Diagnosis, Differential ; Humans ; Lung Diseases, Interstitial ; diagnosis ; pathology ; Pathology, Clinical

Objective:To observe the clinical efficacy of Yi Jin Jing (Sinew-transforming Qigong Exercises) for primary osteoporosis in the elderly.Methods:Eighty old patients with primary osteoporosis were randomized into a Yi Jin Jing group and a medication group,40 cases in each group.The Yi Jin Jing group was intervened by Yi Jin Jing (Sinew-transforming Qigong Exercises) training,while the medication group was intervened by oral administration of alendronate sodium tablet.Prior to and after 6-month intervention,the bone mineral density (BMD) of the proximal femur,visual analog scale (VAS) and activities of daily living (ADL) were estimated.Results:There were no significant differences in the BMD of the proximal femur,and VAS and ADL scores between the two groups before the intervention (P＞0.05).After 6-month intervention,the above items all improved significantly in both groups (both P＜0.01);the improvements in VAS and ADL scores in Yi Jin Jing group were more significant than those in the medication group (P＜0.01),while the between-group difference in the BMD of the proximal femur was statistically insignificant (P＞0.05).Conclusion:Practice of Yi Jin Jing (Sinew-transforming Qigong Exercises) can effectively ameliorate the BMD in the elderly with primary osteoporosis,and it can reduce the pain and improve ADL,with a better general effect compared to oral administration of alendronate sodium tablet.

Medically unexplained dyspnea refers to a group of patients presenting marked dyspnea without structural alterations of organs/systems after thorough examinations. This clinically neglected group of patients accounts for about 14% of patients with dyspnea in secondary health care. They appear very difficult to manage clinically. In this paper an organized approach used to diagnose medically unexplained dyspnea is presented. Breathing re-training is recommended as a therapy for those "difficult to treat patients".
Breathing Exercises ; Diagnosis, Differential ; Dyspnea ; diagnosis ; psychology ; therapy ; Humans ; Psychophysiologic Disorders ; diagnosis ; therapy

OBJECTIVETo evaluate the diagnostic specificity of dynamic assessment and monitoring using a portable spirometer in diagnosis and differential diagnosis of asthma.

METHODSWe retrospectively reviewed the results of dynamic monitoring of spirometry in 145 symptomatic patients with physician-diagnosed asthma. Flow-volume curve and simultaneous symptoms and mood were measured in a fixed-time thrice-daily assessment schedule for 2 weeks. Patients were allowed to make additional measurements in case of symptom exacerbations.

RESULTSThe clinical data of 51 males and 94 females with a mean age of (39.1 +/- 13.0) years (ranged from 10 to 65 years) were analyzed. Duration of asthma before study was (6.7 +/- 9.9) years. Of 145 patients with physician-diagnosed asthma, 126 (87%) could be conclusively confirmed for a diagnosis of asthma. Asthma was misdiagnosed in 14 patients (9.7%). Overdiagnosis of asthma was observed in 5 patients (3.4%).

CONCLUSIONDynamic assessment and monitoring using a portable spirometer by revealing variability and reversibility of airway obstruction may provide an additional tool for diagnosis and differential diagnosis of asthma.

Adolescent ; Adult ; Aged ; Airway Obstruction ; Asthma ; diagnosis ; Child ; Diagnosis, Differential ; Diagnostic Errors ; Female ; Humans ; Male ; Middle Aged ; Peak Expiratory Flow Rate ; Spirometry ; methods ; Young Adult

OBJECTIVETo investigate the clinical applications of portable spirometry in asthma.

METHODSTwenty patients with asthma were recruited from Peking Union Medical College Hospital. Flow-volume loop, simultaneous asthma symptoms, and mood were monitored three times a day for consecutive 14 days.

RESULTSIn patients with a normal daytime spirometry, marked decline of forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF) were observed at night and/or in the early morning. A within subject correlation analysis between FEV1, PEF, and asthma symptoms showed that the correlation between symptoms and airway obstruction was found only in seven out of twenty patients (35%). Four patients (20%) reported many symptoms with nearly normal portable spirometry. Accordingly, their symptoms were not correlated with FEV1 and PEF. This group of patients was defined as over-perceivers. On the contrary, another two patients (10%) did not report any symptoms while obvious airways obstruction was recorded by a portable spirometry. These patients were defined as under-perceivers.

CONCLUSIONSDynamic monitoring of flow-volume loop with a portable spirometry is more accurate than routine lung function test in assessment of asthma severity. In addition, combined with simultaneous monitoring of symptoms, it would be of particularly helpful in identifying two specific types of asthma patients, e.g. over-perceivers and under-perceivers.

Adolescent ; Adult ; Asthma ; physiopathology ; Female ; Forced Expiratory Volume ; Humans ; Male ; Middle Aged ; Peak Expiratory Flow Rate ; Spirometry ; instrumentation ; methods

OBJECTIVETo isolate, identify and culture human spermatogonial stem cells (SSC) and then obtain purified and enriched human SSCs for research and application.

METHODSWe detected the expression of CD90 in the human testis using the immunofluorescence technique and isolated human testicular spermatogenic cells by two-step enzymatic digestion, followed by differential plating and magnetic-activated cell sorting (MACS) with CD90 as an SSC marker. Then we identified the isolated CD90-positive spermatogenic cells by RT-PCR and immunocytochemistry, and meanwhile cocultured them with Sertoli cells in SG medium in vitro.

RESULTSThe isolated CD90-positive cells showed a relatively homogeneous characteristic in size and morphology and expressed the genes specific for human SSCs, with high expressions (90.5%) of GFRA1, GPR125, and UCHL1. After coculture with Sertoli cells in the SG medium for 2 weeks, the isolated CD90-positive cells maintained a good activity.

CONCLUSIONCD90 can be regarded as a speci- fic marker for human SSCs and used to obtain highly enriched human SSCs by differential plating and MACS. Furthermore, the isolated human SSCs can be cultured in SG medium in vitro.

Adult Stem Cells ; cytology ; Biomarkers ; metabolism ; Cell Separation ; methods ; Cell Shape ; Cell Size ; Coculture Techniques ; Glial Cell Line-Derived Neurotrophic Factor Receptors ; metabolism ; Humans ; Immunohistochemistry ; Male ; Receptors, G-Protein-Coupled ; metabolism ; Sertoli Cells ; Spermatogonia ; cytology ; Testis ; metabolism ; Thy-1 Antigens ; isolation & purification ; metabolism ; Ubiquitin Thiolesterase ; metabolism

BACKGROUNDAmyloidosis is a collection of diseases in which different proteins are deposited. Amyloid deposits occur in systemic and organ-limited forms. In both systemic and localized forms of the disease, lung can be involved. The aim of this study was to explore the different respiratory manifestations of amyloidosis.

METHODSChest radiology, clinical presentations, bronchoscopic/laryngoscopic findings and lung function data of 59 patients with amyloidosis involving respiratory tract collected during January 1986 to March 2005, were analysed.

RESULTSOf the 16 cases with localized respiratory tract amyloidosis, 8 had the lesions in the trachea and the bronchi, 2 in the larynx and the trachea, 5 in the larynx and/or the pharynx, and 1 in the lung parenchyma. Of 43 systemic amyloidosis with respiratory tract involvement, 3 had the lesions in bronchi, 13 in lung parenchyma, 33 in pleura, 8 in mediastina, 1 in nose and 1 in pharynx. Chest X-rays were normal in most cases of tracheobronchial amyloidosis. CT, unlike chest X-rays, showed irregular luminal narrowing, airway wall thickening with calcifications and soft tissue shadows in airway lumen. Localized lung parenchymal amyloidosis presented as multiple nodules. Multiple nodular opacities, patch shadows and reticular opacities were the main radiological findings in systemic amyloidosis with lung parenchymal involvement. In pleural amyloidosis, pleural effusions and pleural thickening were detected. Mediastinal and/or hilar adenopathy were also a form of lung involvement in systemic amyloidosis. The major bronchoscopic findings of tracheobronchial amyloidosis were narrowing of airway lumen, while nodular, 'tumour like' or 'bubble like' masses, with missing or vague cartilaginous rings, were detected in about half of the patients.

CONCLUSIONSLocalized respiratory tract amyloidosis mostly affects the trachea and the bronchi. Chest X-rays are not sensitive to detect these lesions. Systemic amyloidosis often involves lung parenchyma and the pleura. Open lung biopsy or pleural biopsy should be performed for the diagnosis.

Adolescent ; Adult ; Aged ; Amyloidosis ; complications ; Bronchoscopy ; Female ; Humans ; Laryngoscopy ; Male ; Middle Aged ; Radiography, Thoracic ; Respiratory Tract Diseases ; diagnosis ; etiology ; therapy ; Tomography, X-Ray Computed

OBJECTIVETo describe a form of interstitial lung disease pathologically characterized by small airway-centered interstitial fibrosis (ACIF).

METHODSWe analyzed the clinical, pulmonary functional, radiographic, and histologic characteristics of one ACIF case in Peking Union Medical College Hospital and reviewed 12 cases in literatures.

RESULTSClinically, patients presented with chronic cough and progressive dyspnea. Pulmonary function tests showed restrictive ventilatory pattern. Bronchoalveolar lavage showed a mild increase in lymphocytes in most cases. Chest radiography revealed diffuse reticulonodular infiltrates, with thickening of the bronchial walls and surrounding fibrosis. The key finding in histopathology was a distinctive pattern of ACIF centered on membranous and respiratory bronchioles.

CONCLUSIONSACIF is a disease that do not fit into any known category of interstitial lung disease. Whether it is a unique disease remains to be determined.

Adult ; Biopsy ; Bronchi ; pathology ; Diagnosis, Differential ; Humans ; Lung ; diagnostic imaging ; pathology ; Male ; Pulmonary Fibrosis ; diagnosis ; diagnostic imaging ; pathology ; Respiratory Function Tests ; Tomography, X-Ray Computed ; methods

Objective To evaluate the safety and efficacy of transplantation of purified CD34 + cells (PCCs) in treatment of critical limb ischemia (CLI) caused by thromboangiitis obliterans (TAO).Methods From May 2009 to June 2015,34 TAO-induced-CLI cases underwent PCCs transplantation.None of these patients were eligible for surgical or endovascular revascularization.G-CSF was subcutaneously injected for 5 days before peripheral CD34 + cells were isolated,purified and intramuscularly injected in the limbs.Patients were regularly follow-up.Results Technical success was achieved in all cases.The mean number of transplanted cells was (7.5 ± 2.4) × 105/kg.The follow-up was accomplished in 32 cases,ranging from 6 to 79 months (mean 45 ±24 months),and two patients were lost.Wong-Baker FACES pain rating scale score significantly decreased from 8.0 ±2.0(4-10)to 2.2 ±3.1 (P ＜0.05) at 1 month.The Peak pain-free walking time improved from (4.0 ± 2.0) min to (13.5 ± 5.3) min (P ＜ 0.05) at 3 months and (19.0 ± 3.1) min (P ＜ 0.05) at 6 months.The ankle-brachial index increased from 0.42 ± 0.20 to 0.50 ± 0.10 (P ＜ 0.05) at 3 months and 0.52 ± 0.11 (P ＜ 0.05) at 6 months,respectively.Transcutaneous partial oxygen pressure rose from (25 ± 11) mmHg to (48 ± 11) mmHg(P ＜ 0.05) at 3 months and (58 ± 10) mmHg (P ＜ 0.001) at 6 months,respectively.Ulcers healed in 21 out of 22 patients at (5 ± 4) months.The overall amputation-free survival rate was 94.1％ at 6 months and 91.2％ at 48 months.No major adverse events were observed perioperatively or postoperatively.Conclusions Transplantation of PCCs could yield safe,satisfactory and durable treatment outcomes in patients with TAO-induced-CLI.

Objective To analyze the perioperative mortality,stroke rates and late benefits of carotid artery stenting for the treatment of unilateral severe stenosis of carotid artery with contralateral obliteration in a single medical center.Methods Clinical data of 38 cases were analyzed retrospectively,including postoperative period and follow-up.Results The technical success rate was 100％ ( 38/38 )with no peri-operative 30-day mortality or ischemic stroke.The overall peri-operative complication rate was 34.2％ ( 13/38),including transient ischemic attack (TIA) in 5.3％ (2/38).The average follow-up time was ( 29 ± 13 ) months with follow-up rate of 86.8％ ( 33/38 ).The mortality was 0 and the overall complication rate was 12.1％ (4/33),including TIA in 6.1％ (2/33).No patients had recurrent stroke.Twenty-three cases underwent whole brain CT perfusion evaluation before and after the therapy.A significant improvement of the perfusion parameters was observed in the stenotic side after CAS.Conclusions CAS contralateral to an occluded carotid artery can be performed with acceptable perioperative mortality and stroke risk rates,as well as a satisfactory long-term beneficial effect in stroke prevention.