Latest Issue
Volume ， Issue 3 ， 2007
- Abstract：Objective To evaluate and reduce inter-observer variations in the detection and characterization of pulmonary nodules on digital radiograph （DR） chest images. Methods Two hundreds and thirty-two new posterior-anterior DR chest images were collected from out-patient screening patients. Consensus was reached by two experienced radiologists on the marking, rating, and segmentation of small actionable nodules ranged from 5 to 15 mm in diameter using a computer-aided diagnosis （CAD） system. Both their own nodule findings and the computer’s automatic nodule detection results were analyzed to make the consensus. Nodules identified together with corresponding likelihood rating and segmentation results were referred as "Gold Standard". Two un-experienced radiologists were asked to first mark and characterize suspicious nodules independently, then were allowed to consult the computer nodule detection results and change their decisions. Results Large inter-observer variations in pulmonary nodule identification and characterization on DR chest images were observed between un-experienced radiologists. Un-experienced radiologists could greatly benefit from the CAD system, including substantial decrease of inter-observer variation and improvement of nodule detection rates. Moreover, radiologists with different levels of skillfulness could achieve similar high level performance after using the CAD system. Conclusion The CAD system shows a high potential for providing a valuable assistance to the examination of DR chest images.4|23|0Updated：2024-04-10
- Abstract：Objective To evaluate the operative technique and preliminary results of video-assisted thoracoscopic anterior correction and fusion of scoliosis. Methods Eleven cases underwent thoracoscopic anterior correction and fusion of scoliosis from March 2003 to April 2005 in our hospital were reviewed. They were all females with an average age of 13.1 years old. Of which, 9 cases were idiopathic scoliosis, 1 case was congenital scoliosis, and 1 case was Marfan syndrome scoliosis. The coronal Cobb angle and apical vertebral translation before and after surgery as well as at final follow-up were measured. The operation time, blood loss during operation, and peri-operative complications were recorded. Results The mean operation time was 6.4 hours, mean instrumented vertebrae were 6.4 segments, and mean blood loss during operation was 364 mL. The coronal Cobb angles of the thoracic curve before and after surgery were 45.5° and 15.4° respectively, with an average correction rate of 65.4%. The lumbar curve was corrected from 28.4° to 11.8°, with an average simultaneous correction rate of 57.2%. All of the patients were followed up regularly with an average time of 21.4 months. At the final follow-up, the coronal Cobb angles of the thoracic and lumbar curves were 19.0° and 20.1°, with a 3.6° and 8.3° loss of correction, respectively. The apical vertebral translation was improved from 32.3 mm to 10.5 mm for the thoracic curve, and from 13.1 mm to 8.2 mm for the lumbar curve. There were 6 cases with peri-operative complications, including 1 case of thoracic effusion, 1 case of chylothorax, 1 case of locking plug loosing, 2 cases of aggravation of the unfused lumbar curve （1 case also with thoracolumbar kyphosis）, and 1 case with a screw tip causing a contour deformity of the aorta. And 4 of them underwent revision surgery. Conclusions Video-assisted thoracoscopic anterior correction and fusion of scoliosis has good correction capability, less intraoperative bleeding, and favorable cosmetic effect for mild and moderate thoracic scoliosis, but with higher rates of correction loss of the lumbar curve and peri-operative complications. A surgeon should be cautious to perform this technique.4|30|1Updated：2024-04-10
- Abstract：Objective To analyze the diagnosis and treatment of pancreatic tuberculosis. Methods Retrospectively reviewed and summarized 13 pancreatic tuberculosis patients’ clinical information, presentation, diagnostic methods, therapeutic approaches, and prognosis from 1958 to 2004 at Peking Union Medical College Hospital. Results All cases presented a wide series of symptoms, including fever in 6 cases, upper abdominal tenderness in 13, epigastric mass in 4, obstructive jaundice in 3, night sweat in 4, weight loss in 7, hypersplenotrophy and hypersplenism in 1, and being complicated with tuberculosis of other organs in 3. One case was diagnosed by clinical symptoms and biopsy of lymph node, and only received anti-tubercular treatment. Others were diagnosed by intra-operative biopsy and anti-tubercular treatment, and got well without recurrent tuberculosis in pancreas and other organs during 6 months to 2 years of follow-up. The non-operative case presented extrahepatic portal hypertension. Conclusions Pancreatic tuberculosis may be considered in the patients with fever, abdominal tenderness, weight loss, and imaging evidence of regional pancreatic lesion. Efficacy of anti-tubercular agents and laparotomy for pancreatic tuberculosis is evident.4|25|1Updated：2024-04-10
- Abstract：Objective To investigate the feasibility and effectiveness of radiofrequency catheter ablation （RFCA） to treat permanent atrial fibrillation （AF） under the guidance of Carto-Merge technique. Methods Fifteen male patients with permanent AF underwent RFCA under the guidance of Carto-Merge technique. The mean age was 54.00±10.44 years, and duration of AF was 23.66±14.93 months. Cardiac magnetic resonance angiography （MRA） was performed to obtain pre-procedural three-dimensional （3D） images on the anatomy of left atrium （LA） and pulmonary veins （PVs） before RFCA procedure. Then the electroanatomical map was integrated with 3D images of MRA to form Carto-Merge map that guided step-by-step ablation strategy of permanent AF. Circumferential PV ablation was performed first until complete PVs electric isolation confirmed by Lasso catheter. If AF was not terminated, lesion lines on roof of LA, mitral isthmus, and tricuspid isthmus were produced. Results The episodes of AF were terminated during RFCA in 2 patients, by direct current cardioversion in the remaining 13 patients. Transient AF occurred in 2 patients after ablation on 1st day and 1st week respectively, AF terminated spontaneously not long after taking metoprolol. One patient developed persistent atrial flutter （AFL） in 2 months after procedure and AFL was eliminated by the second ablation. Persistent AF recurred on 1st day, 1st and 5th week respectively in 3 patients, and did not terminate after 3 months even though amiodarone was given. The remaining 12 patients were all free of AF during 2-11 months of follow-up. The recent success rate for RFCA of permanent AF was 80%. Conclusions Carto-Merge technique can effectively guide RFCA of permanent AF. When combined with single Lasso mapping, it can simplify the mapping, lower expenses, and enhance the success rate of RFCA of permanent AF.4|23|1Updated：2024-04-10
- Abstract：Objective To compare the influence of different sulfonylureas on the myocardial protection effect of ischemic preconditioning （IPC） in isolated rat hearts, and ATP-sensitive potassium channel current （IKATP） of rat ventricular myocytes. Methods Isolated Langendorff perfused rat hearts were randomly assigned to five groups: （1） control group, （2） IPC group, （3） IPC+glibenclamide （GLB, 10 μmol/L） group, （4） IPC+glimepiride （GLM, 10 μmol/L） group, （5） IPC+gliclazide （GLC, 50 μmol/L） group. IPC was defined as 3 cycles of 5-minute zero-flow global ischemia followed by 5-minute reperfusion. The haemodynamic parameters and the infarct size of each isolated heart were recorded. And the sarcolemmal IKATP of dissociated ventricular myocytes reperfused with 10 μmol/L GLB, 1 μmol/L GLM, and 1 μmol/L GLC was recorded with single-pipette whole-cell voltage clamp under simulated ischemic condition. Results The infarct sizes of rat hearts in IPC （23.7%±1.3%）, IPC+GLM （24.6%±1.0%）, and IPC+GLC （33.1%±1.3%） groups were all significantly smaller than that in control group （43.3%±1.8%; P<0.01, n=6）. The infarct size of rat hearts in IPC+GLB group （40.4%±1.4%） was significantly larger than that in IPC group （P<0.01, n=6）. Under simulated ischemic condition, GLB （10 μmol/L） decreased IKATP from 20.65±7.80 to 9.09±0.10 pA/pF （P<0.01, n=6）, GLM （1 μmol/L） did not significantly inhibit IKATP （n=6）, and GLC （1 μmol/L） decreased IKATP from 16.73±0.97 to 11.18±3.56 pA/pF（P<0.05, n=6）. Conclusions GLM has less effect on myocardial protection of IPC than GLB and GLC. Blockage of sarcolemmal ATP-sensitive potassium channels in myocardium might play an important role in diminishing IPC-induced protection of GLM, GLB, and GLC.4|50|4Updated：2024-04-10
- Abstract：Objective To observe the protection of carbon monoxide （CO） inhalation on lipopolysaccharide （LPS）-induced rat multiple organ injury. Methods Sprague-Dawley rats with multiple organ injury induced by 5 mg/kg LPS intravenous injection were exposed to room air or 2.5×10-4（V/V） CO for 3 hours. The lung and intestine tissues of rats were harvested to measure the expression of heme oxygenase-1 （HO-1） with reverse transcription-polymerase chain reaction, the levels of pulmonary tumor necrosis factor-α （TNF-α）, interleukin-6 （IL-6）, and intestinal platelet activator factor （PAF）, intercellular adhesion molecule-1 （ICAM-1） with enzyme-linked immunosorbent assay, the content of maleic dialdehyde （MDA） and the activity of myeloperoxidase （MPO） with chemical method, the cell apoptosis rate with flow cytometry, and the pathological changes with light microscope. Results CO inhalation obviously up-regulated the expression of HO-1 in lung （5.43±0.92） and intestine （6.29±1.56） in LPS + CO group compared with （3.08±0.82） and （3.97±1.16） in LPS group （both P<0.05）. The levels of TNF-α, IL-6 in lung and PAF, ICAM-1 in intestine of LPS+CO group were 0.91±0.25, 0.64±0.05, 1.19±0.52, and 1.83±0.35 pg/mg, respectively, significantly lower than the corresponding values in LPS group （1.48±0.23, 1.16±0.26, 1.84±0.73, and 3.48±0.36 pg/mg, all P<0.05）. The levels of MDA, MPO, and cell apoptosis rate in lung and intestine of LPS+CO group were 1.02±0.23 nmol/mg, 1.74±0.17 nmol/mg, 7.18±1.62 U/mg, 6.30±0.97 U/mg, 1.60%±0.34%, and 30.56%±6.33%, respectively, significantly lower than the corresponding values in LPS group （1.27±0.33 nmol/mg, 2.75±0.39 nmol/mg, 8.16±1.49 U/mg, 7.72±1.07 U/mg, 3.18%±0.51%, and 41.52%±3.36%, all P<0.05）. In addition, injury of lung and intestine induced by LPS was attenuated at presence of CO inhalation. Conclusion CO inhalation protects rat lung and intestine from LPS-induced injury via anti-oxidantion, anti-inflammation, anti-apoptosis, and up-regulation of HO-1 expression.4|22|15Updated：2024-04-10
- Abstract：Objective To evaluate the anti-tumor effect and toxicity of gemcitabine combined with platinum chemotherapy on recurrent epithelial ovarian cancer. Methods Phase Ⅱstudy of gemcitabine combined with platinum chemotherapy was carried out in 22 patients with recurrent epithelial ovarian cancer. Median age of patients was 50.5 years old. Seven patients were platinum-sensitive and 15 patients were platinum-resistant or -refractory. All patients received gemcitabine combined with carboplatin or oxaliplatin chemotherapy. Patients’ response rate （RR） and toxicity of gemcitabine combined with platinum chemotherapy were evaluated. Results A total of 98 gemcitabine-based chemotherapy cycles were performed. Total RR was 36.4%, RR of platinum-sensitive patients was 4/7 and platinum-resistant and -refractory patients was 4/15. The estimated median survival time was 10.0 months （95%CI: 7.0-13.0） after initiation of gemcitabine combined with platinum chemotherapy. There was no significant difference in survival time between platinum-resistant/refractory group and platinum-sensitive group （P=0.061）. Side effects of gemcitabine combined with platinum chemotherapy were observed in 81.8% of patients. Grade Ⅱ/Ⅲ anemia （54.5%） and grade Ⅲ/Ⅳ neutropenia （54.5%） were most common toxicities. Ten （45.5%） patients had to delay their chemotherapy cycles or reduce the dose of chemotherapeutic drugs because of the severe side effects. Fourteen （63.6%） patients received granulocyte colony-stimulating factor to relieve neutropenia, and 8 （36.4%） patients received component blood transfusion to treat anemia or thrombocytopenia. There was no treatment-associated death. Conclusion Gemcitabine combined with platinum chemotherapy appears to be an effective and well-tolerant treatment for recurrent epithelial ovarian cancer, including platinum-resistant or -refractory diseases.4|15|3Updated：2024-04-10
- Abstract：Objective To observe the long-term impact of calcium phosphate （CaP） sol-gel coating on bone growth around porous-surfaced implant. Methods The porous-surfaced Ti-6Al-4V implants were prepared with the addition of a thin film of CaP sol-gel coating, and implanted into the tibiae of 8 rabbits, each with two implants. Implanted sites were allowed to heal for 2, 8, 12, and 24 weeks, after which specimens were obtained for scanning electron microscope analysis using the freeze-fracture technique. Results The sol-gel coated implants recovered by freeze-fracture technique showed extensive bone growth from the endosteum along the implant surface. The bone was in direct contact with the CaP layer. The cement line-like layer was clearly demonstrated to be an intervening electron dense afibrillar layer between the CaP coat and the overlying newly deposited bone. The stability and osseointegration of the porous-surfaced implants seemed not to be affected by the osteoclastic resorption of CaP layer occurred during 24 weeks of healing. Conclusion Based on the findings in the long-term observation, the addition of a thin layer of CaP promotes an extensive osseointegrated interface between the porous-surfaced Ti-6Al-4V implants and the newly deposited bone.4|15|0Updated：2024-04-10
- Abstract：Objective To investigate the methylation status of LRP15 gene in acute leukemia （AL） patients and its role in the tumorigenesis. Methods The methylation of LRP15 promoter and first exon of bone marrow mononuclear cells in 73 patients with AL, 10 with chronic leukemia （CL）, 9 with hematological benign diseases, and 20 healthy transplantation donors was analyzed by using methylation specific polymerase chain reaction. The methylation of LRP15 gene promoter and first exon in COS7, K562, and HL60 cell lines was also assayed. Results No LRP15 gene promoter methylation was detected in COS7 cell line. LRP15 gene promoter was methylated in K562 and HL60 cell lines. No deletion of LRP15 gene was detected in all samples. In nearly all French-American-British leukemia subtypes, we found that frequency of LRP15 methylation in adult patients with AL was 71.23% （52/73）. There was no detectable methylation in any of the 20 healthy donors and 8 chronic myeloid leukemia patients. The difference in frequency of LRP15 methylation between AL patients and healthy donors or CL patients （10.00%, 1/10） was significant （P<0.01）. Hypermethylation of LRP15 gene was found in 57.14% （16/28） of newly diagnosed AL patients, 83.33% of relapsed AL patients respectively, which was significantly different （P<0.05）. We also demonstrated LRP15 methylation in 55.56% （5/9） adults with benign hematological diseases. Conclusions LRP15 methylation changes are common abnormalities in leukemia. LRP15 is postulated to be a tumor suppressor gene.4|18|1Updated：2024-04-10
- Abstract：Objective To investigate the effects of alcohol intake on penile structure and function in rats. Methods Thirty adult male Wistar rats were randomly divided into two groups: control group and alcohol intake group. They were administered with 2 mL of normal saline and 40% alcohol solution respectively through gastric tubes every day. Three months later, the animal model of alcohol intake was evaluated by modified Nayagida’s method, and the effects of alcohol on the rats were studied by sexual behavior, the number of apomorphine-induced penile erection, level of testosterone in the sera, and the content of penile smooth muscle. Results The scores of animal model of alcohol intake evaluated by Nayagida’s method were 0.66±2.05 in the control group and 9.26±5.50 in the alcohol intake group（P<0.05）, which indicated that an animal model of alcohol intake was successfully established. Sexual behavior, the number of apomorphine-induced penile erection, testosterone level in the sera, and the content of penile smooth muscle of the alcohol intake group were all statistically different as compared with the control group（P<0.05）. Conclusion Alcohol intake induces sexual dysfunction in rats, which may be due to the decline of testosterone level in the sera and decline of penile smooth muscle.4|13|0Updated：2024-04-10
- Abstract：Objective To report surgical experience in pseudoaneurysm （PA） repair of arteriovenous fistula （AVF） for renal hemodialysis. Methods Twenty patients undergoing PA repair of AVF for renal hemodialysis were treated in Central Hospital Conde S. Januario of Macao. Sixteen patients had PAs of AVF in upper extremities, 4 in lower extremities. All patients were treated with surgical therapy. Results All operations were finished without death. One patient suffered from acute thrombosis, recovered without any complication through instant thrombectomy. One patient with postoperative incision bleeding recovered after low molecular weight heparin was ceased. And one AVF could not be mature six weeks later, was recovered after ligation of branch vein. And one patient died due to recurrent cerebral infarction. Conclusion Surgical repair is the best choice for PA of AVF for renal hemodialysis.4|13|0Updated：2024-04-10
- Abstract：Objective To measure the quantities and apoptosis-related protein levels of B lymphocyte in the patients with immunorelated pancytopenia（IRP）and explore the action of B lymphocyte in the pathogenic mechanism of IRP. Methods Quantities of whole B lymphocytes and CD5+ B lymphocytes as well as the expressions of Fas and Bcl-2 in B lymphocytes in 35 patients with untreated IRP, 15 IRP patients in complete remission （CR）, and 10 normal controls were assayed by flow cytometry. Results The percentages of B lymphocyte and CD5+ B lymphocyte were significantly higher in untreated IRP patients than in CR IRP patients and normal controls （P<0.05）, and there was no significant difference between the latter two groups （P>0.05）. There was no significant difference of Fas expression in B lymphocyte among three groups （P>0.05）. The expression of Bcl-2 in B lymphocyte was significantly higher in untreated patients than in CR patients or normal controls （P<0.01）, and significantly higher in CR patients than in normal controls （P<0.01）. The apoptosis-related index was significantly lower in untreated patients than in CR patients or normal controls （P<0.05）, and significantly lower in CR patients than in normal controls （P<0.05）. The percentage of B lymphocyte was positively correlated with post-treated response time（r=0.53, P<0.01）. Conclusion The production of auto-antibodies in IRP patients probably has some relationship with the abnormal quantities of B lymphocyte and its subpopulations as well as with the inhibition of B lymphocyte apoptosis.4|15|25Updated：2024-04-10
- Abstract：<正>Patients with lymphocytic malignancies like Non-Hodgkin’s lymphoma （NHL）, multiple myeloma （MM）, and chronic lymphocytic leukemia （CLL） are often complicated with anemia. In this prospective study, we devised a carefully controlled erythropoietin （Epo） level measurement in anemic or non-anemic patients with lymphocytic malignancies, in order to determine whether the response of Epo was decreased in anemic patients.4|10|1Updated：2024-04-10
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