OBJECTIVETo investigate the clinical value of pleural biopsy in the etiological diagnosis of pleurisy in children.

METHODTotally 213 cases with pleurisy, who underwent pleural biopsy and hospitalized in Children's Hospital of Chongqing Medical University from January 2007 to April 2014 were enrolled into this study. Clinical symptoms, imaging manifestations, pleural fluid characteristics, the results of pleural biopsy and postoperative complications were retrospectively analyzed to evaluate the clinical value and security of pleural biopsy in making the etiological diagnosis of pleurisy.

RESULT(1) Of the 213 cases, 144 were boys and 69 were girls, their mean age was (6. 5 ± 4. 1) years. (2) Two hundred and thirteen patients had a surgical pleural biopsy under general anesthesia, the cause of 97 cases (45. 5%) were made clear by histopathological examination, including 35 purulent pleurisy, 55 tuberculous pleurisy and 7 paragonimus infection. For the remaining 83 (41. 3%) cases a final diagnosis was made based on the full analysis of clinical data, including 63 cases of purulent pleurisy, 3 cases of tuberculous pleurisy and 17 cases of paragonimiasis pleurisy but for 33 patients no exact cause was found at the end. (3) The mean operating time of the biopsy was (1. 4 ± 0. 6) hours. Seventy one (33. 3%) patients required blood transfusion during or after the operation. Thirty one (14. 6%) cases used the ventilator after surgery, and the ventilator supporting time was (6. 6 ± 5. 8) hours on average. The wound healing reached grade A in 200 cases (93. 9%), grade B in 13 cases (14. 6%). Postoperative complications included pneumothorax in 92 cases (43. 2%), subcutaneous emphysema in 18 cases (8. 5%), bronchopleural fistula in 3 cases(1. 4%). The average days of hospitalization was (17. 7 ± 7. 1) d.

CONCLUSIONPleural biopsy is of great diagnostic value in the etiological diagnosis and differential diagnosis of pleurisy in children, and it is considered reasonable to be used in the clinical practice when appropriate.

Biopsy ; Child ; Diagnosis, Differential ; Female ; Humans ; Infection ; diagnosis ; Male ; Pleura ; Pleurisy ; diagnosis ; etiology ; Retrospective Studies ; Tuberculosis, Pleural ; complications ; diagnosis

Objective To study ischemic tolerance induced by acanthopannx senticosus saponins(ASS) on ischemia in PC12 cells and involve expression of hypoxia inducible factor-1?(HIF-1?).Methods An ischemic model was developed in PC12 cell line with treatment of oxygen glucose deprivation(OGD).The protective effects of ASS pretreatment on ischemic tolerance of PC12 cells and whether protective effects of ASS could be inhibited by LY294002(PI3K inhibitor) were analyzed through MTT assay.The induction of phospho-glycogen synthesis kinase-3?(p-GSK-3?) and HIF-1? after pretreatment of ASS and possible blocking effects of LY294002 were detected by Western-blot.Results MTT results showed that after 9 h ischemia,the viability of PC12 cells decreased dramatically(P

Objective To further compare the effect of intravitreal injection of bevacizumab (IVB) and photodynamic therapy (PDT) for the treatment of choroidal neovascularization (CNV) secondary to pathologic myopia by meta-analysis.Methods Pertinent publications were identified through systemic searches of PubMed,EMBASE and the Cochrance Controlled Trials Register.All clinical comparative studies of IVB or PDT as initial treatment for CNV secondary to pathologic myopia were included.Meta analysis of these clinical trials was performed to analyze the effect of IVB and PDT for CNV secondary to pathologic myopia.Measurements included best corrected visual acuity (BCVA) and central foveal thickness (CFT).Results A total of 6 comparative studies involving 351 eyes were included.There were 196 eyes in IVB group and 215 eyes in PDT group.Funnel plots,Egger linear regression and Begg method did not show publication bias.Compared with PDT group,at 3,6 and 12 months after IVB treatment,BCVA significantly increased [3 months:weighted mean difference (WMD) =-0.14,95 ％ confidence interval (CI)=-0.26 to-0.01,P=0.04; 6 months:WMD=-0.18,95％ CI=-0.33 to-0.03,P=0.02; 12 months:WMD=-0.26,95％ CI=-0.35 to-0.18,P＜0.001].However,change of CFT at 3,6 and 12 months did not vary significantly between IVB group and PDT group (3 months:WMD=-22.49,95％ CI=-93.49 to 48.52,P=0.53; 6 months:WMD=-17.34,95％ CI=-56.00 to 21.31,P=0.38; 12 months:WMD=-5.32,95％ CI=-56.37 to 45.74,P=0.84).Conclusion Patients with CNV secondary to pathologic myopia experienced a significant benefit of visual improvement after IVB,but reduction in CFT after the IVB or PDT did not vary significantly.

Objective To explore the scanning techniques of piriformis and different ultrasonographic characteristics of normal and abnormal piriformis.Methods A total of 40 cases diagnosed with unilateral piriformis syndrome underwent ultrasonic examination.Then ultrasonic scanning techniques of piriformis were summarized.Contours,thickness and smoothness of epimysium and ultrasonic echo of internal muscle texture of piriformis were compared between the normal and abnormal piriformis.The study was approved by the Third Affiliated Hospital Ethics Committee of Zhejiang Chinese Medical University (Approval no.ZSLL-JS-2016-18).Results Interruption of ultrasonic echo of ilium could be considered as ultrasonographic signs for locating piriformis quickly and accurately.Abnormal piriformis in suffering side of patients with piriformis syndrome showed obscure contours and being thicker than the other side [x2 =9.899,P =0.002;(25.81 ± 0.30)mm vs (22.29 ± 0.27)mm,t =13.604,P =0.000].Moreover,there were significant differences in comparing smoothness of epimysium and ultrasonic echo of internal muscle texture of piriformis between the two sides(x2 =23.226,P =0.000;x2 =54.848,P =0.000).Conclusions Interruption of ultrasonic echo of ilium may be an important sign for locating piriformis.Ultrasound can display piriformis clearly and distinguish ultrasonographic images of normal piriformis accurately from abnormal piriformis,which can be taken as an basis imaging for clinical diagnosis of piriformis syndrome.

Child ; Diagnostic Errors ; Female ; Humans ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; diagnosis ; Sarcoma, Ewing ; diagnosis

The aim of the study is to prepare flurbiprofen axetil nanoemulsion-in situ gel system (FBA/NE-ISG) and observe its ocular pharmacokinetics, rheological behavior, TEM images, irritation and cornea retention. Production of nanoemulsion was based on high-speed shear and homogenization process, and then mixed with gellan gum to prepare FBA/NE-ISG. Rheological study showed that FBA/NE-ISG possesses strong gelation capacity and its viscosity and elastic modulus increases by 2 Pa*s and 5 Pa respectively when mixed with artificial tear at the ratio of 40 : 7. TEM images suggested no significant changes in particle morphology of the pre and post gelation. Good ocular compatibility of FBA/NE-ISG was testified by the irritation test based on histological examination. In vivo fluorescence imaging system was applied to investigate the characteristics of cornea retention, and the results indicated that the nanoemulsion-in situ gel (NE-ISG) prolonged the cornea retention time significantly since K(NE-ISG) (0.008 5 min(-1) was much lower compared with flurbiprofen sodium eye drops (FB-Na, 0.03% w/v) of which the K(Eye drops) was 0.105 2 min(-1), indicated that the cornea retention time of NE-ISG was prolonged significantly. Pharmacokinetics of FBA/NE-ISG in rabbit aqueous humor was studied by cornea puncture, the MRT (12.3 h) and AUC(0-12h) (126.8 microg x min x mL(-1)) of FBA/NE-ISG was 2.7 and 2.9 times higher than that of the flurbiprofen sodium eye drops respectively, which meant that the ocular bioavailability was improved greatly by the novel preparation. Therefore, FBA/NE-ISG can enhance the ocular bioavailability by prolonging drug corneal retention significantly. What's more, encapsulated by emulsion droplets prodrug flurbiprofen (FBA) instead of flurbiprofen (FB) can reduce the ocular irritation.
Animals ; Anti-Inflammatory Agents, Non-Steroidal ; administration & dosage ; adverse effects ; pharmacokinetics ; Aqueous Humor ; metabolism ; Biological Availability ; Cornea ; cytology ; drug effects ; Emulsions ; Female ; Flurbiprofen ; administration & dosage ; adverse effects ; analogs & derivatives ; pharmacokinetics ; Gels ; Male ; Nanoparticles ; Ophthalmic Solutions ; Rabbits ; Rheology ; Viscosity

Objective: To observe the effect of Yi Jin Jing (Sinew-transforming Qigong Exercises) on the muscle strength in senile sarcopenia. Methods: Sixty-five old people with sarcopenia were randomized into Yi Jin Jing group and a blank control group. Thirty-three patients in Yi Jin Jing group practiced Yi Jin Jing (Sinew-transforming Qigong Exercises), while 32 patients in the blank control group didn't receive any interventions. The muscle strength was measured before and after 12-week training. Results: During the study, each group had 1 dropout. The muscle strength was improved after 12-week training in Yi Jin Jing group, and the difference was statistically significant (P<0.05); there was no significant difference in the blank control group (P>0.05). After the intervention, there was a significant difference between Yi Jin Jing group and the blank control group in comparing the muscle strength (P<0.05). Conclusion: Constant Yi Jin Jing (Sinew-transforming Qigong Exercises) training can notably improve skeletal muscle strength in senile sarcopenia.

Objective To establish a method for isolation and cultivation of human invasive pituitary adenoma-derived fibroblast in vitro and explore their biological properties in order to investigate the role of the fibroblasts in the invasive growth of the pituitary adenoma.Methods The fibroblasts were isolated from hu- man invasive pituitary adenoma tissue by different rate of adhesion.Primary culture and passage culture were carried out,and growth characteristics of fibroblasts were observed under phase-contrast microscope in primary and passage culture.Immunohistochemical technique was used to identify the fibroblasts.The cell growth curve was measured by MTT method.The ultrastructure was observed under electronmicroscope.Results The cultured invasive pituitary adenoma-derived fibroblasts showed active proliferative ability.The cell bodies was bigger than other tissue fibroblasts,and the cell shape was irregular.The rough endoplasmic reticulum, Golgi complex and ribosome were profuse in the cytoplasm.The positive expression rate of collagen[and vi- mentin of the fibroblasts were above 95%.Conclusion The method of different rate of adhesion is success- fully utilized to culture human invasive pituitary adenoma-derived fibroblasts.These cells showed active prolif- erative ability,and maybe have an importent function in the invasive growth of the pituitary adenoma.

Objective To evaluate the clinical value of 18floro-deoxyglucose positron emission tomography-CY(~(18)FDG PET-CT)in the diagnosis of lymph node metastasis from advanced esophageal carcinoma. Methods A prospective study is perfonued here to assess whether ~(18)FDG PET-CT can improve the diagnostic accuracy in lymph node metastasis for patients with advanced esophageal carcinoma.Thirty patients had undergone esophagectomy with extensive lymph node dissection.PET-CT findings were compared with that d CT with pathological finding as the final say.Results All patients were operated successfully without peri-operative complications.The pathological examination conformed metastasis in 22 patients and 49 out of 243 excised lymph nodes.In CT analysis,the sensitivity was 40.8%,specificity was 96.9%,with a diagnostic accuracy of 85.6%, The positive and negative predictive value was 76.9%,86.4% respectively;PET-CT resulted in a sensitivity of 93.9%,specificity of 91.2%,accuracy of 91.8%.The positive predictive value was 73.0% and negative predictive value was 98.3%,The difference of sensitivity(P＜0.001),accuracy(P＜0.05)and negative predictive value between the two radiological modalities was statistically significant(P＜0.001).Conclusions With a high sensitivity and accuracy in the diagnosis of lymph node metastasis,PET-CT appears necessary in preoperative examination for advanced esophageal carcinoma in the hope that surgical treatment be guided by the results of PET-CT,especially for the elder patients with poor pulmonary function or heart or brain complications. Moreover,it could be used as the basis of the conformal radiation therapy planning for inoperable patients.