0.05),respectively and the cost-effectiveness ratios were 689 and 1 202 respectively.CONCLUSION:The treatment group was superior to as compared with the control group.

BACKGROUNDTo study the diagnostic value of detection of p16 methylation of sputum exfoliated cells for peripheral lung cancer.

METHODSBefore operation, p16 methylation of the sputum exfoliated cells was detected in 20 normal persons and 50 patients with peripheral pulmonary nodi by p16 methylation-specific PCR (MSP) for judging the nature of the nodi. The results were compared with pathological reports after operation.

RESULTSThe p16 MSP positive rate of sputum exfoliated cells of peripheral lung cancer patients (27/44, 61.4%) was much higher than that of benign pulmonary nodi (1/6, 16.7%) and normal persons (3/20, 15.0%)(Chi-Square=4.281 and 11.869 respectively, both P < 0.05). No significant difference of p16 MSP positive rate of sputum exfoliated cells was found between benign pulmonary nodi and normal persons (Chi-Square= 0.136, P > 0.05). No significant difference of p16 MSP positive rate of sputum exfoliated cells was found between squamous cell carcinoma (13/18, 72.2%) and adenocarcinoma (8/19, 42.1%) (Chi-Square=3.416, P > 0.05 ). If the positive p16 MSP of sputum was chosen as criterion for peripheral lung cancer, its positive predictive value, negative predictive value, sensitivity and specificity were 96.4%, 22.7%, 61.4% and 83.0% respectively.

CONCLUSIONSThe detection of p16 methylation of sputum exfoliated cells is contributable to the diagnosis of lung cancer.

Objective To evaluate the ability of Vitek 2 Compact YST identification cards and pyrosequencing analysis for identifying the clinical isolates of yeast-like fungi.Methods Vitek 2 Compact YST identification cams and ITS1 region pyrosequencing analysis were used to identify the clinical isolates of yeast-like fungi at Jinan Military General Hospital in 2011.The strains which could not be identified to species by pyrosequencing analysis were identified again by the method of ITS1 region Sanger sequencing.The strains with inconsistent identified results by YST and pyrosequencing were identified again using API 20C.Results A total of 282 srtains were isolated from various clinical specimens for culturing in 2011.In addition to the three which could only be identified to similar species,other strains could be clearly identified to species by the method of ITS1 reverse pyrosequencing.Three strains which failed identified to species by pyrosequencing couldn't be distinguished fully by the method of Sanger sequencing.There were 7 strains unidentified,14 strains low discrimination(％ id ＜ 80％),and 6 strains misidentification using YST cams.The identification coincidence rate was 90.4％.The identification coincidence rates were various in different species of yeast-like fungi using YST cards.Conclusions The vast majority of clinical isolates of yeast-like fungi could be identified by ITS1 reverse pyrosequencing analysis.Vitek 2 Compact YST caRD basically meets the needs.But attention should be paid to the standard operating and regular internal quality control.For some rare species it is also needed to combine the source of specimen,colonies and characteristics to determine the identification results for the rare stains.

The evaluation tools were developed based on the theory of validity,the development process and results of the Manual of Home-Based Rehabilitation Mode for Stroke Patients were evaluated by a panel of experts,and the opinions and suggestions for improvement were collected from the evaluation experts.The results showed that the average score for development process and results of the manual were ＞4 points in structural validity,content validity and surface validity,indicating that the manual was of high quality,and the development of the manual was scientific and the results were practical.The manual may provide the guidance for the home-based rehabilitation in community.At the same time,this study has enriched the reviewing tools and evaluation method of manuals,and provided reference for the peers.

Objective To evaluate whether the size,number or location of fibroids affect therapeutic efficacy of uterine artery embolization (UAE).Methods 84 patients with symptomatic uterine fibroids who had received uterine fibroid embolization with the use of polyvinyl alcohol(PVA)or gelfoam sponge particles(GSP).According to the lesion's size,number or location,all patients were divided into different groups and following -up as outpatients. Patient's symptomatic improvement and imaging following -up was assessed after UAE.Results A technically suc-cessful embolization was done in all patients.Postoperative 12 -month following -up was performed in 77 cases.No major life -threatening complications were found and the clinical symptoms were improved after UAE.In the different groups,the uterine size and the leiomyoma size after UAE were markedly decreased(t =5.842,P <0.05).Further comparison showed that the mean reduction in fibroids volume after UAE was not significant between the two groups, so was the mean reduction in uterine volume.Solitary leiomyoma group showed no significant difference in volume reduction rate of fibroids and uterine after UAE as compared with multiple leiomyoma group.Changes were not signifi-cantly in Submucosal uterine fibroids,Subserosal uterine fibroids,Intramural uterine fibroids.Conclusion UAE is an effective treatment for uterine fibroids.In this study,the size,number,and location of fibroids did not affect therapeutic efficacy or the complication rate of UAE.

Objective:To observe the effects of acupuncture at Houxi(SI3)and Huantiao(GB30)on the expression levels of nuclear factor kappa B(NF-κB),inducible nitric oxide synthase(iNOS),and nitric oxide(NO)of NF-κB inflammatory signaling pathway in L5 spinal nerve root of lumbar disc herniation(LDH)model rats and explore the mechanism of acupuncture in LDH treatment.Methods:Forty specific-pathogen-free healthy male Sprague-Dawley rats were randomly divided into a sham operation group,a model group,acupuncture group 1,and acupuncture group 2,with 10 rats in each group.The non-compression nucleus protrusion model was made by puncturing L4-L5 spinous process space and injecting autologous nucleus suspension.Acupuncture at bilateral Shenshu(BL23),Dachangshu(BL25),and Weizhong(BL40)was carried out in acupuncture group 1,and acupuncture at bilateral Houxi(SI3)and Huantiao(GB30)in acupuncture group 2.All rats were treated with balanced reinforcing and reducing needling manipulations,and the needles were retained for 30 min/time with one episode of needling manipulation every 10 min,once a day,14 times in total.The threshold value of paw withdrawal pain was measured by a thermal stimulation pain instrument;the serum NF-κB,iNOS,and NO levels were measured by enzyme-linked immunosorbent assay.The pathomorphological changes of spinal nerve roots were observed by hematoxylin-eosin(HE)staining;quantitative reverse transcription polymerase chain reaction was used to detect iNOS mRNA expression in spinal nerve roots;the NF-κB and iNOS protein expression in spinal nerve roots was detected by the immunofluorescence method.Results:Compared with the sham operation group,the threshold of paw withdrawal pain in the model group was decreased,and the expression levels of serum NF-κB,iNOS,and NO were increased;HE staining showed many degenerated and dissolved Schwann cells in spinal nerve roots with vacuolar changes;meanwhile,the expression levels of NF-κB and iNOS proteins,and the iNOS mRNA in spinal nerve roots were increased.Compared with the model group,the paw withdrawal pain thresholds in acupuncture group 1 and acupuncture group 2 were increased,and the increase in acupuncture group 2 was greater(P<0.05);the expression levels of serum NF-κB,iNOS,and NO in acupuncture group 1 and acupuncture group 2 were decreased,especially in acupuncture group 2(P<0.01);the vacuolar changes of spinal nerve roots,and the degeneration and lysis of Schwann cells in acupuncture group 1 and acupuncture group 2 were decreased,which were more obvious in acupuncture group 2;the NF-κB and iNOS protein expression and the iNOS mRNA expression levels in spinal nerve roots of acupuncture group 1 and acupuncture group 2 were decreased,especially in acupuncture group 2(P<0.01).Conclusion:Acupuncture at Houxi(SI3)and Huantiao(GB30)can improve the morphology of spinal nerve roots,inhibit the NF-κB and iNOS protein expression levels in spinal nerve roots and the serum NO level,and relieve the pain caused by inflammation of spinal nerve roots,which may be one of the mechanisms of acupuncture in LDH treatment.

BACKGROUNDTo study p16 methylation status and p16 mRNA transcription of BEP2D cells during its malignant transformation.

METHODSNormal BEP2D cell and BEP2D cells irradiated by α particle for 20 weeks (R-20), 21 weeks (R-21), 35 weeks (T-35) and 54 weeks (T-54) respectively were chosen to study the p16 methylation status by methylation-specific PCR (MSP). Meanwhile, RT-PCR was used to study p16 mRNA transcription of the above cells.

RESULTS(1) p16 methylation was found in R-20, R-21, T-35 and T-54 cells, but not in normal BEP2D cell. (2) The p16 mRNA transcription levels of R-20, R-21, T-35 and T-54 cells were much lower than that of normal BEP2D cell.

CONCLUSIONSThe p16 methylation occurs in the early stage of lung cancer. The methylation of p16 gene may cause the inactivation of p16 gene.

BACKGROUNDAccording to the international standard in TNM staging of pulmonary carcinoma, pulmonary carcinoma complicated with diffuse pleural metastasis and malignant pleural effusion belongs to IIIB stage. In the past, non-operative therapy was employed, but both the therapeutic efficacy and the quality of life of patients were poor. The purpose of this study is to find out a complex treatment for this disease.

METHODSTotal pleuro-pneumonectomy was performed in 55 cases of patients with pulmonary carcinoma complicated with diffuse pleural metastasis and malignant pleural effusion from December 1978 to February 2003. The patients were followed up postoperatively, and the quality of life and survival period of them were observed.

RESULTSIn all the cases, only 2 patients died of operation. Satisfactory recovery and remarkable relief of symptoms such as short breath, dyspnea and chest pain were found in all the other patients. After a follow-up period of 1-25 years, local recurrence was found in 6 cases (11.3%), and distant metastasis in 42 cases (79.2%). A total of 48 patients died of tumor, with survival period ranging from 5-40 months (average survival period: 15 months; median survival period: 14 months), and 5 patients were still alive in good health.

CONCLUSIONS(1) Patients appropriated for operation should be carefully selected in case that postoperative complications influence their smooth recovery; (2) Tumor tissues should be removed as clear as possible; (3) During the operation, close attention should be paid to the protection of incisions; (4) Removal of the tumor tissues can reduce the tumor load, effectively clean the immunosuppressive factors in malignant pleural effusion, and break the immunity block status, which provides basis for the following comprehensive therapy; (5) The quality of life of the patients can be improved and the median survival period can be prolonged by the operation; (6) The long-term survival rate of patients is still unsatisfactory.

OBJECTIVESTo study the diagnosis and treatment of thymoma and to assess prognosis factors.

METHODSThe clinical data on 116 patients with thymoma were collected. A retrospective analysis was performed by comparison of their survival rates computed by the actuarial method and rate of recurrence and metastasis.

RESULTSChest radiograph was used chiefly for the preoperative diagnosis of thymoma; myasthenia gravis (MG) (25.0%, 29/116) was the most common paraneoplastic disease. An extensive and radical resection was carried out to reduce the recurrence rate of thymoma with stage I and stage II (chi(2) = 4.941 P = 0.0219). The survival time was prolonged by postoperative radiotherapy and chemotherapy. A strong correlation was noted between the clinical stage and histologic subtype of M-H classification, by which the invasive behavior of thymoma was predicted (r = 0.385, P = 0.007). The 3-, 5-, and 10-year survival rates were 81.2%, 67.9% and 40.5%, respectively. Statistical analysis showed a significant negative correlation between stage and survival rate (r = -0.897, P = 0.0000).

CONCLUSIONThe prognosis of thymoma depends mainly on the histologic subtype, clinical stage and multimodality treatment rather than paraneoplastic diseases.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Myasthenia Gravis ; etiology ; Prognosis ; Radiography ; Retrospective Studies ; Thymoma ; complications ; diagnosis ; diagnostic imaging ; therapy

OBJECTIVETo study the diagnosis and treatment of thymoma and to assess its prognostic factors.

METHODSThe clinical data of 116 patients with thymoma were collected. A retrospective analysis was performed, by comparing the survival rate calculated by the Kaplan-Meier method with the rate of recurrence or metastasis.

RESULTSThe standard posteroanterior and lateral chest radiographs were reliable means of detection of most thymomas. Myasthenia gravis was the most commonly paraneoplastic disease (25.0%, 29/116). The extensive radical resection was beneficial for reducing the rate of recurrence of stage I or stage II thymomas (chi(2) = 4.941, P = 0.0219). The survival time could be prolonged by postoperative radiotherapy and chemotherapy. There was a strong correlation between the clinical stage and the histological classification (according to MH classification), through which the invasive behavior of thymoma could be predicted (chi(2) = 19.76, P = 0.007, RR = 1.47). The 3- 5- and 10-year survival rates were 81.2%, 67.9%, and 40.5%, respectively. Statistical analysis showed a significant negative correlation between the stage and the survival rate (chi(2) = 29.73, P = 0.0000, RR = 0.15).

CONCLUSIONThe prognosis of thymoma depends mainly on the histological classification, clinical stage and multimodality treatment rather than on the paraneoplastic diseases.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Myasthenia Gravis ; etiology ; Prognosis ; Retrospective Studies ; Thymoma ; diagnosis ; mortality ; therapy ; Thymus Neoplasms ; diagnosis ; mortality ; therapy