SUVmax of these ASPNs followed a descending order of nodular,lamellar,cloudy and ill:defined on both early and delay imaging (F =30.696 and 24.758,both P＜0.001).(2)There were 54.29％ (19/35) ASPNs with SUVmax ≥2.5 and 45.71％ (16/35) ASPNs with SUVmax ＜2.5.(3) Of 35 ASPNs,24(68.57％ ) were solid nodules and 11(31.43％) were ground glass nodules with SUVmax =4.54 ±2.69 and 1.30±0.87,respectively (t =-5.234,P ＜O.001 ).(4) The SUVmax of ASPNs on delay FDG imaging (4.22 ±3.52) was significantly higher than that on early imaging (3.49 ±2.72) (t =-4.021,P ＜0.001 ).However,SUVmax was dependent on SUVmax on the early imaging:when SUVmax ≥2.5,ΔSUVmax was positive in 94.74％ (18/19) of ASPNs; while SUVmax ＜2.5,ΔSUVmax was positive in 56.25％ (9/16) of ASPNs (P =0.013).(5) Of 31 ASPNs with cell differentiation data,there were 10/17 well-differentiated ASPNs and 13/14 poorly-differentiated ASPNs with positive ΔSUVmax ( P =0.045 ).The average SUVmax of well-differentiated ASPNs was significantly lower than that of poorly-differentiated ASPNs ( 1.70 ± 1.51 vs 4.91 ± 2.69,t =- 3.951,P ＜ 0.001 ).Conclusions The morphological and metabolic features of ASPNs are diversified.It is common for ASPN to present with SUVmax ＜ 2.5.ΔSUVmax may be helpful for differentiating malignant from benign SPNs.

Objective To assess the effectiveness of treatment of meniscal injuries of knee joints by arthroscopy.Methods 33 patients 35 joints were followed up and the parts,types and treatment under arthroscopy were analysed.Results 33 patients were followed up from six months to six years,the mean preoperative Lysholm score was 60.5 points,and the mean postoperative one was 86.7 points.Conclusion The advantage of treating meniscal injuries by arthroscopy was the result of correct examination and little wound of arthroscopy operation,and arthroscopic repair or partial menisectomy could effectively restore the function of the injured knee.

Objective To evaluate the olfactory function and its influence factors by using Sniffin ’ Sticks test, and to compare the quality of Parkinson ’s disease (PD) recognition between Sniffin’ Sticks and 16 kinds of odor identification in Sniffin ’ Sticks(SS-16) tests.Methods The Sniffin’Sticks test was used to assess the olfactory function of 68 PD patients and 76 healthy volunteers , and the relationship between smell and age, disease duration, Unified Parkinson’ s Disease Rating Scale score, Hoehn-Yahr (H-Y) rating, and cognitive function level (Montreal Cognitive Assessment) was analyzed.Results (1)The prevalence of olfactory dysfunction in PD group (83.3%) was significantly higher than that in control group (21.2%).The Sniffin’ Sticks test showed that the odor threshold score (6.6 ±3.2, P=0.000), odor discrimination score (6.6 ±3.3, P=0.000), 16 kinds of odor identification score (6.8 ±2.4, P=0.000) in PD group were significantly lower than those in control group.( 2 ) When comparing the PD cases and healthy controls in recognition , the sensitivity and the specificity of the Sniffin ’ Sticks test were 0.897 and 0.737, respectively, similar to the SS-16 test.However, the Sniffin’ Sticks test showed advantage compared with odor threshold and odor discrimination.( 3 ) The olfactory score in PD group was positively correlated with cognitive function (r=0.243, P=0.046), and was unrelated with age, gender, disease duration, and disease severity.The olfactory score in control group was negatively correlated with age (r=-0.270, P=0.018), but positively correlated with cognitive function (r=0.281, P=0.014).Conclusions There is a higher incidence of olfactory dysfunction in PD patients than in control group.Sniffin’ Sticks test is superior to SS-16 test in quantitative and qualitative analysis of olfactory function in PD patients.Two tests both have high sensitivity and specificity in the recognition of PD .

BACKGROUNDPrevious studies have compared single-photon emission computed tomography (SPECT) and electron beam computed tomography (EBCT) in detection of coronary artery disease (CAD) in patients with myocardial infarction (MI). The purpose of this study was to compare SPECT with EBCT in detection of CAD in patients with no MI.

METHODSOne hundred and forty-seven patients with suspected CAD underwent stress-rest (99)mTc-methoxyisobutylisonitrile ((99)mTc-MIBI) myocardial SPECT, cardiac EBCT and coronary angiography (CAG) within one month. Of them, 73 patients (aged 52.6 +/- 10.6 years old) with no history of MI were included in this study. Coronary artery calcium (CAC) was defined as a CT value >or= 130 HU within the boundary of coronary artery on EBCT.

RESULTSThere were 35 and 38 patients with or without CAD according to CAG. Ninety-six percent of the patients with abnormal SPECT and CAC had a coronary arteries stenosis >or= 50%, and 90.9% patients with normal SPECT and EBCT showed no CAD. The sensitivity of SPECT and EBCT in detection of CAD was comparable, and the specificity of SPECT (92.1%) was significantly higher than that of EBCT (55.3%) (P < 0.005). For the detection of individual coronary artery stenosis, both sensitivity and specificity of SPECT (75.0% and 93.7%) were significantly higher than those of EBCT (53.3% and 76.7%) (P < 0.025 and P < 0.005, respectively). In patients without chest pain, the sensitivity and specificity of SPECT (76.9% and 91.4%) were significantly higher than those of EBCT (23.1% and 69.0%) in detection of a coronary artery stenosis of >or= 50% (P < 0.01 and P < 0.005, respectively). However, in patients with chest pain, both sensitivity and specificity of SPECT were comparable to those of EBCT. In patients or= 50% (P < 0.005), and the specificity of SPECT was comparable to that of EBCT. In patients > 45 years old, the specificity of SPECT (94.3%) was significantly higher than that of EBCT (70.5%) (P < 0.005), and the sensitivity of SPECT was comparable to that of EBCT.

CONCLUSION(99)mTc-MIBI myocardial perfusion SPECT has higher accuracy than that of EBCT in detection of CAD in patients without MI.

Adult ; Age Factors ; Aged ; Calcium ; blood ; Chest Pain ; diagnostic imaging ; Coronary Disease ; diagnostic imaging ; Coronary Vessels ; chemistry ; Heart ; diagnostic imaging ; Humans ; Middle Aged ; Sensitivity and Specificity ; Technetium Tc 99m Sestamibi ; Tomography, Emission-Computed, Single-Photon ; Tomography, X-Ray Computed

OBJECTIVETo investigate the risk factors for pulmonary Candida infection in association with mechanical ventilation and analyze the drug resistance profile of the Candida species that cause the infection.

METHODSA retrospective analysis was conducted 114 patients receiving mechanical ventilation for over 48 h. According to the presence of pulmonary Candida infections, these patients were divided into infected group (n=50, 43.9%) and non-infected group (64 cases). Univariate analysis and multivariate logistic regression analysis were performed to identify the risk factors for the infection, and drug sensitivity test was carried out to evaluate the drug resistance of the Candida species.

RESULTSUnivariate analysis and multivariate logistic regression showed that the presence of at least two underlying diseases (OR=4.758, P=0.009), frequent changes of antibiotics (OR=6.128, P=0.001), and blood albumin below 25 g (OR=15.829, P=0.011) were the independent risk factors for pulmonary Candida infection associated with mechanical ventilation, and prophylactic antifungal treatment (OR=0.062, P=0.012) was a protective factor. Drug sensitivity test showed that Candida albicans was sensitive to most of the antifungal agents (100.0%), but the non-albicans Candida species were resistant to fluconazol (50.0%) and Itraconazole (38.5%).

CONCLUSIONPoor general conditions and frequent changes of antibiotics are the major risk factors for pulmonary Candida infection in patients receiving mechanical ventilation. Drug resistant analysis is helpful in the treatment of the infections.

Adult ; Aged ; Aged, 80 and over ; Candidiasis ; etiology ; China ; epidemiology ; Drug Resistance, Fungal ; Female ; Humans ; Lung Diseases, Fungal ; epidemiology ; etiology ; Male ; Middle Aged ; Pneumonia, Ventilator-Associated ; epidemiology ; microbiology ; Respiration, Artificial ; adverse effects ; Retrospective Studies ; Risk Factors ; Young Adult

Adult ; Fatty Liver ; diagnosis ; drug therapy ; Female ; Humans ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease ; Waist-Hip Ratio

OBJECTIVETo determine the relationship between polymorphisms in the genes encoding IL-1, IL-6, and IL-10 with primary biliary cirrhosis (PBC) in Chinese population.

METHODSWhole-blood samples were taken from 77 patients with PBC and 160 healthy controls. DNA was extracted and the polymorphisms at positions IL-1 +3953, IL-1RN intron 2, IL-6 -174, and IL-10 -1082, -819, and -592 were determined by using sequence-specific polymerase chain reaction (SSP) or polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).

RESULTSThe frequency of IL-1RN1,1 allele in PBC group was significantly higher than in control group (90.9% vs 79.4%, P=0.026), and the frequency of IL-1RN1,2 in PBC group was significantly lower than in control group (6.5% vs 18.8%, P=0.013). There was no significant difference in the frequence of IL-1RN*2 allele between PBC group and control group (P=0.06). Of the 77 patients with PBC, 4 patients were IL-6 -174GC, 73 were IL-6 174GG. All the 160 health controls are IL-6 -174GG (P=0.0036). The frequence of IL-6 -174C allele in PBC group was significantly higher than that in control group (P=0.0038). No significant differences of polymorphisms for IL-1 +3953 and IL-10 (-1082, -819 and -592) were found between PBC group and control group.

CONCLUSIONThe polymorphisms of IL-1RN and IL-6 -174G/C appear to be associated with PBC, and the polymorphisms of IL-1 +3953 and IL-10 promoter gene are not associated with PBC in a Chinese population.

Adult ; Aged ; Female ; Humans ; Interleukin-1 ; genetics ; Interleukin-10 ; genetics ; Interleukin-6 ; genetics ; Liver Cirrhosis, Biliary ; genetics ; Male ; Middle Aged ; Polymerase Chain Reaction ; methods ; Polymorphism, Restriction Fragment Length

This study was purposed to prepare and identify monoclonal antibodies (McAbs) against Homo sapiens hemoglobin alpha 2 (HBA2). Normal human fetal liver tissues were homogenized, and human liver nuclear proteins were isolated by centrifugation. The total human fetal liver nuclear proteins were used to immunize BALB/c mice for preparing McAbs by hybridoma technique. The McAbs specificity was identified by ELISA, Western blot, and immunohistochemistry. The antigen was identified by Uni-ZAP expression library screening. The results showed that one hybridoma cell line, AEE091, secreting specific McAb against HBA2 was established. The Ig subclass of this McAb was IgG1 (kappa). Data from immunohistochemistry assay showed that AEE091 could recognize human liver nuclear protein. Using AEE091 McAb, isolation of the protein antigen by IP revealed that AEE091 McAb could recognize 15 kD protein. Screening the Uni-ZAP XR pre-made liver cDNA library with AEE091 hybridoma cell supernatants demonstrated that AEE091 McAb specially reacted with HBA2. It is concluded that a hybridoma cell line stably secreting specific McAb against HBA2 is established. The specific McAb against HBA2 would be very useful for studying HBA2 function and screening thalassemia.
Animals ; Antibodies, Monoclonal ; biosynthesis ; immunology ; Antibody Specificity ; Base Sequence ; Hemoglobin A2 ; immunology ; Humans ; Hybridomas ; secretion ; Mice ; Mice, Inbred BALB C ; Molecular Sequence Data ; alpha-Thalassemia ; immunology

Objective To observe of the effect of neurophysiological facilitation of respiration combined with external diaphragm pacing on the respiration of stroke survivors. Methods Sixty-four stroke survivors were divided randomly into a treatment group and a control group, each of 32. Both groups were given routine drugs, while the treatment group was additionally provided with an external diaphragm pacemaker. Those in the treatment group also received neurophysiological facilitation of respiration six times a week for 3 weeks. Before and after the treatment, ar-terial oxygen partial pressure (PaO2) was measured in both groups along with arterial carbon dioxide partial pressure (PaCO2), arterial oxygen saturation ( O2sat) and C-reactive protein (CRP). Ultrasonography was used to measure diaphragm mobility at the end of expiration and inspiration (Δm) , diaphragm mobility of the end of forced inspiration and expiration ( ΔM), and the difference of diaphragm thickness ( Δd). First second forced expiratory volume ( FEV), and maximum voluntary ventilation (FVC) were also measured. Results After the treatment, the average PaO2, PaCO2, O2sat, CRP, Δm, ΔM, FEV and FVC of the treatment group were all significantly better than before the treatment and better than those of the control group. Conclusion Neurophysiological therapy combined with an external diaphragm pacemaker can significantly improve the respiration of stroke survivors, reducing the risk of lung infection.