Application of modified Matutes score containing CD200 in diagnosis of chronic lymphocytic leukemia / 中南大学学报(医学版)

OBJECTIVES@#Immunophenotyping technique is a powerful tool for the diagnosis and differential diagnosis of chronic lymphocytic leukemia (CLL) and other B-cell chronic lymphoproliferative diseases (B-CLPD). CD200 is strongly expressed in CLL. This study aims to analyze the clinical value of modified Matutes score (MMS) containing CD200 in the diagnosis of CLL.@*METHODS@#We retrospectively analyzed 103 B-CLPD patients diagnosed from January 2020 to July 2021, including 64 CLL patients, 11 follicular lymphoma (FL) patients, 14 mantle cell lymphoma (MCL) patients, 6 marginal zone lymphoma (MZL) patients, 1 hairy cell leukemia (HCL) patient, and 7 lymphoplasmic lymphoma/Waldenstrom macroglobulinemia (LPL/WM) patients. The expression of CD markers between the CLL group and the non-CLL group was compared, and the sensitivity, specificity, and clinical consistency of MMS and Royal Marsden Hospital (RMH) immunophenotyping score system were analyzed.@*RESULTS@#There were significant differences in the expressions of CD5, CD23, FMC7, CD22, CD79b, CD200, and sIg between the CLL group and the non-CLL group (χ2 values were 37.42, 54.98, 30.71, 11.67, 55.26, 68.48, and 17.88, respectively, all P<0.01). When the RMH immunophenotyping score≥4, the sensitivity was 79.7%, and the specificity was 100%. When the MMS≥3, the sensitivity was 95.3%, and the specificity was 100%. The Kappa coefficient of RMH immunophenotyping system was 0.677, and the Kappa coefficient of MMS system was 0.860.@*CONCLUSIONS@#The MMS system containing CD200 has better sensitivity and same specificity compared with RMH immunophenotyping system, and MMS system may be more useful in the diagnosis of CLL.

A case of tsutsugamushi disease complicated by multiple organ dysfunction syndrome treated by extracorporeal membrane oxygenation / 中华危重病急救医学

Tsutsugamushi disease is an acute infectious disease caused by Rickettsia. Occasionally it has been reported in Macau, China. Critical cases are rare. Because the clinical manifestations of tsutsugamushi disease are non-specific and diverse, if not diagnosed and treated in time, the disease may progress to multiple organ dysfunction syndrome (MODS), severe acute respiratory distress syndrome (ARDS), and even death. A patient with tsutsugamushi disease complicated by MODS was admitted to the intensive care unit (ICU) of Kiang Wu Hospital in Macau, China on September 30, 2021. Combined with the history of outdoor activities (exposure to chigger mite larvae), clinical symptoms and signs (characteristic eschar of tsutsugamushi disease was found on the abdominal skin), related laboratory examinations (Weil-Felix test: negative). Diagnosis of tsutsugamushi disease with MODS. After admission, the patient was treated by anti-infection, correction of coagulation dysfunction, tracheal intubation and mechanical ventilation, noradrenalin to maintain blood pressure, continuous renal replacement therapy (CRRT), but the condition didn't improve significantly. We initiated veno-venous ECMO (VV-ECMO), which was initially setted blood flow to 5 L/min (70 mL·kg -1·min -1), rotate speed to 3 500 rpm, fractional concentration of inspired oxygen (FiO 2) to 1.00. Heparin was used as anticoagulant and activated coagulation time (ACT) was kept between 180 and 200 seconds. Meanwhile the speed of fluid removal in CRRT was adjusted. After 9 hours of ECMO support, the oxygenation improved, the blood flow of ECMO was reduced to about 4 L/min (58 mL·kg -1·min -1), rotate speed to 3 000 rpm. The patient's condition improved after 4 days of ECMO treatment and her ECMO flow rate and FiO 2 could be decreased gradually. On hospital day 5, ECMO was removed. Eight days on mechanical ventilation, the patient was successfully weaned and extubated. On day 11 of hospitalization, weaned the CRRT and turned to intermittent hemodialysis. The patient was transferred out of ICU due to her stable condition on the 12th day hospitalization. After that, her spontaneous urine output increased gradually. The functions of various organs returned to normal. After 36 days of hospitalization, she recovered and was discharged.

Application of"double low"dual source CT coronary angiography in patients with high BMI / 实用放射学杂志

Objective To explore the feasibility of reducing the tube voltage to 80 kV,while ensuring the CT image quality for the diagnosis when the patients with high BMI (26 kg/m2≤BMI≤30 kg/m2)undergo coronary CTA examination,using low concentration isotonic contrast medium (270 mg I/mL)and iterative reconstruction techniques (SAFIRE-3).Methods Sixty patients with high BMI who underwent coronary CTA were randomly divided into group A and group B.Group A was set as"double low"group (n=30,tube voltage=80 kV),using SAFIRE-3 technology and 270 mg I/mL contrast agent.Group B was set as conventional group (n=30,tube voltage=120 kV),using filtered back projection (FBP)technology and 350 mg I/mL contrast agent.Adaptive cardio-sequence prospective ECG-gated technology (CorAdSeq)was applied in both groups,and the collecting phase was 65%-75% R-R interval (heart rate <75 beats per minute)or 40%-50% R-R interval(heart rate ≥75 beats per minute).Subjective and objective assessment methods were applied to evaluate the quality of images.The image quality and radiation dose of"double low"group was analyzed with conventional group as the control group.SPSS 1 9.0 software was applied for statistical analysis.The independent samples t-test was used to evaluate the differences among different measurements data.P<0.05 was considered statistically significant.Results The EDssde of group A [(1.124±0.314)mGy·cm]was significantly lower than that of group B [(3.542±0.797)mGy·cm],and the difference was statistically significant(P<0.001).The difference in noise between group A and B was statistically significant(P<0.05). The SNR and CNR in the group A were not lower than those in the group B and even the CNR in the partial coronary segment of the group A was higher than that in the group B,exhibiting statistically significant difference(P<0.05).Image quality index in the group A was higher than that in group B,and the difference was statistically significant (P<0.05).Conclusion Compared with conventional coronary CTA examination,"double low"coronary CTA examination in patients with high BMI (26 kg/m2≤BMI≤30 kg/m2)can acquire nice CT images suitable for clinical diagnosis and can significantly reduce the radiation dose and the amount of contrast agent.

Clinical utility of needlescopic in hemithyroidectomy and central neck dissection through bilateral breast approach / 中华外科杂志

<p><b>OBJECTIVE</b>To study application of needlescopic assisted hemithyroidectomy and central neck dissection using bilateral breast approach.</p><p><b>METHODS</b>Totally 145 cases of papillary thyroid cancer patients received endoscopic hemithyroidectomy in Fujian Medical University Union Hospital were randomized to needle assisted endoscopic group (NE group, n=81) and conventional endoscopic group (CE group, n=64). The average age of the patients was 35.9 years and 11 patients were male.All patients underwent hemithyroidectomy and central neck dissection through bilateral breast approach, the NE group additional used the MiniLap-assisted intraoperation.The operative time, postoperative complications and cosmetic results were analyzed by t-test and χ(2) test.</p><p><b>RESULTS</b>The operation time of thyroid gland in NE and CE Group was (42±7) min and (31±7) min(t=9.082, P=0.000), respectively. The operation time of central neck dissection was (33±6) min and (26±3) min (t=9.050, P=0.000), respectively.There were 4 cases occurs transient recurrent laryngeal nerve paralysis in CE group and no case occur in NE group(χ(2)=5.206, P=0.036). There was no significant different in other postoperative complications and cosmetic results.</p><p><b>CONCLUSIONS</b>Hemithyroidectomy and central neck dissection using bilateral breast approach and needlescopic assisted technique isa safe and reliable approach, with high cosmetic effect. Application needle assistive devices can shorten the operation time while no significant increase trauma in patients, it will makes endoscopic thyroid surgery easier to promote.</p>

Establishing tumor-bearing animal models at different sites of the head and neck and their growing and metastatic characteristics / 中国组织工程研究

BACKGROUND:To establish a tumor-bearing animal model of the head and neck is of clinical significance for further studying pathogenesis and transfer mechanisms and for actively finding an effective diagnosis and therapeutic regimen. OBJECTIVE:To compare the growth, lymphatic metastasis and distant metastasis characteristics of head and neck tumors in animals. METHODS:VX2 tumor cel lines were resuscitated and passaged to establish tumor-bearing rabbit models. Under anesthesia, the tumor was stripped from the tumor-bearing site to make tumor cel suspension. Then, thecel suspension was injected into the thigh muscle of rabbits and then passaged 2 weeks later. Tumor samples were harvested from the thigh of passage rabbits to make VX2 tumor cel suspension that was injected into the ear, tongue and nasopharynx of rabbits to make a VX2 tumor model of the head and neck in the rabbit. RESULTS AND CONCLUSION: The three groups of rabbits had significant differences in spirit, diet, activity and so on. Rabbits with tumor xenograft of the ear were significantly better than those with tumor xenograft of the tongue and nasopharynx. At 2 weeks after injection of VX2 tumor cel suspension, the VX2 tumor models of the head and neck were made successfuly in rabbits, and the tumor formation rate was 100% (15/15) at the ear, 93% (14/15) at the tongue and nasopharynx. VX2 tumors at different sites experienced rapid growth period, central necrosis period, surface ulceration period, and the life cycle was about 4-6 weeks. Lymph node metastasis in head and neck and pulmonary metastasis were found in the al three groups. Hematoxylin-eosin staining showed that VX2 tumor tissues and metastatic lymph nodes were confirmed as moderately to poorly differentiated squamous cel carcinoma. These findings indicate that tumor-bearing rabbit models of the head and neck established by VX2 cel suspension are characterized by short modeling cycle, good stability, easy to repeat, high tumor formation rate and simple operation. VX2 tumors in the different sites of the head and neck of rabbits have different characteristics, so we can choose the different implanting sites according to the different research purposes.

Clinical significance of the right side lymph node dissection behind recurrent laryngeal nerve in papillary thyroid carcinoma / 中华内分泌外科杂志

Objective To assess clinical significance of the right side lymph node dissection behind recurrent laryngeal nerve (RLN) in papillary thyroid carcinoma (PTC).Methods Clinical data of 111 cases of PTC adimitted in our hospital (Department of Vascular and Thyroid Surgery,the Union Hospital of Fujian Medical University) from Feb.2013 to Mar.2014 were retrospectively analyzed.Central lymph node metastasis was analyzed.Univariate and multivariate analysis were made to analyze relations between the right side lymph node (Ⅵ b2) metastasis behind RLN and gender,age,tumor size,capsule infiltration and so on.Results Among 111 cases of PTC,71 had central lymph node metastasis (63.96％).Total metastasis number of the right side lymph node behind recurrent laryngeal nerve (Ⅵ b2) was 2.720±2.037,and the transfer rate was 27.03％ (30/111) (P＜0.05),all lower than those of Ⅵ bl.The one-way ANOVA results showed that metastasis of the right side lymph node behind RLN (Ⅵ b2) was related with age,lateral neck dissection,and Ⅵ b1 lymph node metastasis (P＜0.05) while Ⅵ bl lymph node metastasis was the only independent risk factor for metastasis of the right side lymph node behind RLN(Ⅵ b2) in PTC.Conclusion For patients with right PTC,the metastasis rate of Ⅵ b2 is high,thus dissection of this area is favorable and can accurately reflect lymph node metastasis and further to guide tumor staging and postoperative treatment.

Reverse trendelenburg position can alleviate postoperative nausea and vomiting in thyroid surgery: from Logistic multivariate analysis / 中华内分泌外科杂志

Objective To assess the clinical significance of reverse trendelenburg position in preventing postoperative nausea and vomiting(PONV)in thyroid surgery.Methods 110 patients with papillary thyroid carcinoma(PTC) admitted from Feb.2013 to Mar.2014 were prospectively divided into experimental group and the control group according to whether reserve trendelenburg position was adopted.Univariate and multivariate method were used to analyze relations between PONV and surgical position,gender,age,body mass index,hypertension,surgical time,ASA classification,anesthesia,and motion sickness.Results Of the 110 cases of PTC,the incidence of PONV was 16.28％ (7/43) in the experimental group while it was 37.31％ (25/67) in the control group.The difference had statistical significance(P ＜ 0.05).Statistical analysis showed that PONV was related to patients'gender,surgical position,surgical time,and motion sickness,while only surgical position and motion sickness was the independent risk factors.Conclusion Reverse trendelenburg position surgery can help to prevent PONV and promote recovery.

Clinical Effect of Ganglioside Sodium in the adjuvant Treatment of Acute Cerebral Infarction and Influence on hs-CRP and TNF-αin serum / 中国药师

To explore the clinical effect of ganglioside sodium in the treatment of acute cerebral infarction and its influ-ence on hs-CRP and TNF-α in serum. Methods:A total of 216 patients with acute cerebral infarction were randomly divided into the observation group and the control group. The control group (108 cases) was given regular treatment, and the observation group (108 cases) was given 100 mg ganglioside in 250 ml 0. 9% sodium chloride, ivd, qd additionally, and the treatment course was 14d. The clinical effect of the two groups was compared, and the change of hs-CRP and TNF-αin serum was also researched in both groups. Re-sults:The total effective rate of the observation group was 90. 7%, which was obviously higher than that of the control group (71. 3%, P<0. 05). After the treatment, the NDS score of the observation group was lower than that before the treatment, while the ADL score was higher than that before the treatment (P<0. 05). After the treatment, the level of hs-CRP and TNF-α in serum was higher than that before the treatment in the two groups (P<0. 05), and that in the observation group was higher than that in the control group (P<0. 05). During the treatment, no adverse reaction was shown in the two groups. Conclusion:The clinical effect of ganglioside sodi-um in the treatment of acute cerebral infarction is promising, which can reduce the level of hs-CRP and TNF-αin serum of the patients and improve the scores of NDS and ADL with good safety, and is worthy of further clinical application.

Comparison of the artifacts on magnetic resonance imaging caused by different porcelain-fused-to-metals / 中国组织工程研究

BACKGROUND:The patients with porcelain-fused-to-metal crowns who do examination of magnetic resonance imaging (MRI) can cause artifacts. In recent years, researching for MRI artifacts of different porcelain-fused-to-metal materials has been some progress, but there are less quantitatively reports on the MRI artifacts of different porcelain-fused-to-metal materials. OBJECTIVE:To evaluate the artifact sizes shown on fast spin-echo T 2-weighted sequence caused by different kinds of porcelain-fused-to-metal crowns. METHODS:Forty-eight lower right first molar crown patients who had MRI examination in MRI room were enrol ed. The patients were divided into nickel-chromium al oy group, cobalt-chromium al oy group and titanium crown group. Al patients were examined with fast spin-echo T 2-weighted sequences by means of 1.5 T MRI apparatus. MRI artifacts areas of same sequence on the MRI images of different porcelain-fused-to-metal materials were analyzed with variance test. RESULTS AND CONCLUSION:Forty-five cases appearing to have high signal samples with clearly curved boundary zone that can be measured were selected, 15 cases for each material. Different artifact sizes were produced on the same sequence of different porcelain-fused-to-metal materials, which were (321.67±33.29) mm in the nickel-chromium al oy group, (263.53±34.95) mm2 in the cobalt-chromium al oy group, and (143.67±31.13) mm2 in the titanium crown group. There were significant differences between groups (P<0.05). The artifact size is smal est for the titanium crown and largest for the nickel-chromium al oy crown.

Vertebral bone marrow infiltration of acute leukemia: diffusion-weighted imaging study / 中华放射学杂志

Objective Using single direction dispersion breathless DWI, to analyze the value of DWI for vertebral bone marrow infiltration in patients with acute leukemia (AL). MethodsForty-two patients with AL and 15 healthy volunteers received vertebral sagittal DWI with single shot spin-echo echoplan imaging (SS-SE-EPI) sequence( b value ＝ 0,650 s/mm2) at a GE Signa Excite 1. 5 T scanner with 8 channels body coil. DWI for all patients were performed from three directions, including from superior to inferior (S/I), from anterior to posterior (A/P) and from right to left (R/L). The apparent diffusion coefficient (ADC) value was measured on ADC map from each direction using GE-Function tool DWI software. Forty two patients consisted of 13 onset with untreated patients and 29 treated patients (7 nonremission,8 complete remission and 14 consolidation therapy). The ADC values among the three diffusion directions were compared. Analysis of variance and t test were used to compare the ADC values in different AL stages, Pearson correlation analysis was used to analyze the correlation between ADC values and the percentage of bone marrow progenitor cells. Results The ADC values from S/I, A/P and R/L of 362 vertebras in the 57 subjects are (0. 758 ±0. 009) × 10-3 mm2/s, (0. 732 ±0. 009) × 10 -3 mm2/s and (0. 758 ±0. 009) × 10 -3 mm2/s, respectively. There is no statistical significance( F ＝ 2. 958, P ＞ 0. 05 ).The ADC values from S/I of 94 vertebras in 15 healthy volunteers is (0. 697 ± 0. 122) × 10 -3 mm2/s, of 85 vertebras in 13 untreated AL patients is (0. 592 ±0. 071 ) × 10-3mm2/s. There is statistical significance between them ( t ＝ 2. 568, P ＜ 0. 05 ) ; The ADC value of 183 vertebras in 29 treated AL patients [ ( 0. 796 ±0. 225 ) × 10-3mm2/s]is higher than that in untreated patients with statistical significance (t ＝ -1. 332,P ＜0. 05). One hundred and forty vertebras in patients with complete remission and consolidation therapy were [ (0. 786 ±0. 184) × 10-3 mm2/s],and 43 vertebras in patients with non-remission(NR) [ (0. 804 ±0. 327 ) × 10 - 3 mm2/s], there was not statistical significance between them ( t ＝ - 0. 160, P ＞ 0. 05 ). The ADC values from S/I direction of untreated patients showed significant negative correlation with the proportion of the blast cell in the bone marrow ( median value 26. 4％. Min 7.9％, Max 48. 2％ ) ( r ＝- 0. 524, P ＜ 0. 05 ). ConclusionsDWI of vertebral bone marrow is isotropy. ADC value is a non-invasive and quantitative index for evaluating the pathogenetic condition of AL.

Bone marrow infiltration in patients with acute leukemia: dynamic contrast-enhanced MRI and its cfinicai significance / 中华放射学杂志

ObjectiveUsing dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to evaluate the hemodynamic perfusion characteristics of bone marrow infiltration in patients with acute leukemia (AL). MethodsForty-seven patients with AL received coronal pelvic T1WI DCE-MRI with fast low angle shot (FLASH) sequence. Among them, 25 were initial onset untreated (IOU) patients, 22 were treated AL patients, including 14 with complete remission (CR) and 8 with non-remission ( NR). The hemodynamic perfusion parameters including maximum percentage of enhancement ( Emax ) and slope were determined based on enhancement-time curves ( ETCs ) of iliac and lumbar vertebra. The proportion of marrow myeloblasts was recorded.For all patients, quantitative perfusion parameters of bone marrow infiltration in ilium were compared with those in lumbar. The values of Emax and ES were compared among IOU,CR and NR patients.Correlations between perfusion parameters and histopathological results were assessed. ResultsIn all the 47 patients, the Emax values of bilateral iliac bone marrow ( 15.70 ± 7.06)were slightly higher than that of lumbar bone marrow ( 11. 28 ± 5.52 ), and the difference was statistically significant (P ＜0. 01 ).There was no significant difference in the slop value between bilateral iliac bone marrow (0. 82 ± 0. 12 ) and lumbar bone marrow (0. 80 ± 0. 09 ) ( P ＞ 0. 05 ). In the 25 untreated patients,the Emax and slop values were 17. 15 ± 5.75 and 0. 98 ± 0. 13, respectively; in the 14 CR patients, they were 8. 76 ±3.93 and 0. 26 ± 0. 04, respectively, and in the 8 NR patients, they were 21.62 ± 6. 50 and 1. 38 ± 0. 02, respectively. There was significant difference in the Emax and slop values among the three groups (P＜0. 05).Compared with IOU and NR patients, both the Emax and slop values decreased significantly in iliac bone marrow of AL patients with CR (P ＜ 0. 05 ). There was no significant difference between IOU and NR patients ( P ＞ 0. 05 ). A significant positive correlation was found between Emax value of iliac bone marrow and the proportion of marrow myeloblasts ( r ＝0. 501 ,P ＜0. 05 ). There was a negative correlation between slop value of iliac bone marrow and the proportion of marrow myeloblasts ( r ＝0. 235 ,P ＞0.05).ConclusionsDCE-MRI can beused for evaluating the hemedynamic characteristics of microcirculation of bone marrow infiltration in patients with AL, which can provide useful information in evaluating prognosis and monitoring therapeutic effect.

Investigation in lower extremiy injuries of new recruits in a Chinese special military force / 中国矫形外科杂志

[Objective] To study the features in lower extremiy injuries of new recruits in the Chinese special military force during Basic Training Program,and supply scientific precautionary measures to reduce the military training injury.[Method]A special military force group had been chosen and the circumstance of military injuries in lower extremiy had been observed from Jan.to March in 2006.The population selected for study included all 281 new recruits of the unit.A questionnaire was designed to document all of the correlated information,and all injuried soldiers were examined and inquired about the case history.All data had been classified for analysis.[Result]In all 281 samples,75 cases occurred lower extremiy injuries(up to 26.69%).In all lower extremiy injuries,35 cases were leg injuries(up to 46.67%),17 cases were ankle injuries(up to 22.67%),11 cases were foot injuries(up to 14.67%).In all injuries,20 cases were acute injuries(up to 26.67%),55 cases were excess fatigue injuries(up to 73.33 %).In all injuries,38 cases were bone and joint injuries(up to 50.67%),37 cases were soft tissue injuries(up to 49.33%).The reasons for injuries were training field(l 8 cases),exercise overload(61 cases).In all training programs,64 cases were occured in 3 kilo run.[Conclusion]Lower extremiy injuries are common and frequently occurring illness.The features and methods of injuries are different and complicated.In this study,excess fatigue injuries caused by exercise overload were the most important.After comprehened the occurring rule,it should be emphasized on health propaganda.During basic military training,we should pay attention to soldiers' health condition.Training should be carried out step by step,to reduce the occurrence lower extremiy training injuries.

An Investigation on the Vibrational Frequency of C=O Bond in Benzoic Acid / 第三军医大学学报

The infrared spectra of benzoic acid in its solid form and in various solvents were determined.The result confirmed that the carbonyl bond of the dimer form of benzoic acid occurs at 1694 cm~(-l),but not at 1653 cm~(-1).The influences of hydrogen bond (polar solvent) and solvent effect (nonpolar solvent) on the vibrational frequency of C=O bond was also studied.In the nonpolar solvent,owing to the increment of the dielectric constant (?) of the solvent,C=O stretching frequency decreases slightly and the relationship between them can be expressed with the following formula:Here K and C are two contants,V_v and V_s represent the vibrational frequencyof C=O bond of benzoic acid in vapor and in solvent respectively.

Studies on Electronegativity by IR Ⅲ. The Relationship between the Electronegativity and the Vibrational Frequence of the Chemical Bond X-H in the Covalent Molecular Hydrides / 第三军医大学学报

In this work we studied systematically the correlation between the electrone-gativity, n/r or n*/r*, and the vibrational frequency of the chemical bond X-H, vX-H, in the covalent molecular hydrides. The results showed that there is good linear relationship between them.For the molecules of the type HnX-H, two cases were discussed.Case I, when the elements (X)are situated in the same group in the periodic table, the linear relation may be expressed in the following formala:(1)Here K is a constant which varies with the number of valence electrons on the atom X.Case II , when the elements(X) are situated in the same period in the periodic table, the empirical equation can be written as follows:(2)Here A and B are constants determined by the principle quantum number and the number of valence electrons in atom X respectively.For the molecules of the type YnX-H there is also a good linear relationship between vX-H and ∑n*/r*(Y), that is,vX-H?10-2=a + b∑n*/r*(Y)(3)Here a and b are constants determined by the position of the atom(X) in the periodic table.Using the above equations we have calculated the vibrational frequences, vX-H The values obtained are close to those obtained by other authors. Therefore, the results also confirm that the values of electronegativty calculated by our methods published in the previous papers(11) are trustworthy.In addition some characteristics of these equations were analyzed and discussed preliminarily.