Objective To assess the diagnostic accuracy of solitary pulmonary nodules while selecting different backgrounds in 99 Tcm‐MIBI SPECT/CT examination .Methods Totally 38 suspected solitary pulmonary nodules (SPN) were analyzed retrospectively .The lesions were divided into malignant group and benign group according to the pathological findings . We selected two different backgrounds , contralateral lung field ( DL ) and the contralateral soft tissue (NST) .The maximum counts and the mean counts of lesion to non‐lesion ratio (L/N) were calculated to evaluate diagnostic efficacy using ROC curve . The relationship between lesion size , pathological grading and L/N ratio was analyzed by Spearman correlation analysis . Results With DL and NST as the backgrounds ,the maximum counts and the mean counts of L/N between benign and malignant groups both differed significantly (all P<0 .05) .ROC curve analysis showed as follows :With DL and NST as the backgrounds ,the area under the curve (AUC) of L/DL‐MAX ,L/DL‐MEAN ,L/NST‐MAX ,and L/NST‐MEAN was 0 .73 ,0 .78 ,0 .80 and 0 .86 ,respectively .By pairwise comparison ,there was no significant difference (all P>0 .05) .The size and pathological grading of SPN did not affect 99 Tcm‐MIBI accumulation in the SPN (all P>0 .05) .Conclusion DL and NST both can be used as the background in diagnosis of pulmonary nodules on 99 Tcm‐MIBI SPECT/CT examination .The mean counts of the contralateral tissue used as the background can provide a stable result and a high diagnostic accuracy to assess the SPN .

Objective To explore and study the effect of bundles on prevention and treatment of oral mucositis caused by chemoradiotherapy for patients with nasopharyngeal carcinoma. Methods A total of 40 patients who met the inclusion criteria from June 2014 to December 2014 were selected as the control group, who adopted routine nursing measures, 40 patients who met the inclusion criteria from January 2015 to June 2015 were assigned to the observation group. Bundles on prevention and treatment of oral mucositis caused by chemoradiotherapy for patients with nasopharyngeal carcinoma were edited using a series of evidence-based approach, and it was used to manage the patients of observation group. Results While doing 21, 28, 33 friction of radiotherapy, the oral mucositis level of 0 degree, Ⅰ degree,Ⅱ degree,Ⅲ degree and Ⅳ degree of the observation group were 8, 25, 7, 0, 0 cases;3, 11, 24, 2, 0 cases;0, 19, 13, 6, 2 cases respectively, which were lower than the control group whose degrees were 0, 31, 6, 3, 0 cases;0, 18, 11, 10, 1 cases;0, 9, 17, 9, 5 cases. The difference between the two groups was statistically significant (Z=-4.440,-3.441,-2.232, all P < 0.05 or 0.01). While doing 21, 28, 33 friction of adiotherapy, the throat pain level of 0 degree, Ⅰ degree,Ⅱ degree,Ⅲ degree of observation group were 4, 31, 5, 0; 2, 22, 14, 2; 0, 26, 12, 2 cases respectively, which were lower than the control group whose degrees were 1, 22, 16, 1 cases; 0, 10, 23, 7 cases; 0, 10, 17, 13 cases. The difference between the two groups was statistically significant (Z=-3.137,-3.326,-3.518, all P<0.01). While doing 28, 33 friction of radiotherapy, the Self Rating Anxiety Scale of the observation group scored 56.76 ± 3.19, 58.72 ± 5.41, which were lower than 60.58 ± 2.46, 63.42 ± 4.97 in the control group. The difference between the two groups was statistically significant (t=11.746, 10.561, all P <0.01). While doing 33 friction of radiotherapy, the self rating anxiety scale of the observation group was 60.56 ± 3.73, which was lower than 63.43 ± 4.77 in the control group. The difference between the two groups was statistically significant (t=-4.983, P<0.01). The following entries:swallow, sensation, eating in public, dry mouth, sticky saliva, feel sick of the quality of life questionnaire of the observation group were higher than the control group while doing 33 friction of radiotherapy. All the differences were statistically significant (t=-3.873-5.130, P<0.05 or 0.01). Conclusions The bundles could effectively prevent and treat oral mucositis caused by chemoradiotherapy for patients with nasopharyngeal carcinoma. It could release the throat pain, anxiety and depression of the patients, as well as improve the quality of life to some extent.

To investigate the cardioprotective effect of formononetin (FMN) on no-reflow (NR) after myocardial ischemia-reperfusion and its molecular mechanism based on integrated pharmacology and experimental verification, firstly, human breast cancer MCF-7 cells and myocardial NR rats were used to confirm the estrogenic activity and the effect of alleviating NR of FMN, respectively. Male SD rats were divided into Sham, NR, FMN (20 mg·kg^-1) and sodium nitroprusside (SNP, 5.0 mg·kg^-1) groups, which were administered once a day for one week, the experiment was approved by the Ethics Committee of Tianjin University of Traditional Chinese Medicine (TCM-LAEC2019095). The pharmacological analysis and in vivo study of NR rats were integrated to reveal the mechanism of FMN improving NR. The results showed that FMN had estrogenic effect and reduced NR by improving cardiac structure and function, reducing NR, ischemic myocardial area and pathological injury of cardiomyocytes. Integrated pharmacology predicts that the mechanism of FMN improving NR is mainly related to phosphatidyinositol-3-kinase-protein kinase B (PI3K-Akt) signal pathway. Phytoestrogens play a role in cardiovascular protection mainly by activating G protein-coupled estrogen receptor (GPER). GPER is also an important regulator in the upstream of PI3K-Akt signaling pathway. This study found that FMN can significantly activate GPER, p-PI3K, p-Akt and phospho-endothelial nitric oxide synthase (p-eNOS). It has good binding ability with GPER and eNOS protein. In this study, through the integration of pharmacology and experimental evaluation, it is revealed that FMN activates PI3K/Akt/eNOS signal pathway by activating GPER, thus significantly improving NR.

BACKGROUNDThe aim of this study was to compare specimen adequacy of SAP-1 provided for cytology with that of dilation and curettage (D & C) or hysteroscopy for histology, and evaluate the accuracy of combining endometrium sampling by SAP-1 and liquid-based cytology using SurePath preparation for screening endometrial carcinoma and its precursor.

METHODSEndometrial specimens from women (n = 1514) with risk factors were obtained using an SAP-1 device for cytological analysis; histological samples were obtained from 375 of these women who underwent D & C or hysteroscopy. Cytological specimens were prepared to liquid-based smear using SurePath technology and stained by Papanicolaou. Histological samples were processed in routine pathology and stained by hematoxylin and eosin.

RESULTSAdequate specimens for cytology were obtained from 1458/1541 patients (96.3%), while adequate samples for pathology were obtained from 285/375 patients (76%). However, for postmenopausal women, 1006 of 1045 cytology (86.3%) were adequate, 153 of 238 histology (64.3%) were adequate, it was easier to collect cytological specimens than histological specimens (P < 0.05). The accuracy of endometrial cytology for detecting endometrial carcinoma and its precursor was 92.4% (sensitivity, 73%; specificity, 95.8%; positive predictive value, 75%; and negative predictive value, 95.3%).

CONCLUSIONSEndometrial cytology using SAP-1 sampling and SurePath preparation may be a reliable approach for screening patients with endometrial carcinoma and its precursor.

Adult ; Biopsy ; methods ; Cytodiagnosis ; methods ; Endometrial Hyperplasia ; diagnosis ; Endometrial Neoplasms ; diagnosis ; Female ; Humans ; Specimen Handling ; methods

OBJECTIVEAlmost every neonate receives Bacillus Calmette-Guerin (BCG) vaccination in China. The authors' previous study showed that BCG promoted cord blood monocyte-derived dendritic cells maturation and induced high level of interleukin (IL)-10, medium level of interferon (IFN)-gamma, but low level of IL-4 production by cord naive T cells. The experiments in the present study were designed to explore the effects of neonatal BCG vaccination on immune functional development of splenic T cells in mice in vivo.

METHODSNeonatal BALB/c mice were inoculated with BCG intraperiotoneally. Four weeks later, spleen cells of mice were isolated and surface molecular markers of CD4, CD25 and CD44 and intracellular IFN-gamma, IL-10, and IL-4 in CD3(+) T cells were detected by flow cytometry. Furthermore, mRNA expression of transcription factor T-bet, Foxp3 and GATA-3 were analyzed by RT-PCR.

RESULTSThe percentage of total CD4(+) T cells decreased [(23.50 +/- 2.59)% vs. (47.38 +/- 10.41)%, P < 0.01] but the percentage of CD25(+) [(24.92 +/- 2.74)% vs. (20.27 +/- 2.85)%, P < 0.05] and CD44(+) [(89.29 +/- 2.56)% vs. (82.98 +/- 5.51)%, P < 0.05] T cells in CD4(+) T cells was higher in BCG-vaccinated mice than that in controls. Meanwhile, the percentage of IFN-gamma positive [(6.52 +/- 2.40)% vs. (3.13 +/- 2.03)%, P < 0.05] and IL-10 positive [(14.81 +/- 3.65)% vs. (10.90 +/- 1.61)%, P < 0.05] but not IL-4 positive [(1.17 +/- 0.46)% vs (1.51 +/- 0.75)%, P > 0.05] cells in CD3(+) T cells of BCG-vaccinated mice was significantly higher than that of non-BCG-vaccinated mice. In comparison with BCG-naive mice, T-bet was significantly high in BCG-vaccinated mice [T-bet/beta-actin 0.44 +/- 0.11 vs. 0.28 +/- 0.06, P < 0.05], but there was no significant difference in GATA-3 [GATA-3/beta-actin 0.46 +/- 0.08 vs. 0.50 +/- 0.10,P > 0.05] and Foxp3 [Foxp3/beta-actin vs. 0.27 +/- 0.11 and 0.30 +/- 0.16, P > 0.05] mRNA expression between the two groups.

CONCLUSIONNeonatal BCG vaccination could induce strong Th1 but weak Th2 response as reported previously. Though neonatal BCG vaccination was not capable of inducing CD4(+)CD25(+) regulatory T cell response with Foxp3 expression, it caused increase of IL-10(+) CD3(+) cells which might represent some regulatory T cells producing IL-10.

Animals ; Animals, Newborn ; BCG Vaccine ; immunology ; GATA3 Transcription Factor ; genetics ; Interferon-gamma ; biosynthesis ; Interleukin-10 ; biosynthesis ; Mice ; Mice, Inbred BALB C ; Spleen ; immunology ; T-Lymphocytes ; immunology ; Vaccination

AIMTo prepare verapamil hydrochloride controlled-onset extended-release pellets (VH-COERP) and study its release behavior in vitro. To compare the pharmacokinetic characteristics and bioavailability in six Beagle dogs after oral administration of VH-COERP and verapamil hydrochloride delayed-release pellets (VH-DRP) as reference.

METHODSThe core of VH-COERP were prepared in the fluidized bed (mini-glatt) by spraying water solution containing drugs onto sucrose-starch pellets with hydroroxy propyl methyl cellulose (HPMC) as the inner coating swelling layer and ethylcellulouse aqueous dispersion as the outer coating controlled layer. Through modifying the coating level of inner and outer layer, the VH-COERP with the optimized cumulative release profile was obtained. The concentration of VH in plasma of six dogs and its pharmacokinetic behaviors after oral administration of VH-COERP and VH-DRP at different times were studied by RP-HPLC. The pharmacokinetic parameters were computed by software program 3P97.

RESULTSThe lag time, the release behavior and the amount of VH from VH-COERP within 24 hours were not influenced by the pH of dissolution medium and post-process, but obviously influenced by the different kinds of added material in swelling layer and the coating level of the inner swelling layer and the outer controlled layer. In vitro the lag time of release profile of VH from VH-COERP was 5 h and then VH was extended release from VH-COERP in the following time. Compared with the VH-DRP, VH-COERP in vivo has an obviously lag time (4 h) , Tmax was also delayed (8 h) and the relative bioavailability was (94.56 +/- 7.64)%.

CONCLUSIONThe release profile of VH from VH-COERP was shown to be extended-release after an conspicuous lag time in vitro and in vivo. So the drug can be taken by the patient before bed time and begin to work at the morning.

Administration, Oral ; Animals ; Biological Availability ; Calcium Channel Blockers ; administration & dosage ; pharmacokinetics ; Cellulose ; analogs & derivatives ; chemistry ; Delayed-Action Preparations ; Dogs ; Drug Stability ; Hypromellose Derivatives ; Methylcellulose ; analogs & derivatives ; chemistry ; Microscopy, Electron, Scanning ; Verapamil ; administration & dosage ; chemistry ; pharmacokinetics

Humans ; Liver Cirrhosis ; Renin-Angiotensin System ; Self-Control

OBJECTIVESTo evaluate the long-term facial nerve function of patients following microsurgical removal of large and huge acoustic neuroma, and to identify the factors that influence these outcomes.

METHODSA retrospective review was performed which included 176 consecutive patients with a large acoustic neuroma (≥ 30 mm) underwent a retrosigmoid craniotomy for tumor resection between January 2002 to November 2009. House-Brackmann (HB) Scale was used preoperatively and in a long-term follow-up after surgery. Test for linear trend was applied for statistic analysis.

RESULTSComplete resection was achieved in 168 (95.5%) of these 176 patients with a mortality of 1.7%. Anatomic preservation of the facial nerve was attained in 96.0% of the patients. In the series of 96 patients who had at least 1-year follow-up (mean 3.0 years) the facial nerve function preservation (HB grade 1 - 2) was totally attained in 79 patients (82.3%), and 40 of 55 patients (72.7%) who presented huge tumors (diameter > 40 mm) among the 96 patients had facial nerve function preserved. Analysis showed that facial nerve function correlated linearly with tumor sizes (χ(2) = 14.114, ν = 1, P < 0.05).

CONCLUSIONSComplete removal of large and giant acoustic neuroma may be obtained via retrosigmoid approach with facial nerve preservation. Excellent long-term facial function can be expected in the majority of patients who undergo microsurgical removal of vestibular schwannoma via the suboccipital retrosigmoid approach. Tumor size is a significant prognostic parameter for facial nerve function following vestibular schwannoma surgery.

Adolescent ; Adult ; Aged ; Facial Nerve ; physiopathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Microsurgery ; Middle Aged ; Neuroma, Acoustic ; surgery ; Prognosis ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVENeonatal Bacillus Calmette-Guerin (BCG) vaccination could decrease asthma prevalence in human according to "hygiene hypothesis". The authors proposed a hypothesis that effect of BCG vaccination on inhibiting asthma in human might be reversed by respiratory virus infection. The objective of this study was to observe combined effects of neonatal BCG vaccination and respiratory syncytial virus (RSV) infection on experimental asthma in mice.

METHODSNeonatal BALB/c mice were divided into five groups. Control and ovalbumin (OVA) groups were mock-vaccinated at birth and mock-infected at 3 weeks of age. BCG + OVA group was BCG-vaccinated and mock-infected. RSV + OVA group was mock-vaccinated and RSV-infected. BCG + RSV + OVA group was BCG-vaccinated and RSV-infected. Except for control group, all the other groups underwent ovalbumin (OVA) sensitization and challenge. Airway responsiveness to inhaled methacholine was measured and bronchoalveolar lavage (BAL) was performed after the last challege. Cells in BAL fluid (BALF) were counted. Cytokines in BALF and serum OVA-specific IgE were detected by ELISA and inflammatory characteristics of lungs was scored by staining with hematoxylin and eosin.

RESULTS(1) The numbers of total white cells, lymphocytes, monocytes, neutrophils, and eosinophils in the BALF from all OVA-sensitized/challenged groups were significantly greater than those in control (P < 0.01), and BCG + OVA group had significantly lower total white cells, lymphocytes and eosinophils as compared with other OVA-sensitized/challenged groups (P < 0.05 or 0.01). (2) All OVA-sensitized/challenged groups had significantly lower IFNgamma (P < 0.05) and higher IL-4 (P < 0.05) level in BALF as compared with control, but there was no significant difference among all OVA sensitized/challenged groups. There was no significant difference in IL-10 level between all experimental groups. (3) All OVA-sensitized/challenged groups showed significantly higher serum OVA-specific IgE titers than control (P < 0.05 or 0.01), but no significant difference was found among all OVA sensitized/challenged groups. (4) RSV + OVA and BCG + RSV + OVA groups displayed the highest airway resistance and subsequently in order as follows: OVA group, BCG + OVA group and control group in severity of airway hyperreactivity (AHR), but no significant difference was found between RSV + OVA and BCG + RSV + OVA groups. (5) Histological score of peribronchiolitis, perivasculitis, alveolitis, and peribronchial eosinophilia in all OVA-sensitized/challenged groups was significantly higher than that in control. BCG + OVA group had significantly milder peribronchiolitis and peribronchial eosinophilia than the other OVA-sensitized/challenged groups (P < 0.05) and significantly milder alveolitis than OVA and BCG + RSV + OVA groups (P < 0.05).

CONCLUSIONNeonatal BCG vaccination decreased asthmatic inflammation and AHR and RSV infection could reverse anti-asthma effect of neonatal BCG vaccination in OVA-sensitized/challenged mouse model.

Animals ; Animals, Newborn ; Asthma ; immunology ; prevention & control ; BCG Vaccine ; administration & dosage ; immunology ; pharmacology ; Bronchoalveolar Lavage Fluid ; Disease Models, Animal ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; drug effects ; immunology ; secretion ; Immunoglobulin E ; analysis ; immunology ; Interferon-gamma ; analysis ; immunology ; Interleukin-10 ; analysis ; immunology ; Interleukin-4 ; analysis ; immunology ; Leukocytes ; drug effects ; immunology ; secretion ; Lung ; drug effects ; immunology ; Mice ; Mice, Inbred BALB C ; Ovalbumin ; administration & dosage ; immunology ; toxicity ; Respiratory Syncytial Virus Infections ; immunology ; Respiratory Syncytial Viruses ; immunology ; pathogenicity ; Treatment Outcome

OBJECTIVETo study the clinical effificacy of electroacupuncture (EA) on treating knee osteoarthritis (KOA) of Shen ()-Sui () insuffificiency (SSI) syndrome type.

METHODSA total of 245 patients (279 knees) of KOA-SSI were randomly assigned to two groups by lottery: 141 knees in the treatment group and 138 knees in the control group. The treatment group was managed with EA at the dominant points of Neixiyan (Ex-LE4) and Waixiyan (Ex-LE5) as well as the conjugate points of Xuanzhong (GB39) and Taixi (KI3) for 30 min, once a day, with 15 days as one course; 2 courses were applied with a 5-day interval in between. The control group was treated with intra-articular injection of 2 mL hyaluronic acid into the affected joint every 7 days for 5 times in total. The clinical effects on the patients in different stages were observed, and their symptom scores of knee and contents of cytokines, including interleukin-1 (IL-1), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), prostaglandin E(2alpha) (PGE(2alpha)) and matrix metalloproteinases-3 (MMP-3), in the knee joint fluid were measured before and after treatment.

RESULTSThe study was completed in 235 patients (263 knees); four patients (7 knees) in the treatment group and six patients (9 knees) in the control group dropped out. Comparison of therapeutic effects (excellent and effective rates) between the two groups showed insignificant differences (P>0.05). Symptom scores of knee and contents of cytokines in the knee flfluid after treatment were lowered signifificantly in the patients of stage I-III in both groups (P<0.05 or P<0.01). However, the lowering of the total symptom score of knee in the patients of stage III in the treatment group was more signifificant (P<0.05).

CONCLUSIONSEA could effectively alleviate the clinical symptoms in KOA patients of stage III, showing an effect superior to that of hyaluronic acid. EA also shows action in suppressing the secretion of IL-1, IL-6, TNF-alpha, PGE(2alpha) and MMP-3 in the knee flfluid.

Aged ; Cytokines ; metabolism ; Electroacupuncture ; adverse effects ; methods ; Female ; Humans ; Male ; Matrix Metalloproteinase 3 ; metabolism ; Middle Aged ; Osteoarthritis, Knee ; diagnostic imaging ; enzymology ; therapy ; Radiography ; Syndrome ; Synovial Fluid ; enzymology ; Treatment Outcome