Latest Issue
Volume 24 ， Issue 2 ， 2009
- Abstract：Objective To evaluate the clinical features,renal histopathology and therapeutic response to glucocorticoid and immunosuppressive agents in patients with glomerular disease associated with Takayasu arteritis（TA）.Methods Patients with TA and renal biopsy-confirmed glomerular disease were investigated retrospectively.None of them had renal artery stenosis or occlusive changes.Results Six patients with glomerulopathy,accounting for 3.75% of the 160 TA patients admitted to our hospital at the same period,were analyzed.All of them were females with a mean age of 35.5 ± 10.0 years.Four cases presented with lower extremity edema.Laboratory tests showed that one was nephrotic syndrome,three were nephrotic range proteinuria,and two of them had mild renal dysfunction.The other two patients were asymptomatic microscopic hematuria and proteinuria.Renal pathology revealed mild immunoglobulin A nephropathy in two cases,mild mesangial proliferative glomerulonephritis（GN）,membranoproliferative GN,minimal change disease,and fibrillary GN in one case respectively.Five cases received glucocorticoids and cyclophosphamide therapy.Proteinuria and microscopic hematuria disappeared in 2 to 4 weeks after the initiation of therapy in three cases.The patient with membranoproliferative GN also reached complete remission of proteinuria and recovered renal function 6 months after the treatment.Conclusions TA may induce glomerular disease as a part of its histological spectrum.Apart from ischemic glomerular disease,glomerular disease should be suspected when TA patients have microscopic hematuria or proteinuria,that may be therapeutically responsive to glucocorticoids and immunosuppressive agent in relative early phase.4|32|2Updated：2024-04-10
- Abstract：Objective To compare the postoperative outcomes of patients with the diagnostic univentricular heart undergoing lateral tunnel（LT） operation with extracardiac conduit（EC） operation.Methods From June 1996 to July 2007,114 consecutive patients with a single ventricle underwent total cavopulmonary connection（TCPC） in Children’s Heart Center,University Hospital Giessen and Marburg GmbH,Germany.A LT was performed in 19（16.7%） patients,and an EC in 95（83.3%） patients.The mean age of EC group was 50.8±31.6（ranging from 22 to 212） months,and that of LT group was 61.5±41.2（ranging from 30 to 168） months.Early and midterm outcomes of two groups were analyzed.Results One died in LT group（5.3%） and three in EC group（3.2%）.The overall mortality was 3.5%.There was no significant difference in mortality between EC and LT groups（P>0.05）.The postoperative pulmonary arterial pressure,oxygen saturation,and effusion time of two groups had no significant difference（all P>0.05）.No significant difference in the occurrences of complications（arrhythmias,enteropathy,and thrombosis） was found between two groups after operation（P>0.05）.Conclusions There seems no difference between LT and EC in the clinical results in the early and middle postoperative stage.Glenn anastomosis followed by an EC seems to have some advantages.4|16|1Updated：2024-04-10
- Abstract：Objective To study the value of ultrasound elastography in evaluation of ethanol-induced lesions of liver.Methods Alcohol with a dose of 2 ml was injected into a fresh porcine liver under ultrasound guidance to create stiff necrosis.Then freehand elastography of the lesion from the identical scan plane was obtained with SONOLINE Antares system using VF10-5 probe at about every 30 seconds till 6 minutes later.The original high quality radiofrequency data were acquired through an ultrasound research interface which was provided by the ultrasound system.Then,corresponding elastograms were produced offline using cross-correlation technique and compared with gross pathology findings.Results Gray-scale sonogram showed a hyperechoic area with acoustic shadow below appeared immediately after alcohol injection.The hyperechoic area tended to be diffuse and its boundary to be illegible with time.On the contrary,the ethanol-induced lesion in elastogram appeared as a low strain hard region surrounded by high strain soft hepatic tissues,with clear but irregular boundaries.Sequential elastograms with the sketched lesion boundaries showed that the lesion area increased in the first 3 minutes after ethanol injection,and then reached a plateau which corresponding to gross specimen.Conclusion Ultrasound elastography is capable of detecting and evaluating the diffusion of ethanol-induced hepatic lesion,and more sensitive and accurate than routine sonography.4|24|3Updated：2024-04-10
- Abstract：Objective To evaluate the significance of several Dermatophagoides pteronyssinus allergen extracts for skin prick test（SPT） in patients allergic to Dermatophagoides pteronyssinus.Methods Two hundred and nineteen patients enrolled in Peking Union Medical College Hospital underwent SPT and serum specific IgE assay to detect the Dermatophagoides pteronyssinus allergen.Three kinds of house dust mite allergen extracts were used for SPT,including the Dermatophagoides pteronyssinus extract prepared by our laboratory（group A）,standardized Dermatophagoides pteronyssinus extract（group B）,and mixed extracts of Dermatophagoides pteronyssinus and Dermatophagoides farinae（group C）.Human serum specific IgE result was regarded as the reference standard for diagnosis of Dermatophagoides pteronyssinus allergy.The receiver operating characteristic（ROC） curve was used to evaluate the diagnostic performance of SPT with the extracts of three groups.Results SPT results showed that the median wheal diameter of group A,group B,and group C was 0.43,0.35,and 0.28 cm,respectively,with significant difference among three groups（P<0.05）.The difference was significant between group A and B（P<0.01） as well as group A and C（P<0.01）,but not between group B and C（P>0.05）.There was no local urticaria or systemic allergic reactions following the procedure of SPT.Local reaction was observed in 5 patients and delayed reaction was in 2 patients of group A.As for group B and C,local reaction occurred in 3 cases and delayed reaction in 2 cases in each group.The area under ROC curve of SPT with extract in group A,group B,and group C was 0.765,0.801,and 0.782,respectively.Based on the detection results of serum specific IgE,the sensitivity of SPT in diagnosis of Dermato-phagoides pteronyssinus allergy with extract of group A,group B,and group C was 92.4%,87.0%,and 81.5%,and the specificity was 60.6%,73.2%,and 74.8%,respectively.Conclusion The Dermatophagoides pteronyssinus extract for SPT prepared by our laboratory offers good sensitivity and specificity comparable to commercially available allergen extracts,and it may be an appropriate candidate for clinical screening and diagnosis of Dermatophagoides pteronyssinus allergy.6|33|0Updated：2024-04-10
- Abstract：Objective To investigate the effects of small interfering RNA（siRNA） recombinant expression vector targeting survivin gene on chemotherapy sensitivity of human colon cancer cells to 5-fluorouracil.Methods siRNA recombinant expression vector targeting survivin gene was constructed and transfected into human colon cancer cell lines LOVO.After 48 hours of transfection,cells were harvested for analysis of survivin mRNA and protein expressions using RT-PCR and Western blot.In addition,after human colon cancer cell lines were treated with Survivin siRNA and/or 5-fluorouracil,MTT assay and flow cytometry were used to analyze cell proliferation and apoptosis.Results Restriction endonuclease analysis confirmed that siRNA recombinant expression vector targeting survivin gene was successfully constructed.Inhibitory ratios of survivin mRNA and protein expressions by Survivin siRNA were 36.33% and 44.65%,respectively.Survivin siRNA combined with 5-fluorouracil significantly increased the cell proliferation inhibitory ratio and apoptosis ratio compared with 5-fluorouracil treating alone（P<0.05）.Conclusion The siRNA recombinant expression vector targeting survivin gene can inhibit the expression of survivin gene,and enhance chemotherapy sensitivity of human colon cancer cells to 5-fluorouracil.4|38|8Updated：2024-04-10
- Abstract：Objective To investigate the influence of gender on osteoarthritic knee rehabilitation outcome of osteoarthritis patient undergoing total knee arthroplasty（TKA）.Methods We prospectively studied thirty male and thirty female knee primary osteoarthritis patients receiving unilateral TKA with posterior stable-fixed plateau prosthesis at our hospital from March 2003 to March 2008.The age and body mass index of male and female patients were matched.The surgical and rehabilitation clinical factors were compared between two groups.Results There was no significant difference in postoperative hospitalization time,surgical tourniquet time,and wound drainage volume between two groups（P>0.05）.The extension/flexion degrees of knee joint before operation,1-week,2-week and 1-year after operation for male patients were 6.0 ± 3.3 degrees/ 114.0 ± 10.0 degrees,2.0 ± 1.6 degrees/93.0 ± 7.4 degrees,0.6 ± 0.6 degrees/104.0 ± 9.9 degrees and 0.3 ± 0.5 degrees/125.0 ± 8.8 degrees,for female patients were 7.0 ± 3.4 degrees/112.0 ± 14.0 degrees,2.0 ± 1.3 degrees/89.0 ± 10.9 degrees,0.9 ± 0.8 degrees/101.0 ± 11.8 degrees,0.4 ± 0.5 degrees/124.0 ± 7.1 degrees.The range of motion before operation,1-week,2-week,and 1-year after operation for male patients was 108.0 ± 9.5 degrees,91.0 ± 7.1 degrees,103.0 ± 9.9 degrees,and 125.0 ± 8.9 degrees,for female patients was 105.0 ± 14.1 degrees,87.0 ± 11.4 degrees,100.0±11.9 degrees,and 124.0 ± 7.0 degrees.The preoperative and 1-year postoperative HSS scores were 55.8 ± 13.3 and 89.6 ± 6.7 for males and 54.5 ± 13.8 and 89.2 ± 4.1 for females.No significant statistical difference was observed between two gender groups in regards to degree of extension and flexion,range of motion and HSS score（P>0.05）.Conclusions Gender does not influence postoperative knee function of osteoarthritis patients.TKA significantly improves knee joint function and relieve osteoarthritis-related pain.4|30|2Updated：2024-04-10
- Abstract：Objective To investigate the variability of human cytomegalovirus（HCMV） UL138 open reading frame（ORF） in clinical strains.Methods HCMV UL138 ORF was amplified by polymerase chain reaction（PCR） and PCR amplification products were sequenced directly,and the data were analyzed in 19 clinical strains.Results UL138 ORF in all 30 clinical strains was amplified successfully.Compared with that of Toledo strain,the nucleotide and amino acid sequence identities of UL138 ORF in all strains were 97.41% to 99.41% and 98.24% to 99.42%,respectively.All of the nucleotide mutations were substitutions.The spatial structure and post-translational modification sites of UL138 encoded proteins were conserved.The result of phylogenetic tree showed that HCMV UL138 sequence variations were not definitely related with different clinical symptoms.Conclusion HCMV UL138 ORF in clinical strains is high conservation,which might be helpful for UL138 encoded protein to play a role in latent infection of HCMV.6|50|7Updated：2024-04-10
- Abstract：Objective To evaluate the value of whole-body diffusion weighted imaging（WB-DWI） on detection of malignant metastasis.Methods Forty-six patients with malignant tumors underwent WB-DWI examinations between April 2007 and August 2007 in our hospital.Before WB-DWI examination,the primary cancers of all the patients were confirmed by pathology,and the TNM-stage was assessed with conventional magnetic resonance imaging（MRI） or computed tomography（CT）.WB-DWI was performed using short TI inversion recovery echo-planar imaging（STIR-EPI） sequence.Abnormal high signal intensities on WB-DWI were considered as metastases.The results of WB-DWI were compared with other imaging modalities.For the assessment of the diagnostic capability of WB-DWI,WB-DWI were compared with CT for demonstrating mediastinal lymph node metastases and lung metastases,and with conventional MRI for demonstrating metastases in other locations.Results WB-DWI demonstrated 143 focuses,14 of which were diagnosed to be benign lesions in routine imaging.The number of bone metastases depicted on WB-DWI and routine imaging was 85 and 86;lymph node metastases was 17 and 18;liver metastases was 14 and 14;lung metastases was 4 and 8;and brain metastases was 6 and 8,respectively.WB-DWI failed to detect 12 metastatic lesions including 3 osteoplastic bone metastases,4 lung metastases,3 mediastinal lymph node metastases,and 2 brain metastases.Four metastatic lesions including 2 deltopectoral lymph nodes and 2 rib metastases were detected with WB-DWI alone,all of which evolved greatly during clinical follow-up for more than 6 months.WB-DWI had higher detection rates for metastatic lesions in liver,bone,and lymph nodes than those in lung and brain（χ2=30,P<0.001）.Conclusions WB-DWI could detect most of metastatic lesions that were diagnosed with conventional MRI and CT.The limitations of WB-DWI might be had high false-positive rate and low efficiency in detecting mediastinal lymph node,brain,and lung metastases.4|46|17Updated：2024-04-10
- Abstract：Objective To testify the efficacy of 18F-fluorodeoxyglucose（18F-FDG） positron emission tomo-graphy（PET） in the diagnosis of cancer.Methods A total of 170 patients with diagnosed cancer or suspicious cancer were enrolled in this study,and underwent 18F-FDG PET.The standard uptake value（SUV） and diameter for each abnormal region in PET images were analyzed.All data were analyzed by SPSS 11.5.Results PET scan identified a primary cancer in 45.8%（11/24） patients.The sensitivity and specificity of PET scan in differentiating malignant lesions from benign ones were 78.8%（52/66） and 77.1%（27/35） respectively.Twenty-nine out of 68（42.6%） lesions were detected earlier by PET than by computed tomography.The SUV of primary cancer was significantly higher than that of metastatic lymph nodes（5.84±3.12 vs.3.14±2.24,P<0.001）.And SUV of primary lung cancer was also significantly higher than that of metastatic lung cancer（6.30±3.01 vs.2.86±2.37,P<0.01）.Conclusion 18F-FDG PET plays a very important role in cancer diagnosis.4|14|0Updated：2024-04-10
- Abstract：Objective To assess the reproducibility of whole-body diffusion weighted imaging（WB-DWI） technique in healthy volunteers under normal breathing with background body signal suppression.Methods WB-DWI was performed on 32 healthy volunteers twice within two-week period using short TI inversion-recovery diffusion-weighted echo-planar imaging sequence and built-in body coil.The volunteers were scanned across six stations continuously covering the entire body from the head to the feet under normal breathing.The bone apparent diffusion coefficient（ADC） and exponential ADC（eADC） of regions of interest（ROIs） were measured.We analyzed correlation of the results using paired-t-test to assess the reproducibility of the WB-DWI technique.Results We were successful in collecting and analyzing data of 64 WB-DWI images.There was no significant difference in bone ADC and eADC of 824 ROIs between the paired observers and paired scans（P>0.05）.Most of the images from all stations were of diagnostic quality.Conclusion The measurements of bone ADC and eADC have good reproducibility.WB-DWI technique under normal breathing with background body signal suppression is adequate.4|18|4Updated：2024-04-10
- Abstract：Objective To investigate the effects of the flexible surgical approaches on therapeutic and cosmetic outcomes of facial nevi.Methods From August 2002 to January 2008,16 cases with facial nevi had been treated in our wards with the selected approaches.Surgical approaches including serial excision or one-time radical excision,free skin graft,and expanded flap were adopted in accordance with the individual size and location of the facial nevi.Results All cases experienced complete excision and had satisfactory cosmetic appearance in the end.Conclusion The flexible surgical measures help to minimize the risk of malignant transformation and achieve good cosmetic results.4|12|0Updated：2024-04-10
- Abstract：<正>DESPITE the strong association between gastroesophageal reflux disease （GERD） and asthma has been undisputedly established and widely recognized by experts in advanced countries. Yet few topics in medicine are as controversial as4|23|28Updated：2024-04-10
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