Objective To evaluate the clinical diagnostic value of nucleic acid amplification (TB- RNA),bacteriophage-based assay,3D culture and smear on the detection of Mycobacteria tuberculosis.Methods 291 clinical sample including 110 sputum,54 thoracic fluid,37 throat swab,31 bronchial fluid,13 cerebrospinal fluid,12 urine,8 lymph fluid and 20 others (pericardial effusion,feces, blood and abdominal fluid) and gynecological specimen (including 6 leucorrhoea and menstrual blood) were analyzed by these four methods.Results Among the 291 clinical samples,the positive rate of mycobacteria tuberculosis for TB-RNA,bacteriophage-based assay,3D culture and smear were 37.1%,28.9%,27.5% and 10.3%.The sensitivity and specificity of the TB-RNA,bacteriophage-based assay,3D culture and smear were 54.3% & 100%,41.7% & 88.9%,31.7% & 93.5% and 14.6% & 98.9%,respectively.Conclusions TB-RNA is an effective clinical diagnostic method for Mycobacteria tuberculosis.Although the sensitivity of smear is poorer than others,it is a universal testing method in clinical laboratory due to low cost.The positive rate of mycobacteria tuberculosis for 3D culture is lower than that of bacteriophage-based assay and TB-RNA.Although the time to result for 3D culture might last for few weeks,the isolates can be used for drug resistance screening and bacterial identification.

OBJECTIVETo analyze the current situation and trend of Mycobacteria other than tuberculosis (MOTT) in the old city area of Guangzhou and to provide information for diagnosis, treatment and policy on tuberculosis (TB) control in the city.

METHODSRelevant data regarding Mycobacteria culture, species identification and drug-resistance from out-patients under suspicion of having pulmonary tuberculosis seen at our TB and Pulmonary Tumor Control Institute, was analyzed retrospectively during 1994-2003.

RESULTSA total number of 12,634 strains of Mycobacteria were isolated and 794 strains were identified as MOTT which accounted for 6.28% of the isolated strains during the ten years. The annual isolation rates of MOTT were between 3.51% and 10.06%. When compared with 1994, the rates of isolation on MOTT had increased 73.15% in 2003, i.e. from 5.81% in 1994 to 10.06% in 2003. 512 strains were not susceptible at least to rifampin and isoniazid out of 613 MOTT strains tested for drug susceptibility to isoniazid, rifampin, streptomycin sulfate and ethambutol. The average rate of multi-drugs resistance of these strains was 83.5%, and the annual rates were between 71.4% and 93.9%. Based on the results of species identification on 136 strains of MOTT in 2003, most of them belonged to pathogenic/opportunistic species of Mycobacteria. All together, 30 strains of M. abscessus, 26 of M. intracellulare, 17 of M. smegmatis, 14 of M. scrofulaceum, 11 of M. avium, 5 of M. kansasii and M. chelonae and M. fortuitum respectively, 4 of M. nonchromogenicum, 2 of M. triviale and 1 of M. aurum were identified. People at 45 years of age or older, with 55-65 the most, were more susceptible to MOTT than other age groups. Sex ratio was 3.36 to 1.

CONCLUSIONBased on information from the Third National Tuberculosis Epidemiology Survey in 1990 and the Fourth one in 2000, the current situation and trend of MOTT were nearly the same in the old city area of Guangzhou during 1994-2003. However, the rising tendency of rate of isolation, mainly consisted of opportunistic pathogens and the surprisingly high rate of multi-drugs resistance to MOTT all call for special attention. Studies regarding the epidemiology of MOTT should be posed and implemented in the National TB Control Program.

Adult ; Aged ; China ; epidemiology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Mycobacterium Infections, Nontuberculous ; epidemiology ; Mycobacterium avium-intracellulare Infection ; epidemiology

OBJECTIVETo study spiral CT cholangiography (SCTC) before treatment in patients with obstructive jaundice due to unknown cause.

METHODSBetween October 1998 and November 2000, a total of 59 patients with obstructive jaundice of unknown cause were examined by two-phase enhanced spiral CT (eSCT). Twenty-nine of these cases were excluded because they had had T-Bil of > 34 micromol/L so that their biliary duct system could not have been visualized. The remaining 30 patients were 17 male and 13 female with an age range of 31 - 76 years (mean 56.6). Pathologically, the lesion was proven to be carcinoma of pancreatic head (n = 9), Vater's ampulla carcinoma (n = 4), extrahepatic or hilar cholangiocarcinoma (n = 13), hepatocellular carcinoma (n = 1), chronic pancreatitis (n = 1) and cholelithiasis (n = 2). SCTC was performed through intravenous injection of 20 ml 50% Cholografin within 20 min before eSCT. SCTC was undertaken with parameters of a slice thickness of 2 - 3 mm, a table feed of 3 - 5 mm, a gantry time of 0.75 sec, a reconstruction interval of 1 - 2 mm, a pitch of 1.1 - 1.2, a voltage of 120 kV, a current of 220 - 240 mA, a matrix of 512 x 512 and a scan range from the level above hepatic hilum to the third segment of duodenum within 60 - 105 min following the injection. Both reconstructed SCTC source images and later eSCT scans were considered as axial CT (ACT). Multiplanar reconstruction (MPR) was obtained immediately on the operator console. 3D imaging adopted in our study was volume rendering technology (VRT) that was processed on the Siemens 3D Virtuoso workstation within 30 min. Opacification of biliary tree (OBT) analyzed by Grades 1 to 5 and image quality (IQ) assessed by 4 scales as excellent, good, fair and poor were investigated in ACT, MPR and VRT, respectively. The correlation between total OBT, which was the highest among the 3 image methods in the same case, and T-Bil, D-Bil, ALT, severity of the biliary obstruction (SBO) as well as level of the obstruction was analyzed.

RESULTSIn OBT, no statistically significant difference was found in the five grades by the three imaging techniques (P > 0.05), the distribution of percentages being 0, 0, 13.3%, 30.0% and 56.7% in ACT, 0, 6.7%, 20.0%, 30.0% and 43.3% in MPR and 0, 0, 13.3%, 40.0% and 46.7% in VRT. The evident correlation between total OBT and D-Bil (r(s) = -0.719), ALT (r(s) = -0.544) and SBO (r(s) = 0.650) was showed. In IQ, only a statistical significance existed between ACT and MPR (P = 0.034), having the scales "excellent to poor" in percentages of 93.3%, 6.7%, 0 and 0 for ACT, 66.7%, 30.0%, 3.3% and 0 for MPR and 70.0%, 23.3%, 6.7% and 0 for VRT, respectively.

CONCLUSIONAccording to our study, spiral CT cholangiography is very useful for the evaluation of selected patients with suspected obstructive jaundice before treatment.

Adult ; Aged ; Bile Duct Neoplasms ; diagnostic imaging ; Cholangiography ; methods ; Female ; Humans ; Image Processing, Computer-Assisted ; Jaundice, Obstructive ; diagnostic imaging ; Male ; Middle Aged ; Pancreatic Neoplasms ; diagnostic imaging ; Tomography, Spiral Computed ; methods

OBJECTIVETo investigate the status of male reproductive health among middle-aged and older men in the urban area of Nanjing.

METHODSWe collected the laboratory results of 884 middle-aged and older men aged 55 - 89 years from the Xuanwu District of Nanjing present for routine physical examinations, including those of blood routine tests, liver and kidney function, blood glucose, blood lipid, and total prostate specific antigen (TPSA), as well as such reproductive hormone indexes as total serum testosterone (TT), free serum testosterone (fT), and sex hormone binding globulin (SHBG). We also obtained the above reproductive hormone indexes from 119 young and middle-aged men aged 20 - 39 years as controls.

RESULTSAging-related changes were found in the 50 percentiles of all the reproductive hormones and relevant parameters but those of TT and E2, with gradual increases in LH, FSH and SHBG and decreases in fT, TSI and fTI. Comparison of reproductive hormones and relevant parameters by Mann-Whitney U test did not show any statistically significant differences in the TT level between any two of the five age groups (20 - 39, 55 - 59, 60 - 69, 70 - 79, and > or = 80 yr) (P > 0.05) except between the control and > or = 80 yr groups and the 60 - 69 and > or = 80 yr groups (P < 0.05), nor in the E2 level between any two groups, nor in the levels of LH and FSH except between the 55 - 59 and 60 - 69 yr groups and the 70 - 79 and > or = 80 yr groups, and nor in the levels of fT and TSI except between the 55 - 59 and 60 - 69 yr groups. However, there were significant differences in the levels of SHBG and fTI between any two age groups. Spearman correlation analysis revealed that fT, TSI, and fTI were correlated negatively with aging and LH (P < 0.05, I r I > 0.5) but weakly positively with cholesterol, blood glucose and hemoglobin (P < 0.05, /r/ < 0.5), SHBG and LH positively with aging, SHBG weakly negatively with blood glucose and hemoglobin, LH weakly negatively with hemoglobin, and TT weakly negatively with aging but positively with hemoglobin.

CONCLUSIONThe levels of serum testosterone, particularly that of fT, declined with aging in middle-aged and older men in the urban area of Nanjing, which may contribute to abnormal lipid metabolism, low hemoglobin and high blood glucose.

Aged ; Aged, 80 and over ; Aging ; blood ; Blood Glucose ; analysis ; Case-Control Studies ; China ; Follicle Stimulating Hormone ; blood ; Humans ; Luteinizing Hormone ; blood ; Male ; Middle Aged ; Prostate-Specific Antigen ; blood ; Sex Hormone-Binding Globulin ; analysis ; Statistics, Nonparametric ; Testosterone ; blood

OBJECTIVESTo observe immunogenicity of new DNA vaccine encoding for hepatitis B virus core antigen (HBcAg).

METHODSA new DNA vaccine (pSW3891/HBc) encoding for hepatitis B virus core antigen was constructed using plasmid pSW3891 which can be used in human. Control and experiment groups of Balb/c mice were immunized with pSW3891 or pSW3891/HBc by gene gun. Anti-HBc in sera of mice was tested by ELISA (enzyme linked immune sorbent assay). Specific cytotoxicity of cytotoxic T lymphocyte (CTL) of mice was detected by LDH release assay.

RESULTSpSW3891/HBc can express in 293T cell line effectively. Mice immunized with pSW3891/HBc showed strong anti-HBc response and specific high cytotoxicity of CTL.

CONCLUSIONpSW3891/HBc induced significantly humoral and cellular immune responses in Balb/c mice.

Animals ; Hepatitis B Antibodies ; blood ; Hepatitis B Core Antigens ; genetics ; immunology ; Hepatitis B Vaccines ; immunology ; Immunity, Cellular ; Mice ; Mice, Inbred BALB C ; T-Lymphocytes, Cytotoxic ; immunology ; Vaccines, DNA ; immunology

OBJECTIVETo explore the pathogenesis of the damage to peripheral nerves induced by Campylobacter jejuni exotoxin (CJT).

METHODS(1) Animal models: (1) The CJT was extracted from PEN 19-CJ and injected perineurally and intravenously to Wistar rats. (2) The sera and the supernatants of peripheral blood mononuclear cells (PBMCs), taken from the rats immunized with the CJT, were injected perineurally at sciatic nerves of experimental rats and intravenously, respectively. (2) Histopathologic study of sciatic nerves: the animals were sacrificed and their sciatic nerves were examined for tease fibers, transverse section with toluidine blues staining and electron microscopy. (3) Immunohistochemistry: sections of sciatic nerves of either normal rats or human which were incubated with CJT and the sciatic nerves with pathological changes induced by CJT were obtained for observation of the binding capability of CJT with peripheral nerves by SABC and FITC-immunofluorescence methods, and nucleic acid hybridization techniques for detection of TNF-alpha mRNA expression in pathological sciatic nerves samples.

RESULTS(1) Remarkable peripheral neuropathies with axon degeneration and/or demyelination were found in the nerves induced by both CJT injection perineurally and intravenously. The axon degeneration was more obvious. Pathological changes were identified in 76.8% (2,763/3,600) of teasing fibers after perineural injection, but only 9.6% (230/2,400) of fibers were damaged in control group (P < 0.01). The peak severity of fiber damage was found on the 3rd day after CJT intravenous injection with the incidence of abnormal fibers was 19.5% (390/2,000), and abnormalities of 15.5% (310/2000) on the 14th day. However, no abnormal changes were demonstrated in control group (P < 0.01). So was in the groups injected with anti-CJT sera and the supernatants of PBMCs compared with control (P > 0.05). (2) Binding of CJT to the nerve was found dominant in the sciatic nerves taken from normal rats or human either incubated with CJT or in the pathological sciatic nerves induced by CJT to various degrees. The binding of CJT to all these nerves was determined. (3) After intravenous injection with CJT, no histopathologic change could be found in the other viscera of the rats, with the exception of remarkable pathological change in peripheral nerves.

CONCLUSIONS(1) CJT could remarkably damage the peripheral nerves in rats. Specific pathogenicity of CJT to peripheral nerves was well shown, because no histopathologic abnormalities could be found in the other viscera, such as brain, liver and kidney etc. although there was remarkable pathological change along the peripheral nerve in the animals. (2) No immunological pathogenicity of CJT could be demonstrated in the nerves of rats after immunization with CJT.

Animals ; Antibodies, Anti-Idiotypic ; blood ; Bacterial Toxins ; immunology ; toxicity ; Campylobacter jejuni ; immunology ; Exotoxins ; immunology ; toxicity ; Gene Expression ; drug effects ; Peripheral Nerves ; drug effects ; metabolism ; pathology ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Wistar ; Sciatic Nerve ; drug effects ; metabolism ; pathology ; Tumor Necrosis Factor-alpha ; genetics

OBJECTIVETo assess the efficiency and safety of radiofrequency ablation (RFA) of recurrent hepatocellular carcinoma (RHCC) after hepatectomy and to investigate efficacy of RFA for patients with early and late phase recurrence, separately, setting 1 year as the cut-off between the early and late phases.

METHODSA total of 42 patients with 77 RHCC and a history of hepatic resection for hepatocellular carcinoma (HCC) underwent ultrasound-guided percutaneous radiofrequency ablation in our department and entered this study (RHCC group). The average diameter of RHCC was (3.8 +/- 1.4) cm (range, 1.5-6.6 cm). 21 of the 42 RHCC patients had Child-Pugh class A cirrhosis 19, class B and two, class C cirrhosis. The average interval between initial surgery and the diagnosis of recurrence was 22.8 months (range, 1-96 month). 42 RHCC patients were divided into two groups as early recurrence group including 20 patients with 40 RHCC, and late recurrence group including the other 22 patients with 37 RHCC according to the recurrence interval. During the same period 148 patients with 217 primary HCC were also treated by RF ablation and regarded as primary HCC group. The average diameter of primary HCC was (4.0 +/- 1.4) cm (range, 1.2-7.0 cm). Regular follow-up with enhanced CT was performed to evaluate the treatment results. Ablation was considered a success if no contrast enhancement was detected in the treated area on 1 month CT scans.

RESULTSThe ablation success rate, local recurrence rate, new tumor incidence and mean survival in RHCC group were 90.5%, 14.3%, 38.1% and (28.0 +/- 3.5) months, respectively, which were similar to the corresponding results of 87.2%, 16.2%, 37.8% and (39.0 +/- 2.1) month in primary HCC group. However, when further comparison was performed between early recurrence group, late recurrence group and primary HCC group, there were some significant differences. The incidence of new tumors in early recurrence group was significantly higher than that in late recurrent group (60.0% vs. 18.2%, P = 0.005); early recurrence group survived shorter than primary HCC group [(15.4 +/- 2.3) vs. (39.0 +/- 2.1) months, P < 0.005]. The survival time was similar between late recurrence group and primary HCC group. One case was found haemorrhage after RFA and recovered with conservative treatment. No major complications occurred in the remaining 41 patients.

CONCLUSIONSRF ablation is generally effective and safe in treating RHCC. And it's more effective in late recurrence than in early recurrence.

Adult ; Aged ; Carcinoma, Hepatocellular ; diagnostic imaging ; surgery ; Catheter Ablation ; Female ; Humans ; Liver Neoplasms ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; surgery ; Retrospective Studies ; Survival Rate ; Time Factors ; Treatment Outcome ; Ultrasonography, Interventional

OBJECTIVETo study the manifestation of breast cancers of different sizes in contrast-enhanced sonography.

METHODSEighty-four patients with breast cancers were examined by contrast-enhanced ultrasound. Among them, the tumor diameter was beyond 2.0 cm in 50 cases, and no greater than 2.0 cm in the rest cases. The time-intensity curve (TIC) on the enhanced images was analyzed quantitatively, and the relations between the type of TIC and the enhancement patterns of the tumors were analyzed.

RESULTSThe enhancement patterns of the breast cancers showed significant difference between patients with tumor diameter beyond 2.0 cm and those with smaller tumors (P<0.01), but the other parameters were comparable between the two groups (P>0.05).

CONCLUSIONThe enhancement patterns of breast cancers differ between tumors with sizes over 2.0 cm and smaller tumors, and differential analysis is suggested in the diagnosis of breast cancer using contrast-enhanced ultrasound.

Adult ; Aged ; Breast Neoplasms ; diagnostic imaging ; pathology ; Contrast Media ; Female ; Humans ; Middle Aged ; Retrospective Studies ; Tumor Burden ; Ultrasonography

OBJECTIVETo evaluate the feasibility of whole body diffusion weighted imaging (DWI) in bone metastasis detection using bone scintigraphy as comparison.

METHODSForty-five patients with malignancy history were enrolled in our study. All the patients received the whole body DWI and bone scintigraphy scan within 1 week. The magnetic resonance (MR) examination was performed on 3.0T MR scanner using embedded body coil. The images were reviewed separately by two radiologists and two nuclear medicine physicians, who were blinded to the results of the other imaging modality. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the two techniques for detecting bone metastasis were analyzed.

RESULTSA total of 181 metastatic lesions in 77 regions of 34 patients were detected by whole body DWI, and 167 metastatic lesions in 76 regions of 31 patients were identified by bone scintigraphy. The patient-based sensitivity and PPV of whole body DWI and bone scintigraphy were similar (89.5% vs. 81.6%, 97.1% vs. 91.2%), whereas, the patient-based specificity and NPV of whole body DWI were obviously higher than those of bone scintigraphy (85.7% vs. 57.1%, 60.0% vs. 36.4%). Ten regions negative in scintigraphy but positive in whole body DWI, mainly located in spine, pelvis, and femur; nine regions only detected by scintigraphy, mainly located in skull, sternum, clavicle, and scapula. The region-based sensitivity and specificity of whole body DWI were slightly higher than those of bone scintigraphy (89.5% vs. 88.4%, 95.6% vs. 87.6%).

CONCLUSIONWhole body DWI reveals excellent concordance with bone scintigraphy regarding detection of bone metastasis, and the two techniques are complementary for each other.

Aged ; Bone Neoplasms ; diagnosis ; pathology ; secondary ; Diffusion Magnetic Resonance Imaging ; instrumentation ; methods ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Radionuclide Imaging ; Sensitivity and Specificity ; Whole Body Imaging ; instrumentation ; methods

OBJECTIVETo investigate the time of whole brain irradiation and the prognostic factors for non-small lung cancer patients with brain metastasis.

METHODSFrom August 1996 to December 2003, 147 patients with brain metastasis from non-small cell lung cancer received whole brain irradiation. The patients were divided into two groups: with or without symptoms caused by brain metastasis, each group was then divided into two sub-groups, early whole brain irradiation group (the interval between the diagnosis of brain metastasis and the brain irradiation < or = one month) and late group ( the interval > one month ). Univariate and multivariate analysis (Cox regression) as well as Kaplan-Meier method in SPSS software package 11.5 was used to analyze the data of the 147 patients including 72 with brain metastasis symptom and 75 without.

RESULTSThe median survival time (MS) of patients with or without extracranial metastasis was 9.9 months and 11.3 months (P = 0.0002). Multivariate analysis indicated that extracranial metastasis was an independent prognostic factor (P = 0.0004). For 72 patients with brain metastasis symptom, the MS of the patients with and without extracranial metastasis was 9.3 months and 11.3 months (P = 0.0036). The MS of patients with early and late whole brain irradiation was 11.4 months and 9.2 months (P = 0.001). Multivariate analysis showed that extracranial metastasis, the interval between the diagnosis of brain metastasis and the whole brain irradiation were independent prognostic factors. However, for 75 patients without brain metastasis symptom, the MS difference of those with early or late whole brain irradiation was not statistically significant (P = 0.1643).

CONCLUSIONThe extracranial metastasis in non-small cell lung cancer patients with brain metastasis is an independent prognostic factors. Early whole brain irradiation may improve the survival for those with brain metastasis symptoms.

Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bone Neoplasms ; drug therapy ; radiotherapy ; secondary ; Brain Neoplasms ; drug therapy ; radiotherapy ; secondary ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; pathology ; radiotherapy ; secondary ; Combined Modality Therapy ; Cranial Irradiation ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms ; drug therapy ; radiotherapy ; secondary ; Lung Neoplasms ; drug therapy ; pathology ; radiotherapy ; Male ; Middle Aged ; Neoplasm Staging ; Proportional Hazards Models ; Radiotherapy, High-Energy ; Retrospective Studies ; Survival Rate ; Time