ABSTRACT
Objective@#To determine the clinical significance of nontuberculous mycobacteria (NTM) isolated from respiratory specimens. @*Methods@#Clinical data of patients with NTM strains isolated from the respiratory tract between January 2014 and February 2017 were retrospectively analyzed. Clinical significance of NTM isolated strains was evaluated based on diagnostic criteria of NTM pulmonary diseases from American Thoracic Society (ATS). Quantitative data of two groups were analyzed by independent t test. Categorical data were analyzed by Pearson χ2 test or Fisher exact test. @*Results@#Totally 352 NTM strains from 257 patients had been isolated between January 2014 and February 2017. Among 15 identified NTM species, M. intracellular (51.7%, 182/352), M. abscessus (25.6%, 90/352), and M. avium (10.8%, 38/352) were predominant. Of the 157 patients with full clinical data involved in the analysis, 58 (36.9%) patients were determined to have definite disease, and 34 patients (21.7%) were designated as probable disease candidates, and 16 (10.2%) patients were regarded as uncertain disease, and 49(31.2%) patients were diagnosed as unlikely disease. The age of 58 patients with definite disease was (63.9±12.7) years, and 48.3% (28/58) were female. M. intracellulare (55.2%, 32/58) was the main cause of pulmonary NTM disease, followed by M. abscessus (25.9%, 15/58) and M. avium (12.1%, 7/58), while other NTM species only accounted for 6.8% (4/58). Definite cases with M. intracellulare, M. abscessus, M. avium, M. kansasii, M. marseillense, and M. columbia accounted for 35.2% (32/91), 57.7% (15/26), 7/15, 2/3, 1/3 and 1/2, respectively, among patients with corresponding isolations, while patients with other species of isolation did not meet the diagnostic criteria. Patients with clinical significant isolation of NTM were older than those without clinical significance (χ2=3.603, P=0.000), and proportion of anti-acid staining positivity of patients with clinical significance was higher than that of patients without clinical significance (χ2=18.815, P=0.000). The proportion of M. abscessus in patients with clinical significance was higher than that in patients without clinical significance (χ2=6.313, P=0.012). However, there was no significant difference between the two groups in the isolation of M. Gordon (Fisher exact test, P=0.028). The proportion of M. abscessus lung disease in women was 11/15, which was higher than that of M. intracellulare lung disease (41.5%, 17/41), and the difference between the two groups was statistically significant (χ2=4.462, P=0.035). There was no significant difference of clinical symptoms and underlying diseases in NTM lung disease among different groups (all P>0.05). In these patients with definite disease, 39.7% (23/58) of them manifested the upper lobe cavitary form, 53.4% (31/58) exhibited nodular bronchiectatic form, and only 6.9% (4/58) exhibited unclassified form. The upper lobe cavitary form (43.8%, 14/32) and the nodular bronchiectatic form (53.1%, 17/32) dominated in patients with M. intracellulare lung disease. M. abscessus lung disease was dominated by the nodular bronchiectatic form (11/15) while the upper lobe cavitary form only accounts for 3/15. There was no significant difference of image characteristics between NTM lung disease and other different groups (all P>0.05). @*Conclusions@#36.9% of the patients with NTM isolates met the ATS diagnostic criteria for NTM lung disease. Different species have different clinical significance. M. intracellulare and M. abscessus are the most predominant NTM isolated species that cause NTM lung disease. Majority of patients manifest as the upper lobe cavitary form, followed by the nodular bronchiectatic form.
ABSTRACT
Objective To investigate the low-dose hyper-radiosensitivity (HRS)/induced radioresistance (IRR) in A549 cells synchronized at G2 phase and the role of ATM kinase in the process.Methods Human lung adenocarcinoma cell line A549 was synchronized at G2 phase by aphidicolin.The ATM-specific activator and inhibitor,chloroquine and KU55933,were used to regulate the activity of ATM.The colony formation assay was used to evaluate cell survival.Flow cytometry was used to determine the cell cycle of radiation-exposed A549 cells synchronized at G2 phase.Immunofluorescence was used to observe the dynamics of γ-H2AX fluorescence and evaluate the efficiency of DNA repair in A549 cells synchronized at G2 phase.Western blot was used to detect the expression of phosphorylated ATM (Ser1981) and ATM.Results A549 cells synchronized at G2 phase had substantially enhanced HRS than non-synchronized cells.The dose-induced transition from HRS to 1RR was in accordance with the dose-response pattern of early G2/M checkpoint.However,with the same threshold dose,the activation of early checkpoint occurred earlier and lasted longer than normal.The activation of ATM kinase inhibited HRS and enhanced DNA repair,while the inhibition of ATM kinase enhanced HRS and hindered DNA repair.Conclusions ATM kinase-mediated early G2+M checkpoint is a molecular switch for HRS in synchronized A549 cells.Low-dose irradiation with G2-phase synchronization and ATM inhibitor can enhance the low-dose radiosensitivity.
ABSTRACT
Objective To assess the effect of iDose4 in image quality and radiation dosage in CT angiography of craniocervical arteries.Methods Imaging data of 50 patients with 256-slice spiral CT angiography of craniocervical arteries were randomly divided into two groups:(A) 120 kV,250 mAs (25 patients),(B) iDose4 100 kV,180 mAs (25 patients).Dose length product (DLP) of the two groups were compared.Objective image noise was compared by two blinded readers,t test and nonparametric tests were used for statistical analysis.Results The overall image quality score of group A (3 points =1 patient,4 points =6 patients and 5 points =18 patients) and group B (4 points =5 patients and 5 points =20 patients) were shown.The image noise of group A (1 point =1 patient,2 points =5 patients and3 points =19 patients) and group B (2 points =4 patients,3 points =21 patients) were also evaluated.There was no statistical difference in revealing rate of image quality scores and objective noise between the two groups (Z =-0.334,-0.218,P ＞ 0.05).The estimated effective radiation dose was reduced by 56％ in group B than in group A.DLP was significantly lower in group B [(642.4 ±36.6) mGy · cm]than in group A [(1462.1 ± 64.3) mGy · cm].Conclusion Low dose contrast medium of CT angiography can display craniocervical arteries and the intracranial arteries very well with high image quality.
ABSTRACT
The application of multimedia technology in the teaching of TCM Features Science has intuitive, figurative, scientific and interactive advantages, which makes the teaching course simple and easy to operate, and enables a knowledge-point described from multi-channel, multi-angle and multi-dimension. Thus the students can analyze a question from many respects, deepen their understanding ability, realize the optimization of the teaching process, and improve the effectiveness of the teaching results.
ABSTRACT
Objective To improve the diagnostic level of uncommon hepatic malignancy in 5 cases with different histopathological nature by analyzing their CT features. Methods CT scan was performed in 5 cases with pathologically proved uncommon malignancy of the liver including hepatic sarcoma ( n =3) and primary carcinoid tumor ( n =2). Results These uncommon malignancies of the liver had a variety of presentations. Undifferentiated embryonal sarcoma presented as a single huge cyst mixing with solid mass. Hepatic angiosarcoma demonstrated as multiple well defined hypoattenuation lesions without cirrhosis. Necrosis, cystic degeneration, and hemorrhage may be accompanied. Malignant fibrous histiocytoma displayed as a single large hypoattenuation lesion within hyperdense septations, and most of the tumor was in the right lobe. Immunohistochemistry had the diagnostic value. The CT features of carcinoid tumor were single or multiple, unilocular or multilocular mixed dense masses. The solid portion of the masses enhanced obviously and carcinoid syndrome may highly suggest the diagnosis. Conclusion The forementioned 5 cases of hepatic malignancy are seldomly seen clinically. Each of them with different pathologic nature has different CT findings, and sometimes with some similar signs. Typical CT findings, coupled with clinical information may lead to a correct diagnosis.