Objective To study X-ray and CT findings of retroperitoneal fibrosis and their value for diagnosis of this disease.Methods X-ray and CT findings and clinical data of 5 cases confirmed with retroperitoneal fibrosis by clinicopathology were retrospectively analysed in combination with literature review.Results X-ray and CT manifestations of retroperitoneal fibrosis included diffuse mass at retroperitoneum,the neighboring organs were enveloped by masses,and one or bilateral renal pelvis and the ureter expansion.Conclusion X-ray and CT have vital clinical significance in diagnosing the retroperitoneal fibrosis.

Objective To describe the MR imaging features and pathologic findings of hepatic angiomyolipoma (HAML), and to evaluate the utility of MR imaging in diagnosis of this tumor. Methods The MR imaging features of eight patients with HAMLs confirmed pathologically were analyzed retrospectively and correlated with pathologic findings. Results Eight patients had a solitary hepatic mass, five (mixed type HAML) of which were diagnosed correctly, and two (1 myomatous type HAML and 1 angiomatous type HAML) of which were diagnosed as hepatic adenoma and focal nodular hyperplasia, and one (mixed type HAML) with hemorrhage and multiple cystic change was mistaken for malignant tumor. Six cases of mixed type HAML exhibited heterogeneously high signal intensity on T 1 and T 2WI. The high signal intensity on T 1WI in five cases disappeared completely after using fat saturation, and most part of the high signal intensity in one case disappeared and some of the high signal intensity remained unchanged after using fat saturation, and multiple cystic change within this mass was detected. One myomatous type HAML and one angiomatous type HAML showed hypointensity on T 1WI and hyperintensity on T 2WI. Multiphase dynamic Gd DTPA enhanced MR scanning was performed in six patients and all those masses showed strong enhancement during arterial phase, and four of which showed moderate enhancement and two slight enhancement during portal venous and delayed phase. Pseudocapsule detected in five cases showed slight enhancement on portal venous and (or) delayed phase. Conclusion MR imaging can reveal the characteristic findings of mixed type HAML and accurate preoperative diagnosis can be made.

Objective To determine the immunophenotypic features of peripheral lymphocytes in adult patients with Epstein-Barr virus (EBV)-associated infectious mononucleosis (IM) and chronic active EBV infection (CAEBV).Methods Eighteen IM patients,12 CAEBV patients and 18 healthy donors were included.Lymphocyte subsets including CD3-CD+19 B cells,CD3-CD+16/56 NK cells,CD4+ and CD8+T cells in peripheral blood were measured by flow cytometry.The expression of activation markers (HLA-DR and CD38) on CD8+T cells and CD28 expression on T cells were also determined.Kruskal-Wallis H and MannWhitney U tests were used to compare variables among groups.Results IM patients had dramatically increased CD8+T cell counts than healthy donors (5.22 × 109/L vs 0.54 × 109/L,P ＜ 0.001).B cell counts moderately reduced in patients with IM than in healthy donors.No difference was found in absolute CD4+T cell and NK cell counts between IM and healthy donors.The levels of HLA-DR and CD38 on CD8+T cells significantly increased in IM patients compared with those in healthy controls.The intensity of CD28 on CD8+T cells significantly decreased,which was not seen on CD4+T cells.The median cell counts of B,NK,CD4+T and CD8+T subsets in CAEBV patients were 0.02 × 109/L,0.06 × 109/L,0.26 × 109/L and 0.21 ×109/L respectively,which were significantly lower than those in healthy donors (0.22 × 109/L,0.38 ×109/L,0.78 × 109/L,0.54 × 109/L) and IM patients (0.12 × 109/L,0.40 × 109/L,0.91 × 109/L,5.22 ×109/L).The positive rates of HLA-DR and CD38 on CD8+T cells in CAEBV patients were higher than those in healthy controls,but lower than those in IM patients.Conclusions The immunophenotypic pattern in adult patients with IM is characterized by a dramatic increase of extensively activated CD8+ T cells,a moderate reduction of CD+19B cells and no significant change of CD4+T cells and CD+16/56NK cells.CAEBV is featured by an immunosuppression status as demonstrated by significantly decreased B,NK,CD4+T and CD8+T subsets.

Objective To investigate the sensitivity of tumor cells to photodynamic therapy(PDT), and to select the optimal photo-dose and photo density for PDT to the cultured cells. Methods Cells of SHEE and SHEEC cell lines were divided into 21 groups randomly,after 24 h inoculation, the cells accreted on paries of culture capsule completely, we replaced M199 complete culture solution with 30 μg/rnl Photofrin-Ⅱ solution 100 μl and then replacd with M199 complete culture solution without Photofiin-Ⅱ after 150 min of incubation in Photofrin-Ⅱ. Within 15 min,we dealed the cells with PDT using Photofrin-Diomed 630 under three different power densities:25 raW/cm~2,50 mW/cm~2 and 100 mW/cm~2 for 10 s,20 9,30 s,50 s, 100 s, 150 s and 200 s respectively,and then continue for 24 h culture. We examined the inhibiting effect on cell line SHEE and SHEEC under PDT by the method of CCK-8. Results There was no significant difference in the inhibition ratio with same power density of PDT between cell line SHEE and SHEEC under the concentration of 30 μg/ml Photofrin-Ⅱ. However, the inhibition ratio increased with the raising of photo-dose of PDT,but there was a platform stage after the 2.5～30 J/cm~ 2 photo-dose. Conclu-sion The difference for photodynamic sensitivity between human immortalization esophageal epithelial cell line SHEE and the malignant transformation cell line SHEEC is not significant. The targeting of PDT to malignant tumor cell may not be involved in the photosensitivity for tumor cell.

Objective To figure out and verify infiltration related miRNAs in bladder urothelial carcinoma (BUC). Methods Fresh tissues (20 samples,12 were infiltrative BUC samples,8 were non-infiltrative BUC samples) were collected in liquid nitrogen.The total RNA was extracted by using Trizol reagents.RNA quality control; miRNA microarray hybridization; data analysis.Another 22 samples were collected in fresh (15 were infiltrative BUC samples,7 were non-infiltrative BUC samples) for verifying purpose.4 types of bladder cancer cell lines were used for the study.BUC cell strain; total RNA was extracted by Trizol reagents; RNA quality control; RT-PCR and analysis of the data. Results ①In infiltrative BUC group,compared with non-infiltrative BUC group,there were 7 differentially expressed miRNAs:hsa-miR29c,hsa-miR-200a,hsa-miR-378,hsa-miR-429,hsa-miR-200c and hsa-miR-141 were up-regulated; hsamiR-451 was down-regulated.②In collected samples,the result of RT-PCR was consistent with miRNA array.③In bladder cancer cell lines,only the results of T24 were consistent with miRNA array. Conclusion Infiltration of BUC might relate with different expression of miRNAs.

BACKGROUND: Pergolide and madopar are the effective medicines to treat Parkinson disease, but the effects on the prognosis of patients with Parkinson disease are still under discussion. The progress of neuroimaging makes it possible to evaluate quantitatively the effect of the drug treatment on the prognosis of Parkinson disease.OBJBCTIVE: To observe the influence of pergolide or madopar as initial treatment on the prognosis and the striatal dopaminergic neuron in patients with early Parkinson disease by means of 99Tcm-TRODAT-1 dopamine transporter imaging single-photon emission computed tomtheography (SPECT) in combination with Parkinson disease scale.DESIGN: A randomized grouping, parallel control and placebo control trial.SETTING: Department of Neurology, the 81 Hospital of Chinese PLA;Department of Neurology and Department of Nuclear Medicine, Changhai Hospital of the Second Military Medical University of Chinese PLA.PARTICIPANTS: Thirty-six patients with early Parkinson disease who were recruited at the Specific Clinic of Parkinson Disease in the Shanghai Changhai Hospital affiliated to the Second Military Medical University of Chinese PLA and did not receive any drug treatment before, were enrolled between February and July 2002. They were randomly divided into artane control group (n=12), pergolide-treated group (n=12) and madopar-treated group. The diagnosis accorded with the clinical diagnostic standard set by United Kingdom Society of Parkinson Disease. This protocol was approved by the Medical Ethics Committee of Changhai Hospital, and all the subjects were enrolled in this study with informed consent.INTERVENTIONS: After test with unified Parkinson disease rating scale (UPDRS) and 99Tcm-TRODAT-1 SPECT, patients in the artane control group, pergolide-treated group and madopar-treated group were treated with corresponding drugs respectively, and each capsule of artane, pergolide and madopar contained drug of 0.05, 0.05 and 125 mg respectively. In the 1st week, the dosage was 1 capsule for each time, once a day, and then the daily dosage was increased by 1 capsule per week later, and the daily dosage reached 0.2, 0.2 and 500 mg respectively after 1 month, and then the dosages were kept constant. The curative effects were evaluated with UPDRS at 6 and 10 months after treatment. At 10 months after treatment,the 99Tcm-TRODAT-1 specific intakes of ipsilateral or contralateral striatum of the affected limb were tested with striatum dopamine transporter SPECT and semi-quantitative analysis.MAIN OUTCOME MEASURES: ① Changes of percentage of 99Tcm-TRODAT-1 decrease of ipsilateral or contralateral striatum of the affected limb at 10 months after treatment were compared among the three groups;② Changes of UPDRS scores before and after treatment were compared among the three groups.RESULTS: Totally 36 patients were involved in the study, and 1 case lost in each of the 3 groups respectively at 10 months after treatment, finally 33 cases entered the analysis of results. ① Changes of percentage of 99Tcm-TRODAT-1 decrease of ipsilateral or contralateral striatum of the affected limb at 10 months after treatment: At 10 months after treatment, the percentage of 99Tcm-TRODAT-1 decrease of ipsilateral or contralateral striatum of the affected limb were obviously higher in the madopar-treated group than in the artane control group and pergolide-treated group [(46.3±19.4)%, (28.9±13.0)%, (34.4±18,1)%; (47.5±20.8)%, (31.8±15.6)%, (33.8±17.2)%; P all ＜ 0.05]. ② Changes of UPDRS scores before and after treatment: As compared with the UPDRS scores before treatment, there was no obvious change in the artane control group at 10 months after treatment,but those in the madopar-treated group and pergolide-treated group were obviously decreased [(15.5±8.68), (6.4±9.05); (15.8±6.75), (10.36±8.30); Pall ＜ 0.05].CONCLUSION: Both madopar and pergolide can ameliorate the symptoms of early Parkinson disease, but they had different influences on the prognosis of patients with Parkinson disease. Madopar may accelerate the apoptosis of dopaminergic neuron and then aggravate the severity, but pergolide does not affect the prognosis of Parkinson disease, so it is a more suitable selective drug for the treatment of early Parkinson disease.

BACKGROUND: Selegiline can effectively alleviate motor disorder symptoms during the earlier stage of Parkinson disease(PD),but the influence on prognosis is still warmly discussed. With the development of neuroiconologicai study,the objective predictor for dopaminergic neuronal degeneration in PD would became possible.OBJECTIVE: To observe the influence of selegiline on dopaminergic neurons in earlier stage of PD with the aid of iconology.DESIGN: Randomized controlled study based on patients.SETTING: Neurological department in a military hospital of Chinese PLA,the nuclear medicine and neurological department in a military medical hospital of Chinese PLA.PARTICIPANTS: Between April and December 2001,25 patients were selected from PD specific clinic of Changhai Hospital,the Second Military Medical University of Chinese PLA. They were confirmed of earlier stage of PD without given any related drugs.INTERVENTIONS: Totally 25 patients were randomly divided into placebo group of 13 cases and selegiline group of 12 cases. After assessed with unified PD rating scale(UPDRS),they were given placebo and selegiline respectively with the dosage gradually increased from 0.05 mg at the beginning and added with 0.05 mg every week for four weeks until reaching the sustaining dosage of 0.2 mg. Dopamine transporting protein (99Tcm-TRODAT-1) examination and single photon emission-computerized tomography (SPECT) were performed at entering the experiment and after the treatment for 13 months,and semi-quantitative analysis was used for counting striatal emission of the ipsilateral and contralateral side. Scores for UPDRS were obtained at entering the experiment,after the treatment for 6months and 13 months.MAIN OUTCOME MEASURES:①Main outcomes:The differences ofstriatal 99Tcm-TRODAT-1 specific intake decreasing percentage on ipsilateral and contralateral side were compared between the two groups after the treatment for 13 months.②Subordinate outcome:Scores for UPDRS of the two groups was also compared.RESULTS: After the treatment for 13 months,striatal 99Tcm-TRODAT-1 specific intake decreasing percentages were (28.9 ± 13.0)% and(31.8 ± 15.6) % on ipsilateral and contralateral side of placebo group compared with the corresponding (30.39 ± 14. 7)% and(32.6 ± 16. 6)% of the selegiline group,the difference was of no statistical significance( P ＞ 0.05). Scores for UPDR was(23.7 ±4.3) in placebo group and(13.1 ± 5.5) in selegiline group after the treatment for 6 months,and(27.0 ±4.3) and(9. 8 ±4. 8) after the treatment for 13 months,indicating that slegiline group was obviously better than placebo group( P ＜ 0. 05).CONCLUSION: Selegiline showed better therapeutic effect in the treatment of earlier-stage PD without increasing the apoptosis of striatal dopaminergic neurons.

objective To summarize the clinical characteristics of AIDS phobia patients and establish the preliminary clinical diagnostic criteria.Methods The clinical information of 46 AIDS phobia patients was collected and summarized.General demographic data,clinical manifestations and laboratory results were analyzed.Results The clinical characteristics of AIDS phobia patients include:(1)With or without high-risk behavior of HIV-1 infection;(2)Patients repeatedly demanded HIV/AIDS related laboratory tests,suspected or believed in HIV-1 infection with daily life affected;(3)The main complaints were non-specific including influenza-like symptoms(headache,sore throat and so on),fasciculation,formication,arthrodynia,fatigue and complaint of fever with normal body temperature;physical examination did not reveal any positive physical sign except white coated tongue;(4)Symptoms mainly appeared 0-3 months after the high-risk behavior while HIV-1 antibody kept negative;(5)T lymphocyte subsets test was carried out in 23 patients and showed 19(82.6%)with CD4+ T lymphocyte count>500/μl,the remaining 4 were 300-500/μl,with the lowest count of 307/μl.Few patients had inversed CD4+/CD8+ ratio but without excessive CD8+T lymphocyte activation.Conclusion AIDS phobia is a complicated physical and mental disease,whose diagnosis and treatment still need further investigation.

Objective To analyze the correlation between CD4+ T cell count and HLA-DR or CD38 expression on peripheral CD8+ T cells in treatment-naive Chinese HIV/AIDS patients.Methods A total of 471 treatment-naive HIV-infected patients and 53 healthy volunteers were enrolled.HLA-DR or CD38 expression on peripheral CD8+ T cells, CD4+ T cell count, naive CD4+ T cell subsets and CD28 expression on T cells were measured by flow cytometry.Plasma HIV RNA load was quantified by real-time PCR (COBAS TaqMan RT-PCR).Mann-Whitney U test and Spearman's rank correlation test were used for statistical analysis.Results CD38 expression intensity on CD8+ T cells was negatively correlated with CD4+ T cell count (r =-0.53, P ＜ 0.001) and naive CD4+ T cell count (r =-0.48, P ＜ 0.001).CD38 expression on CD8+ T cells also displayed significantly negative correlation with CD28 expression on CD8+ T cells (r =-0.46, P ＜ 0.001).HLA-DR expression on CD8+ T cells did not show significant correlation with CD4+ T cell count.Only weak positive correlation was found between CD38 intensity on CD8+ T cells and plasma HIV RNA load.Conclusions Compared with HLA-DR, CD38 expression on CD8+ T cells shows more significant negative correlation with CD4+ T cell count in treatment-naive patients.CD38 and HLA-DR may play different roles on the persistent immune activation in HIV infection.

Objective To evaluate the accuracy of lymphocyte count as a surrogate for CD4+T cell count in treatment-na(i)ve HIV-infected adults.Methods A total of 2 013 HIV-infected patients were screened at 23 sites in China.CD4+ T cell counts were measured by flow cytometry.Correlation between CD4+ T cell count and peripheral lymphocyte count were analyzed by spearman coefficient.AUCRoc were used to evaluate the performance of lymphocyte count as a surrogate for CD4+ T cell count.Results The lymphocyte count and CD4+T cell count of these 2 013 patients were (1 600±670) × 106/L and (244 ± 148) × 106/L respectively.CDa+ T cell count were positively correlated with lymphocyte count(r =0.482,P ＜0.000 1).AUCROC of lymphocyte count as a surrogate for CD4+ T cell counts of ＜ 100 × 106/L,＜200 × 106/L and ＜ 350 × 106/L were 0.790 (95％ CI 0.761-0.818,P ＜ 0.000 1),0.733 (95％ CI 0.710-0.755,P ＜ 0.000 1) and 0.732 (95％ CI 0.706-0.758,P ＜ 0.000 1) respectively.Conclusion Lymphocyte count could be considerad as a potential surrogate marker for CD4+ T cell count in HIV/AIDS patients not having access to T cell subset test by flowcytometry.