Employment ; Humans ; Japan ; Surveys and Questionnaires

ObjectiveTo evaluate the diagnostic performance of bone SPECT and CT fusion imaging in bone metastases from pediatric neuroblastoma.MethodsTwenty-four pediatric patients with neuroblastoma were included in this retrospective study.All patients underwent planar imaging and SPECT integrated with CT.Lesion visibility,diagnostic certainty and diagnostic performance were evaluated with KolmogorovSmirnov test andx2 test.ResultsLesion visibility of SPECT alone,SPECT integrated with CT were significantly better than that of planar imaging ( both H =69.000,P ＜ 0.05 ).SPECT and CT fusion imaging,SPECT alone both detected five more bone lesions than planar bone imaging (77 vs 72).The diagnostic accuracy of SPECT imaging (62.34％,48/77 )was significantly higher than that of planar imaging (45.45％,35/77; x2 =4.416,P ＜ 0.05 ).The sensitivity,specificity and accuracy of SPECT and CT fusion imaging for diagnosing malignant bone lesions were significantly higher than those of planar imaging:82.35％ (42/51) vs 53.19％ ( 25/47),88.46％ ( 23/26 ) vs 40.00％ ( 10/25 ),84.42％ ( 65/77 ) vs 45.45％ (35/77 ; x2 =12.571,14.016,25.667,all P ＜ 0.01 ).The diagnostic specificity and accuracy of SPECT and CT fusion imaging were significantly higher than those of SPECT alone ( 53.85％,14/26 ;62.34％,48/77) (x2 =7.589,9.606,both P ＜0.01 ).However,there was no significant difference of sensitivity between the two methods (x2 =2.942,P ＞ 0.05 ).Diagnostic certainty by SPECT and CT fusion imaging was significantly higher than that by SPECT alone ( H =28.000,P ＜ 0.05 ) and by planar imaging (H =21.000,P ＜ 0.05).ConclusionSPECT and CT fusion imaging can detect more bone lesions in patients with pediatric neuroblastoma.It is helpful for diagnosing bone metastases from pediatric neuroblastoma.

AlM: To discuss the application effect of surgical simulator to improve the microsurgical skills in junior ophthalmologist. METHODS: Lecture teaching, training in surgical simulator and operation in animal eyes were received in all these ophthalmologists. Results of the ability of operation in cataract surgery after this training were analyzed. RESULTS: After taught theory, students completed cataract surgical procedures on simulator and the mean test score was 75. 91 ± 6. 53 points. After trained on simulator repeatedly, the mean test score was 85. 57±4. 64 points. There was statistically significant difference ( P<0. 01) . During the third stage of practicing on animal eyes, the score was 89. 77 ± 7. 61 points, there was statistically significant difference compared with former two stages (P<0. 05).CONCLUSlON: Comprehensive training can improve microsurgical skills of junior ophthalmologist, but the long effect need to be observed.

Objective To evaluate the assistant diagnostic value of low dose CT in patients with pulmonary embolism (PE) based on ventilation/perfusion (V/Q) SPECT imaging.Methods One hundred and two patients with clinical suspected PE had been enrolled for this retrospective study.The final diagnosis of PE was made according to the 2008 guidelines of European Society of Cardiology (ESC).All patients underwent V/Q SPECT/CT (Hawkeye 4,GE).The imaging findings from low dose CT lung window were used for differential diagnoses of abnormal regions in SPECT imaging.The diagnostic efficiency of V/Q SPECT alone was compared with that of V/Q SPECT combined with low dose CT scan.Crosstabsx2 test was performed using SPSS 13.0 software.Results Twenty-nine patients (28.43％,29/102) were finally diagnosed as PE.V/Q SPECT alone had a sensitivity of 93.10％ (27/29),a specificity of 90.41％ (66/73),and an accuracy of 91.18％ (93/102).With additional diagnostic information from low dose CT,the diagnostic specificity increased to 95.89％ (70/73,X2 =1.72,P ＞ 0.05 ),and the accuracy increased to 95.10％ (97/102,x2 =1.23,P ＞ 0.05) though the sensitivity remained the same.Conclusion Imaginginformation from low dose CT in hybrid SPECT/CT may enhance V/Q diagnostic accuracy for PE.

Objective: To investigate the inhibitory effects of PTEN gene transfection combined with L-OHP on human cholangiocarcinoma cell line, QBC939, providing a new method for gene therapy of human biliary duct carcinoma. Methods: A eukaryotic expression vector containing PTEN gene was transfected into human QBC939 cells under mediation of lipofectamine and positive cell clones were selected and amplified. Expression of PTEN gene was detected by immunohistochemistry. MTT test was used to determine the in vitro activity of cells, electron microscope was applied to observe cell ultrastructure, and flow cytometry was used for determining the cell cycle and apoptosis. In vitro test was used to study the invasive ability of cells before and after treatment. Results: After transfected with PTEN gene, QBC939 cells had a higher expression of PTEN gene (P

Animals ; Fatty Liver ; metabolism ; Humans ; Ion Channels ; biosynthesis ; genetics ; physiology ; Mitochondrial Proteins ; biosynthesis ; genetics ; physiology ; RNA, Messenger ; biosynthesis ; genetics ; Uncoupling Protein 2

Objective To understand the virology test characteristics of hepatitis B virus (HBV) for discuss the relation of HBV genotype and HBeAg, anti-HBc-IgM, HBV DNA and disease progression. Methods Two hundred cases of hepatitis B were detected by the ELJSA assay with two pairs of semi-markers (HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc) and anti-HBc-IgM, using fluorescence quantitative polymerase chain reaction (FQ-PCR) for detecting HBV DNA, using monoclonal antibody ELISA method (mAbs ELISA) for HBV genotyping and analysis of test results. Results In 200 patients with hepatitis B, the HBV genotype detected in 179 cases (89.5%), B-type 121 cases(60.5%), C-type 58 cases (29.0% ). There had no relationship with HBeAg, anti-HBc-IgM, HBV DNA and genotype. B-type HBV prevalent in asymptomatic carriers (ASC) and chronic hepatitis B (mild);C-type common in patients with liver cirrhosis (LC) and chronic hepatitis B (severe). Conclusions HBV genotype in Shenzhen mainly is B-type, C-type second;mAbs ELISA assay with HBV genotype is specific, sensitive, simple and practical features, HBV replication strength has nothing to do with the virus genotype. HBV genotype and HBeAg, anti-HBc-IgM, HBV DNA testing may complement each other, with the clinical application value.

Objective To investigate the association between CYP11 B2 gene polymo-rphism and left ventricle hypertrophy with meta analysis.Methods Literatures about the association of CYP11 B2 gene polymorphism and left ventricle hypertrophy from January 1992 to December 2011 were searched.The electronic databases retrieved from Pubmed,Embase,China national knowledge intemet,Chinese biological medicine disk,VIP fulltext database and Wanfang fulltext database.Odds ratio of CYP11 B2 genotype distributions in left ventricle hypertrophy patients comparing with healthy control were analyzed.RevMan5.1 software was applied for investigating hereogeneity among individual studies and summarizing effects with proper statistical methods.Six case control studies were enrolled.Results A total of 541 cases and 553 controls were enrolled for the study.The pooled OR of CC vs TT + TC genotype was 1.15 (95％ CI:0.74 ～ 1.80) (Z =0.63,P =0.53) in the subgroup of hypertension,and the pooled OR of CC vs TT + TC genotype was 1.15 (95 ％ CI:0.74 ～ 1.80) (Z =0.63,P =0.53) in the subgroup of race.The pooled OR of C vs T allele was 1.15 (95％ CI:0.76 ～ 1.74) vs 0.87 (95％ CI:0.58 ～ 1.31) (Z =0.67,P =O.50).Conclusion Whether the hypertension or the race,the genotype of CYP11 B2 polymorphism has no association with an increased risk of left ventricle hypertrophy.

Objective:To evaluate the outcome and prognostic factors of conventional radiotherapy followed by intensity-modulated radiation therapy (IMRT) as a boost combined with chemotherapy in the treatment of high-grade gliomas (HGG). Methods:From Nov. 2004 to Nov. 2006, 112 HGG patients were treated with conventional radiotherapy followed by IMRT as a boost combined with chemotherapy. The radiotherapy regimen included first-course conventional radiotherapy and latE-course IMRT as a boost with the total radiation dosage of 57.5- 62.5Gy (27-29 fractions in 37-45 days). All the patients received chemotherapy. Sixty-three patients received temozolomidE-based chemotherapy and 49 patients received semustine plus teniposide chemotherapy. The treatment reaction was recorded. The overall survival rate and local progression-free survival rate were calculated. The prognostic factors were analyzed by using multivariate COX regression model. Results:The acute treatment toxicity was the most at grade 1 to grade 2 and no grade 4 adverse reaction was observed. Three cases had late radiation-induced brain necrosis. The overall 1-, 2-, and 3-year survival rates were 78.9%, 54.7%, and 30.8%, respectively. Multivariate analysis revealed that tumor location (P=0.001) and KPS score (P=0.011) were independent prognostic factors. The 1-, 2-, 3-year local progression-free survival rates were 63.8%, 38.9%, and 10.5%, respectively. Multivariate analysis revealed that tumor location (P=0.001), KPS score (P=0.001), and histologic type (P=0.005) were independent prognostic factors. Multivariate analysis did not reveal the significant correlation of temozolomide chemotherapy with the prognosis of the patients. Conclusion:Postoperative conventional radiotherapy followed by IMRT as a boost combined with chemotherapy has better short-term efficacy in the treatment of HGG and the adverse reaction is tolerable. KPS score, tumor location, and histologic type are important prognostic factors. Temozolomide chemotherapy is not associated with the prognosis of patients.

Objective:To study the causes of misdiagnosis of patients with POEMS syndrome and to discuss the clues for its early diagnosis.Methods:The clinical and laboratory data of 26 inpatients with POEMS syndrome,who were treated in Changhai hospital over the last decade,were retrospectively analyzed.Results:The misdiagnosis rate of our group was 100%. The misdiagnosis was made in(3.31?0.97)hospitals and in(3.31?0.93)clinical departments;the misdiagnosis period was (19.42?10.86)months and it had been misdiagnosed as 18 other diseases.The initial symptoms included polyneuropathy in 21 (80.8%)cases,edema of lower extremity in 22(84.6%)cases,and body weight loss in 8(30.8%)cases.The typical clinical symptoms included polyneuropathy in 26(100%)cases and organomegaly in 24(92.3%).Two cases had newly-identified uterine hypertrophy,one had adrenal gland hypertrophy,and one had gastric wall thickening mimicking advanced gastric cancer.Hypothyroidism,impotence,skin pigmentation and sclerosis occurred in 76.9%(20/26),60%(6/10),92.3%(24/ 26)and 65.4%(17/26)cases,respectively.Monoclonal plasma cell proliferation was documented in 18(81.8%);M proteins were positive in 14(63.6%)cases by serum immunofixation,and only 2(9.1%)cases also positive by serum protein electrophoresis.One patient was positive of M protein by urine immunofixation and one had abnormal infiltration of plasma cells in the gastric wall.Lymph node biopsy were performed in 8 patients and 3 were found to have Castleman disease;the other 5 cases had lymphocyte infiltration,with 3 complicated with plasma cell proliferation.Nerve biopsy in 4 cases all revealed axonal degeneration and one patient complicated with demyelination.Bone marrow biopsy in 5 cases revealed plasmacytosis in 2 cases and myeloma in one.Excessive radioactivity resorption was found in 10 of the 16 cases(62.5%)and abnormal plasma cells were detected in 2 cases by bone aspiration guided by radioisotope bone scan.Conclusion:Misdiagnosis of POEMS syndrome is very common.Polyneuropathy,edema of lower extremity and body weight loss are the common early symptoms of POEMS syndrome. Early diagnosis can be made by having an intimate knowledge of the progression of the disease and by detecting M protein through various approaches.