Latest Issue
Volume 0 ， Issue 1 ， 2007
- Abstract：Objective To assess inter-observer variations of pulmonary nodule marking in routine clinical chest digital radiograph （DR） softcopy reading by using a lung nodule computer toolkit.Methods A total of 601 chest posterior-anterior DR images were randomly selected from routine outpatient screening in Peking Union Medical College Hospital. Two chest radiologists with experience more than ten years were first asked to read the images and mark all suspicious nodules independently by using computer toolkit IQQA-Chest, and to indicate the likelihood for each nodule detected. They were also asked to draw the boundary of the identified nodule manually on an enlarged region of interest, which was instantly analyzed by IQQA-Chest. Two sets of diagnostic reports, including the marked nodules, likelihood, manually drawn boundaries, quantitative measurements, and radiologists’ names, were automatically generated and stored by the computer system. One week later, the two radiologists read the same images together by using the same computer toolkit without referring to their previous reading results. Marking procedure was the same except that consensus was reached for each suspicious region. Statistical analysis tools provided in the IQQA-Chest were used to compare all the three sets of reading results.Results In the independent readings, Reader 1 detected 409 nodules with a mean diameter of 12.4 mm in 241 patients, and Reader 2 detected 401 nodules with a mean diameter of 12.6 mm in 253 patients. In the consensus reading, a total of 352 nodules with a mean diameter of 12.4 mm were detected in 220 patients. Totally, 42.3% of Reader 1’s and 45.1% of Reader 2’s marks were confirmed by the consensus reading. About 40% of each reader’s marks agreed with the other. There were only 130 （14.4%） out of the total 904 unique nodules were confirmed by both readers and the consensus reading. Moreover, 5.6% （51/904） of the marked regions were rated identical likelihood in all three readings. Statistical analysis showed significant differences between Readers 1 and 2, and between consensus and Reader 2 in determining the likelihood of the marks （P<0.01）, but not between consensus and Reader 1. No significant difference in terms of size was observed in nodule segmentation between either two of the three readings. Conclusion Large variations in nodule marking and nodule-likelihood determination but not in nodule size were observed between experts as well as between single-person reading and consensus reading.Keywords：inter-observer variation;chest digital radiograph;computer toolkit;pulmonary nodule4|30|1Updated：2024-04-10
- Abstract：Objective To compare the short- and long-term clinical outcomes between sirolimus-eluting stent （Cypher stent） and paclitaxel-eluting stent （TAXUS stent） in patients with in-stent restenosis （ISR） lesions of the coronary arteries.Methods From December 2002 to March 2005, 253 patients with ISR lesions of the coronary arteries were selected and divided into two groups. Cypher group （152 cases） was treated with Cypher or Cypher Select stents, and TAXUS group （101 cases） with TAXUS stents. A total of 262 ISR lesions in these patients were treated with 308 drug-eluting stents （DESs）, including 176 Cypher or Cypher Select stents and 132 TAXUS stents. All patients were followed up for 10 months. Procedure success rates of DES implantation in both groups were observed. Major adverse cardiac events （MACE） rates in hospital and at 10 months follow-up, as well as in-DES restenosis observed using coronary angiography at follow-up were compared between two groups. Results Success rate of DES implantation was 100% in both groups. No significant difference in MACE rate during hospitalization was found between the two groups. However, at 10 months follow-up, MACE rate was higher in TAXUS group than in Cypher group （16.00% vs. 6.67%, P=0.031）. As for coronary angiography at 10 months follow-up, we observed an increasing tendency of in-DES restenosis rate in TAXUS group compared with Cypher group （29.41% vs. 14.04%, P=0.075）. Conclusions Cypher and TAXUS DESs both have good short- and long-term outcomes in treating ISR. Cypher DES proved better long-term clinical outcome than TAXUS DES.Keywords：in-stent restenosis;drug-eluting stent;outcome4|25|0Updated：2024-04-10
- Abstract：Objective To investigate the clinical value of different magnetic resonance （MR） pulse sequences in diagnosis of spinal metastatic tumor. Methods Fifteen patients with clinically suspected spinal metastatic tumor were included in this study. These patients were with documented primary tumors. Four MR pulse sequences, T1-weighted spin echo （T1WI SE）, T2-weighted fast spin echo （T2WI FSE）, short time inversion recovery （STIR）, and gradient echo 2-D multi echo data imaging combination （GE Me-2D） were used to detect spinal metastasis. Results Fifteen vertebral bodies were entire involvement, 38 vertebral bodies were section involvement, and totally 53 vertebral bodies were involved. There were 19 focal infections in pedicle of vertebral arch, 15 metastases in spinous process and transverse process. Fifty-three vertebral bodies were abnormal in T1WI SE and GE Me-2D, 35 vertebral bodies were found abnormal in T2WI FSE, and 50 vertebral bodies were found abnormal in STIR. The verges of focal signal of involved vertebral bodies were comparatively clear in T1WI SE, comparatively clear or vague in T2WI FSE, vague in STIR, and clear in GE Me-2D.Conclusions GE Me-2D may be the most sensitive technique to detect metastases. So three sequences （T1WI SE, T2WI FSE, GE Me-2D） can demonstrate the early changes of spinal metastasis roundly.Keywords：spinal metastatic tumor;T1-weighted spin echo;T2-weighted fast spin echo;gradient echo 2-D multi echo data imaging combination4|13|2Updated：2024-04-10
- Abstract：Objective To investigate ureteral injury during gynecological laparoscopic surgeries.Methods From January 1990 to December 2005, 12868 gynecological laparoscopic surgeries were conducted in Peking Union Medical College Hospital with 12 ureteral injuries reported. The present study investigated several aspects, including surgical indications, uterine size, pelvic adhesion, operative procedures, symptoms, diagnostic time and methods, injury site and type, subsequent treatment, and prognosis. Results The incidence of ureteral injury was 0.093% （12/12868） in all cases, 0.42% （11/2586） in laparoscopic hysterectomy [laparoscopically assisted vaginal hysterectomy （LAVH） or total laparoscopic hysterectomy （TLH）], and 0.01% （1/10282） in non-LAVH surgeries. Enlarged uterus, pelvic adhesion, and endometrosis were risk factors associated with ureteral injury. Only one injury was found intraoperatively while others were found postoperatively. The injury sites were at the pelvic brim （2 cases） or the lower part of ureter （10 cases）. Patients were treated with ureteral stenting （effective in 2 cases） or laparotomy and open repair. Prognoses were favorable in most cases. Conclusions Most laparoscopic ureteral injuries occur during laparoscopic hysterectomy. Further evaluation is required when ureteral injury is suspected, and surgical repair is the major treatment for ureteral injury.Keywords：ureteral injury;laparoscopy;iatrogenic complication4|36|11Updated：2024-04-10
- Abstract：Objective To evaluate color Doppler ultrasonography （CDU） appearances of renal vein thrombosis （RVT） and its diagnostic value.Methods Ten patients with RVT were analyzed retrospectively. Renal structure, distributions of intrarenal flow signals, echogenicity, and flow fullness in main renal veins were observed with CDU. Resistance index （RI） was recorded from the waveforms of segmental or interlobar renal artery.Results Ten kidneys in nine patients were confirmed to have thrombus within the main renal veins, and one patient was confirmed to have thrombus within the small intrarenal veins. The appearances of the main renal vein thrombosis included full of solid echogenicity or strip echogenicity and complete or partial filling defect within the main renal veins, and absent or a few intrarenal venous flow signals in 70% of kidneys involved. The appearances of intrarenal vein thrombosis included obscure renal structure and no venous flow signal within the involved part of the kidneys. Reverse diastolic flow in the intrarenal artery had only a sensitivity of 36% （4/11）; in other 7 kidneys without intrarenal arterial reverse diastolic flow, increased RI （mean, 0.84; range, 0.74-0.96） was found.Conclusion CDU is helpful for rapid clinical diagnosis and follow-up of RVT, and therefore can be the first imaging modality of choice for RVT.Keywords：color Doppler ultrasonography;renal vein thrombosis;diagnosis4|16|1Updated：2024-04-10
- Abstract：Objective To investigate the mechanism of a novel angiotensin Ⅱ type 1 receptor-associated protein （ATRAP） interfering with angiotensin II type 1 （AT1） receptor-mediated vascular smooth muscle cell （VSMC） growth and neointimal formation. Methods VSMCs isolated from thoracic aorta of adult Sprague-Dawley （SD） rats were used in this study. ATRAP cDNA was subcloned into pcDNA3 vector and then transfected into VSMCs. DNA synthesis and extracellular signal-regulated kinase （ERK） and phospho-ERK expressions in VSMCs were assayed by measurement of 3H thymidine incorporation and Western blotting, respectively. Morphological changes were observed in the balloon injured artery with or without transfection of ATRAP cDNA using 12-week-old male SD rats. Results ATRAP overexpression in VSMCs inhibited angiotensin II（Ang II）-induced 3H thymidine incorporation 48 hours after Ang II stimulation （P<0.05）. In VSMC, Ang II stimulation increased the phosphorylation of ERK, which reached the peak around 60 minutes. The activation of phospho-ERK was significantly decreased by ATRAP （P<0.05）. Neointimal formation was markedly inhibited by ATRAP overexpression in injuried arteries. Conclusions The AT1 receptor-derived activation of ERK plays an essential role in Ang II-induced VSMC growth. The growth inhibitory effects of ATRAP might be due to interfering with AT1 receptor-mediated activation of ERK in VSMC growth and neointimal formation.Keywords：angiotensin;receptor;vascular smooth muscle cell;neointimal formation 04|32|5Updated：2024-04-10
- Abstract：Objective To analyze the role of resistin in insulin resistance （IR） through investigating the variation of plasma resistin levels and single-nucleotide polymorphisms （SNPs） in resistin gene 5’ flanking region in stroke patients.Methods In 103 atherothrombotic cerebral infarction （ACI） patients, 85 lacunar infarction （LI） patients, 70 intracerebral hemorrhage （ICH） patients, and 86 healthy controls, plasma resistin and insulin levels were measured by ELISA , SNPs in resistin gene 5’ flanking region were detected by PCR and direct DNA sequencing. The subjects’ body height and weight, the body mass index, quantitative insulin sensitivity check index （QUICKI）, blood pressure, and the concentration of fasting plasma glucose, triglyceride, total cholesterol, creatinine, low-density lipoprotein, and high-density lipoprotein were also determined. Results QUICKI was significantly lower in the ACI and ICH patients （0.316±0.037 and 0.309±0.032, respectively） than that in the controls （0.342±0.043, P<0.001）, while plasma resistin level was significantly higher in the ACI and ICH patients （6.36±3.79 and 7.15±4.27 ng/mL, respectively） than that in the controls （5.28±2.56 ng/mL, P<0.05）, but such difference was not observed in the LI patients compared with controls. There was a statistically negative correlation between plasma resistin level with QUICKI （r=-0.228, P<0.001）. The distributions of allele and genotype frequencies of resistin gene -420C>G and -537A>C SNPs were not significantly different among the different groups, and those SNPs were not correlated with other clinical and biochemical parameters.Conclusions Plasma resistin is associated with stroke by participating in the development of IR. The SNPs in resistin gene 5’ flanking region has no impact on the plasma resistin level.Keywords：resistin;insulin resistance;single-nucleotide polymorphisms;stroke4|128|3Updated：2024-04-10
- Abstract：Objective To silence annexin II gene expression by using small interference RNA （siRNA） in prostate cancer cell line PC3. Methods For in vitro transcription, four sequences of 29-nucleotide DNA template oligonucleotides were designed, and one pair of the sequences were complementary to annexin II gene. The other pair was negative control. The 8 nucleotides at the 3’ end of each oligonucleotide were complementary to the T7 Promoter Primer. The sense and antisense siRNA templates were transcribed by T7 RNA polymerase and the resulting RNA transcripts were hybridized to create dsRNA. The siRNA was transfected into prostate cancer cell PC3. For assaying the efficiency of siRNA, confocal microscopy, Northern blotting, and Western blotting were employed to examine the expression of annexin II protein and its mRNA. 3H thymidine was used to measure DNA synthesis. Results The siRNA sequence specific to annexin II gene was capable of inhibiting the expression of annexin II protein and its mRNA. And cellular DNA synthesis was significantly reduced in siRNA transfected cells. Conclusions The protocol for the synthesis of siRNA by T7 RNA polymerase is feasible. Annexin II might be involved in DNA synthesis.Keywords：small interference RNA;gene silencing;annexinⅡ;prostate cancer cell4|62|4Updated：2024-04-10
- Abstract：Objective To study the effect of γ-interferon （IFNγ）, tumor necrosis factor related apoptosis inducing ligand （TRAIL）, and cisplatin or etoposide induced apoptosis in human neuroblastoma cell line SH-SY5Y and its possible molecular mechanisms.Methods The expressions of Caspase 8 mRNA and protein were detected with RT-PCR and Western blot analysis. The effects of IFNγ, TRAIL, IFNγ+TRAIL, IFNγ+Caspase 8 inhibitor+TRAIL, IFNγ+cisplatin+TRAIL, and IFNγ+etoposide+TRAIL on the growth and apoptosis of SH-SY5Y cells were detected with the methods of MTT and flow cytometry. The relative Caspase 8 activity was measured with colorimetric assay. Results Caspase 8 was undetectable in SH-SY5Y cells but an increased expression of Caspase 8 mRNA and protein was found after treatment with IFNγ. SH-SY5Y cells themselves were not sensitive to TRAIL, but those expressing Caspase 8 after treatment with IFNγ were. The killing effect of TRAIL on SH-SY5Y cells expressing Caspase 8 was depressed by Caspase 8 inhibitor. Cisplatin and etoposide could enhance the sensitivity of TRAIL on SH-SY5Y cells. The relative Caspase 8 activity of SH-SY5Y cells in IFNγ+TRAIL group was significantly higher than those of control group, IFNγ group, TRAIL group, and inhibitor group （P<0.01）. There was no significant difference among IFNγ+TRAIL group, IFNγ+cisplatin+TRAIL group, and IFNγ+etoposide+TRAIL group.Conclusions IFNγ could sensitize SH-SY5Y cells to TRAIL-induced apoptosis and this may be realized by the upregulation of Caspase 8. Cisplatin and etoposide could enhance the killing effect of TRAIL on SH-SY5Y cells.Keywords：neuroblastoma;apoptosis;tumor necrosis factor related apoptosis inducing ligand;γ-interferon4|37|10Updated：2024-04-10
- Abstract：Objective To investigate the role of Caspase-3 in retinal damage caused by light exposure in rats. Methods Light injury to retina was induced by persistent exposure to illumination （intensity:30000±50lux） of operating microscope for 30 minutes in the right eyes of Sprague-Dawley rats. The pathological changes of retina were observed under optical and electron microscopies at different time points, which were 6 hours, 1, 3, 7, and 15 days after the light exposure. Apoptosis of retinal cells was analyzed by flow cytometry. The activity of Caspase-3 was evaluated by using the Caspase-3 assay kit. At the same time, the expression of Caspase-3 protease was determined with Western blot analysis. Results The examination results of optical and transmission electron microscopes showed that edema of inner and outer segments of the retina, especially the chondriosome inside the inner segment, became obvious 6 hours after the light exposure. The change was deteriorated along with the increasing time. The structures of the discoidal valve dissociated in the outer segment simultaneously. Disorderly arranged nuclei, karyopycnosis, and thinning in the outer nuclear layer were observed. The retinal pigment epithelium almost disappeared during the later stage. The staining results of Annexin-V combined with PI demonstrated that the proportion of apoptotic cells increased with time. The proportion between 7th day （82.7%） and 15th day （80.4%）, however, showed no significant difference. Caspase-3 became remarkably active with the lapse of time, which increased from 0.02 at 6th hour to the peak of 9.8 at 7th day before it started to descend. The Western blot detected a expression of the active form of Caspase-3 at 7th day and 15th day.Conclusion Apoptosis of photoreceptor cells is markedly involved in the light damage and Caspase-3 protease may play an important role in the apoptotic process of the retina after light exposure in rats.Keywords：retina;light damage;Caspase-3;apoptosis;rat4|30|10Updated：2024-04-10
- Abstract：Objective To investigate whether the effect of E.coli on U937 cell lines apoptosis is mediated via p38 mitogen-activated protein kinase （MAPK） activation. Methods The U937 cell lines were treated with E.coli at different time or together with SB203580, an inhibitor for p38. Cell apoptosis was analyzed by flow cytometry. p38 activities were detected by Western blotting. Results E.coli induced apoptosis in cultured U937 cell lines in a time-dependent manner. The phosphorylation of p38 was induced after 10 minutes infection, reached the peak after 20 minutes, and started to decline after 30 minutes. In contrast, the level of total p38 protein was not changed in whole experimental period. Inhibition of p38 with SB203580 significantly inhibited E.coli induced apoptosis in U937 cells. Conclusion The activation of the p38 MAPK in U937 cell lines by E.coli is a major pathway to mediate the apoptosis.Keywords：E.coli;apoptosis;U937;p38 mitogen-activated protein kinase4|20|0Updated：2024-04-10
- Abstract：Objective To estimate the clinical and pathological features of pancreatic solid cystic papillary tumor （SCPT） in children. Methods From 2000 to 2005, 8 cases with SCPT of the pancreas were analyzed retrospectively. All cases but one were females. Average age was 12.8 years. By case review, we discussed the clinical and pathological features of SCPT in children. Results The chief complains were abdominal pain and palpable mass. There were 3 cases in the head, 1 case in the body, and 4 cases in the tail of pancreas. The procedures employed included local resection （1 case）, distal pancreatectomy （5 cases）, pancreaticoduodenectomy （1 case）, and biopsy （1 case）. Histological examination showed solid with cystic areas and papillary protrusions in the 8 cases; as for immunohistochemical examinations, the positive rate was 100% for α-antitrypsin （AACT）, 87.5% for vinmentin, and 62.5% for neuron-specific enolase （NSE）. The patients were followed up for 2 months to 4 years but one was lost by follow-up and all were alive postoperatively. SCPT in 2 cases relapsed. Conclusion Occurring predominantly in young females, SCPT is usually curable by surgical resection with a favorable prognosis.Keywords：pancreatic neoplasms;pathology;therapy;prognosis;children4|12|4Updated：2024-04-10
- Abstract：Objective To test the hypothesis that delayed X-irradiation can enhance the functional and structural recovery of the injured spinal cord in rats. Methods Seventy Sprague-Dawley rats were randomly divided into two groups, 35 rats in each. The control group sustained a one-minute clip compression （force of clip was 30 g） injury of the spinal cord at the T2 level, without X-irradiation. The experimental group received X-irradiation 14 days after injury. Neurological function was assessed by the modified Tarlov method, including hind limbs movement, inclined plane, and pain withdrawal. These tests were performed in a blinded fashion at 3, 7, 14, 21, 28, 35, and 42 days after injury. At 43 days after injury, histological examination of the injured spinal cord was performed following decapitation of the rats. Results Sixty-two rats met the experimental requirements （spinal cord injury was similar）, 32 rats in experimental group and 30 rats in control group. Statistically significant difference was observed between the two groups in hind limbs movement and inclined plane （P<0.01）, but not in the pain withdrawal test. The edema and necrosis areas of injured spinal cords in experimental group were less than those in control group, and axons in experimental group were significantly more than those in control group （P<0.01）. Conclusion Delayed X-irradiation following spinal cord injury may enhance functional recovery by improving and restoring structural integrity of the injured spinal cord in rats.Keywords：X-irradiation;spinal cord injury;axon;rat4|24|1Updated：2024-04-10
- Abstract：Objective To investigate the anti-hypoxia and anti-oxidation effects of aminophylline on human with acute high- altitude exposure. Methods Totally 100 young male army members newly recruited from Sichuan province （400 meters above sea level） were enrolled. They were randomly divided into two groups: 50 in aminophylline group （A group） and 50 in control group （C group）. A group and C group orally took aminophylline and placebo respectively for 10 days, 7 days before entering Lhasa （3 658 meters above sea level） by air and 3 days after it. Several parameters were measured at three time points: before drug taken, 7 days after drug taken, and 3 days after ascending high altitude. These parameters included serum levels of nitric oxide （NO）, superoxide dismutase （SOD）, catalase （CAT）, hydrogen dioxide （H2O2）, lactic acid （LA）, as well as arterial oxygen saturation （SO2）, arterial oxygen partial pressure （PaO2）, and arterial carbon dioxide partial pressure （PaCO2）. Statistical analysis was conducted to compare the difference between two groups with Stata 7.0 software system. Results There were no statistical differences between groups in hypoxia and oxidation indicators before and after drug taken in plain area. Three days after ascending high altitude, the serum levels of SOD, CAT, H2O2, LA, PaCO2 increased in both groups, yet to a much larger degree in C group than A group （P<0.01）; and NO, SO2, PaO2 decreased more markedly in C group （P<0.05 for NO, P<0.0001 for SO2 and PaO2）. Conclusion Aminophylline has significant anti-hypoxia and anti-oxidation effects at high altitude.Keywords：aminophylline;high altitude;anti-hypoxia;anti-oxidation4|54|11Updated：2024-04-10
- Abstract：<正>ANGIOSARCOMA is the most common primary malignant cardiac tumor. Until recently, the diagnosis is often not established until the tumor is advanced with vital cardiac structure involved or distal metastasis, mainly because the symptoms are initially nonspecific. The natural history of cardiac angiosarcoma is characterized by a short clinical course and a fatal outcome. Surgical resection remains the preferential therapy for palliation or cure, where as irradiation and chemotherapy have only limited use. We herein reported a successful radical resection of cardiac angiosarcoma with concomitant reconstruction of right coronary artery, tricuspid leaflet, and atrial wall. The literature on cardiac angiosarcomas is reviewed extensively, with emphasis on presentation and surgical management4|14|0Updated：2024-04-10
- Abstract：<正>MEDIASTINAL cavernous hemangioma is a kind of primary mediastinal mesenchymal tumor that occurs rarely in any age. It was first reported by Shennon1 in 1914. In this study we reported a case of mediastinal cavernous hemangioma with abnormal vessel originating from left brachiocephalic vein.4|18|0Updated：2024-04-10
- Abstract：<正>Chinese Medical Sciences Journal （Chin Med Sci J） is a peer-reviewed, general medical journal published by the Chinese Academy of Medicai Sciences. Chin Med Sci J reports on all aspects of basic and clinical medicine and pharmacology in China, while contributions from abroad are welcomed as well.4|1631|0Updated：2024-04-10
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