Adult ; Aspergillosis ; pathology ; Female ; Humans ; Laryngeal Diseases ; microbiology ; Male ; Middle Aged ; Vocal Cords ; microbiology

Objective To investigate the application value of DWI based on biexponential signal decay model with extended b-fac-tor range in differential diagnosis of benign and malignant breast lesions.Methods A total of 57 patients with breast tumor under-went DWI based on the biexponential model with 12 b-factors (0,10,20,50,100,200,400,600,800,1000,1 200 and 1 500 s/mm2 ), including benign lesions in 1 9 patients (24 breast tumors,defined as benign group)and malignant ones in 38 (47 tumors,defined as malignant group ).The values of slow apparent diffusion coefficient,fast apparent diffusion coefficient and fraction of fast ADC of le-sions were measured at a workstation (Advantage Windows 4.5).Differences in these parameters between the benign and malignant groups were compared.Results The ADCslow,ADCfast and ffast were(1.434±0.291)×10 -3 mm2/s,(2.744±0.050)×10 -3 mm2/s and (0.677±0.130)% in benign group,and (0.614±0.196)×10 -3 mm2/s,(2.692±0.068)×10 -3 mm2/s and (0.446±0.112)% in malig-nant one,respectively.The statistical differences in ADCslow and ffast were found between two groups (P <0.05),whereas no difference in ADCfast was found.Conclusion Biexponential signal decay model of DWI with extended b-factor range can provide helpful tissue characterization parameters for the differential diagnosis of benign and malignant breast lesions.

Objective To investigate the quality of life and its influencing factors in hver transplantation recipients in order to supply scientific reference for improving their life quality.Methods 33 patients with terminal liver diseases waiting for liver transplantation(the pre-operation group)and 102 patients 2 weeks after liver transplantation and outpatients for follow-up visits(the post-operation group)were conducted with SF-36,self-rating anxiety scale,self-rating depression scale,and social support questionnaire.Results Except for the scores of physiological function,emotional role,social function in SF-36.differences of scores of other factors were evident between the preand post-operation groups.Life quality of patients over 1 year after operation was better than those within 1 year. The influencing factors of QOL were subjective support and anxiety.Conclusions After liver transplantation,the patients' QOL evidently improves.Life quality of patients over 1 year after operation was better than those within 1 year.Patients' QOL is positively related to subjective support,negatively related to anxiety.

Objective To study the effect of different fraction interval with same total radiation dose on tumor growth delay and survival in C57BL mice implanted with lewis lung cancer,and to determine whether prolonged fraction interval will decrease the tumor response to radiation. Methods Forty-eight mice were implanted with lewis lung cancer in the back legs.When the diameter of transplanted tumor reached 0.8 to 1 cm,the mice were randomized into 6 groups:normal control group,single fraction of 18 Gy group,18 Gy in 2 fractions of 9 Gy at 30 min interval group,18 Gy in 7 fractions of 2.57 Gy at 5 min inter val group,18 Gy in 2 fractions of 9 Gy at 60 min interval group and 18 Gy in 7 fractions of 2.57 Gy at 10 rain interval group.The maximal and minimal diameters of the tumor were measured and record every other day to study the tumor growth tendency,the tumor growth delay and the mice survival time. Results The tumor growth delay of groups at prolonged fraction interval was shorter than the group with single fraction of 18 Gy (P < 0.05).The tumor growth delay of groups at fraction interval of 30 rain was longer than that of groups at interval of 60 rain (P < 0.05).There was no significant difference of the tumor growth delay be tween the groups with same delivery time (P >0.05).The mice survival time of the groups with prolonged fraction interval was shortened when omparing to the group with single fraction of 18 Gy.While the difference was not significant between the groups at fraction interval of 30 min and 60 min. Conclusions The pro longed fraction interval but same total radiation dose shortens the tumor growth delay and survival time in the mice implanted with Lewis lung cancer.The longer fraction interval impairs the tumor control more signifi candy.However the difference of the effect on mice survival time is not significant between the groups at fraction interval of 30 min and 60 min.

Objective To discuss the mode of onset,clinical characteristics,treatment and prognosis of children with granulocyte sarcoma (GS),in order to provide guidance for early diagnosis and effective treatment of GS.Methods Six cases of children with GS diagnosed at the Department of Hematology,Children's Hospital Affiliated to Soochow University between June 2009 and June 2014 were analyzed,the data including the mode of onset,clinical manifestation,diagnosis,treatment and outcome.Results There were 2 cases with a painless mass onset (1 case was 2 years old,characterized by right waist mass,about 10 cm × 5 cm;the other case was 6 years old,characterized by axillary lump,about 2 cm × 3 cm),and both of them received surgical removal of the tumor,then the postoperative tumor was examined by pathologic and immunohistochemical method,and at last the primary granulocyte sarcoma was diagnosed.The third case was a 7 years old girl,she was onset characterized by scalp lump,about 2 cm × 3 cm,and was diagnosed by the pathologic and immunohistochemical method,and changes in hematological system appeared a month later and acute myeloid leukemia(AML) was confirmed by bone marrow examination.The onset ages of other 3 cases were in 10 months,1 year and 7 months,13 years and 3 months old respectively,characterized by scalp lump (about 2 cm × 3 cm),spinal canal tumor (about 1.0 cm × 1.5 cm),intracranial tumors (6.0 cm × 4.9 cm),with AML occurring at the same time,which was confirmed by surgical pathology,immunohistochemistry and bone marrow cell morphology,immune classification,chromosome,and fusion gene diagnosis.Four cases were hematopoietic malignancies by pathology,2 cases of then belonging to small round cell tumor.The immune pathology showed 5 cases of myeloperoxidase positive,CD68-positive,3 cases of CD43-positive,CD123-positive.All children CD3,CD20 levels in all children were negative.Four cases underwent surgery combined with chemotherapy,other 2 cases received surgery and then gave up treatment,1 case discontinued follow-up 3 months later,and the other case died of intracranial hemorrhage after 3 months,which induced by thrombocytopenia.The treated 4 cases were followed up 3 to 58 months,and all had disease-free survival.Conclusions Children with GS have low incidence and non-specific diagnostic criteria,its diagnosis depends on immune pathology,and the treatment is mainly in accordance with AML program for high-dose chemotherapy.The systematic chemotherapy helps to prolong overall survival;at the same time,the hematopoietic stem cell transplantation with bone marrow may help to improve the prognosis.

OBJECTIVE:To systematically review the effectiveness and safety of methotrexate(MTX)in the treatment of rheuma-toid arthritis,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from Medline,EMBase,Cochrane Library,PubMed,CJFD,CBM,VIP and Wanfang Database,randomized controlled trials(RCT)about MTX in the treatment of rheu-matoid arthritis were collected,Meta-analysis was performed after data extraction and quality evaluation. RESULTS & CONCLU-SIONS:33 effectiveness evaluation were included,involving 8 253 patients,and 53 safety evaluation were included,involving 4 803 patients. Results of analysis show,the efficacy of MTX was not higher than leflunomide in the treatment of rheumatoid arthritis,superi-or to cyclosporine A,and similar to sulfasalazine. In addition,MTX shows similar efficacy with etanercept(7.5-20 mg per week),goli-mumab,adalimumab or rituximab,but less effective than trastuzumab. The incidence of adverse reactions of MTX is high,but mainly mild or moderate,and the most common adverse reactions are gastrointestinal symptoms. Oral administration of MTX is more secure than intramuscular injection and subcutaneous injection.

OBJECTIVE To investigate the clinical characteristics,risk factors and preventive measures for nosocomial pneumonia in patients with post-hepatitis liver cirrhosis.METHODS A prospective and retrospective study was carried out to investigate the clinical data of 495 patients with post-hepatitis liver cirrhosis in Department of Infectious Diseases during Jan 1,2005 to Dec 31,2007.RESULTS The incidence rate of the nosocomial pneumonia in post-hepatitis liver cirrhosis patients was 13.50 %.The death rate was 25.40 %,which was obviously higher than 6.8% of patients without no nosocomial infection(?2=23.77,P

Objective To observe the effect of comprehensive rehabilitation on POEMS syndrome during sequel period. Methods Two cases of POEMS syndrome with multiple peripheral nerve injury as the main manifestation received physical therapy, occupational therapy, acupuncture, surface electromyography biofeedback and other comprehensive rehabilitation treatment. Results After treatment, the muscle strength, trunk balance, standing balance ability, activities of daily living (ADL) improved. The score of Berg Balance Scale increased from 18 to 28 in the first case, the modified Bathel Index increased from 55 to 70 in the second case. Conclusion Comprehensive rehabilitation can improve the function of patients with POEMS syndrome during sequel period, and surface electromyography biofeedback plays an im-portant role.

ObjectiveTo evaluate the efficacy and toxicity of gemcitabine plus cisplatin (GP)chemotherapy combined with intensity-modulated radiation therapy (IMRT)in locoregionally advanced nasopharyngeal carcinoma (NPC).Methods71 patients (Stage Ⅲ:41,Stage ⅣA:30) with locoregionally advanced NPC were entered this study.Neoadjuvant chemotherapy was consisted of cisplatin 25 mg/m2 intravenously on d1-3 and gemcitabine 1000 mg/m2 in 30 minutes intravenous infusion on days 1 and 8,every 3 weeks for 2 cycles.Adjuvant chemotherapy consisted of 2 cycles of the same GP regimen was given at 28 days after the end of radiotherapy.The prescription doses was 66.0-70.4 Gy to the gross tumor volume,66 Gy to positive neck nodes,60 Gy to the high-risk clinical target volume,54 Gy to the low-risk clinical target volume.ResultsThe overall response rate to neoadjuvant chemotherapy was 91.2％,acute toxicity was mainly grade 1-2 myleosuppression.All patients completed IMRT.The median follow-up duration was 38 months.The 3-year nasopharyngeal local control,regional control,distant metastasis-free survival rate and overall survival rate were 93％,99％,91％,90％,respectively.Severe late toxicities included grade 3 trismus in 1 patient,grade 3 hearing impairment in 2 patients and cranial nerve palsy in 2 patients,respectively.No grade 4 late toxicities were observed.Conclusions The combination of GP chemotherapy and IMRT for locoregionally advanced nasopharyngeal carcinoma is well-tolerated,convenient,effective,and warrants further studies of more proper cycles of GP regimen.

【Objective】 To detect the copy numbers of brain-deriv ed neurotrophic factor (BDNF) gene in BDNF transfected PcDNA3.1(+)/BDNF/CHO cel ls with fluorescent quantitative polymerase chain reaction (FQ-PCR). 【Methods 】 BDNF DNA were amplified by GeneAmp 5700 Sequence Detection System with eq ual quantitative genomic DNA of PcDNA3.1(+)/BDNF/CHO, PcDNA3.1(+)/CHO and CHO cells as tamplates respectively. The process was repeated 30 times for every sam ples. The results were analyzed using q test. 【Results】 The copy numbers o f BDNF of PcDNA3.1(+)/BDNF/CHO cells and PcDNA 3.1(+)/CHO and CHO cells were 9 5 164±12, 31 622±10, 31 622±11 respectively. The copy numb ers of BDNF of PcDNA3.1(+)/BDNF/CHO cells were as three times as those of the P cDNA3.1(+)/CHO and CHO cells. The copy numbers of the two latters were the same . 【Conclusion】 The results clearly show that the PcDNA3.1(+)/BDNF/CHO cells h arbor two BDNF DNA copies.