Objective To survey the incidence of acquired adult aplastic anemia (AA) in Shanghai, China. Meanwhile, we compared it with the previous data from China in 1986 and other countries in order to explore the trends. Methods Newly diagnosed AA patients were registered in 6 districts (Jingan, Xuhui, Huangpu, Changning, Putuo, Yangpu ) in Shanghai from 2004 to 2006. Then we calculated the crude and age-adjusted incidence of AA according to the population data from Shanghai Statistic Yearbook. Results There were 38 adult patients with acquired AA. The average crude incidence of AA was 0. 33/100 000 from 2004 to 2006. The incidences per 100 000 persons per year were 0. 40, 0. 14and 0. 64 in 18-34, 35-59 and ≥ 60 years, respectively. The rate of severe AA was 0. 17/100 000.Conclusion The incidence of severe AA has no marked change, but the total rate is a little decreased compared with the data from China in 1986.

BACKGROUND:Pulmonary infection after kidney transplantation evolves rapidly. There is a high mortality rate in patients with server pulmonary infection. It has the important significance of early diagnosis and treatment of pulmonary infection, but some patients appear to have impaired kidney function because of the adjustment of immunosuppressants. OBJECTIVE:To explore the approaches to applying the immunosuppressants during the treatment of pulmonary infection after kidney transplantation. METHODS:The clinical data of 85 kidney transplantation patients who suffered from pulmonary infection were retrospectively analyzed. There were 43 cases in which the infection occurred within 1-6 months after kidney transplantation, 39 of which within 2-4 months; 7 cases of infection occurring within 6-12 months; 7 cases of infection within 12-24 months; 6 cases of infection within 24-36 months; 22 cases of infection occurring beyond 36 months. The immunosuppressant dose was adjusted based on a per-case basis. As a complement, the smal-dose hormone was used for anti-inflammation. Etiological treatments for resisting infections were also conducted accordingly. Ventilators were utilized for patients with respiratory failures. The body temperature of patients was monitored and controled. Appropriate nutrition support was also provided accordingly. There were 44 cases of decreasing or stopping the use of immunosuppressants during the early period of pulmonary infection; 19 cases of decreasing or stopping the use of immunosuppressants during the treatment of pulmonary infection;5 cases of stopping the use of immunosuppressants during the period of severe pneumonia; 15 cases of gradualy changing the dose of immunosuppressants during the early and progressive period of pneumonia; 2 cases of decreasing the use during the early period of pneumonia and stopping the use during the period of severe pneumonia. The duration of decreasing or stopping the use of immunosuppressants ranged from 3-51 days, with an average of 10.7 days. RESULTS AND CONCLUSION: Among the 85 patients, there were 81 cases cured and 4 cases of death. Among the four death cases, two cases died of acute respiratory failure and two cases died of multiple organ failure. Of the cured 81 cases, acute rejection occurred in 3 cases, while renal alograft dysfunction occurred in 6 cases. Decreasing or temporarily stopping the use of immunosuppressants during the treatment of pulmonary infection caused by the kidney transplantation increases the cure rate and decreases the mortality rate; while timely resuming the usage of immunosuppressants effectively protects the renal graft function, especialy for patients with renal graft dysfunction.

Objective To evaluate the feature of level Ⅱaxillary lymph nodes from breast cancer detected by ultrasound. Methods Eighty-nine cases of breast cancers with level Ⅱaxillary lymph nodes diagnosed in Sun Yat-sen University Cancer Center from January 2008 to October 2013 were retrospectively studied, including 66 cases of breast cancer patients pre-operatively, 23 cases of breast cancer post-operatively, all cases were female. The number, size, long/short ratio, presence of a hilum, and Doppler features of the lymph nodes were observed. The accuracy sensitivity, speciifcity, positive predictive value (PPV), and negative predictive value (NPV) of each signiifcant parameter were analyzed. Results Ultrasound examination revealed more than axillary lymph nodes, the accuracy sensitivity, specificity, positive predictive value and negative predictive value of diagnosing lymph nodes were 71.9%, 56.8%, 89.7%, 87.9%and 61.4%respectively. The maximum diameter of levelⅡaxillary lymph node was more than or equal to 10 mm, the accuracy sensitivity, specificity, positive predictive value and negative predictive value of diagnosing lymph nodes were 67.4%, 58.0%, 79.5%, 78.4%and 59.6%respectively. If there were two ultrasonographic characteristics simultaneously, the diagnostic sensitivity (87.8%) and accuracy (78.6%) could be significantly improved, the specificity, positive predictive value and negative predictive value of diagnosing lymph nodes were 60.0%, 72.3%and 80.0%. Conclusion The number and size of lymph nodes in level Ⅱaxillary area are valuable sonographic characteristics for the diagnosis of benign and malignant lymph nodes.

Objective To evaluate the clinical impact of 18F-FDG PET/CT on patients with suspected cervical cancer recurrence. Methods Fifty-one cervical cancer patients, clinically suspected to have tumor recurrence during follow-up, underwent 18F-FDG PET/CT examination. 18 F-FDG PET/CT results were compared with those of conventional images, as referred to histopathology or clinical follow-up. Impacts of 18F-FDG PET/CT were evaluated based on documented changes of clinical management. Results In total, 43 patients were found to have positive lesions by 18F-FDG PET/CT, in which 40 were true recurrence,but 2 were pelvic abscess and 1 was radiation enterocolitis. Other 8 patients were found negative by 18F-FDG PET/CT and confirmed by pathology or follow-up. In patient-based analyses, the sensitivity, specificity, and accuracy of 18F-FDG PET/CT for the detection of tumor recurrence were 100% (40/40), 72. 73% (8/11),and 94.12% (48/51) respectively. In 7 patients, the clinical management was changed due to 18F-FDG PET/CT findings. Conclusion 18F-FDG PET/CT is an efficient tool for determining the recurrence of cervical cancer and instructing the clinical management.

Objective To investigate the value of echocardiography application in the diagnosis of large amount of pericardial effusion (PE) in children by retrospective etiology and prognostic analysis.Methods A total of 68 children with large amount of PE admitted in Beijing Children's Hospital,Capital Medical University from March 2010 to March 2016 were reviewed retrospectively,and the echocardiographic presentations,etiology diagnosis,treatment,and prognosis were analyzed.Results Analysis indicated that the etiology diagnosis ratio was 97.1％ (66/68 cases),the effective ratio of the medical treatment was 71.8％ (46/64 cases),and the mortality rate was 7.8％ (5/64 cases).The morbidity was ranked from high to low as follow:large amount of PE included infectious pericarditis 27 cases,tumor associated PE 14 cases,postpericardiotomy syndrome and cardiotrauma 14 cases,systemic diseases 6 cases,vasa lymphatic related diseases 5 cases and idiopathic PE 2 cases.PE resulted from tumor associated PE and vasa lymphatic diseases had lower cure rate than the overall cure rate,and there were statistical significance (28.6％ vs.71.8％,x2 =9.092,P =0.003;20.0％ vs.71.8％,x2 =5.059,P =0.018).Thirty-five children received pericardiocentesis or fenestration drainage.Chylopericardium was restricted to vasa lymphatic diseases.All tumor associated PE had the hemorrhagic PE.The strong echo point in the pericardial cavity might indicate implication for hemorrhagic PE (x2 =5.166,P =0.023).The abnormal mass detected by echocardiography might indicate the tumor related or infectious causes.Conclusions The etiology of large amount of PE could be determined in most of children.As the preferred diagnosis method,echocardiography could help etiological diagnosis combined with clinical manifestation.

0.05).Conclusion CYPIA1 MspⅠ polymorphism is not related to the susceptibility to colorectal carcinoma.

Myasthenia gravis (MG) is a disease of neuromuscular junction and mainly autoimmune in aetiology. The state of thymus is a critical determinant for the prognosis. In this retrospective review study, we aimed at clarifying the relationship between the mode of clinical presentation of MG and the radiopathological classification of the thymus. We identified patients with MG from the database of our medical center from 1988 – 2017. The patients were classified into two groups according to their clinical presentation: those with a typical presentation with diurnal variation, and those with an atypical presentation of persistent weakness or respiratory failure from the beginning. The underlying thymic state was categorized into six groups: normal, abnormal by imaging (if no operation was performed), hyperplasia, benign thymoma, cortical type thymoma, and malignant thymoma. In total, 227 patients (133 females and 94 males) were included in the analysis, of whom 68% were classified into the typical presentation group. The atypical presentation correlated significantly with thymic categories (p = 0.014) and sex (p = 0.026) but not age at onset (p = 0.232). The atypical presentation was more common in the male patients and in those with thymic carcinoma.

Adult ; Aged ; Autoimmune Diseases ; diagnosis ; metabolism ; Female ; Humans ; Insulins ; metabolism ; Male ; Middle Aged

OBJECTIVETo investigate the effect of propofol on cell invasion and expressions of aquaporin-3 (APQ-3) and matrix metalloproteinase-9 (MMP-9) in human lung adenocarcinoma cancer A549 cells.

METHODA549 cells were treated with propofol at the concentrations of 25, 50, and 100 µmol/L for 12 or 24 h. RT-PCR was used to detect the effect of propofol on AQP-3 mRNA level in A549 cells, and the effects of propofol treatments for 24 h on AQP-3 and MMP-9 protein expression and the invasive ability of A549 cells were assessed with Western blotting and Transwell assay, respectively.

RESULTSCompared with the control cells, the cells treated with 25, 50, and 100 µmol/L propofol showed a obvious inhibition of AQP-3 mRNA expression, with inhibition rates ranging from 0.19 to 0.65 in cells with a 12-h treatment and from 0.13 to 0.41 in cells treated for 24 h; 100 µmol/L propofol treatment for 24 h produced the strongest inhibitory effect (0.13∓0.035, P<0.05). AQP-3 protein expression in cells treated with 25, 50, and 100 µmol/L propofol for 24 h (0.91∓0.009, 0.60∓0.020, and 0.57∓0.006, respectively) and MMP-9 protein expression in cells treated with 50 and 100 µmol/L propofol for 24 h (0.65∓0.006 and 0.46∓0.021, respectively) were significantly lower than those in the control cells (P<0.05). Treatment with 25, 50, and 100 µmol/L propofol for 24 significantly lowered the number of invading cells (122.55∓17.20, 96.33∓5.82, and 74.33∓2.85, respectively) compared with the control group (199.33∓23.88, P<0.05).

CONCLUSIONTreatment with 50 and 100 µmol/L propofol inhibits cell invasion by down-regulating the expression of AQP-3 and MMP-9 in A549 cells.

OBJECTIVETo explore the effect of propofol on H19 expression, migration and invasion of human breast cancer MDA-MB-231 cells in vitro.

METHODSMDA-MB-231 cells were randomly divided into 5 groups for treatment with basal medium, DMSO, or propofol at concentrations of 25, 50, and 100 µmol/L. H19 expression of the treated cells was assessed with RT-PCR, and the changes of cell motility, migration and invasion were evaluated with wound-healing assay and Transwell assays.

RESULTSTreatment of the cells with 25, 50, and 100 µmol/L propofol for 24 h down-regulated H19 by 17.83%, 37.50% and 63.67% (P<0.05), and suppressed cell motility by 13.46%, 36.54% and 46.17% (P<0.05), cell migration by 27.93%, 57.90% and 76.51% (P<0.05), and cell invasion by 25.72%, 53.32% and 81.43% (P<0.05), respectively.

CONCLUSIONPropofol-induced cell migration and invasion suppression are partially mediated by down-regulating H19 in MDA-MB-231 cells in vitro.