[Correlation of qAnti-HBc with antiviral efficacy in children with chronic hepatitis B and exploration of its possible immune mechanism].

Objective: To compare the baseline difference in the quantitative hepatitis B core antibody levels (qAnti-HBc) between non-response and response group in children with HBeAg-positive chronic hepatitis B (CHB) who received antiviral therapy, and further explore the proportion and functional activity of CD8 + memory T lymphocyte subsets with different qAnti-HBC levels in peripheral blood of children. Methods: The baseline anti-HBc quantification (qAnti-HBc) levels of 85 children with HBeAg-positive CHB who visited the Department of Infectious Diseases, Children's Hospital of Chongqing Medical University from June 2018 to December 2020 were detected retrospectively. The relationship between the baseline qAnti-HBc level and HBeAg serological response in 37 children who received antiviral therapy was analyzed. The proportion of CD8(+) memory T lymphocyte subsets and the secretion levels of interferon (IFN) γ, and tumor necrosis factor (TNF) α in peripheral blood of 59 children at baseline were detected by flow cytometry. The relationship between qAnti-HBc level and the proportion and functional activity of CD8(+) memory T lymphocyte subsets was analyzed. Pearson's Chi-square test was used to compare the count data. Mann-Whitney U test or Kruskal-Wallis test was used to compare measurement data between two or more groups, and Spearman's rank correlation analysis was used for the correlation between continuous variables. Results: Among 37 children who received entecavir (ETV, 21/37 cases) or pegylated interferon (Peg-IFN, 16/37 cases), 18 cases had developed HBeAg seroconversion (10/ 21 cases in the ETV group, 8/16 cases in the Peg-IFN group). The baseline qAnti-HBc level was significantly higher in the response group [4.71 (4.64~4.81) log(10)IU/ml] than the non-response group children [4.54 (4.45~4.64) log(10)IU/ml, Z = -3.316, P = 0.001]. The proportion of CD8(+) Tem, CD38(+)CD8(+) Tem, CD38(+)CD8(+) Temra cells and the levels of IFNγ and TNFα secreted by CD8(+) T lymphocytes were significantly higher in the high-qAnti-HBc group than the low-qAnti-HBc group (P < 0.05). The proportion of CD8(+) Tem, CD38(+)CD8(+) Tem and CD38(+)CD8(+) Temra cells was significantly higher in ALT > 1× upper limit of normal value (ULN) group than ALT≤1×ULN group (P < 0.05). However, there were no significant differences in the levels of IFNγ and TNFα secreted by CD8(+) T lymphocytes between the two groups (P > 0.05). Spearman's correlation analysis showed that qAnti-HBc was positively correlated with the proportion of CD8(+) Tem, CD38(+)CD8(+) Tem, CD38(+)CD8(+) Temra cells and the level of IFNγ secreted by CD8(+)T lymphocytes (P < 0.05). Additionally, ALT was only positively correlated with the proportion of CD38(+)CD8(+) TEM and CD38(+) CD8(+) Temra cells (P < 0.05). Conclusion: Raised baseline qAnti-HBc level is related to the HBeAg serological response to antiviral therapy in children with CHB. Peripheral blood effector CD8+ T lymphocytes of CHB children with higher qAnti-HBc show stronger phenotype and functional activation characteristics, which may shed some light on the underlying immune mechanism related to antiviral therapy efficacy in children with CHB.

[Curative effect analysis of ultrasound-guided percutaneous radiofrequency ablation for caudate lobe hepatocellular carcinoma].

Objective: To investigate the safety and efficacy of ultrasound-guided percutaneous radiofrequency ablation (RFA) for caudate lobe hepatocellular carcinoma (HCC) and the failure factors of incomplete tumor ablation. Methods: Twenty-four cases with caudate lobe hepatocellular carcinoma who underwent ultrasound-guided percutaneous RFA in the Affiliated Tumor Hospital of Zhengzhou University from January 2017 to October 2019 were enrolled. The ablation effect and complications conditions were recorded, and the primary technical effectiveness and local tumor progression (LTP) were evaluated. Results: Among 24 cases, 20 cases had complete ablation at one session, 4 cases had incomplete ablation, and after supplementary radiofrequency ablation all cases had achieved complete ablation. There was no evidence of local tumor progression in 24 cases after one-month postoperative evaluation. The primary technical effectiveness rate was 100%. The postoperative follow-up was 2 to 29 months (median follow-up time was 18 months). Of the 24 cases after ablation, LTP were detected in 11 cases, of which only 3 cases had distant intrahepatic recurrence, 1 case had distant intrahepatic recurrence and distant metastasis, and 5 cases had only distant metastasis, 2 cases died, and 4 cases had SIR grade B complications related to ablation. Conclusion: Ultrasound-guided percutaneous radiofrequency ablation was safe and effective for caudate lobe hepatocellular carcinoma. In addition, the distance between the tumor and the inferior vena cava < 0.5cm is a suspected risk factor for incomplete ablation of caudate lobe hepatocellular carcinoma (P < 0.05).

The value of PCT, IL-6, and CRP in the early diagnosis and evaluation of COVID-19.

OBJECTIVE: The aim of the present study was to assess the value of inflammatory factors procalcitonin (PCT), interleukin 6 (IL-6), and C-reactive protein (CRP) in the early diagnosis and evaluation of novel coronavirus pneumonia (COVID-19). MATERIALS AND METHODS: The data of 140 patients with pneumonia in our hospital, including 70 who had COVID-19 and 70 who had community-acquired pneumonia (CAP), were statistically analyzed. The levels of PCT, IL-6, and CRP were measured and statistically analyzed to determine the differences between the two groups. The differences in the COVID-19 group were analyzed after subgrouping into the ordinary type, severe type, and critical type. RESULTS: The PCT and CRP levels in the COVID-19 group were statistically lower than those in the CAP group (p < 0.05), but IL-6 was not statistically different between the two groups (p > 0.05). Statistically significant differences existed in IL-6 and CRP when comparing the COVID-19 subgroups of the critical type, severe type, and ordinary type (p < 0.05). However, there was no clinical meaning in the evaluation of the difference in PCT levels among the three subgroups with COVID-19. CONCLUSIONS: PCT and CRP could be used as indicators in the differentiation between COVID-19 and CAP, but IL-6 was of little significance in the differentiation. The higher the IL-6 and CRP, the more severe the condition of COVID-19 might be.

[The therapeutic outcomes of ultrasound-guided percutaneous radiofrequency therapy for subcardiac liver malignant tumor].

Objective: To examine the safety and effectiveness of ultrasound-guided percutaneous radiofrequency ablation in the treatment of liver malignant tumor under subcardiac. Methods: The clinical data of 26 patients (31 tumors) with subcardiac liver malignant tumors who underwent ultrasound-guided percutaneous radiofrequency ablation from January 2017 to October 2019 at the Affiliated Tumor Hospital of Zhengzhou University were retrospectively analyzed. There were 21 males and 5 females. The age was 55 years old (range: 40 to 77 years old) .There were 14 cases of primary liver cancer and 12 cases of metastatic liver cancer. The maximum diameter of tumor was (2.3±1.0) cm (range: 1.0 to 4.2 cm) .According to the maximum diameter of the tumor, 1∶1 match was made between 27 non-subcardiac patients admitted at the same time and a total of 36 liver malignant tumors. subcardiac tumor is defined as tumor ≤1 cm from pericardium in sagittal or coronal imaging. The ablation effect and complications were recorded, and the one-time complete ablation rate, main technical efficiency and complications were evaluated. The preoperative baseline characteristics, ablation effect and complications of the two groups of patients were collected and counted. Single factor analysis and Logistic regression analysis were used to analyze the independent risk factors that affect the ablation effect of ultrasound-guided percutaneous radiofrequency ablation for liver malignant tumors under subcardiac. Results: The one-time complete ablation rate of tumor after radiofrequency ablation was 80.8% (21/26) in the subcardiac group and 92.6% (25/27) in the non-subcardiac group. There was no significant difference between the two groups (P>0.05) . No evidence of local tumor progression was found in the follow-up evaluation of the two groups one month after radiofrequency ablation, and the main technical effective rate was 100%.Ablation-related complications occurred in 2 patients in the subcardiac group. Multivariate analysis both showed that the distance between tumor margin and pericardium ≤5 mm was an independent risk factor affecting radiofrequency ablation (OR=0.020, 95%CI: 0.001 to 0.454, P=0.014) . Conclusions: Ultrasound-guided percutaneous radiofrequency ablation can safely and effectively treat liver malignant tumor under subcardiac. When there is a tumor near the patient's heart (the distance between the edge of the tumor and pericardium is ≤5 mm) , special attention should be paid to formulate a detailed and reasonable ablation plan to minimize tumor residue.

Correlation between MRAS gene polymorphism and atherosclerosis.

OBJECTIVE: The aim of this study was to explore the correlation between muscle RAS oncogene homolog (MRAS) gene polymorphism and the onset risk of atherosclerosis (AS). PATIENTS AND METHODS: A total of 135 AS patients diagnosed and treated in our hospital from November 2017 to October 2018 were randomly enrolled in the observation group. Meanwhile, 150 healthy adults were selected as control group. Venous blood was withdrawn from all the subjects, and DNAs were extracted. MRAS gene loci rs9818870 and rs3755751 were analyzed by the multiplex SNaPshot method, and their correlations with the onset risk of AS were explored. RESULTS: No statistically significant differences in the frequencies at gene loci were observed between the two groups (p>0.05). Subjects with genotype TT at rs9818870 exhibited significantly higher risk of AS (p=0.041<0.05). The recessive model of rs9818870 (GG + AG/AA) in AS patients with coronary heart disease was correlated with AS (p=0.048<0.05). Similarly, the dominant model of rs3755751 (TT/TC+CC) in those with hypertension was associated with AS (p=0.027<0.05). CONCLUSIONS: MRAS gene is correlated with the onset of AS to a certain degree.

[The 476th case: skin rash, edema, thrombocytopenia and anemia].

The 21-year-old male patient was admitted to the Department of Rheumatology and Immunology at Peking Union Medical College Hospital with chief complaints of "skin rash for 1 year and edema for 2 months". He was diagnosed with systemic lupus erythematosus (SLE) with renal, cardiac and hematological involvement. Remission was not achieved after glucocorticoid pulse treatment. The patient experienced oliguria, malignant hypertension, accompanied by thrombocytopenia and low serum complements, and elevated lactate dehydrogenase and serum creatinine. Schistocytes were seen in the peripheral blood smear. Thrombotic microangiopathy (TMA) secondary to SLE was diagnosed. Though plasma exchange was partially effective, TMA could not be controlled yet. The activity of serum von Willebrand factor -cleaving protease (ADAMTS 13) was 100%, and ADAMTS 13 inhibitor was negative. Finally, remission of the disease was achieved after second glucocorticoid pulse therapy and rituximab treatment. At the 3-month follow-up, the patient's condition was stable with mild anemia and normal platelet count. Patients with TMA secondary to SLE are heterogenous, while normal ADAMT 13 activity indicates poor prognosis. Early and aggressive treatment is important for disease control, and plasma exchange is helpful as a supportive care.

[Long-term outcomes of multiple arterial off-pump coronary artery bypass grafting].

Objective: To evaluate the long-term clinical outcomes of multiple arterial off-pump coronary artery bypass grafting (OPCAB) on left main coronary artery or multivessel disease. Methods: A total of 329 patients [303 males and 26 females, with a mean age of (55.1±9.1) years old] with left main coronary artery or multivessel disease who underwent isolated multiple arterial OPCAB in Ruijin Hospital between January 2006 and June 2018 were included. The baseline characteristics, perioperative and long-term outcomes were analyzed. Kaplan-Meier analysis was applied for estimation of freedom from major adverse cardiac and cerebrovascular events (MACCE) and overall survival. Independent predictors of MACCE were assessed by Cox regression analysis. Results: The perioperative mortality was only 0.9% (3/329). The median follow-up time was 65(22, 126) months, and 302 (91.8%) patients were followed up. The long-term MACCE rate, mortality, cardiac mortality, myocardial infarction (MI) rate, stroke rate and target vessel revascularization (TVR) rate were 13.9%, 4.6%, 1.3%, 3.6%, 6.0% and 6.0%, respectively. Among the alive patients, 51.3% were in New York Heart Association (NYHA) Ⅰ class and 80.9% had no recurrence of angina pectoris. The estimated 5-year and 10-year overall survival rates were 97.3% and 93.1%, respectively. The estimated 5-year and 10-year freedom from MACCE survival rates were 91.5% and 78.0%, respectively. Senility (OR=1.058, 95%CI: 1.020-1.097, P=0.002) and history of MI (OR=2.200, 95%CI: 1.131-4.412, P=0.021) were the independent risk factors for late MACCE. Conclusion: Multiple arterial OPCAB appears to be safe and with excellent clinical outcomes in treating left main coronary artery or multivessel disease.

[The 469th case: multiple cutaneous abscesses, pelvic mass, and lung cavities].

A 28-year-old woman with multiple abscesses for 2 month and fever for 1 month was admitted in Peking Union Medical College Hospital. The skin abscesses gradually developed at skull, face, abdominal wall and pelvis. Laboratory examinations related to inflammatory reactions were strongly high including erythrocyte sedimentation rate 99 mm/1 h,C-reactive protein160.28 mg/L and ferritin 1 584 µg/L. Multiple nodules and cavities were detected in lungs. And vesico-cervical fistula was found during exploratory laparotomy. The pathological tests of abdominal tissues demonstrated necrosis and granuloma. Evidence of infectious diseases was not definite. Positive anti-proteinase 3 (PR3) antibody confirmed the diagnosis of granulomatosis with polyangiitis. After treated with glucocorticoid and immunosuppressants, the patient's symptoms improved remarkably. This case suggested that systemic vasculitis should be considered as a differential diagnosis of multiple abscesses which are not explained by infections.

[Lymphomatoid gastropathy: one case report and literatures review].

Objective: To report the first case of lymphomatoid gastropathy in China, and to demonstrate the clinical characteristics, diagnostic approach, treatment and prognosis in this kind of patients. Methods: One patient was diagnosed as lymphomatoid gastropathy at Peking Union Medical College Hospital, and her clinical characteristics, lab data, treatment and follow-up outcomes were reviewed. Results: A case of a 51-year-old female was presented, who underwent esophagogastroduodenoscopy (EGD) due to slight epigastric discomfort. EGD revealed multiple ulcers and erosions. Biopsies showed atypical lymphocytes infiltration with CD3(+), CD56(+), CD20(-), CD8(-), TIA(+), Granzyme B(-) and Ki-67 (75%). Epstein-Barr virus-encoded RNA in situ hybridization was negative. Four months later, repeated EGD examination showed regression of the lesions without specific treatment. Conclusion: Lymphomatoid gastropathy was a unique disease entity mimicking NK/T-cell lymphomas in pathology, with the quite different profile of treatment and prognosis. It's important to consider this issue during the differential diagnosis to avoid any excessive treatment.

[Efficacy of medium dose dexamethasone androgen suppression test in the diagnosis of female hyperandrogenism].

Objective: To evaluate the diagnostic value of medium dose dexamethasone androgen suppression tests (DAST) in female hyperandrogenism. Methods: DAST results were retrospectively analyzed in 85 cases of women with hyperandrogenism including 55 cases of congenital adrenal hyperplasia (CAH), 10 cases of testosterone-producing tumors and 20 cases of polycystic ovary syndrome (PCOS) between January 1984 and December 2017 in Peking Union Medical College Hospital. The suppression rate of testosterone and 17 hydroxyprogesterone (17OHP) were evaluated. The cut-off point of suppression rates were calculated by receiver operating characteristic (ROC) curve in the differential diagnosis of CAH and non-CAH causes. Results: The 1-day medium dose DAST was performed simultaneously in 41 cases of CAH patients and the 5-days medium dose DAST was performed simultaneously in 19 cases of CAH patients. The results indicated that the average suppression rate of testosterone were 77.9% and 91.3% (P<0.001) and the average suppression rate of 17OHP was 95.2% and 97.0%, respectively (P=0.220). In patients (41 cases of CAH, 10 cases of testosterone producing tumor and 20 cases of PCOS) with 1-day DAST, the optimal testosterone suppression rate was 61.2% (the sensitivity and specificity was 87.8% and 96.7%, respectively) and the optimal 17OHP suppression rate was 87.1% (the sensitivity and specificity was 95.1% and 93.3%, respectively) in the identification of CAH and non-CAH cases. There is no clinical significance between the testosterone and 17OHP suppression rate in the differential diagnosis of CAH and non-CAH cases. Conclusions: There was no difference in the suppression rate of 17OHP between the 1-day and 5-days DAST in CAH cases. The sensitivity of suppression rate of 17OHP is equal in the differential diagnosis of hyperandrogenism. One-day approach DAST could be used as functional test for the diagnosis of the etilology of hyperandrogenism (CAH or non-CAH).

[Expression of phosphatase and tensin homology deleted on chromosometen (PTEN) in squamous-cell lung cancer and its clinical significance].

OBJECTIVE: To explore the expression of PTEN in squamous-cell lung cancer(SQCLC) and its clinical significance. METHODS: A total of 50 patients with SQCLC, including 43 males, 7 females, aged 40 to 83(average age 66 ) years, in Meitan General Hospital from May 2009 to July 2013 were included. Tumor adjacent tissues from 10 patients, including 9 males, 1 female, aged 42 to 79 (average age 59 )years, and 13 patients with benign pulmonary disease tissues, including 11 males, 2 females, aged 34 to 76 (average age 58 ) years were also included as the controls. The expression of PTEN protein was detected by using immunohistochemistry (S-P)method and compared among SQCLC tissues tumor adjacent tissues and benign disease tissues. The correlations of expression of PTEN protein with gender, age, smoking status, lymph node metastasis, clinical stages and differentiation grades were performed. RESULTS: (1) PTEN expression was low in 50 cases SQCLC, while there was a high expression in the tumor adjacent tissues and benign disease tissues. The PTEN protein positive rate of the SQCLC cases (20%, 10/50) was significantly lower than that of cases of tumor adjacent tissues and benign disease tissues (8/10, 12/13), χ(2)=23.542, P<0.01. (2) In the SQCLC group, the expression of PTEN protein was significantly related to differentiation grades and lymph node metastasis (P<0.05), but not gender, age, smoking status, and clinical stages (P>0.05). CONCLUSIONS: The lower expression of PTEN in SQCLC was associated with high degree of malignancy and lymph node metastasis. The lost of expression of PTEN may serve as a marker for evaluation of malignancy and an independent factor for prognosis.

[Incidence, bacterial spectrum and predictive risk factors for stent associated respiratory tract infection].

OBJECTIVE: To evaluate the incidence, bacterial spectrum and predictive risk factors for stent associated respiratory tract infection (SARTI). METHODS: A prospective nested case-control study was conducted to evaluate the incidence of SARTI and the predictive risk factors for SARTI. Respiratory symptoms, sputum bacterial culture, electronic bronchoscopy investigation, bacterial culture obtained from protective bronchoscopic brushing, and chest radiographs were evaluated before and after stent implantation. RESULTS: (1) Between January, 2011 and March, 2015, a total of 103 patients were included. The incidence of SARTI was 27.2% (28/103). (2) The incidence of SARTI was similar in subgroups with different stent types (metal stent or silicon stent) and different stent shapes (straight, L or Y shape). (3)Staphylococcus aureus (50.0%, 14/28) and Pseudomonas aeruginosa (35.7%, 10/28) were the dominant pathogens. The infection of Staphylococcus aureus, Pseudomonas aeruginosa and Candida albicans occurred 7 (4-60) days, 53 (15-67) days and 63 (28-90) days after stent implantation, respectively. (4) Binary logistical regression model analysis showed that female gender(OR=0.178, P=0.011) and age below 50 years (OR=3.91, P=0.036) were favorable predictive risk factors for SARTI. CONCLUSIONS: SARTI occurs in a quarter of the patients. Staphylococcus aureus and Pseudomonas aeruginosa are the dominant pathogens. Female gender and younger age are favorable predictive factors for SARTI.

[A randomized, single-blind, parallel-controlled and multicentre study: compare the efficacy and safety of domestic and imported human recombinant FSH in WHO group â ¡ anovulatory infertility].

OBJECTIVE: To evaluate the efficacy and safety of domestic human recombinant FSH(rhFSH)in women with anovulation of WHO group Ⅱ. METHODS: A randomized, blind, parallel-controlled, non-inferiority and multicenter study was performed. A total of 534 admitted to 13 hospitals from May 2008 to August 2009. There were 531 women with ovulatory disorder was included in the statistical analysis, were randomly divided into test group(domestic rhFSH, n=352)and control group(imported rhFSH, n=179). Percentage of cycle with mature follicle, ovulation rate, clinical pregnancy rate, multiple pregnancy rate, ovarian hyperstimulation syndrome(OHSS)and adverse events were observed. RESULTS: No statistical significant differences(P>0.05)were observed between the two groups in terms of the efficiency on mature follicle[91.8%(323/352)versus 88.8%(159/179)], ovulation rate[91.3%(295/323)verus 90.6%(144/159)], clinical pregnancy rate[19.2%(62/323)verus 18.2%(29/159)], the number of the follicles<14 mm, the level of serum LH and progesterone, the thickness of endometrium on the day of hCG administration. The number of follicle≥18 mm and 14 mm≤follicle<18 mm and the level of serum estradiol on the day of hCG in the test group were significantly higher than those in the control group(P<0.05). The number of days of rhFSH administration in the test group was significantly less than that in the control group[(9.8±2.2)versus(11.4± 0.6)days, P<0.05], the dosage of rhFSH was significantly lower than that in the control group[(879 ± 419)versus(1 043±663)U, P<0.05]. The multiple pregnancy rate in the test group was significantly higher than that in the control group[21%(13/62)versu 10%(3/29), P<0.05]. The incidence of OHSS and adverse events were similar between the two groups(P>0.05), and no other adverse events were observed in test group during treatment. CONCLUSION: Ovarian stimulation with domestic rhFSH is effective, safe and economical in women with anovulation of WHO group Ⅱ.

Estradiol 1 mg and drospirenone 2 mg as hormone replacement therapy in postmenopausal Chinese women.

OBJECTIVES: Drospirenone is a novel progestogen that, combined with 17ß-estradiol, reduces the frequency and severity of menopausal vasomotor symptoms (VMS) in different populations. This double-blind, multicenter study compared the efficacy, safety and tolerability of 2 mg drospirenone/1 mg estradiol (DRSP/E2) vs. placebo in Chinese postmenopausal women with moderate to severe VMS. METHODS: Women, aged 45-65 years, were randomized to DRSP/E2 (n=183) or placebo (n=61) once daily for four 28-day cycles. Changes in the frequency and severity of hot flushes were analyzed as primary variables, together with other climacteric and urogenital symptoms, clinical global improvement, adverse events and physical/gynecological parameters. RESULTS: Relative changes in numbers of hot flushes/week were -80.4% for DRSP/E2 vs. -51.9% for placebo (treatment difference -28.5%, p<0.0001). There were trends toward a greater reduction in severity of hot flushes with DRSP/E2 treatment. Patients treated with DRSP/E2 were more often free from sweating episodes (p<0.0001) and vaginal dryness (p=0.0008). Other climacteric symptoms, including nervousness and pollakisuria, followed a trend of greater response with DRSP/E2. Similar to other combination HRT regimens, DRSP/E2 increased occurrences of bleeding, but these decreased over time. Adverse events in patients treated with DRSP/E2 were mostly mild to moderate and withdrawal rates were low. CONCLUSIONS: Daily treatment of postmenopausal Chinese women with DRSP/E2 for 16 weeks significantly reduced the incidence of hot flushes and demonstrated advantages vs. placebo for other climacteric symptoms. These results indicate that DRSP/E2 is effective, safe and well tolerated in postmenopausal Chinese women.

[Features of breast ultrasound image and its correlation with estradiol and progesterone level in different phases of menstrual cycle in normal women].

OBJECTIVE: To determine the features of the breast ultrasound image and its correlation with estrogen and progestogen level during different phases of menstrual cycle in normal women. METHODS: Breast ultrasound was performed during luteal phase and late follicular phase in 50 women aged 25-45, with normal menstrual cycle and no distinct breast disease. Breast section thickness, ductal width, breast structure and blood flow were measured. Initial time and persistent days of the cyclic breast pain were recorded. Serum estradiol (E2) and progesterone (P) levels were measured by enzyme immunoassay on the day of ultrasound performed. RESULTS: Breast glandular section was thicker (increasing by 7.3%) in luteal phase than that in late follicular phase and breast ductal was wider (increasing by 13%) in late follicular phase than that in luteal phase. However, both of them had no significant difference. Thirty women (60%) experienced cyclic premenstrual mastalgia, lasting 4 days. Twenty four women (48%) had breast structure changes, nineteen (63.3%) of 30 women with cyclic mastalgia, but only 5 (25%) of 20 women without breast pain had breast structure change (chi 2, P < 0.01). Average serum E2 level of women with or without cyclic breast pain in luteal phase were 365.0 pmol/L and 335.3 pmol/L respectively (P > 0.05), serum progesterone level were 73.3 nmol/L and 66.1 nmol/L respectively (P > 0.05). Serum E2 levels of women with or without cyclic breast pain in late follicular phase were 299.9 pmol/L and 385.8 pmol/L respectively (P = 0.05). Average serum E2 levels of women with or without breast structure change in luteal phase were 368.1 pmol/L and 322.7 pmol/L respectively (P < 0.05). Serum P levels were 78.8 nmol/L and 62.2 nmol/L respectively (P = 0.05); Estradiol levels in late follicular phase were 301.9 pmol/L and 364.2 pmol/L respectively (P > 0.05). CONCLUSIONS: Image of breast ultrasound changed following menstrual cycle in normal menstrual women. Breast structure changes is related to breast pain. Breast pain and breast structure changes may be caused by higher E2 and P level in luteal phase and lower E2/P ratio in late follicular phase.

99mTc-MIBI single-photon emission-computed tomography in diagnosis of lung cancer and mediastinal metastasis lymph nodes.

AIM: To evaluate the value of technetium-99m-methoxyisobutyl isonitrile (99mTc-MIBI) single-photon emission-computed tomography (SPECT) in diagnosis of lung cancer and in preoperative prediction of mediastinal metastasis lymph nodes. METHODS: After the chest image of 99mTc-MIBI SPECT, fifty patients (40M, 10F; age 56 a +/- 11 a) diagnosed "lung field shadow" underwent the lung focus and mediastinal lymph nodes resection. As the golden standard, pathologic diagnosis was used to evaluate the role of preoperative 99mTc-MIBI SPECT. RESULTS: The sensitivity, specificity, and accuracy of 99mTc-MIBI SPECT were 93%, 50%, and 86%, respectively in lung cancer and 81%, 95%, and 88%, respectively in mediastinal metastasis lymph node. The results were also better than those of chest scan with CT. CONCLUSION: The 99mTc-MIBI SPECT is a useful and noninvasive method for diagnosing lung cancer and predicting mediastinal metastasis lymph nodes, which will guide the surgeon to resect the mediastinal metastasis lymph nodes.

Frequent loss of chromosome 8p in hepatitis B virus-positive hepatocellular carcinomas from China.

The majority of hepatocellular carcinomas (HCCs) from hepatitis B virus (HBV)-endemic areas contain integrated viral sequences. To better understand the role of HBV DNA insertion in tumorigenesis, we examined the integration site of a HCC harboring a single insert. Cellular DNAs flanking the viral sequences were mapped to chromosomes 17 and 8, indicating a translocation had occurred at the site of viral integration. Regional mapping of chromosome 17 demonstrated that HBV had integrated in 17p12-pter, a region that harbors the p53 tumor suppressor gene. Many studies have shown that chromosome 17p allele loss occurs frequently in HCCs from certain geographical areas. To investigate the chromosome 8 allele status in Chinese HCCs, a panel of 37 matched normal and HCC DNAs from Qidong, China was analyzed for tumor-specific allele loss with RFLP probes from both arms of chromosome 8. Tumor-specific loss of heterozygosity was highest on the short arm with 71.4% (10/14) and 85.0% (17/20) of the informative patients missing an allele for 8p23 (YNM3) or 8p21 (NEFL), respectively. Allele loss from the long arm of chromosome 8 was also observed with 30.0% (6/20) and 33.3% (7/21) of the samples informative for 8q22 (CA2) and 8q24 (MCT128.2), respectively. The high allele loss on 8p correlates with recent studies of other human cancers and is interpreted to indicate that a tumor suppressor gene(s) whose loss is important for carcinogenesis lies within this region. These findings also support a model in which HBV insertions associated with gross chromosomal changes can identify genomic regions where alteration is important for development of some HCCs.