Purpose To study the cytopathologic features of CT-guided percutaneous lung biopsy samples and to evaluate the role of cytopathology in the diagnosis and staging of lung carcinomas, as compared to histopathology. Methods Four-hundred twenty-five specimens were collected by CT-guided percutaneous lung biopsy which were also confirmed by histological diagnosis. Direct smears were performed for each case. Cytological and histological examination was carried out. Results The sensitivity, specificity, false positive rate, false negative rate and accuracy of cytopathology in diagnosing lung carcinomas by CT-guided percutaneous lung biopsy was 86. 6% (264/305), 100% (120/120), 0 (0/120), 13. 4% (41/305), 90. 4% (384/425), respectively. Overall 51. 1%(135/264) of the cases were precisely typed, including 77. 6% (83/107) of adenocarcinoma, 76. 9% (40/52) of squamous cell car-cinoma and 75. 0% (9/12) of small cell carcinoma. Conclusions Cytopathology of CT-guided percutaneous lung biopsy specimens is sensitive and accurate for diagnosing pulmonary carcinomas. In some cases, the lung carcinoma can be precisely typed. Therefore, it is useful for diagnosing and staging lung carcinomas.

Objective:To approach the clinicopathologic characteristics, treatment modalities, and prognosis of the patients with double primary carcinoma of endometrial carcinoma and colorectal carcinoma and analyze the relationship between this disease and Lynch syndrome. Methods:The clinicopathologic and follow-up data of 34 cases with double primary carcinoma of endometrial carci-noma and colorectal carcinoma treated in Cancer Hospital of Chinese Academy of Medical Sciences were reviewed. Results:The medi-an age of the 34 patients was 51.5 years old (ranging from 39 to 76). Twenty-two of the total cases (22/34, 64.7%) had tumor family his-tory. The pathologic results indicated that 79.4%(27/34) was endometrioid adenocarcinoma. In the 34 cases, 33 were treated by surgical procedure. Of the 33 cases undergoing surgery, 17 patients with endometrial carcinoma and 19 with colorectal carcinoma received fur-ther adjuvant treatment of chemotherapy and/or radiotherapy. The 2-and 5-year survival rates were 84.3%and 63.1%in the 34 cases, respectively. Conclusion:The age of onset is earlier in the patients with double primary carcinoma than in those with sporadic colorec-tal carcinoma. Some cases have cancer family history, and their survival rates are similar to those of the patients with sporadic colorec-tum carcinoma. Diagnosis of some patients with double primary carcinoma may be in line with Lynch syndrome.

Adult ; Bacteremia ; Hematopoietic Stem Cell Transplantation ; Humans ; Male ; Nontuberculous Mycobacteria ; Postoperative Complications

Objective To synthesize glycylproline p-nitroanilide tosylate as a substrate for glycylprolyl dipeptidyl-aminopeptidase(GPDA),and to study its clinical application.Methods The title compound was prepared by DCC-HOBt synthesis.GPDA in human serum was detected by continuous monitoring method using substrate. Results The substrate with purity of 98.5% was obtained.The linearity of the method was up to 358.1 U/L.Intraassay CV and interassay CV of GPDA in diverse serum samples were 3.01% and 5.04%,respectively.It was shown that GPDA level in patients with hepatic cancer was significantly increased,while those in patients with gastric carcinoma and chronic gastritis were significantly decreased compared with that in the control group in clinical detecting(P

Objective To investigate the efficacy and toxicity of low dose of docetaxel and cisplatin (TP) combined with radiotherapy in the treatment of elderly patients with esophageal cancer.Methods The data of 65 elderly patients with esophageal cancer were studied retrospectively, including 33 patients treated by TP combined with radiotherapy (chemoradiotherapy group) and 32 patients by radiotherapy only (radiotherapy group).Patients in both groups received 3D conventional radiotherapy (3D-CRT).In chemoradiotherapy group, 40 mg/1f docetaxel and 40 mg/1f cisplatin were administered once a week on the 1st, 8th, 15th, 22th, 36th day of five successive weeks.Results In chemoradiotherapy group and radiotherapy group, the response (CR+RR) rates were 87.8 ％ (29/33) and 65.6 ％ (21/32), respectively (P ＜ 0.05), the median TTPs were 5.5 months and 4.3 months, and the difference had statistically significant (P ＜ 0.05).The 1-year survival rate was 69.6 ％ and 59.3 ％ in chemoradiotherapy group and radiotherapy group, respectively, and there was no statistically significant difference between both groups (P ＞ 0.05).The incidences of esophagitis and gastrointestinal tract were slightly higher in chemoradiotherapy group than those in radiotherapy group (P ＜ 0.05).Conclusion Concurrent radiotherapy and chemotherapy with low dose TP can treat effectively esophageal cancer in elderly patients with the tolerable toxic reactions.

Objective To analyse the clinical data of 77 patients with unsuspected gallbladder carcinoma,and to determine the impact of TNM stage and the timing of the second operation on postoperative survival.Methods A retrospectively analysis of 77 patients operated between January 2008 and January 2013 in our hospital for unsuspected gallbladder carcinoma was carried out.The case inclusion criteria was in strict accordance with the medical records which described without preoperative diagnosis,or cholecystectomy for benign gallbladder diseases,or intraoperative or postoperative pathological diagnosis of gallbladder cancer.References to previous published medical literature and the intervals from initial cholecystectomy to further treatment were analyzed to see whether the prognosis and survival varied depending on the TNM staging and whether secondary radical surgery was carried out.Results For the 77 patients in this study,they all had high risk factors associated with gallbladder cancer which included:women,aged ＞ 50 and gallbladder stones.The initial surgery included laparoscopic cholecystectomy (n =53),and open cholecystectomy (n =24).In 26 patients,intraoperative frozen section confirmed the diagnosis and they were treated according to the TNM staging (radical operation n =7,palliative surgery n =17).The postoperative 1-,2-,3-year cumulative survival rates were 65％,45％ and 20％,respectively.For the 54 patients who underwent radical or extended radical cholecystectomy within a short interval from the first operation,the 1-,2-,3-year cumulative survival rates were 82.5％,62.5％ and 45.7％,respectively.Conclusions For resectable gallbladder cancer,the prognosis of unsuspected gallbladder carcinoma was related not only to the clinical staging,but also to the timing of the radical operation.The shorter time interval,the longer the survival,and the better the prognosis.There was no significant difference in prognosis for the group of patients with time intervals between the two operations of less than two weeks when compared with the group with immediate radical surgery.For advanced stages of gallbladder cancer,palliative surgery should be given according to the patient's general condition,aiming to improve quality of life.

BACKGROUND: When the dynamic equilibrium between oxidation system and anti-oxidation system in the body is upset, the overly produced active oxygen-derived free radicals will attack the target organs, thus resulting in the damage to organs and big molecules, and then diseases. Total anti-oxidation capacity (T-AOC), superoxide dismutase (SOD), and nitric oxide synthase (NOS) activity are the majorindexes for the defense system of the body, and their status is closely related to diseases. OBJECTIVE:To explore the level of T-AOC, SOD and NOS in serum,and find out its relationship with lifestyle. DESIGN:Single sample investigation. SETTING:Department of Health Laboratory Technology, College of Public Health of Harbin Medical University. PARTICIPANTS:Totally 531 residents of Bin County aged 20 to 70years were recruited between September 2000 and May2001. MATERIALS:The reagents kits of T-AOC, SOD and NOS were manufactured by Nanjing Jiancheng Bio-engineering Institute. METHODS:The investigators surveyed the residents with the same questionnaire. Questionnaire was made and the investigators were trained in advance. The questionnaire was filled in item by item as required. Questionnaire items consisted of the general situation, financial status, dietary habit, hobby, status of health care, and mental factor. Finally 95 investigation indexes were completed. The activity of serum T-AOC, SOD and NOS of the 531 residents in Bin County was determined, respectively, with reagent kits produced by Nanjing Jiancheng Bio-engineering Institute. The lifestyle factors were analyzed by multivariate stepwise regression analysis,and informed consent was obtained from the participants. MAIN OUTCOME MEASURFS:① Serum T-AOC, SOD and NOS in the participants; ② lifestyle factors affecting T-AOC, SOD and NOS.RFSULTS:According to actual analysis, the 531 participants entered the results analysis. T-AOC was measured in 489 participants, SOD in 525participants, and NOS in 531 participants. ① Indexes of the participants:T-AOC of the males was obviously higher than that of the females [(20.01±7.21), (15.25±6.22) kU/L, P ＜ 0.05]. SOD of the males was slightly lower than that of the females while NOS of the males was slightly higher than that of the females, but there was no significant difference. ②Multivariate stepwise regression analysis showed that risk factors related to T-AOC were gender difference (OR=2.188), educational level (OR=1.859),and the presence of rheumatism, respectively (OR =1.142). SOD-related risk factors were educational level (OR=1.584), years of spirit drinking (OR =1.048), presence of nephritis (OR=1.093), and irradiation (OR=1.770);frequency of tea drinking was a beneficial factor (OR=0.800). NOS-related risk factors were the average amount of cigarette smoking (OR=1.194) and the times of weekly spirit drinking (OR=1.368). However, the beneficial factor that affected serum NOS was the frequency of weekly mutton eating (OR=0.458) CONCLUSION:This experiment revealed that the ability to clean free radical in the 531 subjects was good and that it was better in males than in females. The increased educational level and presence of rheumatism can decrease T-AOC. Drinking, smoking and irradiation decrease SOD activity while the frequency of tea drinking and mutton eating are beneficial factors.

Objective To understand the adherence to current treatment guidelines after training in man-agement of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in emergency department (ED),and to assess the patients' prognosis. Methods Were ED doctors trained with a standard management flow-sheet for AECOPD. The treatment of 152 AECOPD patients recruited from November 1,2008 to April 30,2009 in our hospital and their prognosis were compared to those of 133 AECOPD patients who were treated between Novem-ber 1,0007 to April 30,2008. Results After training, the ED doctors' management of AECOPD is more standard. The rate of the combination of inhaled anticholinergics and short-acting β_2-agonists was increased from 12.0% (16/133) to 27.6% (42/152), the use of inhaled glucocorticosteroids was increased from 52.6% (70/133) to 88.8% (135/152), and the early use of noninvasive imermittent positive pressure ventilation(NIPPV) for the mod-erate to severe was increased from 10.5% (14/133) to 16.4% (25/152). The use of theophylline was decreased from 69.2% (92/133) to 49.3% (75/152). The in-ED mortality rate was decreased from 15.8% (21/133) to 12.5% (19/152). All the difference were significant (P< 0.05). The rate of inhaled β_2-agonists was increased from 78.2% (104/133) to 82.9% (126/152), the use of systemic glucocorticosteroids was decreased from 63.2% (84/133) to 56.6% (86/152),the use of antibiotics was increased from 88.0% (117/133) to 92.8% (141/152), and the use of invasive mechanical ventilation was increased from 14.3% (19/133) to 15.1% (23/152) ,the in-hos-pital mortality rate was decreased from 6.0% (8/133) to 5.3% (8/152), the average days in hospital was decreased from 13.3 to 12.4 days, but the difference was not significant (P > 0.05). Conclusions There are still some differences exist between guideline recommendations and actual ED management of AECOPD. After training ED doctora with a standard flow-sheet, their management of AECOPD is improved. The rate of the combination of inhaled anticholinergics and short-acting β_2-agonists, use of inhaled glucocorticosteroids, and early use of NIPPV is increased. The use of theophylline and the in-ED mortality rate is decreased.

Objective To establish a reference range of cancellous bone ultrasonic backscatter coefficient (BSC) in term neonates,and to determine the significance of BSC in bone nutritional status in term newborns and infants.Methods Six hundred and sixty-five term newborns,who were born in Shanghai First Maternity and Infant Hospital from July 2014 to August 2014,were enrolled.On the third day and the 42nd day after birth,all infants underwent ultrasonic measurement of the calcaneum bone using a broadband-non-focus ultrasonic transducer at three frequencies (2.25,3.5 and 5 MHz).MATLAB software was used to analyze the backscatter signals.Clinical data of the infants,including gestational age,birth weight and birth age,were recorded at the same time.Statistical analyses of the data included variance analysis,Tukey's test,rank sum test,Dunn test and Pearson or Spearman correlation analysis.Results (1) Of the 665 infants,335 were male.The mean gestational age at birth was (38.0± 1.9) weeks,and the mean birth weight was (3 1524±226) g.(2) On the third day,there were significant differences in BSC values acquired at 2.25 and 3.5 MHz among the groups with different gestational ages or birth weights (2.25 MHz:H=9.842 and 17.271;3.5 MHz:H=6.275 and 21.450,respectively,all P＜0.05).At 3.5 and 2.25 MHz,BSC values were positively correlated with gestational age (r=0.047 and 0.035,respectively,both P＜0.05) and birth weight (r=0.125 and 0.186,both P＜0.05).(3) On the 42nd day,significant differences in BSC were observed at each frequency among the groups with different gestational ages or birth weights (gestational age:H=76.832,16.498 and 32.756;birth weight:H=70.014,18.095 and 34.126;all P＜0.01).Gestational age and birth weight were positively correlated with BSC value acquired at each frequency (r=0.397,0.286 and 0.272 for gestational age,0.451,0.223 and 0.196 for birth weight;all P＜0.01).Conclusions A preliminary BSC reference percentile in term-born infants is established.There are positive correlations between BSC value and newborn gestational age and birth weight at certain frequencies,which can reflect the status of the newborn's cancellous bone.Determination of BSC value should be performed during the follow-up period to assess the nutritional status of neonatal bone.

As an important neurotransmitter, adenosine displays its functions by acting on the adenosine receptors. Recent studies have shown that the distribution, expression and balance among subtypes of adenosine receptors are closely related with cognitive activities, and changes of adenosine receptors play key roles in neurodegenerative disorders including Alzheimer's disease. It has been pointed out that prolonged activation of adenosine receptors by high level adenosine may lead to the disturbance of balance among adenosine receptor subtypes. This imbalance mainly performed as increased expression of A2a receptor and decreased expression of A1 receptor, and enhancement of the excitatory signals mediated by A2a receptor and weakened inhibitory signals mediated by A1 receptor. Changes of these two subtypes of adenosine receptors may lead to a lot of disorders of neurological activities which developed into dysfunction of cognition to the end. These findings imply that the potential of maintaining the balance among adenosine receptors on the treatment of AD would facilitate both the revealing of the mechanism and the cure of AD.
Adenosine ; physiology ; Alzheimer Disease ; physiopathology ; Humans ; Neurotransmitter Agents ; physiology ; Receptors, Purinergic P1 ; classification ; physiology