Objective To evaluate the effect of CT temporal subtraction(TS) for detection of lung nodules.Methods 80 cases of CT images (current and previous CT images) and corresponding CT TS images were presented, which included 30 cases with nodules(75 nodules) and 50 controls.4 observers, including 2 radiologists and 2 residents, indicated their confidence level regarding the presence of a new emerging or larger or solid component than before,which first used standard CT images, then with the addition of CT TS images.Receiver operating characteristic(ROC) curve analysis was used to evaluate the observers'' performance.Results The mean value of the area under the ROC curve (AUC) were 0.860 and 0.925 for four observers without and with TS images,respectively(P<0.01).Average sensitivity for detection of lung nodules was improved from 77.3%(58/75) to 89.3%(67/75) by using CT TS images.Conclusion The use of CT TS images can significantly improve radiologists'' performance for detection of lung nodules,especially when a small size solid or subsolid nodule presents near the pulmonary hilum.CT TS is more helpful for residents.

Objective To prospectively compare MR pulmonary perfusion imaging with quantitative HRCT for the detection of mild chronic obstructive pulmonary disease (COPD) and classification of COPD.Methods Sixty-two consecutive patients with COPD and 17 healthy volunteers underwent pulmonary function test (PFT),HRCT and MR perfusion imaging on the same day.According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD),all COPD patients were classified into 4 stages:stage Ⅰ (n =19),stage Ⅱ (n =17),stage Ⅲ (n =14),stage Ⅳ (n =12).The signal intensity of perfusion defects (SIPD),signal intensity of normal lung perfusion (SInormal) on 3D MR perfusion were obtained through postprocessing and the signal intensity ratio (RSI) was calculated.The total lung volume (TLV) was calculated automatically on HRCT and the total emphysema volume (TEV) was obtained by applying -950 HU thresholds.The TEV/TLV was deduced as emphysema index (EI).Several comparisons were made between the volunteers and COPD patients by one-way ANOVA and Kruskal-Wallis test.Results The RSI,SIPD,PEI,MSI,MSD values of MRI perfusion in volunteers (43.9 ± 7.2,48.2 ± 19.7,31.4,55.7,44.1) were significantly different from those in patients with COPD (18.1 ± 8.1,47.4 ± 20.0,8.6,30.2,22.7) (P ＜ 0.01).The RSI showed a significant difference between stage Ⅰ (24.4 ± 9.8) and stage Ⅲ (15.9 ± 5.3) or Ⅳ (9.2 ± 2.7) and between stage Ⅱ (19.9 ± 3.1) and stage Ⅳ (t =4.05-6.64,P ＜0.01).However,all MRI perfusion parameters between stage Ⅰ and stage Ⅱ,stage Ⅱ and stage Ⅲ,stage Ⅲ and stage Ⅳ were no differences (t =2.00-4.46,P ＞ 0.05).The median of EI in volunteers and stage Ⅰ-Ⅳ COPD patients were 1.2,3.8,8.0,13.7,18.3,and the quartile range were 3.7,7.1,9.2,10.5,7.7,respectively.The EI in volunteers showed significant differences with that of stage Ⅱ-Ⅳ COPD and the EI of stage Ⅳ was different from that of stage Ⅱ or Ⅰ (t =-7.32--1.85,P ＜ 0.01),but there was no significant difference between volunteers and stage Ⅰ COPD (t =-1.99,P ＞ 0.05).Conclusions The RSI of MRI is more sensitive than that of HRCT for assessing mild COPD.The severity of COPD could be reflected by MRI perfusion and HRCT.

Objective To evaluate the performance of bone suppression images on the detection of lung nodules in comparison with the radiologists'reading results.Methods There were 141 standard posteroanterior digital chest radiographs,which included 95 patients with a solitary nodule and 46 controls.In this observational study,4 observers,including 2 radiologists and 2 residents,in-dicated their confidence level regarding the presence of a nodule for each lung,first by use of standard images,then with the addition of bone suppression images.Receiver operating characteristic (ROC)curve analysis was used to evaluate the observers'performance. Results Average nodule size was (1.9±1)cm (range from 0.9 cm to 2.9 cm).The mean value of the area under the ROC curve (AUC)was significantly improved from 0.844 with use of standard images alone to 0.873 with use of bone suppression images (P<0.01).Conclusion The use of bone suppression images can improve radiologists'performance on detection of lung nodules on chest radiographs.

Objective To observe the effects of vaporized perfluorocarbon (PFC) combined with exogenous pulmonary surfactant (PS) inhalation on rabbit models of acute lung injury (ALI).Methods Thirty-two New Zealand rabbits were randomly divided into four groups: ALI group, combination treatment group, PFC group, and PS group (each groupn = 8 rabbits). The rabbit model of ALI was induced by the whole lung normal saline lavage. After modeling, in the combined group, 3 mL/kg vaporized perfluorooctyl bromide/dipalmitoylphosphatidylcholine (PFOB/DPPC) emulsion was inhaled, the rabbits in PFC and PS groups were treated with vaporized PFOB emulsion and vaporized DPPC emulsion 3 mL/kg inhalation respectively, and in the ALI group was given the same amount of vaporized normal saline inhalation. In each group, before modeling for 30 minutes (basic value), after modeling for 1 hour and after treatment at 0 minute, 30 minutes, 2 hours, 4 hours, the respiratory rate (RR), oxygenation index (OI), dynamic lung compliance (Cdyn) were observed, and the lung coefficient (LI) and lung permeability index (LPI) were calculated; the levels of serum tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) were measured by double antibody sandwich enzyme-linked immunosorbent assay (ELISA); the lung tissue was collected and the lung pathological changes were observed under macroscopic and microscopic observation.Results Aftermodeling, the levels of OI, Cdyn were quickly lowered, RR became significantly elevated, and there were obvious edema, hemorrhage and exudation in lung tissue of ALI group. The levels of OI were significantly increased in combined group and PFC group compared with the level in ALI group after treatment at 0 minute initially [mmHg (1 mmHg = 0.133 kPa): 231.0±16.7, 221.4±19.0 vs. 189.5±21.0, both P < 0.05], while the level of OI in PS group was increased significantly until 4 hours after treatment, being higher than that in ALI group (mmHg: 297.0±20.7 vs. 243.3±36.7,P < 0.05); RR was decreased significantly in combined treatment group at 30 minutes after treatment compared with that in ALI group (bpm: 151.1±13.3 vs. 178.5±32.0,P < 0.05), while the RR in PFC group and PS group were not increased significantly until 4 hours after treatment being higher than that in ALI group (bpm: 129.3±14.3, 133.1±13.9 vs. 157.5±32.5, bothP < 0.05). Compared to ALI group, the three treatment groups resulted in significant improvement in Cdyn right at 0 minute (mL/cmH2O: 1.64±0.10, 1.45±0.10, 1.43±0.09 vs. 0.57±0.05, allP < 0.05), their LPI, LI and inflammatory cytokines were significantly decreased [LPI (×10-5): 4.21±0.42, 4.76±0.55, 4.87±0.49 vs. 5.56±0.52, LI: 8.04±0.58, 8.90±0.88, 9.22±0.71 vs. 10.85±0.73, TNF-α (ng/L): 50.05±4.91, 56.18±5.54, 63.60±5.96 vs. 73.60±5.27, IL-1β (ng/L): 34.27±4.55, 40.29±5.03, 48.13±6.38 vs. 54.71±4.26, allP<0.05], and pulmonary edema, congestion and inflammatory cell infiltration were obviously ameliorated (pathological scores: 3.74±0.58, 4.50±0.75, 5.29±0.72 vs. 6.13±0.72, P < 0.05). Cdyn levels were increased significantly in combined treatment group at 0 minute, 30 minutes, 4 hours after treatment compared with thosein PFC and PS group, but there were no significant differences between PFC and PS group. Levels of LI, LPI, inflammatory factors and pathological scores were decreased significantly in combined treatment group compared with those in PFC and PS group, the degrees of improvement of inflammatory factors and pathological scores in PFC group were more obvious than those in PS group (allP < 0.05).Conclusions PFOB combined with DPPC inhalation can provide greater oxygen delivery, reduce the pro-inflammatory cytokines, supplement PS and influence its distribution on the surface of lung, which might lead to a marked and sustained improvement in oxygenation, pulmonary function and amelioration of lung edema and inflammatory reaction in saline lavage induced lung injury of rabbits.

Objective To analyze the morphological features of smokers' lung on MDCT scan,measure the CT volumetric parameters,and explore the correlation with pulmonary functional test(PFT) indexes.Methods 59 smokers were enrolled,in which 14 were chronic obstructive pulmonary disease(COPD) patients,and 39 non-smokers were chosen as control group.All subjects underwent inspiratory and expiratory phase MDCT scan and PFT.Eleven pulmonary CT features caused by smoking among three groups were analyzed and compared.The emphysema index (EI 95) and mean lung density (MLD) were measured.The correlation between above mentioned parameters and PFT indexes were analyzed.Results ①Among three groups,significant differences were found for the score and incidence of entrilobular emphysema,paraseptal emphysema and brochiectasis or bronchial wall thickness(P＜0.01).②In COPD patients,paraseptal emphysema and DLCO/VA,brochiectasis or bronchial wall thickness and DLCO SB(％P),DLCO/VA(％P),as well as EI and MEF25％ (％P),DLCO SB(％P),DLCO/VA (％P)were negatively related.In smokers without COPD,there were negative correlation between centrilobular emphysema and FEV1/FVC,MEF25％ (％ P),MEF5％ (％ P),DLCO SB (％ P),DLCO/VA (％ P),paraseptal emphysema and DLCO SB(％P),DLCO/VA(％P),brochiectasis or bronchial wall thickness and DLCO/VA(％P),as well as EI and FEV1/FVC,MEF5％ (％P),and MLD and FEV1 (％ P),MEF25％ (％ P)were positively related.Conclusion MDCT can be used to analyze smokers' pulmonary morphology,and the morphological features and volumetric parameters are good predictions for pulmonary function.

Objective To explore the effects of acupuncture and individualized occupational therapy on the rehabilitation of patients with unilateral spatial neglect ( USN ) after stroke.Methods Stroke patients with hemiplegia were evaluated by neuropsychological tests,including line bisection,a cancellation test,clock drawing,and figure and shape copying.Sixty-nine right hemispheric stroke patients identified with USN were randomly assigned to 3 groups:20 patients as a control group received conventional rehabilitation therapy ; another 22 patients as an occupational group received type-specific individualized occupational therapy combined with conventional rehabilitation therapy; the remaining 23 patients as an acupuncture combined with occupational therapy group received acupuncture in addition to both conventional rehabilitation therapy and occupational therapy.These three groups were evaluated with neuropsychological tests and the modified Barthel index (MBI) before and after treatment.Results ①MBI scores in the occupational therapy group and the combined group were significantly higher after treatment,but no significant difference was observed in the control group.②The increased MBI scores in the combined and occupational groups were higher than those in the control group.At the same time the increase in MBI scores in the combined group was significantly greater than in the occupational therapy group.③The assessment results with both line bisection and cancellation tests in all three groups were significantly different after treatment.The line bisection results in the occupational therapy group and the combined group were significantly better than in the control group.The cancellation test results in the combined group were significantly better than in the control group.Conclusion These findings show that acupuncture combined with occupational therapy can have a positive effect on neglect recovery and greatly improve the daily life of USN patients.

SAαt2,6 and SAα2,3 linked sialic acid molecules on epithelial cell membrane served as receptors for influenza virus, which axe specifically recognized by human and avian influenza viruses, respectively. The distribution of these two species of sialic acids in human respiratory tract from different anatomical sites and different age groups was investigated. The results showed that SAα2,3Gal species was prevalent in respiratory bronchiole and lung alveolar epithelium, but was infiequent in trachea, bronchus and bronchiole. On the contrary, the SAα2,6Gal species was more common in the trachea and bronchus and to a lesser degree in the alveolar epithelium. When compared the expression levels of SAα2,6Gal and α2,3Gal in the respiratory tract among different age groups, no significant difference was found. In the ex vivo H5N1 virus infection study, alveolus epithelium were found to be more susceptible to avian influenza than trachea and bronchus epithelial cells. These results suggest that the human respiratory tract, to some extent, is permissive for avian influenza viruses. The currently-observed limited human to human transmission of H5N1 virus may be associated with the different abundance of SAα2,3Gal linkages in human upper respiratory tract among individuals.

Chinese traditional patent medicine for promoting blood circulation and removing blood stasis(PBCRBS) originated from traditional Chinese medicine theory and had approved efficacy and safety standards. However, its compatibility regularity and anti-thrombotic mechanism is not clear. To analyze the compatibility regularity and anti-thrombotic mechanism of Chinese traditional patent medicine for PBCRBS, a statistical and bioinformatics analysis was carried out using traditional Chinese medicine inheritance support system (TICMISS, V2.0) and ingenuity pathway analysis (IPA). The compatibility regularity analysis shows that the most commonly used herb combinations are Danshen (Salvia miltiorrhiza Bge.), Chuanxiong (Ligusticum chuanxiong Hort.) and Honghua (Carthamustinctorius L.). The anti-thrombotic mechanism analysis reveals that 25 ingredients have an effect on 29 thrombosis related molecules which 23 molecules are related to inflammation response. Furthermore, there are 5 inflammation molecules (NOS2, PTGS2, IL6, TNF, IL1β) served as major targets. At the same time, Danshen, Chuangxiong and Honghua mainly used as sovereign herb or minister herb in the application of cardiovascular and cerebrovascular diseases. Therefore, Chinese traditional patent medicine for PBCRBS probably has an effect on anti-thrombotic activity through inhibiting the inflammatory response. In summary, the most commonly used herb combinations of Chinese traditional patent medicine for PBCRBS are Danshen, Chuanxiong and Honghua. Inhibiting inflammatory response, especially inflammation related molecules (NOS2, PTGS2, IL6, TNF and IL1β), is probably a new starting point to clarify the anti-thrombotic mechanism of Chinese patent medicine for PBCRBS.
Anti-Inflammatory Agents ; pharmacology ; Carthamus tinctorius ; Computational Biology ; Drugs, Chinese Herbal ; pharmacology ; Fibrinolytic Agents ; pharmacology ; Humans ; Inflammation ; drug therapy ; Medicine, Chinese Traditional

Fine Particulate Matter (PM2.5-particles with an aerodynamic diameter ≤2.5 μm)can penetrate deeply into the lung,deposit in the alveoli,and consequently impair lung function.Both short term and long term exposures to PM2.5 are associated with the incidence of respiratory diseases (e.g.asthma,chronic obstructive pulmonary disease,lung cancer).This paper summarizes the effects of ambient air PM2.5 exposure on human respiratory system revealed by epidemiological studies.

OBJECTIVETo evaluate the correlation between the mean of time blood flow velocity (TVmean) of feeding artery around hepatocellular carcinoma (HCC) and the microvessel density (MVD) in relation to tumor cell differentiation, and to evaluate the usefulness of TVmean as a noninvasive preoperative marker of biologic characteristic of HCC.

METHODSTo measure TVmean of feeding arteries around the HCC in 45 patients before operation and TVmean of minute arteries in hepatic tissue in 45 normal subjects by ultrasonographic examination. Tumor cell differentiation grade was determined by routine histopathological staining. Tumor MVD was measured by immunohistochemical staining with monoclonal antibodies against F VIII RAg of excised HCC. Correlationship between TVmean of feeding arteries and MVD of HCC was studied.

RESULTSA linear correlation between TVmean of feeding arteries around the tumors of HCC and MVD of HCC tissue (r = 0.794, y = 18.2764 + 1.5544x) was obtained. With TVmean > or = 21.3 cm/s, the positive and negative predictive values of poorly differentiated HCC were 97.4% and 87.5%, respectively. With TVmean < 21.3 cm/s, those of well differentiated HCC were 88.5% and 97.3%, respectively. The degree of reliability of calculating HCC cell differentiation according to TVmean was 89.5%.

CONCLUSIONTumor growth and cellular differentiation, the two major factors affecting prognosis of HCC, may be evaluated by TVmean of feeding arteries around the tumor. It offers a useful preoperative information for predicting prognosis of HCC patients.

Adult ; Aged ; Arterioles ; pathology ; Blood Flow Velocity ; Capillaries ; pathology ; Carcinoma, Hepatocellular ; blood supply ; pathology ; physiopathology ; Female ; Humans ; Liver Neoplasms ; blood supply ; pathology ; physiopathology ; Male ; Middle Aged ; Neovascularization, Pathologic ; pathology