Objective To investigate radionuclide imaging and routine CT in diagnosing hepatic focal nodular hyperplasia (FNH) and the combined diagnostic value of the two modalities. Methods Thirty-two patients with hepatic FNH were retrospectively studied. All patients underwent routine CT scan. Twenty-four patients were examined by 99Tcm-sulfur colloid (SC) hepatic planar scintigraphy and SPECT/CT imaging, and then patients who had abnormal foci underwent 99Tcm-diethyl iminodiacetic acid (EHIDA) triple-phase hepatobiliary imaging. x2 -test of four-table or Fisher exact probabilities in 2 × 2 table was applied for statistical analysis. Results Of all 32 patients pathologically diagnosed as FNH with single solitary nodule, 25 were classified as classic type and the rest 7 as non-classic type. Although routine CT found all hepatic lesions, only 15 cases were diagnosed pathologically as FNH classic type but the rest were either misdiagnosed or left as indeterminate. On radionuclide imaging (hepatic colloid scintigraphy plus triple-phase hepatobiliary images), 11 patients with big foci (with maximal diameter ＞3 cm) out of 24 patients were correctly diagnosed as FNH, with 7 diagnosed as classic type FNH and 4 as non-classic. Other 13 patients were either misdiagnosed or simply missed. The diagnosing rates of routine CT and radionuclide imaging were60.0% (15/25) and 38.9% (7/18) for FNH classic type, 0/7 and 4/6 for non-classic type,50.0% (10/20) and 73.3% (11/15) for big foci, 41.7% (5/12) and 0/9 forsmall foci (with maximal diameter≤3 cm), respectively. The total diagnosing rate of radionuclide imaging combined with routine CT was significantly higher than that of routine CT or radionuclide imaging alone ( x2 = 4. 48, P ＜ 0. 05;x2 =4.27, P ＜0.05 ). Conclusion Radionuclide imaging in combination with routine CT may improve the diagnostic accuracy for hepatic FNH patients.

Objective To evaluate the diagnostic value of ~(99)Tc~m-methoxyisobutylisonitrile (MIBI) SPECT scintigraphy combined Iocalizable CT in the localization of ectopic parathyroid glands in hyperparathyroidism.Methods Retrospective data of surgery,pathology and imaging were collected from 28 patients with hyperfunctioning ectopic parathyroid glands.All cases underwent CT studies.Twenty-five patients had ~(99)Tc~m-MIBI planar imaging first:SPECT scintigraphy combined localizable CT was performed for the patients with abnormal radionuclide foci immediately.The fusion images obtained after reconstruction showed the exact location of the ectopic foci.Operative histopathologic results were regarded as "gold standards".Presuming 4 parathyroid glands as normal findings,findings confirmed by operation and pathology were regarded as positive,otherwise negative.The results of CT and radionuclide imaging were compared by X~2-test of four-foId table.Results Twenty-eight ectopic parathyroid glands were found in 28 patients,all pathologically confirmed as adenomss.CT found 22 foci,of which 17 were true positive,5 false positive,11 false negative,and 79 true negative.~(99)Tc~m-MIBI SPECT scintigraphy combined localizable CT found 23 foci,no false positive,2 false negative,and 75 true negative.The results showed that the sensitivities were 61% (17/28),92%(23/25),specificities 94%(79/84),100%(75/75),accuracies 86%(96/112),98% (98/100),positive predictive values 77%(17/22),100%(23/23),and negative predictive values 88% (79190),97%(75/77),respectively,for CT and radionuclide imaging.~(99)Tc~m-MIBI SPECT scintigraphy combined localizable CT was therefore significantly higher than CT in sensitivity(X~2=6.98,P＜0.01),specificity (X~2=4.61,P＜0.05),accuracy (X~2=10.30,P＜0.01),positive predictive value(X~2=5.88,P＜0.05) and negative predictive value (X~2=5.36,P＜0.05).Conclusion ~(99)Tc~m-MIBI SPECT scintigraphy combined localizable CT is superior to CT alone in the localization of ectopic parathyroid glands in hyperparathyroidism,but false negative can be found in some patients.

Conclusions The maximum resistance strength of the bone-bonding screw could suffice for orthodontics.

OBJECTIVE: To explore the effect and significance of tumor necrosis factor-α( TNF-α) in serum and bronchoalveolar lavage fluid( BALF) of coal workers' pneumoconiosis( CWP). METHODS: Twenty-eight cases of CWP were selected by purposive sampling method and divided into 3 groups based on different stages of pneumoconiosis. There were 7 cases in stage Ⅰ,10 cases in stage Ⅱ,and 11 cases in stage Ⅲ. The venous blood and BALF were collected.TNF-α in the serum and BALF were detected by chemiluminescence assay. The lung function was determined. RESULTS: In the serum,the TNF-α level of CWP patients was positively correlated with the CWP stage [Spearman correlation coefficient( rS) = 0. 843,P < 0. 01],and negatively correlated with the forced expiratory volume in one second/forced vital capacity( FEV1/ FVC)( rS=- 0. 503,P < 0. 01). In BALF,the TNF-α level of CWP patients was negatively correlated with the CWP stage( rS=- 0. 654,P < 0. 01),and positively correlated with the FEV1/ FVC( rS= 0. 432,P <0. 05). The TNF-α level in the serum was negatively correlated with the TNF-α level in BALF( rS=- 0. 561,P < 0. 01).CONCLUSION: With the development of pneumoconiosis,the levels of TNF-α in the serum and BALF showed different variation,and were correlated with the changes of FEV1/ FVC. The level of TNF-α could be used as a reference index for evaluating the severity of CWP.

Intestine,the body's largest digestive and immune organ,always affects the occurrence and development of cardiovascular disease process.Especially the trimethylamine N-oxide as one of the metabolic derivatives produced by intestinal microbiota,can increase the risk of atherosclerosis and promote cardiovascular diseases such as chronic heart failure.Therefore,changing the level of trimethylamine N-oxide in the circulation by taking different measures to intervene the structure,composition and metabolic activity of intestinal flora can affect the occurrence and development of the disease.Thus,the intestinal flora is recognized as a new target for the treatment of cardiovascular diseases.

Objective To evaluate the predictive value of admission plasma amino-terminal pro-B type natriuretic peptide(NT-proBNP)on in-hospital mortality in patients with decompensated heart failure.Methods Plasma NT-proBNP levels were measured in patients with decompensated heart failure within 24 hours after admission with ELISA method.The NT-proBNP levels were compared between survivals and dying patients in hospital.ROC analyses were performed to evaluate the predictive value of admission plasma NT-proBNP on in-hospital mortality and to identify the optimal NT-proBNP cut-point for predicting in hospital mortality.A binary logistic regress analyses was used to evaluate if NT-proBNP was an independent predictor for in-hospital mortality.Results A total of 804 patients with decompensated heart failure were enrolled in his study(293 valvular heart diseases,219 ischemic cardiomyopathy,141 dilated cardiomyopathy,14 hypertrophic cardiomyopathy,21 restrictive cardiomyopathy,39 hypertensive heart disease,41 chronic pulmonary heart disease and 36 adult congenital heart disease)and 96 patients were in class Ⅱ,450 in classⅢand 258 in cases Ⅳ according to NYHA Classification.During hospitalization,64 deaths were recorded and the on admission plasma NT-proBNP levels of patients died during hospitalization were significantly higher than those of survivals[4321.1(3063.8,6606.5)pmol/L VS.1921.6(873.9,3739.2)pmol/L,P＜0.01].Area under receiver operating characteristic curve(AUC)of NT-proBNP to predict in-hospital death was 0.772(95%CI:0.718-0.825,P＜0.01),the optimal plasma NT-proBNP cut-point for predicting in-hospital mortality Was 3500 pmol/L,with a sensitivity of 70.3%,a specificity of 72.0%,an accuracy of 71.9%.a positive predictive value of 17.8%and a negative predictive value of 96.6%.Patients whose NT-proBNP levels were equal or more than 3500 pmol/L had a much higher in hospital mortality(17.8%)compared with those with NT-proBNP levels of less than 3500 pmol/L (3.4%),P＜0.01.Binary logistic regress analyses demonstrated that admission plasma NT-proBNP,pneumonia,heart rate and NYHA class were independent predictors for in-hospital mortality in patients with decompensated heart failure(P＜0.05 or 0.01)and admission plasma NT-proBNP Was the strongest predictor for in-hospital mortality.Conclusions Admission plasma NT-proBNP level was an independent predictor for in-hospital mortality in patients with decompensated heart failure.The optimal NT-proBNP cut point for predicting in-hospital mortality was 3500 pmol/L in this patient cohort.

Formalin-inactivated respiratory syncytial virus (RSV) vaccination causes vaccine-enhanced disease (VED) after RSV infection. It is considered that vaccine platforms enabling endogenous synthesis of RSV immunogens would induce favorable immune responses than non-replicating subunit vaccines in avoiding VED. Here, we investigated the immunogenicity, protection, and disease in mice after vaccination with RSV fusion protein (F) encoding plasmid DNA (F-DNA) or virus-like particles presenting RSV F (F-VLP). F-DNA vaccination induced CD8 T cells and RSV neutralizing Abs, whereas F-VLP elicited higher levels of IgG2a isotype and neutralizing Abs, and germinal center B cells, contributing to protection by controlling lung viral loads after RSV challenge. However, mice that were immunized with F-DNA displayed weight loss and pulmonary histopathology, and induced F specific CD8 T cell responses and recruitment of monocytes and plasmacytoid dendritic cells into the lungs. These innate immune parameters, RSV disease, and pulmonary histopathology were lower in mice that were immunized with F-VLP after challenge. This study provides important insight into developing effective and safe RSV vaccines.
Animals ; B-Lymphocytes ; Dendritic Cells ; DNA ; Germinal Center ; Immunoglobulin G ; Lung ; Mice ; Monocytes ; Plasmids ; Respiratory Syncytial Virus Vaccines ; Respiratory Syncytial Viruses ; T-Lymphocytes ; Vaccination ; Vaccines, Subunit ; Viral Load ; Weight Loss

Background: and Purpose Oral nucleos(t)ide analogs (NAs) are the mainstay treatment for chronic hepatitis B (CHB). Myotoxicity is an important extrahepatic effect related to NA treatment. Telbivudine is the NA for CHB that is frequently associated with muscle-related side effects. The risk factors for telbivudine-induced myopathy (TIM) are not yet clear. Methods: This study characterized the clinical, magnetic resonance images (MRI), and pathological features of 12 TIM cases. A group of telbivudine-tolerant (TT) patients with CHB who received regular telbivudine treatment during the same period without the occurrence of myopathy was collected. Demographic and clinical factors were compared between the patients with TIM and the TT controls. Factors independently associated with TIM were identified using logistic regression analysis. Results: The patients with TIM (males/females: 7/5, mean age: 57 years) developed myopathy after using telbivudine for a median period of 19.5 months. Muscle histopathology revealed abnormal proliferation, subsarcolemmal or sarcoplasmic accumulations, and ultrastructural defects of mitochondria. When compared with TT cases, patients with TIM had a lower estimated glomerular filtration rate and were more frequently positive for hepatitis B e antigen (HBeAg). Conclusions Mitochondrial abnormalities are characteristic histopathological features, and impaired renal function and HBeAg positivity are risk factors for TIM. Telbivudine-induced mitochondrial dysfunction and immune activation related to mitochondrial damage and HBeAg serostatus changes may underlie TIM. Constant clinical surveillance of myopathy during telbivudine treatment is needed due to the significant latency of its development. Dose adjustment for impaired renal function does not eliminate the risk of TIM occurrence.

Background Roux-en-Y gastric bypass (GBP) is the main surgical procedure used in type 2 diabetes.The objective of this study was to evaluate the different types of GBP in treatment of type 2 diabetes.Methods Patients with type 2 diabetes were randomly divided into two groups:those who underwent gastrojejunal loop anastomosis bypass and those who underwent gastrojejunal Roux-en-Y bypass.Blood glucose alterations,operation time,and operation complicatiors were observed.Results Gastrojejunal loop anastomosis bypass and gastrojejunal Roux-en-Y bypass were both effective in the treatment of selected patients with type 2 diabetes.Compared with gastrojejunal Roux-en-Y bypass,gastrojejunal loop anastomosis bypass had the advantages of easier implementation,shorter operation time,and fewer operation complications.Conclusions Gastrojejunal loop anastomosis is effective in treatment of type 2 diabetes.It is safe,easy to implement,and worthy of clinical popularization.

BACKGROUND: Several factors contribute to differences in Streptococcus pneumoniae serotype distribution. We investigated the serotype distribution and antimicrobial resistance of S. pneumoniae isolated between 2014 and 2016 in Korea. METHODS: We collected a total of 1,855 S. pneumoniae isolates from 44 hospitals between May 2014 and May 2016, and analyzed the serotypes by sequential multiplex PCR. We investigated the distribution of each serotype by patient age, source of the clinical specimen, and antimicrobial resistance pattern. RESULTS: The most common serotypes were 11A (10.1%), followed by 19A (8.8%), 3 (8.5%), 34 (8.1%), 23A (7.3%), and 35B (6.2%). The major invasive serotypes were 3 (12.6%), 19A (7.8%), 34 (7.8%), 10A (6.8%), and 11A (6.8%). Serotypes 10A, 15B, 19A, and 12F were more common in patients ≤5 years old, while serotype 3 was more common in patients ≥65 years old compared with the other age groups. The coverage rates of pneumococcal conjugate vaccine (PCV)7, PCV10, PCV13, and pneumococcal polysaccharide vaccine 23 were 11.8%, 12.12%, 33.3%, and 53.6%, respectively. Of the 1,855 isolates, 857 (46.2%) were multi-drug resistant (MDR), with serotypes 11A and 19A predominant among the MDR strains. The resistance rates against penicillin, cefotaxime, and levofloxacin were 22.8%, 12.5%, and 9.4%, respectively. CONCLUSIONS: There were significant changes in the major S. pneumoniae serotypes in the community. Non-PCV13 serotypes increased in patients ≤5 years old following the introduction of national immunization programs with the 10- and 13-polyvalent vaccines.
Cefotaxime ; Humans ; Immunization Programs ; Korea ; Levofloxacin ; Multiplex Polymerase Chain Reaction ; Penicillins ; Pneumococcal Vaccines ; Pneumonia ; Serogroup ; Streptococcus pneumoniae ; Streptococcus ; Vaccines