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Objective:To construct the pathological classification prediction model for malignant pulmonary pure ground-glass nodule (pGGN) patients based on CT imaging and to analyze the predictive efficacy.Methods:A total of 193 pulmonary pGGN patients with histopathological findings who underwent surgical treatment in 3201 Hospital from January 2018 to December 2022 were retrospectively included, with 217 lesions. All patiens were divided into invasive adenocarcinoma group (68 patients, 73 lesions) and non-invasive adenocarcinoma group (125 patients, 144 lesions) based on whether they were invasive adenocarcinoma; The clinical feature data and CT imaging parameters were compared between the two groups; Multivariate logistic regression analysis was used to analyze the risk factors of malignant lung pGGN diagnosed as invasive adenocarcinoma; A logistic prediction model for pathological classification of malignant lung pGGN was constructed to analyze its predictive efficacy using receiver operator characteristic (ROC) curves.Results:The percentages of burr signs in invasive adenocarcinoma group and non-invasive adenocarcinoma group were 34.25% (25/73) and 5.56% (8/144), respectively; The proportion of internal vascular signs was 93.15% (68/73) and 18.75% (27/144), respectively; The air bronchial signs were 67.12% (49/73) and 12.50% (18/144), respectively, with statistically significant differences ( χ2=30.93, P<0.001; χ2=108.95, P<0.001; χ2=67.72, P<0.001). The maximum CT value of nodular plain scan in invasive adenocarcinoma group (-527.82±72.95) HU, was significantly higher than that in non-invasive adenocarcinoma group (-592.79±86.47) HU, with a statistically significant difference ( t=-5.50, P<0.001). The results of multivariate analysis showed that spicule sign ( OR=8.93, 95% CI: 1.99-39.97, P=0.004), air bronchial sign ( OR=8.16, 95% CI: 2.91-22.86, P<0.001), internal vascular sign ( OR=48.39, 95% CI: 14.81-158.07, P<0.001) and the maximum CT value of plain scan ( OR=1.01, 95% CI: 1.00-1.02, P=0.001) were independent factors for the diagnosis of malignant pulmonary pGGN as invasive adenocarcinoma. Using burr sign, air bronchogram sign, internal vascular sign, maximum CT value of plain scan, and logistic regression model P-value to predict the pathological classification of malignant lung pGGN, the optimal cutoff values were 0.50, 0.50, 0.50, -547.23 HU, 0.46, and the area under the curve was 0.64, 0.77, 0.87, 0.69 and 0.96, respectively. The sensitivity was 34.25%, 67.12%, 93.15%, 82.19% and 89.04%, and the specificity was 94.44%, 87.50%, 81.25%, 46.53% and 92.36%, respectively, with the Jordan index being 28.69%, 54.62%, 74.40%, 28.72% and 81.40%. Conclusion:Patients with malignant pulmonary pGGN who have concomitant spicule sign, air bronchial sign, internal vascular sign, and maximum CT value on plain scan have a higher risk of being diagnosed with invasive adenocarcinoma; The predictive model constructed based on spicule sign, air bronchial sign, internal vascular sign, and maximum CT value on plain scan has shown good predictive performance in assisting the differential diagnosis of malignant pulmonary pGGN pathological classification.
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Objective@#To investigate the risk factors of postoperative acute kidney injury (AKI) in patients aged between 40 and 50 years old undergoing cardiac valvular surgery and the impact on outcome.@*Methods@#The clinical data of 286 patients aged between 40 and 50 years old undergoing cardiac valve surgery in Guangdong Provincial People′s Hospital from January 2012 to December 2016 were analyzed retrospectively. Preoperative coronary angiography was performed in all patients. All patients enrolled were divided into AKI group and non-AKI group according to the existence or not of postoperative AKI. Patients with AKI were further divided into AKI stage 1, stage 2, and stage 3 groups according to KDIGO guideline. Demographic characteristics, preoperative clinical data including serum creatinine, estimated glomerular filtration rate, hemoglobin, uric acid, urinary protein, presence or absence of chronic kidney disease, left ventricular ejection fraction, pulmonary artery pressure, New York Heart Association (NYHA) functional classification, preoperative co-morbidity (hypertension, diabetes, anemia, cerebrovascular disease, peripheral artery disease), preoperative medication(vasoactive drugs, diuretic, renin-angiotensin system inhibitor (RASI), surgical data (contrast dosage in coronary angiography, type of cardiac valve surgery) were recorded and analyzed in this retrospective study. The risk factors for postoperative AKI and its impact on clinical outcomes (mortality, hospitalization expenses and Intensive Care Unit stay duration) were evaluated. Logistic regression analysis was used to determine the risk factors for postoperative AKI and the adjusted variables with P<0.2 were selected for the multivariate logistic regression analysis to define the independent determinants for AKI.@*Results@#AKI was defined in 106 out of 286 enrolled patients, including 96 patients with AKI stage 1, 10 patients with AKI stage 2 and no patients with AKI stage 3. The proportion of coexisting cerebrovascular diseases was higher in AKI group than in non-AKI group (9(8.49%) and 5(2.78%), χ2=4.677, P=0.031), while there was no difference among other baseline data between the two groups. Multivariate logistic regression analysis showed that preoperative complications of cerebral vascular disease was an independent risk factor of postoperative AKI (OR=3.578, 95%CI 1.139-11.242, P=0.029). Five out of 106 AKI patients died during hospitalization while there was only 1 patient died among 180 patients without AKI. Patients with AKI after cardiac valve operation experienced higher mortality than patients without AKI (χ2=5.625, P=0.028). Further analysis showed that there was no difference in hospitalization mortality between patients with AKI stage 2 and stage (χ2=0.686, P=0.408) while the hospitalization mortality in patients with AKI stage 2 was higher than those without AKI (χ2=8.113, P=0.004). The hospitalization expenses in patients with AKI were 10.38(8.59,12.54) ×104 RMB, significantly higher than that in patients without AKI (9.72(8.03,11.93) ×104 RMB)(P=0.043). There was no difference in hospitalization expenses between patients with AKI stage 1 and without AKI (P=0.635). The hospitalization expenses in patients with AKI stage 2 was higher than those without AKI (P=0.023). Intensive Care Unit stay duration in patients with AKI was 3(1,4) days, significantly higher than those without AKI (P=0.044). There was no difference in Intensive Care Unit stay duration in patients with AKI stage 1 and without AKI (P=0.978), while Intensive Care Unit stay duration in patients with AKI stage 2 was significantly longer than those without AKI (P=0.006).@*Conclusions@#Preoperative complications of cerebral vascular disease is an independent risk factor of postoperative AKI. Non-senile patients with AKI after cardiac valvular surgery is associated with a higher proportion of mortality, hospitalization expenses and Intensive Care Unit stay duration as compared patients without postoperative AKI.
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Objective To determine the value of ultrasonography(US) and magnetic resonance cholangiopancreatography(MRCP) in the diagnosis of obstructive jaundice.Methods The data of 454 cases(213 cases underwent US,241 cases underwent MRCP) with obstructive jaundice confirmed by clinical or surgery and pathology in our hospital were be collected and analyzed.Results US and MRCP had different characteristics in displaying the different lesions caused obstructive jaundice.There were statistically significant differences for the diagnosis of obstructive jaundice and common bile duct stone and carcinoma of ampulla between US and MRCP (P＜ 0.01).Conclusion US should be the first choice of screening for the diagnosis.MRCP is valuable in differential diagnosis.
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Objective To investigate the short-term clinical effect of CT guided 125Ⅰ radioactive particle therapy in superficial malignant tumor. Methods The clinic data of 28 patients with metastatic superficial malignant tumor in our hospital were analyzed retrospectively.All patients were treated with CT guided 125Ⅰ radioactive particle therapy.The short-term effects,1 year survival rate and 1 year progression free survival rate of the patients were compared.Results Objective remission rate(ORR)and disease control rate(DCR)after 6 months were 92.86% and 100.00%.1 year overall survival and 1 year progression free survival were 96.43%(27/28)and 82.14%(23/28), respectively.The median overall survival and median progression free survival were 26.978 months (95%CI:22.558-31.399)and 16.932 months (95 % CI:14 .471-19.393).There were 27 cases of 0-Ⅱ degree adverse reactions,1 case of grade Ⅲ adverse reactions and no grade Ⅳ adverse reactions.No signs of 125Ⅰ radioactive particle translocation,vascular embolism and vascular rupture were found. Conclusion 125Ⅰ radioactive particle treatment of superficial malignant tumor has a definite short-term curative effect,with overall survival and progression free survival longer and higher safety,which can be considered in clinical application.
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Objective To investigate the incidence of hyperkalaemia and analyze the risk factors in pa-tients with acute kidney injury(AKI)in cardiology department.Methods We conducted a retrospective case-con-trol study,using the electronic medical information of the patients in Guangdong General Hospital. Results A to-tal of 37 837 patients were included in this study and 1 571(4.3%)patients with AKI were detected.Hyperkalae-mia occurred in 517 patients(1.4%).The incidence of hyperkalaemia in AKI patients was higher than that in non-AKI patients(10.1% vs. 1.0%,P < 0.001)and the incidences of hyperkalaemia at AKI stage 1~3 were 2.6 %, 13.9% and 20.6 %,respectively. Multiple logistic regression analysis demonstrated that AKI stages,chronic kid-ney disease and heart failure were risk factors for hyperkalaemia.AKI and hyperkalaemia were related to increased hospitalization expenses,delayed hospital stay,renal replacement therapy and in-hospital mortality. Based on AKI,the combination of hyperkalemia could significantly increase clinical burden and adverse outcomes. Conclu-sion In cardiology department,the monitoring of serum creatinine and potassium level should be emphasized.
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Objective To explore the clinical application of a new laryngeal mask in implantation of tracheal stent.Methods The new laryngeal masks were implanted under general anesthesia for 20 patients with tracheal or primary bronchus stenosis.The oxygen was continuously supplied from its side hole,and the stents were subsequently implanted from the tail hole.Results By using the new laryngeal masks under general anesthesia,all of 20 patients were successfully and leisurely implanted the tracheal stent.After the operation,the dyspnea symptoms were significantly improved,and there was no complication.Conclusion Stent implantation by using the new laryngeal mask under general anesthesia will provide a safe and effective treatment for tracheal stenosis.
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Objective To assess the epidemiology and clinical correlates of acute kidney injury(AKI)on patients in department of dermatology. Methods A total of 4710 patients hospitalized in dermatology department with at least two creatinine tests within 7 days were selected as research objects.AKI was defined and staged accord-ing to Kidney Disease Improving Global Outcomes criteria. Results The incidence of AKI was 6.3%. AKI inci-dences of psoriasis with systemic reaction(14.8%),erythroderma(12.8%),drug eruption(12.6%)and systemic lupus erythematosus (12.5%) were significant higher than the total incidence. In multivariate logistic regression model,these 4 skin diseases were independent risk factor of AKI incidence. The OR(95% confidencel interval) was 2.970(2.047~4.310),1.932(1.005~3.717),2.446(1.752~3.415)and 2.254(1.287~3.946). The in-hospital mortality was much higher in patients with AKI than those without(3.1% vs 0.1%,P < 0.001). And the AKI was related to in-hospital death after adjusted by age and comorbidities(Odds ratio 24.630,95%confidencel interval 7.385~82.149 ). Conclusion AKI is common in patients hospitalized in department of dermatology and is associated with patiensts′medical burden ,which shoule be noticed.
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Objective To explore the clinical application of a new laryngeal mask in implantation of tracheal stent.Methods The new laryngeal masks were implanted under general anesthesia for 20 patients with tracheal or primary bronchus stenosis.The oxygen was continuously supplied from its side hole,and the stents were subsequently implanted from the tail hole.Results By using the new laryngeal masks under general anesthesia,all of 20 patients were successfully and leisurely implanted the tracheal stent.After the operation,the dyspnea symptoms were significantly improved,and there was no complication.Conclusion Stent implantation by using the new laryngeal mask under general anesthesia will provide a safe and effective treatment for tracheal stenosis.
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Objective To assess the epidemiology and clinical correlates of acute kidney injury(AKI)on patients in department of dermatology. Methods A total of 4710 patients hospitalized in dermatology department with at least two creatinine tests within 7 days were selected as research objects.AKI was defined and staged accord-ing to Kidney Disease Improving Global Outcomes criteria. Results The incidence of AKI was 6.3%. AKI inci-dences of psoriasis with systemic reaction(14.8%),erythroderma(12.8%),drug eruption(12.6%)and systemic lupus erythematosus (12.5%) were significant higher than the total incidence. In multivariate logistic regression model,these 4 skin diseases were independent risk factor of AKI incidence. The OR(95% confidencel interval) was 2.970(2.047~4.310),1.932(1.005~3.717),2.446(1.752~3.415)and 2.254(1.287~3.946). The in-hospital mortality was much higher in patients with AKI than those without(3.1% vs 0.1%,P < 0.001). And the AKI was related to in-hospital death after adjusted by age and comorbidities(Odds ratio 24.630,95%confidencel interval 7.385~82.149 ). Conclusion AKI is common in patients hospitalized in department of dermatology and is associated with patiensts′medical burden ,which shoule be noticed.
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Objective To explore the MRI diagnosis characteristics of reversible splenial lesion syndrome (RESLES).Methods The clinical and imaging data of 12 cases of RESLES was analyzed retrospectively.MRI plain scan and DWI of brain were performed in all the cases.Apparent diffusion coefficient (ADC) value was obtained through post-processing function.Results 8 of 12 cases were children and 4 were adults.The splenium of corpus callosum of 12 cases showed round lesions,with slightly long T1 and slightly long T2 signal on MRI,high signal on DWI,and low signal on ADC map.The mean value of ADC of 12 cases was about 0.43× 10-3 mm2/s.The MRI reexamination was made after treatment in 12 cases,which showed the lesion of splenium of corpus callosum disappeared,and clinical syndromes were improved.Conclusion The MRI manifestation of RESLES is characterized by solitary lesion.The ADC value could accurately reflect the molecular diffusion information of the lesion.
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Objective We aimed to investigate the clinical values of combination of blood creatinine and cystatin C for acute kidney injury(AKI)diagnosi. Methods Total 7 627 patients were studied retrospectively. The AKI was classified by creatinine or cystatin C according to the Kidney Disease:Improving Global Outcomes criteria. Results The maximum levels of cystatin C and creatinine were correlated(Spearman′s rank coefficient 0.699,P < 0.001). The area under a receiver operating characteristic curve of maximum cystatin C value for pre-dicting in-hospital death was 0.761(95% confidence interval 0.693 ~ 0.828). Total 1 004 and 173 patients were classified into AKI by blood creatinine or by cystatin C(13.2% vs.2.3%,P<0.001),respectively.The total inci-dence of AKI was 14.7% diagnosed by the combination of the two markers.In multivariable logistic model,the cre-atinine negative plus cystatin C positive group was associated with a higher in-hospital death compared with the cre-atinine and cystatin C double negative group(OR 15.524,95% confidence interval 5.110 ~ 47.166,P < 0.001). Conclusion Combination of cystatin C increased sensitivity of creatinine for AKI diagnosis and facilitated to iden-tify in-hospital patients with high risk.
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Objective To conduct eugenics inspections for preparing pregnant couples,to find out risk factors causing fetal birth defects,to provide the scientific basis of eugenic and superior nurture.Methods A total of 2 1 63 preparing pregnant couples were conducted eugenics detection before childbirth to assess pregnant risk.Results A total of 1 547 cases were checked out with preg-nancy risk with the positive rate as 35.76%(1 547/4 326).Among them,the positive rate of male was 26.81% (580/2 1 63).the positive rate of women was 44.71% (967/2 1 63).Women positive rate was significantly higher than the male.Conclusion The eu-genics detection before pregnant could found risk of pregnancy as soon as possible,in order to take corresponding preventive meas-ures in time,has important significance for prevention of birth defects.
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Objective To investigate the value of MRCP in conjunction with CT or MRI contrast-enhanced scan in locating and qualitative diagnosis of biliary obstruction.Methods 954 patients with biliary obstruction confirmed by surgical pathology and clini-cal follow up underwent MRCP scans in our hospital.Contrast-enhanced CT scans in 87 patients,contrast-enhanced MRI scans in 52 and both CT and MRI enhancement in 37 were performed.Results The accuracy of location of biliary obstruction with MRCP was 100%,the accuracy of quality of biliary obstruction with MRCP combined with CT or MRI dynamic contrast-enhanced scan was 96%.Conclusion MRCP combined with CT or MRI dynamic contrast-enhanced scans has an important clinical value for the locali-zation and qualitative diagnosis of biliary obstruction.
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Objective To evaluate the application of prevention technique for mother‐to‐child transmission of human immunode‐ficiency virus(HIV) in Laibin City .Methods Prevention techniques for mother‐to‐child transmission of HIV were applicated in the city .Women in pregnancy test received acquired immunodeficiency syndrome(AIDS) counseling and test at the same time .Measures were taken to prevent the mother‐to‐child transmission of HIV for women who confirmed HIV positive ,including the use of antiret‐roviral drugs ,safety midwifery and feeding guidance ,and so on .Results The average HIV counseling and testing rate was 99 .1%(176 001/177 738) for the past 5 years .269 cases were HIV positive ,and the positive rate was 0 .15% (269/176 001) .Via health advisory guidance ,pregnant women diagnosed with AIDS understood the dangers of AIDS and the mode of its transmission ,and then free to chose weather to have the pregnancy terminated .Finally ,there were 67 pregnant women chose to terminate the preg‐nancy ,and 202 women decided to have children who were included in the prevention management system of mother‐to‐child trans‐mission .202 infants were born alive ,192 of which took full amount of antiretroviral drugs .The medication rate was 95 .05% (192/202) .42 d and 3 months after birth ,early diagnosis of HIV/AIDS was performed for the infants ,the positive rate of HIV was 0 .50% (1/202) .There were 118 infants at least 18‐months‐old who had underwent HIV test and no positive case was detected . Conclusion AIDS counseling tests in pregnancy test women is necessary ,which could detect HIV positive women .Comprehensive measures are effective methods for the prevention of mother‐to‐child transmission .
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Objective To investigate the value of the three-dimensional high-resolution magnetic resonance imaging curve planar reformation(CPR)combined with virtual endoscopy reconstruction in vascular compression of trigeminal neuralgia.Methods 65 pa-tients with trigeminal neuralgia performed three-dimensional MR doubly excited balanced steady-state free precession sequence (3D-FIESTA-C),and CPR combined with virtual endoscopy reconstruction was used to evaluate the relationship of neurovascular anato-my.And 60 cases with microvascular decompression (MVD)surgery were analyzed.Results 65 cases of 3D-FIESTA-C CPR com-bined with MRVE showed responsibility vascular with a positive rate of 92.3% (60/65).60 cases of all patients with the results of surgery showed responsibility blood vessels and oppression parts with 3D-FIESTA-C CPR combined with MRVE,and it was found that the findings of oppression had a good consistency with MVD with the diagnose accordance rate of 95% (57/60).Conclusion Three-dimensional high-resolution magnetic resonance imaging CPR combined with virtual endoscopy reconstruction can be a new method to clearly and accurately show the anatomical relationship between blood vessels and nerves,which helps to improve the posi-tive rate of detection and to give operative guidance.
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Objective To assess the correlation of serum 25-hydroxyvitamin D (25-OHD) levels with vitamin D-binding protein (the group-specific component,GC) gene polymorphism in chronic obstructive pulmonary disease (COPD).Methods In a cross-sectional case-control study,250participants,including 116 COPD patients with smoking history and 134 healthy smokers,were investigated.A questionnaire about smoking history,vitamin D intake and comorbidities was collected.General pulmonary function was done by routine.Serum 25-OHD levels were detected by ELISA.The genetic variants (rs4588and rs7041) were genotyped by real time fluorescence polymerase chain reaction (RT-PCR) with TaqMan probe technology.Results The COPD patients had lower serum vitamin D level than the smoker subjects (36.58 nmol/L vs 43.80 nmol/L,P ＜0.001).In the COPD patients,vitamin D level was 39.43 nmol/L in those with percentage of predicted forced expiratory volume in 1 second (FEV1 ％ pred) greater than or equal to 80％.In other groups with FEV1 ％ pred 50％-80％,30％-50％ and lower than 30％,vitamin D levels were 35.32 nmol/L,32.21 nmol/L,26.25 nmol/L respectively (P ＜ 0.01).Moreover,there was a significant relevance of 25-OHD levels with FEV1 ％ pred in both COPD patients and healthy smokers (r2 =1.911; P ＜0.000 1).The mean 25-OHD concentration had a negative correlation with Global Initiative for Obstructive Lung Disease (GOLD) stages.Homozygous carriers of vitamin D-binding protein gene rs7041 T allele were independently related to 25-OHD levels and susceptibility of COPD (P ＜ 0.01 ; OR =2.140,95％ CI 1.157-3.959,P =0.015 respectively).Conclusions Patients with COPD are at high risk of vitamin D deficiency and the severity of COPD is inversely correlated with vitamin D levels.Furthermore,homozygous carrier of rs7041 T allele influences 25-OHD serum levels and is related to susceptibility of COPD,which may be a potential candidate gene for screening COPD.
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Objective To discuss the medium-term follow-up of clinically insignificant residual fragments (CIRF) after minimally invasive percutaneous nephrolithotomy lithotripsy (MPCNL).Methods The clinical data of 72 patients with CIRF medium-term follow-up were analyzed retrospectively.Results Seventy-two patients with CIRF.The anatomical distribution of CIRF was 10 at upper pole,15 at middle,35 at lower,10 at renal ureteropelvie junction and 2 at upper and lower pole.Stone analysis showed that 41 cases of calcium oxalate calculi,16 of calcium oxalate calculi mixed with carbonate calculi,3 calcium oxalate calculi mixed with uric acid,4 calcium oxalate calculi mixed with struvite stone,3 struvite stone,2 uric acid stone and 3 carbonate apatite mixed with struvite stone.Fifteen cases had clinical symptoms,including 2 renal colic pain,8 hematuria,5 lower urinary tract symptoms,4 cases CIRF located in upper pole,1 case in middle pole,4 cases in lower pole,6 cases in ureteropelvic junction,the incidence of clinical symptoms in ureteropelvic junction was significantly higher than that in other locations (6/10 vs.4/12,1/15,4/37,P ＜0.05).Eight cases required surgical procedure,5 cases underwent extracorporeal shock wave lithotripsy,3 cases with ureteral CIRF were performed with ureteroscopic lithotripsy.CIRF were clear after surgery,7 patients with ureteral CIRF had renal colic pains.The stones were excluded after spasmolytic analgesic treatments.Conclusions CIRF can be located variously in the kidney and ureter.Most CIRF are calcium oxalate calculi and locate in the lower pole.Patients with the history of previous open surgery or extracorporeal shock wave lithotripsy are more likely to get CIRF.Medium-term follow-up of CIRF reveals that CIRF located in the renal ureteropelvis junction are more likely to have clinical symptoms.
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Objective To evaluate the clinical effects and safety of percutaneous nephrolithotomy (PCNL) by middle renal calice used as the main target for the treatment of staghorn stones with the combination of pneumatic and ultrasonic lithotrite.Methods Clinical data of 73 patients underwent PCNL by middle renal calices as main access with 57 incomplete staghorn stones and 35 complete staghorn stones.To observe the situation calculus removal rate and complications.Results Seventy cases (88 sides) underwent one session PCNL by single access tract (middle caliees),3 cases (4 sides) underwent one session PCNL by double access tracts (2 cases by middle and low calices,1 case by up and middle caliees).After the first period of lithoclasty,17 patients (25 sides) residual stones and the stone removal rate 72.8％ (67/92),among these patients,1 case (1 side) had fragments of lateral renal calyeeal stones with no further treatment.Other 16 cases (24 sides)underwent second session PCNL,all were treated by single access tract (middle calices) and 2 cases (2 sides)had extracorporeal shock wave lithotripsy before the second PCNL.After the second period of lithoclasty,76 sides composed of 27 complete staghorn stones and 49 incomplete staghorn stones had no residual fragments with the stone removal rate 82.6％ (76/92).The operative time lasted 120-320 min.Hemoglobin dropped 1-4 g/L,11 cases in the operation procedure and 3 cases after operation needed blood transfusion respectively.One case of renal pelvic infection after operation and 1 case had split renal dysfunction with peri-parenchyma infection.The hospitalization time was 9-18 days.Conclusion It is effective and safe to perform PCNL for staghorn stone by middle calices as a main access.Combining pneumatic and ultrasonic lithotrite will be very useful with high stone clearance,short procedure time and less complications.
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Objective To investigate the expression of macrophage migration inhibition factor (MIF) in pulmonary tissues of the smokers with and without chronic obstructive pulmonary disease (COPD).Methods The subjects were assigned into three groups:non-smokers without COPD (control group,n =12),smokers without COPD (smoker group,n =13) and smokers with COPD (COPD group,n =16).The specimens were obtained from lung tissues as far away from cancer focus as possible (＞ 5cm).Real-time quantitative PCR and immunohistochemistry were used to investigate the expression and distribution of MIF in pulmonary tissues.The relationship between the severity of airflow obstruction and the differential expressions of MIF in lung tissues of the smokers with or without COPD was analyzed.Results (1) MIF mRNA expression in COPD group (4.87 ± 1.79) was higher than that in the smoker group (2.16 ±0.72;P＜0.01),which was higher than that in the control group (1.09 ±0.48;P ＜0.01).(2)Immunohistochemistry analysis showed that MIF protein expression in lung tissues of the COPD group (0.277±0.025) was higher than that in the smokers group (0.199 ±0.034;P ＜0.01),which was significantly higher than that in control group (0.130 ±0.021 ;P ＜0.01).(3) Correlation analysis of MIF mRNA expression in the lung tissues and pulmonary function parameters of forced expired volume in one second (FEV1) percentage of predicted (FEV1 pred) and ratio of FEV1 to forced vital capacity (FEV1/FVC) suggested that MIF mRNA expression in the lung tissues was negatively related with FEV1 pred (r=-0.578,P ＜ 0.01) and FEV1/FVC (r =-0.607,P ＜ 0.01).Conclusions MIF expression significantly increases in the smokers with COPD,and MIF level in the lung is positively correlated with airflow limitation.The results suggest that MIF may play an important role in the pathogenesis of smokinginduced COPD.
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Objective To discuss the feasibility and curative effect of intra-radiation stenting(125Iparticle stent)for the treatment of advanced esophageal cancers.Methods Fifteen patients with advanced esophageal cancer were enrolled in this study.Under X-ray guidance the esophageal stent,which was tied up with 125I radioactive particles,was orally inserted to the diseased region of the esophagus.The clinical manifestations and imaging findings were observed and the results were analyzed.Results After the operation all the clinical symptoms such as dysphasia showed an obvious improvement.No serious complications such as infection,hemorrhage,radiation pneumonia,etc.Occurred.The re-examination at 3-6 months after the treatment showed that the tumor size Was decreased in a certain degree in 14 patients,and in the remaining one patient the lesion became bigger and grew to the upper opening of the stent,resulting in esophageal restenosis.Conclusion The intra-esophageal implantation of radioactive stent is a feasible and safe treatment for the advanced esophageal cancers with excellent curative results.