Objective To evaluate the role of multi-slice computed tomography (MSCT) in the diagnosis of pulmonary sequestration.Methods MSCT scans of 18 cases of pulmonary sequestration proved by surgery and pathology were reviewed.All cases underwent plain and contrast enhanced CT scanning,and retrospective reconstruction was made.Various reconstruction techniques in displaying the pulmonary sequestration and associated malformation were evaluated.Results Anomalous systemic arterial supply was discovered by transverse CT images in 12 cases.The reconstructed images using multiple methods showed the aberrant artery more clearly in all cases,including 6 cases in which the abnormalities were not confirmed by transverse CT.Drainage vein was revealed in 13 cases and lung heteroplasia with other malformation was demonstrated in 14 cases.Volume rendering (VR) reconstruction is the optimal choice for displaying the abnormal vessels and airway.Conclusion Enhanced MSCT with image post-processing can show the abnormal artery and vein of the pulmonary sequestration and the associated malformation,so it is the first choice in diagnosing pulmonary sequestration in pediatric population.

ObjectiveTo study the clinical features, arterial involvement, therapeutic strategies and outcomes of Takayasu arteritis (TA). MethodsThe clinical symptoms, arterial images, inflammatory parameters and follow-up information of 173 patients with TA were retrospectively studied. Comparisons between groups were performed by t-test. ResultsThere were 136 female and 37 male patients in this study. The mean age at onset was(26±11 ) years. Hypertension, pulse deficit or asymmetrical pulse, and fever were present in 46.6％, 41.1％, 28.7％ of patients, respectively. The distribution of arterial involvement were 64.7％in aorta, 9.8％ in pulmonary artery, 19.1％ in innominate artery, 65.9％ in common carotid arteries, 65.3％in the subclavian artery, 36.2％ in the renal artery, 12.1％ in the vertebral artery, and 5.8％ in coeliac axis.Elevated erythrocyte sedimentation rate(ESR) was found in 61.0％ patients. Active tuberculosis or history of tuberculosis was implicated in 45 patients(26.0％). Ten patients(5.8％) were hepatitis B virus carriers.Among 105 followed-up patients, 98 patients(94.2％) achieved persistent remission, 17 patients relapsed when corticosteroids were tapered. ConclusionCorticosteroids combined with or steroid alone, supplemented with endovascular intervention procedures or surgical bypass procedures when necessary, can effectively control the clinical symptoms and inflammatory parameters and improve the quality of life of patients.

Middle East respiratory syndrome coronavirus (MERS-CoV) has caused outbreaks of SARS-like disease with 35% case-fatality rate, mainly in the Middle East. A more severe outbreak of MERS occurred recently in the Republic of Korea, where 186 people contracted the infections, causing great concern worldwide. So far, there has been no clinically available drug for the treatment of MERS-CoV infection. The potential drugs against MERS-CoV mainly consist of monoclonal antibodies, peptides and small molecular agents. Small molecular agents have an advantage of easier synthesis, lower cost in production and relatively higher stability. There is better chance for those candidates to gain a quick development. This article reviews the progress of developing small molecular MERS-CoV agents.
Antibodies, Monoclonal ; pharmacology ; Antiviral Agents ; pharmacology ; Coronavirus Infections ; drug therapy ; Drug Design ; Humans ; Middle East Respiratory Syndrome Coronavirus ; drug effects

Objective To assess the clinical value of MSCT in congenital esophageal atresia (EA) and tracheoesophageal fistula (TEF) of newborns. Methods Twenty neonates (17 boys and 3 girls) with a mean age of 4.6 days (1 day to 16 days) diagnosed EA and distal TEF underwent MSCT, and multiple planar volume reconstruction (MPVR) and three-dimensional transparency lung volume rendering (TL-VR) imaging were used. The initial diagnosis was made on esophagram by showing the catheter into a blind-ended esophageal pouch. The MSCT manifestations were compared with the surgical findings. Statistical analysis was performed by using SPSS 10.0. Paired-Samples t test and Pearson correlation analysis were used. Results MSCT clearly showed the distal esophageal pouches in all EA patients. The distance between the proximal and distal esophageal pouches determined by MPVR (0.15--3.10 cm, median 0.70 cm) and TL-VR (0.10--3.10 cm, median 0.82 cm) had no remarkable differences and correlated well with the surgical findings (r=0.87, P<0.01). MPVR revealed the orifice of the fistula in 13 TEF cases, while TL-VR only in 4. Conclusion MSCT is an useful and noninvasive imaging method for demonstrating congenital EA and distal TEF, and is highly valuable for surgical planning.

0.02 kgf was considered as signifieant.All patients were studied within the first week of presentation with stroke, and underwent every day follow-up within the first month.Results Nine htmdred and fourteen patients were recruited into the study during 1-year period. WECSFP without lesion in brain stem was present in 4.4% of patients within the first week of stroke presentation.The patients with WECSFP had less JFS than the patients without WECSFP(P

0.05).There was significant difference between normal control group and group A and B(P0.05 ).Neuron counting was significantly higher in group B than that in group A 4 weeks after treatment(P

OBJECTIVETo compare the indications and therapeutic effects of several invasive interventions in treating postoperative sputum retention.

METHODSBronchoscopy, cricothyroidotomy, intubation or tracheotomy was performed in 112 patients with postoperative sputum retention from January 2002 to December 2006. There were 95 male and 17 female patients. The age ranged from 14- to 81-years-old with a mean of (65.2 +/- 11.1) years old. Their clinical data were collected to prove the improvement of PaO2, SpO2, and pulmonary atelectasis. Sputum clearance results of these invasive methods were compared as well.

RESULTSBronchoscopies were effective in 24 out of 60 cases (40.0%), while the rest 36 cases called for multiple bronchoscopies or other maneuvers. Tracheal intubations were effective in 31.2% (15/48) patients, among whom 11 patients required further cricothyroidotomies, and 22 patients required tracheotomies. Intubations and bronchoscopies resulted shorter intervention durations and efficacy durations, comparing with the other two methods.

CONCLUSIONSPersonalized risk analysis helps decision making in invasive interventions for postoperative sputum clearance. Tracheal intubations and bronchoscopic clearance are helpful in short-term symptomatic relief and recommended the first choice in cases of postoperative sputum retentions.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bronchoscopy ; Female ; Humans ; Intubation, Intratracheal ; Male ; Middle Aged ; Postoperative Care ; Retrospective Studies ; Sputum ; Thoracic Surgical Procedures ; Tracheotomy ; Young Adult

ObjectiveThe purpose of this study was to assess the efficacy,safety and optimal dose of tacrolimus monotherapy in patients with refractory lupus nephritis(LN) who were resistant to cyclophosphamide(CYC).MethodsA total of 14 LN patients (2 men and 12 women) with persistent proteinuria who were resistant to CYC treatment more than 8 g for half a year were enrolled.Tacrolimus was initiated at 2 mg/d (patient weight＜60 kg) or 3 mg/d(patient weight≥60 kg) which was administered in two divided doses.Prospective data on daily proteinuria,serum album level and serologic lupus activity were collected and followed for 6 months.ANOVA and Pearson correlation analysis were used for statistical analysis.Results Mean age at baseline was(30±9) years.Mean urinary protein decreased significantly from(6.2±5.1) g at baseline to (1.1±0.9) g at 6 months (F=16.21,P＜0.01).Mean serum album level increased significantly from (27.9±9.7) g/L at baseline to(37.8±2.2) g/L at 6 months(F=16.71,P＜0.01 ).Complete or partial response was observed in 86％ of patients receiving tacrolimus therapy.The effective dosage in this study was 0.03-0.06mg·kg-1·d-1 of the patients who had complete response or partial response to tacrolimus.The tacrolimus level in partially and completely responding patients was less than 3 ng/ml.There was no significant difference among blood tacrolimus levels of complete,partial,and no response patients [(1.6-±0.4),(2.0±0.6) and (22±1.1) ng/nl],respectively).No definite correlation was found between efficacy and tacrolimus level.Tacrolimus was well tolerated at current dose,besides one with new onset hypertension and one with alopecia.ConclusionOur results suggest that tacrolimus at low dosage and serum level is potentially effective and safe for the treatment　of patients with LN and persistent proteinuria resistant to CYC.The optimal dosage of tacrolimus for LN may　be 0.03-0.06 mg·kg-1·d-1.

In this study, we investigated the inhibitory effect of SYT-1, a new compound of tetrahydroisoquino-line, on tumor cell proliferation and underlying mechanisms. Cell counting kit-8 (CCK-8) method was used to detect cell proliferation; clone formation experiment was used to detect cell clone formation ability; JC-1 probe was used to detect cell mitochondrial membrane potential; 2',7'-dichlorodihydrofluorescein diacetate (DCFH-DA) probe was used to detect intracellular reactive oxygen species; Annexin V-FITC/PI (fluorescein isothiocyanate/propidium) counterstaining method was used to detect apoptosis; Western blot assay was used to detect the expression level of related proteins. The experimental results show that SYT-1 has a significant inhibitory effect on the proliferation of six human-derived cancer cells. Among them, the inhibitory effect on breast cancer MCF-7 cells is the strongest, the half maximal inhibitory concentration (IC₅₀) of SYT-1 of 48 h administration on MCF-7 cells is 5.87 μmol·L^-1, which is better than that of cisplatin (8.92 μmol·L^-1). Further studies have shown that SYT-1 can dose-dependently inhibit the monoclonal formation ability of MCF-7 cells, and can cause the mitochondrial membrane potential of the cells to decrease and the level of reactive oxygen species to increase. In addition, SYT-1 can significantly inhibit the activation of PI3K-Akt (phosphatidylinositol 3-kinase/protein kinase B) signaling pathway and induce apoptosis of MCF-7 cells. The above research results show that, as a new type of tetrahydroisoquinoline compound, SYT-1 has the potential to inhibit tumor cell proliferation.

OBJECTIVETo study the expression and localization of nuclear transcription factor Sp1 in macrophages after stimulated by silicon dioxide in vivo and in vitro.

METHODSForty Sprague Dawley rats were randomly divided into the control group and the silica exposure group, 20 in each group. The rat silicosis models were established by direct tracheal instillation of silica into rat lung (0.2 g/kg) only once while the control group was instilled with equal amount of saline. Animals were killed at 1st, 7th, 14th, 21st and 28th day after instillation. Dynamic changes of Sp1 protein expression and its cellular localization were detected by immunohistochemistry in pulmonary macrophages. In vitro, Sp1 mRNA and protein expression and their dynamic changes were monitored by RT-PCR and western blotting after stimulated by silicon dioxide in cultured RAW264.7 macrophages respectively. Cellular localization of Sp1 protein was characterized by immunocytochemistry.

RESULTSCompared to the control group, the Sp1 protein expression was increased in pulmonary macrophages and reached the peak at the 14th day in the silica exposure group. In vitro, the Sp1 mRNA level began to rise at 30 minutes after the administration of silicon dioxide and reached the peak at 240 minutes and then decreased to the minimal level at 960 minutes. The Sp1 total protein and nuclear protein also exhibited the similar trend. The former reached the peak at 240 minutes and the latter at 480 minutes. The significant nuclear translocation of Sp1 protein was observed at 120 minutes after the administration of silicon dioxide and became most significant at 480 minutes.

CONCLUSIONSilicon dioxide can activate nuclear transcription factor Sp1 in macrophages in vivo and in vitro. Sp1 might play an important pathogenic role in the development of silicosis.

Animals ; Cells, Cultured ; Gene Expression Regulation ; drug effects ; Immunohistochemistry ; Macrophages, Alveolar ; drug effects ; metabolism ; Macrophages, Peritoneal ; drug effects ; metabolism ; Male ; RNA, Messenger ; genetics ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction ; Silicon Dioxide ; pharmacology ; Sp1 Transcription Factor ; biosynthesis ; genetics