Objective　To determine the value of spiral CT in diagnosis of endobronchial tuberculosis(EBTB) after analysing the spiral CT appearance. Methods　Retrospective analysis of CT signs in 13 cases who were finally pathologically found suffering from EBTB via biopsy with bronchoscope. Results　Five cases have signs of bronchial structure with obstructive atelectasis and pneumonia. Two cases have signs of irregular bronchial wall. Four cases have signs of scattering dot and patchy increase density in lung fields. Two cases' bronchi and lung tissues are normal. Conclusion　CT examination can determine the site and extent of EBTB and help the localization of bronchoscope.

OBJECTIVE: To establish a practical, convenient and accurate method of DNA molecular marker for the identification of Testudinis Carapax et Plastrum. METHODS: Phenol extraction method and salting-out method were used to extract mtDNA from Testudinis Carapax et Plastrum and its adulterants. Cyt b mtDNA sequences of Chinemys reevesii and other turtle species were downloaded from GenBank. Species specific PCR primers were designed according to the differential DNA fragments of Cyt b genes, and Cyt b gene segment was amplified by PCR technique and sequenced. RESULTS: The complete 16.6 kb mtDNA was extracted from all samples by the two extraction methods. The specific primers could only amplify the Cyt b gene sequence of Chinemys reevesii, and its fragment was about 319 bp. The result of sequencing indicated that the homologous similarity was 100% with Chinemys reevesii. CONCLUSION: Salting-out method is suitable for the DNA extraction from Testudinis Carapax et Plastrum. The primers are specific to Chinemys reevesii and can be used to distinguish Testudinis Carapax et Plastrum from its adulterants. Copyright 2012 by the Chinese Pharmaceutical Association.

Objective To evaluate the diagosis value of different spiral computed tomography(CT) chest scanning methods in the differentiation of various pulmonary diseases,in order to avoid x-ray irradiation damage and reduce patients economic burden,but the diagnosis criterion should be guaranteed still.Methods 1000 cases of chest scan by spiral CT were randomly analyzed.In 927 conventional scan cases,including 155 cases of simple plainscan,474 cases of direct contrast scan,25 cases of plain plus contrast scans,73 cases of CT angiography.In addition,high resolution CT(HRCT) for 105 cases,thin layer scan for 86 cases,dynamic scan for 6 cases,and 40 cases bronchgraphy diagnosis were also carried out in the conventional scanning cases.Results The different CT scanning methods were adapted for diffenent pulmonary diseases.An adaptive scanning method and technique can decrease X-ray irradiation dosage and rise accuracy of diagnosis.Conclusions Aptimal scanning method and technique should be alternative according the clinical need and the patients status.

Objective To explore the effects of fibroblast transdifferentiation for myofibroblast (MFB) in the pathogenesis of systemic sclerosis (SSc) and to explore the antifibrotic mechanism of interferon γ (IFN-γ) in SSc.Methods The fibroblasts derived from the skin lesions of SSc patients and healthy adult controls were cultured in vitro and the MFB proportion in fibroblasts was examined by qualitative and quantitative α-smooth muscle actin (α-SMA) detection.By adding IFN-γ to the culture system with several doses,the influence on fibroblast proliferation and transdifferentiation for MFB in SSc was observed with MTT and enzyme linked immunosorbent assay (ELISA) respectively.Differences in the means of two independent samples were tested by Student' t-test.The means among multiple independent samples were com-pared by ANOVA.Results The means of positive α-SMA in SSc fibroblasts were higher than those in the controls (P＜0.01).With extended culture time,α-SMA levels of the two groups all increased gradually (P＜ 0.01 all),but there were higher α-SMA levels in SSc fibroblasts (24 h:130±19,48 h:183±21,72 h:249± 22) than those in controls (24 h:98±21,48 h:143±16,72 h:174±19) (P＜0.05 all).Although fibroblast proliferation and α-SMA levels were not influenced after adding of IFN-γ 10 U/ml (P＞0.05 all),but IFN-γ at concentration of 100 U/ml and 1000 U/ml could obviously repress fibroblast proliferation and α-SMA levels (P＜0.05 all),and 1000 U/ml had the strongest inhibiting effect at 24,48,72 h.Conclusion The fibroblasts in the skin of SSc patients have a strong potency to transdifferentiate to MFB.Early appropviate dose of IFN-γ could repress fibroblast proliferation and transdifferentiation in SSc.

Objective To investigate the clinical manifestations, endoscopic manifestations, histological characteristics, diagnosis and treatment of the primary gastrointestinal melanoma in China. Methods The gender, age, position, endoscopic manifestations, histological characteristics, treatment, prognosis of the primary gastrointestinal melanoma were gathered and analyzed by reviewing retrospectively the data of 2 cases seen at our hospital and 449 cases searched in CNKI from 1983 to 2015. Results The primary gastrointestinal melanoma was mostly seen in the rectum and anus, and secondly in the esophagus. A typical endoscopic finding was a protuberant or nodular tumor, with erosion or dirty surface on it. Most lesions were friable and easily hemorrhagic. The maximum diameters of most lesions, accounted for 83.3 %, were larger than 2.0 cm. The average value of the maximum diameters was (4.79 ± 2.67) cm. Most cases presented brown or black, followed by hoar. However, some lesions presented various colors, such as blue, red, even co-exited color or achromatic color. Preoperative misdiagnosed rate was 73.64 % and 1-year mortality was 54.19 %. Negative correlation was observed between survival time and lesion size, infiltration depth. Positive correlation was observed between lesion size and metastasis infiltration depth. Survival time had nothing to do with metastasis and age. Conclusion The primary gastrointestinal melanoma was highly aggressive, and usually found in the terminal age, usually together with extensive metastasis, misdiagnosed and poor prognosis. Knowing the clinical features, endoscopic manifestations, histological and immunohistochemical characteristics is the key to early diagnosis.

Objective To investigate the application value of CT/MR image fusing in gross tumor volume (GTV) delineation of esophageal squamous cell carcinoma.Methods Twenty-nine patients with esophageal squamous cell carcinoma to be treated with radical surgery underwent routine CT scanning,MR T2-weighted imaging (T2WI) and diffusion weighted imaging (DWI) before surgery.Diffusion-sensitive gradient b values were taken at 400,600,and 800 s/mm2.GTVs were delineated on the CT image,CT/ MR T2WI,and CT/MR DWI respectively.The MR T2W1 image was used as the intermediary for the fusion of the CT image and MR DWI image.The length of GTVs measured under different imaging conditions were compared with the length of the resected specimen of esophagus.Results The GTV length was (44.94 ± 18.46) and (45.05 ±21.47) mm on the CT images and CT/MR T2WI images respectively.When the b values were 400,600,and 800 s/mm2,the esophageal carcinoma GTV length on CT/MR DWI images was (42.12 ± 17.79),(41.18 ± 17.17) and (39.77 ± 17.66) mm,respectively.The coefficient between the esophageal carcinoma GTV lengths on CT/MR DWI images and the pathological lesion lengths was 0.928,0.926 and 0.927 respectively.Conclusions CT/MR DWI images displays esophageal carcinoma GTV length more accurately,thus guiding the delineation of GTV effectively.

Objective To study the prenatal diagnosis and clinical significance of fetal hyperechogenic kidneys.Methods Thirty one cases with fetal hyperechogenic kidneys were prenatally diagnosed with ultrasound.Autopsy was conducted and histological examination of the kidney was performed when pregnancy was terminated.A close follow-up was given for cases continuing pregnancy.Umbilical cord blood was collected for fetal chromosome analysis after delivery.Results(1)6 fetuses were complicated with other organ abnormalities,3 fetuses had abnormal chromosome,and 2 cases had a family history.(2) 12 cases chose to terminate pregnancy,10 of whom were oligohydromnios.Causes for fetal hyperechogenic kidneys were infantile polycystic kidney disease(IPKD,10 cases),adult polycystic kidney disease (APKD,1 case),polycystic kidney dysplasia(PKD,1 case)after postmortem histological examination. (3)Nineteen cases continued pregnancy,2 neonates with oligohydramnios died during neonatal period,both of them were IPKD;3 cases that were IPKD,IPKD and KPD respectively died 3 months,8 months and 1 year after birth,respectively;one case presented with hypertension symptom 26 months after birth,which was diagnosed as IPKD.The other 13 cases had no clinical manifestation and a close following-up is being undertaken for them at present.Conclusions(1)Fetal hyperechogenic kidneys could be caused by IPKD, APKD,or PKD,and are sometimes a normal variant.(2)Aminotic fluid volume is a key factor for prognosis;a suggestion for termination would be given to cases with fetal hyperechogenic kidneys and oligohydromnios.(3)For cases with fetal hyperechogenic kidneys,a complete and careful ultrasonography should be given to both parents and fetus,and fetal chromosomal analysis is suggested prenatally.

Castleman Disease ; genetics ; pathology ; surgery ; Diagnosis, Differential ; Female ; Gene Rearrangement, B-Lymphocyte, Heavy Chain ; Humans ; Hyperplasia ; Lung ; pathology ; surgery ; Lung Diseases ; genetics ; pathology ; surgery ; Lymph Nodes ; pathology ; Middle Aged

Actins ; metabolism ; Adenocarcinoma ; pathology ; Adult ; Diagnosis, Differential ; Endometriosis ; pathology ; Epithelium ; pathology ; Female ; Gastrointestinal Stromal Tumors ; pathology ; Hamartoma ; metabolism ; pathology ; Humans ; Muscle, Smooth ; pathology ; Stomach Diseases ; metabolism ; pathology

Objective To explore the expression of transcriptional regulation factor FHL 1 in pancreatic fibrosis of chronic pancreatitis (CP) and clinical significance.Methods Serum samples from 20 CP patients treated in the Department of Gastroenterology , Nanjing General Hospital and 20 healthy controls in the corresponding period were collected .The level of FHL1 in the serum was detected by ELISA .Twenty male Wistar rats were randomly divided into control group and CP group according to the body weight .The CP rat model was established by injecting dibutyltin dichloride ( DBTC) through tail vein .All the rats were killed at 28 days after injection and the pancreas was collected , which was observed using hematoxylin and eosin ( HE) staining to investigate pathological changes . The expression of FHL1 in pancreas was measured by immunohistochemistry (IHC) and Western blotting (WB).Results The average of serum FHL1 level in two groups were (0.86 ±0.22)g/L and (1.18 ±0.22)g/L, respectively.The level of FHL1 in serum of CP patients was significantly lower than that of healthy cases , and the difference was statistically significant (t=10.54, P=0.001).Damaged pancreatic lobular structure , acinar atrophy and the obvious fibrous hyperplasia were observed in CP rats .The pathological score of abnormal structure , acinar atrophy, fibrosis, and inflammatory cell infiltration in the pancreas of the CP group was (2.2 ±0.4),(2.0 ±0.7),(2.4 ±0.3) and (2.8 ±0.6), respectively, but was all 0 in control group.The difference between two group was statistically significant ( t value =17.24, 9.01, 25.22 and 14.75, respectively, all P<0.001).The expression of FHL1 in the pancreatic tissue of CP group were less than that of normal group , and the difference was statistically significant (IHC:15 798 ±3 247 vs 37 570 ±9 254, t=2.438,P=0.016;WB:0.44 ±0.11 vs 0.89 ±0.03, t=4.289, P=0.002).Conclusions The protein of FHL1 was in low expression in the pancreas of CPs , indicating that FHL1 may participate in the formation of pancreatic fibrosis .