Endotoxins are lipopolysaccharides ( LPS) , major component of out wall in Gram-negative bacteria. Often they are considered as "prime criminals" of triggering systemic inflaming reaction such as sepsis, bacteremia and so on. It was found in recent years that bactericidal/permeability-increasing protein, a 55kDa member of lipid-related protein family, was a kind of natural molecule of anti-infection and it has special endotoxin-neutralising activity and antibacterial activity. Comprehensive phase II/III clinical trials demonstrated the feasibility and safety of recombinant BPI. So pharmaceutical corporations are attracted to try to apply it to therapy.

Adenocarcinoma ; pathology ; Carcinoma, Small Cell ; pathology ; Carcinoma, Squamous Cell ; pathology ; Cytodiagnosis ; methods ; Humans ; Lung Neoplasms ; pathology ; Sensitivity and Specificity ; Specimen Handling ; methods ; Sputum

Objective To discuss the diagnostic value of contrast-enhanced ultrasonography in differentiating benign and malignant tumor of pelvic cavity.Methods From October 2014 to January 2016,abdominal ultrasonography or trans-vaginal ultrasonography were performed among outpatients and inpatients in the First Affiliated Hospital of Kunming Medical University.We found 62 cases with pelvic cavity tumors with 64 lumps,which were detected at cystic mass,cystic-solid mass,and solid mass in conventional ultrasonography.We made the diagnosis of all the lumps by performing contrast-enhanced ultrasonography,observing the infusion process and analyzing perfusion pattern,the intensity of perfusion and time intensity curve.By contrasting the diagnosis and the pathologic and long-term follow-up results,we classified the tumors into two groups,benign and malignant.Then we analyzed the time intensity curve and imaging parameters of the two groups.Restlts Among the total 64 lumps,43 was found in the group of benign tumor and 21 in the group of malignant tumor.Sixty-two were proved by pathologic results and 2 were proved by long-term follow-up results.Benign tumors showed that the infusion flowed from the peripheral to the center and enhanced equably and the vessels were regularly shaped.Malignant tumor showed that the infusion infiltrated from the center to the peripheral and enhanced quickly and unequally,and vessels were distorted.In the time intensity curve,group of benign tumors presented a gently slow raise and fall type,and group of malignant tumors showed a quickly raise and fall type.Rise time (RT) of malignant group (7.70 ± 2.56s) was shorter than benign group (11.40 ± 6.77s) (P＜0.05).Peak intensity (PI) of malignant group (16.30 ± 7.41dB) was higher than benign group (12.12 ± 6.70dB) (P＜0.05).Area Under the Curve (AUC) of malignant group (981.65 ± 548.04 dB s) was bigger than benign group (715.22 ± 651.04dB s) (P＜ 0.05).No difference was found between two groups in Time to Peak (TP) and Mean Transit Time (MTF) (P＞ 0.05).The sensitivity,specificity,positive and negative predictive value of contrast-enhanced ultrasonography were 95.2％,93.0％,86.9％,and 97.5％ respectively.Conclusion Contrast-enhanced ultrasonography ean show an eligible blood perfusion and vascularity of lumps.Analyzing perfusion pattern,time intensity curve,and other parameters can improve capacity of diagnosing and differentiating benign tumor and malignant tumor of pelvic cavity.

Objective To investigate the changes in systemic and pulmonary hemodynamics in patients with liver cirrhosis and portopulmonary hypertension(PPH)during liver transplantation.Methods Eight patients with liver cirrhosis and PPH(5 male,3 female)aged 50-63 yr weighing 45-80 kg were included in PPH group. Another 8 liver-cirrhotic patients without PPH served as control group.The patients were premedicated with intramuscular phenobarbital 0.1 g and atropine 0.5 mg.Anesthesia was induced with midazolam 3-5 mg,fentanyl 0.15-0.2 mg,propefol 1 mg?kg~(-1) and vecuronium 0.1 mg?kg~(-1) and maintained with 0.5%-3% isoflurane inhalation and intermittent Ⅳ boluses of fentanyl and vecuronium.The patients were mechanically ventilated after tracheal intubation.P_(ET)CO_2 was maintained at 30-45 mm Hg.Right subclavian vein was cannulated for fluid and drug administration and blood transfusion.Radial artery was cannulated for BP monitoring.Swan-Ganz catheter was placed via right internal jugular vein.BP,CVP,MPAP,PAWP,CI,PVRI and SVRI were monitored and recorded before operation(baseline),during preanhepatic phase,at 3 and 30 min of anhepatic phase and 3,7, 15,60 min of neohepatic phase and at the end of operation.Results(1)The two groups were comparable with respect to fluid balance,the amount of vasoactive drugs used during anhepatic and neohepatic phase,duration of anhepatic phase and operation.(2)MPAP and PVRI were significantly higher before operation in PPH group than in control group.(3)CI,MPAP, PAWP and CVP were siguificanfly decreased during anhepatic phase as compared to the baseline values(before operation)in both groups and then gradually returned to and even exceeded the baseline values during neohepatic phase.(4)During neohepatic phase PVRI in PPH group was significantly increased as compared to the baseline value and was significantly higher than that in control group.Conclusion MPAP and PVRI are significantly increased during neohepatic phase in patients with PPH and need to be treated.

ObjectiveTo investigate the value of diffusion tensor imaging (DTI) at high b value for unilateral middle cerebral artery (MCA) occlusive disease in patients without obvious infarct lesions on conventional MR imaging.MethodsDTI at high b value (2200 s/mm2 ) was performed using a 3.0 Tesla MR scanner in 34 patients with unilateral middle cerebral artery occlusion,who had no obvious infarct lesions on conventional MR imaging. Fractional anisotropy (FA),apparent diffusion coefficient (ADC),axial diffusivity (eigenvalue λ1) and radial diffusivity (eigenvalues λ2,λ3) were measured at the ipsilateral and contralateral corona radiata,anterior and posterior limbs of the internal capsule,cerebral peduncle and pons in all subjects.Mean ADC,FA,λ1,λ2 and λ3 values of corona radiata,anterior and posterior limbs of the internal capsule,cerebral peduncle and pons were compared between the ipsilateral and contralateral MCAterritory by t test. Results Among the 34 patients,left MCA occlusion in M1 segment occurred in 16 patients and right MCA occlusion in Ml segment occurred in 18 patients.At the ipsilateral corona radiata,mean FA,ADC,λ1,λ2 and λ3 were 0.419 ±0.032,(5.975 ±0.272) × 10 3,(5.704 ±0.365) ×10-3,(6.412 ±0.368) × 10-3 and (6.605 ±0.343) × 10-3 mm2/s,respectively.At the contralateral corona radiata,mean FA,ADC,λ1,λ2 and λ3 were 0.443 ± 0.033,(5.804 ± 0.282) × 10 -3,(5.651 ±0.350) × 10-3,(6.099 ±0.353) × 10-3 and(6.372 ±0.355) × 10-3 mm2/s,respectively.At the ipsilateral corona radiata,mean FA was significantly decreased(t =11.614,P ＜0.01),and mean ADC (t=12.421,P＜0.01),λ1(t =7.447,P＜0.01),λ2(t=10.244,P＜0.01) and λ3(t=9.890,P＜0.01) were significantly increased.At the ipsilateral anterior and posterior limb of the internal capsule,mean FA were 0.609 ±0.026 and 0.674 ±0.033,λ1 were(5.330 ±0.462) × 10 -3 and(5.171 ±0.456) ×10-3 mm2/s,respectively.At the contralateral anterior and posterior limb of the internal capsule,FA were 0.622 ±0.026 and 0.694 ±0.034,λ1 were(5.064 ± 0.448) × 10 -3 and(4.924 ± 0.365) × 10 -3 mm2/s,respectively.Mean FA was significantly decreased (t =7.823,8.013,all P ＜ 0.01) and mean λ1 was significantly increased (t =7.811,8.800,all P ＜0.01) at the ipsilateral anterior and posterior limbs of the internal capsule.There was no significant difference in ADC,λ2 and λ3 value between the ipsilateral and contralateral sides.And all the DTI parameters,including mean ADC,FA,λ1,λ2 and λ3 values,showed no statistical difference between both sides of cerebral peduncle and pons.ConclusionDTI at high b valuc can provide useful information for visualizing ischemic white matter injury in patients without obvious infarct lesions on conventional MR imaging.

Fibroma, Desmoplastic ; pathology ; Humans ; Male ; Middle Aged ; Nose Neoplasms ; pathology

Objective: To monitor the content of bisphenol S ( BPS ) in vegetables and fruits in Henan Province and evaluate the dietary exposure risk of the population, so as to provide the basis for formulating relevant food safety standards. Methods: From 2018 to 2019, 276 samples of vegetables and fruits produced and sold in Henan Province were collected. BPS was determined by isotope dilution ultra performance liquid chromatography triple quadrupole tandem mass spectrometry ( UPLC-MS/MS ) , and the dietary exposure was calculated according to the dietary structure and average body weight of local residents. The risk index of BPS was calculated according to the daily tolerable intake ( TDI ) of bisphenol A ( BPA ). Results: The BPS contents in vegetables and fruits were 0.006-12.600 µg/kg and 0.006-9.380 µg/kg, the medians were 0.053 µg/kg and 0.023 µg/kg, the detection rates were 78.43% and 62.60%, respectively.The detection rate and content of BPS in vegetables were higher than those in fruits ( P<0.05 ). The maximum exposure of BPS from vegetables and fruits was 5.37×10-2 µg/ ( kgbw·d ), and the exposure risk index was 1.07 × 10-3, which was acceptable. Conclusions BPS was detected from vegetables and fruits in Henan Province. The detection rate and content of BPS in vegetables were higher than those in fruits. The health risk of BPS exposed by vegetables and fruits is small.

BACKGROUNDComputer-aided diagnosis (CAD) of lung cancer is the subject of many current researches. Statistical methods and artificial neural networks have been applied to more quantitatively characterize solitary pulmonary nodules (SPNs). In this study, we developed a CAD scheme based on an artificial neural network to distinguish malignant from benign SPNs on thin-section computed tomography (CT) images, and investigated how the CAD scheme can help radiologists with different levels of experience make diagnostic decisions.

METHODSTwo hundred thin-section CT images of SPNs with proven diagnoses (135 small peripheral lung cancers and 65 benign nodules) were analyzed. Three clinical features and nine CT signs of each case were studied by radiologists, and the indices of qualitative diagnosis were quantified. One hundred and forty nodules were selected randomly to form training samples, on which the neural network model was built. The remaining 60 nodules, forming test samples, were presented to 9 radiologists with 3 - 20 years of clinical experience, accompanied by standard reference images. The radiologists were asked to determine whether a nodule was malignant or benign first without and then with CAD output. Diagnostic performance was evaluated by receiver operating characteristic (ROC) analysis.

RESULTSCAD outputs on test samples had higher agreement with pathological diagnoses (Kappa = 0.841, P < 0.001). Compared with diagnostic results without CAD output, the average area under the ROC curve with CAD output was 0.96 (P < 0.001) for junior radiologists, 0.94 (P = 0.014) for secondary radiologists and 0.96 (P = 0.221) for senior radiologists, respectively. The differences in diagnostic performance with CAD output among the three levels of radiologists were not statistically significant (P = 0.584, 0.920 and 0.707, respectively).

CONCLUSIONSThis CAD scheme based on an artificial neural network could improve diagnostic performance and assist radiologists in distinguishing malignant from benign SPNs on thin-section CT images.

Adult ; Aged ; Aged, 80 and over ; Diagnosis, Differential ; Female ; Humans ; Lung ; diagnostic imaging ; Lung Neoplasms ; diagnostic imaging ; Male ; Middle Aged ; Neural Networks (Computer) ; ROC Curve ; Radiographic Image Interpretation, Computer-Assisted ; Solitary Pulmonary Nodule ; diagnostic imaging ; Tomography, X-Ray Computed ; methods

Purpose To examine the expression of Fascin-1 and β-catenin protein and K-ras gene mutation in colorectal adenocarcinoma, and to explore their role in progression of colorectal neoplasm and their relevance. Methods Fascin-1 and β-catenin were analyzed by use of immunohistochemistry En Vision two-step. K-ras gene mutation was detected by ARMS method.Relationship between overexpression of Fascin-1, the nuclear expression of β-catenin, and the mutations of K-ras gene and clinicopathologic parameters was analyzed, the correlation between them was also analyzed. Results In 112 colorectal adenocarcinoma samples, the overexpression rate of Fascin-1 protein was 27.7％ (31/112), significantly higher than non-neoplastic mucosa (P < 0.01). The high nuclear expression rate of β-catenin was 29.5％ (33/112) in adenocarcinoma and non-neoplastic mucosa respectively with a significant difference between two groups (P < 0.01). High expression rate of Fascin-1 protein and β-catenin were correlated significantly with lymph node metastasis (P = 0.022, P = 0.027), and TNM staging (P =0.042, P = 0.019) in colorectal adenocarcinoma. The overexpression of Fascin-1 protein was correlated with tumor location (P = 0.004). The mutation rate of K-ras gene was 34.8％ (39/112), which showed no correlation with age, gender, tumor size, grade of differentiation, lymph node metastasis and TNM staging (P> 0.05). There was a correlation between the overexpressison of Fascin-1 protein, the nuclear expression of β-catenin and the mutation of K-ras gene (rs= 0.252, rs= 0.258, P < 0.05). The overexpression of Fascin-1 protein positively correlated with the nuclear expression of β-catenin (rs= 0.213, P < 0.05). Conclusion Fascin-1 protein and β-catenin protein are involved in invasion and metastasis of colorectal cancer and are associated with K-ras gene mutation. K-ras may promote the overexpression of Fascin-1 by virtue of nuclear expression ofβ-catenin, which provided a new research direction on the treatment of K-ras gene mutated colorectal adenocarcinoma.

Streptococcal toxic shock syndrome (STSS) has a low morbidity and high mortality in neonates. We recently diagnosed and treated a case of neonatal streptococcal toxic shock syndrome. This paper reviewed the diagnosis and treatment of the patient and reviewed the relevant literature of the epidemiology, diagnosis and treatment.