脑囊虫的MRI表现

目的：探讨脑囊虫不同分期、分型的磁共振表现及应用价值.方法：收集脑囊虫病例127例,行MR轴、矢、冠位扫描及增强扫描.结果：脑囊虫分型：单发小囊型44例,单发大囊型6例,多发小囊型34例,脑实质钙化型18例;脑室型11例;蛛网膜下腔型7例;混合型7例.脑囊虫分期：活动期32例,退变死亡期49例,钙化期18例,混合期28例.结论：磁共振扫描能够清晰显示各种细节,是诊断脑囊虫的有力手段.     

MRI在喉癌术前分期中的临床应用价值

目的:探讨MRI在喉癌术前诊断、分期中的临床应用价值。方法:对114例行电子喉镜检查并经病理学证实为喉癌的患者行术前MRI扫描,根据图像资料判断肿瘤侵及范围及判断有无淋巴结转移;同时进行术前分期、分型,并与术后病理分期、分型对照研究。结果:术前MRI T1期27例,其中25例经病理证实为T1期,2例为T2期,准确率为92.6%;术前MRI T2期39例,其中经病理证实35例为T2期,3例T1期,1例T3期,准确率为89.7%;术前MRI T3期29例,其中经病理证实25例为T3期,4例T2期,准确率为86.2%;术前MRI T4期17例,其中经病理证实15例为T4期,2例T3期,准确率为88.2%;MRI术前T分期总准确率为87.7%。N1期准确率为81.8%,N2期准确率为94.1%。结论:MRI图像能很好地显示喉癌肿块的侵及范围及淋巴结转移等,对喉癌的术前分期、分型及制定合理的手术方案具有指导意义。     

结肠癌患者贫血与肿瘤大体分型及临床病理分期的关系分析

目的:分析结肠癌患者贫血与其肿瘤大体分型及临床病理分期的关系。方法:选取我院最近几年收治的结肠癌患者100例,按是否贫血分为贫血组及非贫血组,比较两组患者不同大体分型及临床病理分期的血常规与铁代谢指标。结果:非浸润型的红细胞、血红蛋白、血清铁和铁蛋白水平均明显高于浸润型(p0.05)。A、B期的红细胞、血红蛋白、血清铁和铁蛋白水平均明显高于C、D期(p0.05)。结论:结肠癌患者贫血与肿瘤大体分型及临床病理分期存在一定的关联,值得临床医务人员的重视。     

脑内单发环形强化病变的1H磁共振波谱成像研究进展

脑内单发环形强化病变是一类在磁共振增强扫描时呈现环形强化的特征性病变。肿瘤和炎症性病变均可表现为环形强化。临床上高级别胶质瘤、单发脑转移瘤和脑脓肿最常见,且用常规影像学方法常难以鉴别。~1HMRS可检测病变内及周围组织的代谢物浓度,反映病变性质及病理过程,结合影像学征象分析对这三种疾病的鉴别诊断意义重大。     

64层螺旋CT增强扫描对结直肠癌术前T分期的临床应用价值

目的:探讨64层螺旋CT增强扫描检查对结直肠癌术前T分期的临床应用价值。方法:对2012年3月~10月在我院行64层螺旋CT增强扫描,术后病理证实为结直肠癌的173例患者的CT成像结果进行回顾性分析。将CT分期的结果与术后病理分期结果进行一致性比较分析,并对肿瘤长度、CT值、病理分型等进行相关分析及比较。结果:CT术前T分期:T1-2期、T3期、T4期的灵敏度分别为60.90%(14/23)、89.92%(116/129)、95.24%(20/21),特异度为95.33%(143/150)、77.27%(34/44)、96.05%(146/152),准确率为66.67%(14/21)、92.01%(116/126)、76.92%(20/26),诊断一致性检验结果 Kappa=0.685,P=0.000,P0.05,有统计意义。不同病理分期中肿瘤长度及不同病理分型中肿瘤CT值方差分析结果,P0.05,有统计意义。不同病理分期中CT值方差分析结果,P0.05,没有统计意义。病理分期与病理分型的X2检验结果,P0.05,有统计意义。对T1-2过分期和T3低分期两组病例进一步分析,发现增强扫描后强化程度、管壁僵硬和浆膜不光整有助于鉴别T1-2过分期和T3期低分期,能够提高T1-2期和T3期的准确性。结论:64层螺旋CT增强扫描多种征象的相互结合有助于提高结直肠癌术前分期的准确性,对临床诊治有重要价值。     

64排螺旋CT对粗隆间骨折Evans分型的影响研究

目的:探讨64排螺旋CT对粗隆间骨折Evans分型的影响,为临床使用提供参考依据。方法:2015年3月至2017年3月,三甲医院高年资创伤骨科主任医师2名,医师1、医师2分别按照术前X线、术前64排螺旋CT平扫和三位重建结果对128例新鲜闭合单侧粗隆间骨折患者进行Evans分型,分别记为X线分型、CT分型。本院术者依据围术期X线、CT及术中所见骨折情况进行Evans分型(逆粗隆间骨折定义为Ⅴ型)作为最终分型。记录分型结果,计算并对比准确率、误诊率。结果:(1)剔除5例,90.09%(123/128)的患者完成研究。(2)分型结果:X线分型中,3例(最终分型Ⅲ型2例,Ⅳ型1例)无法定型;Ⅰ型正确1例,改为Ⅱ型1例;Ⅱ型正确18例,改为Ⅰ型2例,改为Ⅲ型3例,Ⅳ型2例;Ⅲ型正确45例,改为Ⅱ型7例,改为Ⅳ型1例;Ⅳ型正确19例,改为Ⅱ型3例,改为Ⅲ型15例。CT分型中,Ⅰ型正确3例,Ⅱ型正确29例,Ⅲ型正确64例,改为Ⅳ型1例,Ⅳ型正确22例,Ⅴ型正确3例。(3)CT分型的总准确率、总误诊率优于X线分型(99.19%vs67.48%、0.81%vs30.08%,P0.05)。(4)Ⅰ型、Ⅱ型、Ⅲ型、Ⅳ型骨折进行CT分型,准确率高于X线分型(P0.05),误诊率低于X线分型(P0.05);Ⅴ型骨折,两种分型准确率、误诊率相等。结论:64排螺旋CT平扫及三维重建是粗隆间骨折Evans分型较为可靠的辅助检查,可考虑推广运用。     

B超在肝囊型包虫病诊断中的临床价值与意义

目的：评价B超在肝囊型包虫病诊断中的价值与临床意义。方法：回顾性分析我院2000年12月至2011年12月收治的接受B超检查和手术治疗的332肝囊型包虫病例的临床资料。结果：332例肝囊型包虫病患者中,303例经过手术证实;肝囊型包虫病的B超分型可分为单发单囊型、多发单囊型、多子囊型、破裂感染型和坏死钙化型。单发单囊型患者以低年龄组多发,而高年龄组较少;破裂感染型以高年龄组多发;坏死钙化型病人共3例年龄均在60岁以上;破裂感染型占各型中病例数最多。结论：B型超声检查是肝囊型包虫病的主要检查方法,可确定包虫病的分型,了解包虫囊肿的部位、数目、大小和结构,为术前诊断、手术定位、观察治疗效果提供参考依据。     

慢性淋巴细胞性甲状腺炎合并甲状腺结节的临床分析

目的:研究分析中国东北地区慢性淋巴细胞性甲状腺炎(CLT)合并甲状腺结节的诊断和治疗方式.方法:回顾性分析2009年9月--2010年12月收治经病理证实的CLT合并甲状腺结节的共151病例,依据不同的病理类型分组,就临床特点、诊断和治疗进行比较.结果:CLT合并甲状腺乳头状癌组共58例,女性51例,男性7例,平均年龄37.5±4岁,平均病程18个月,28例为腺体内单发结节,病灶平均直径为0.9± 0.56 cm,36例病灶直径小于1.0 cm,42例见结节内伴钙化.CLT合并良性结节组98例,女性患者93例,男性患者5例,平均年龄48.1±9岁,平均病程72个月,34例为腺体内单发结节,病灶平均直径1.8± 0.42 cm,35例病灶直径小于1.0 cm,10例见结节内伴钙化.两组在发病年龄、病程、结节个数及钙化方面的差异均有统计学意义.结论:CLT合并甲状腺癌微小癌多见,淋巴结转移率低,彩超提示单发结节或者结节合并钙化的病例,应行手术治疗.     

40例慢性脑型血吸虫病的脑电图分析

目的:了解脑型血吸虫病脑电图(EEG)的脑电活动状况,为临床诊断与治疗提供参考。方法:收集1997~2004年临床诊断为脑型血吸虫病的40例EEG资料,主要分析异常EEG的脑电活动状况与异常程度、临床分型及预后的关系。结果:31例出现不同程度的EEG异常改变,异常率为77.5%,其中癫痫性为70%;脑瘤型为100%。绝大部分EEG检查是患者经治疗后作的。治疗前后均作了EEG检查的仅9例。治疗前,9例均有不同程度异常,治疗后7例有不同程度改善,2例恢复正常。结论:EEG对脑型血吸虫病的诊断及预后的评价有参考价值。     

前列腺钙化灶的超声显像诊断与分型的临床研究

目的:探究超声显像诊断前列腺钙化灶(PFC)的临床实用价值和超声分型。方法:对1284例经腹部超声显像诊断为PFC的临床资料进行回顾性分析,并根据超声所见进行分型。结果:超声显像诊断PFC 1,284例,单发768例(59.81%),多发516例(40.19%);钙化灶直径2~36mm;Ⅰ度542例(42.21%),Ⅱ度460例(35.83%),Ⅲ度282例(21.96%);孤立型412例(32.09%),散在型319例(24.84%),聚集型395例(30.76%),条索型158例(12.31%)。内腺435例(33.88%)、外腺348例((27.10%)、内外腺交界处351例(27.34%)、后尿道周围150例(11.68%)。单纯性钙化520例(40.50%),合并前列腺增生597例(46.50%)、前列腺炎129例(10.05%)、前列腺囊肿36例(2.80%)、前列腺癌2例(0.16%)。结论:PFC是男性泌尿生殖系统常见疾病,其程度和类型与年龄密切相关,近半数与前列腺增生并存,可能与组织退变、增生、炎症、钙磷代谢紊乱等因素有关。超声显像是诊断PFC最可靠、最简便的方法,具有重要的临床实用价值。     

Loss of heterozygosity at chromosome 6 as a marker of early genetic alterations in cervical intraepithelial neoplasias and microinvasive carcinomas

Oncogenic human papillomaviruses (mostly HPV types 16 and 18) are the major cause of cervical intraepithelial neoplasia (CIN), which progresses into cervical cancer (CC). To reveal early genetic alterations of chromosome 6 that are important for CC progression, we analyzed the loss of heterozygosity (LOH) in DNAs from 45 CIN cases, 47 microcarcinomas, and 19 invasive squamous cell carcinomas stage IB. LOH analysis of DNA samples prepared with microdissection from all CIN foci, as well as from CC lesions and synchronous CIN, permitted investigation of CIN and CC heterogeneity. Out of all CC stage I cases, 79% showed LOH with six microsatellite markers at chromosome 6. LOH with the microsatellite markers D6S276 (6p22) and TNFa (6p21.3) was found in 50% of the CC cases. LOH frequency in CIN lesions synchronous with CC was higher then in CIN cases without cancer; the statistical significance (P = 0.004) was shown for D6S291 (6p21.2). The finding suggests that the high frequency of LOH in CIN lesions is a marker of unfavorable prognosis for CIN. Progression from microcarcinoma to invasive CC of stage IB was associated with a higher LOH frequency at D6S344 (6p25) and TNFa (6p21.3). Early genetic alterations were found in CIN with microsatellites D6S273 and TNFa located at 6p21.3. Moreover, LOH frequency at D6S273 remained the same in both CIN and CC cases. Based on HPV typing, LOH analysis, and X-chromosome inactivation, the polyclonality of CC lesions, as well as CIN, was observed in a few patients.     

Phylogenetic Analysis and the Evolution of the 18S rRNA Gene Typing System of Acanthamoeba

Species of Acanthamoeba were first described using morphological characters including cyst structure and cytology of nuclear division. More than 20 nominal species were proposed using these methods. Morphology, especially cyst shape and size, has proven to be plastic and dependent upon culture conditions. The DNA sequence of the nuclear small‐subunit (18S) rRNA, the Rns gene, has become the most widely accepted method for rapid diagnosis and classification of Acanthamoeba. The Byers–Fuerst lab first proposed an Rns typing system in 1996. Subsequent refinements, with an increasing DNA database and analysis of diagnostic fragments within the gene, have become widely accepted by the Acanthamoeba research community. The development of the typing system, including its current state of implementation is illustrated by three cases: (i) the division between sequence types T13 and T16; (ii) the diversity within sequence supertype T2/T6, and (iii) verification of a new sequence type, designated T20. Molecular studies make clear the disconnection between phylogenetic relatedness and species names, as applied for the genus Acanthamoeba. Future reconciliation of genetic types with species names must become a priority, but the possible shortcomings of the use of a single gene when reconstructing the evolutionary history of the acanthamoebidae must also be resolved.     

HPV E6/E7 promotes aerobic glycolysis in cervical cancer by regulating IGF2BP2 to stabilize m6A-MYC expression

Enhanced aerobic glycolysis constitutes an additional source of energy for tumor proliferation and metastasis. Human papillomavirus (HPV) infection is the main cause of cervical cancer (CC); however, the associated molecular mechanisms remain poorly defined, as does the relationship between CC and aerobic glycolysis. To investigate whether HPV 16/18 E6/E7 can enhance aerobic glycolysis in CC, E6/E7 expression was knocked down in SiHa and HeLa cells using small interfering RNA (siRNA). Then, glucose uptake, lactate production, ATP levels, reactive oxygen species (ROS) content, extracellular acidification rate (ECAR) and oxygen consumption rate (OCR) were evaluated. RNA-seq was used to probe the molecular mechanism involved in E6/E7-driven aerobic glycolysis, and identified IGF2BP2 as a target of E6/E7. The regulatory effect of IGF2BP2 was confirmed by qRT-PCR, western blot, and RIP assay. The biological roles and mechanisms underlying how HPV E6/E7 and IGF2BP2 promote CC progression were confirmed in vitro and in vivo. Human CC tissue microarrays were used to analyze IGF2BP2 expression in CC. The knockdown of E6/E7 and IGF2BP2 attenuated the aerobic glycolytic capacity and growth of CC cells, while IGF2BP2 overexpression rescued this effect in vitro and in vivo. IGF2BP2 expression was higher in CC tissues than in adjacent tissues and was positively correlated with tumor stage. Mechanistically, E6/E7 proteins promoted aerobic glycolysis, proliferation, and metastasis in CC cells by regulating MYC mRNA m⁶A modifications through IGF2BP2. We found that E6/E7 promote CC by regulating MYC methylation sites via activating IGF2BP2 and established a link between E6/E7 and the promotion of aerobic glycolysis and CC progression. Blocking the HPV E6/E7-related metabolic pathway represents a potential strategy for the treatment of CC.     

Tissue inhibitor of matrix metalloproteinase-2 in nasopharyngeal carcinoma

By regulating matrix metalloproteinase (MMP) activity and controlling the breakdown of extracellular matrix components, tissue inhibitors of metalloproteinases (TIMPs) play an important role in the process of tumor invasion and metastasis. The present study was designed to clarify the role of TIMP-2 in nasopharyngeal carcinoma (NPC) patients and to evaluate its importance relative to clinicopathologic parameters. It was carried out in 30 patients with NPC and 20 controls. Tissue biopsies were studied and graded pathologically, and Western blot analysis was performed to assess TIMP-2 protein expression. Clinically, in accordance with TNM classification (T: tumor size, N: lymph node involvement, M: distant metastasis), 8 cases were diagnosed as stage II, 12 as stage III, and 10 cases as stage IV; however, pathologic typing with use of the World Health Organization (WHO) classification revealed the presence of 9 specimens of squamous cell carcinoma (WHO type 1), 6 cases of nonkeratinizing carcinoma (WHO type 2), and 15 cases of undifferentiated carcinoma (WHO type 3). The difference in percentage of TIMP-2 positivity between NPC patients (76.6%) and normal controls (30%) was statistically highly significant (P < .01). In addition, there was a significant positive correlation between TIMP-2 protein positivity and either the clinical staging or the histopathologic typing (P < .01) using Chi-square test (x(2)), suggesting that TIMP-2 can be used as a marker of the severity of NPC.Accordingly, we can assume that TIMP-2 may play a role in regional lymph node and/or distant metastasis and in progression of squamous cell carcinoma. Further studies are needed to investigate the role of TIMP-2 as a marker for tumor progression and to evaluate its potential value in the follow-up of patients.     

Molecular epidemiological characterization of Staphylococcus aureus isolates originating from food poisoning outbreaks that occurred in Tokyo,Japan

Staphylococcal food poisoning (SFP), one of the commonest food‐borne diseases, results from the ingestion of one or more staphylococcal enterotoxins (SEs) produced in foods by Staphylococcus aureus. In the present study, 203 S. aureus strains originating from 83 outbreaks that had occurred in Tokyo were examined for their coagulase type and genotype of SEs to analyze their molecular epidemiological characteristics. The representative subsets of the 83 S. aureus isolates were analyzed by multilocus sequence typing (MLST) and S. aureus pathogenicity island (SaPI) scanning. The isolates were integrated into eight specific clonal complexes (CC) s; CC81, CC8, CC6, CC5, CC508, CC59, CC20 and CC30. The profiles of the coagulase type, SE/SEl genotype and the suspected type of enterotoxin‐encoding mobile genetic element (MGE) indicated a correlation with each CC. SaPI scanning showed fixed regularity between the distributions of genomic islands, including SaPIs, and the phylogenetic lineage based on MLST. These results indicate that the S. aureus isolates, which classified into eight CCs, have distinguishable properties concerning specific coagulase type, enterotoxin genotype and MGE type. Strains of S. aureus harboring these particular elements possess the potential to cause SFP.     

Genotyping of Giardia duodenalis Isolates from Dogs in Guangdong,China Based on Multi-Locus Sequence

This study aimed to identify the assemblages (or subassemblages) of Giardia duodenalis by using normal or nested PCR based on 4 genetic loci: glutamate dehydrogenase (gdh), triose phosphate isomerase (tpi), β-giardin (bg), and small subunit ribosomal DNA (18S rRNA) genes. For this work, a total of 216 dogs'' fecal samples were collected in Guangdong, China. The phylogenetic trees were constructed with MEGA5.2 by using the neighbor-joining method. Results showed that 9.7% (21/216) samples were found to be positive; moreover, 10 samples were single infection (7 isolates assemblage A, 2 isolates assemblage C, and 1 isolate assemblage D) and 11 samples were mixed infections where assemblage A was predominant, which was potentially zoonotic. These findings showed that most of the dogs in Guangdong were infected or mixed-infected with assemblage A, and multi-locus sequence typing could be the best selection for the genotype analysis of dog-derived Giardia isolates.     

Identification of the clonal complexes of Staphylococcus aureus strains by determination of the conservation patterns of small genomic islets

Aims:  To investigate the clonality of Staphylococcus aureus isolates, it is important to identify their clonal complexes (CCs) with multilocus sequence typing (MLST). However, it is expensive to carry out MLST analyses for many isolates. The aim of this study, therefore, was to develop a cost-effective method to identify CCs by determining the conservation pattern of 'small genomic islets' (SGIs). SGIs are nonconserved regions between strains and have single or multiple open-reading frames (ORFs).
Methods and Results:  The whole-genome sequences of nine strains were compared in order to select 16 SGIs. The conservation patterns of the 16 SGIs (islet patterns) were investigated in 136 S. aureus isolates, which were classified into 21 CCs. The islet patterns (IPs) exhibited a one-to-one correspondence with the CCs, except for isolates belonging to CC1, CC5 and CC8. The IPs typical of strains belonging to CC1, CC5 and CC8 differed between those of sequence type 1 (ST1) and ST188 (CC1), ST5 and ST6 (CC5) and ST8 and ST239 (CC8).
Significance and Impact of the Study:  The CCs of many isolates can be identified in an easy and inexpensive manner by detecting these 16 SGIs. Emergent clones, particularly methicillin-resistant ones, can be identified by examining numerous islets by IP analysis.     

Multilocus sequence typing reveals high genetic diversity and epidemic population structure for the fish pathogen Yersinia ruckeri

Yersinia ruckeri is the causative agent of enteric redmouth in fish and one of the major bacterial pathogens causing losses in salmonid aquaculture. Previously typing methods, including restriction enzyme analysis, pulsed-field gel electrophoresis and multilocus enzyme electrophoresis (MLEE) have indicated a clonal population structure. In this work, we describe a multilocus sequence typing (MLST) scheme for Y.ruckeri based on the internal fragment sequence of six housekeeping genes. This MLST scheme was applied to 103 Y.ruckeri strains from diverse geographic areas and hosts as well as environmental sources. Sequences obtained from this work were deposited and are available in a public database (http://publmst.org/yruckeri/). Thirty different sequence types (ST) were identified, 21 of which were represented by a single isolate, evidencing high genetic diversity. ST2 comprised more than one-third of the isolates and was most frequently observed among isolates from trout. Two major clonal complexes (CC) were identified by eBURST analysis showing a common evolutionary origin for 94 isolates forming 21 STs into CC1 and for 6 isolates of 6 STs in the CC2. It was also possible to associate some unique ST with isolates from recent outbreaks in vaccinated salmonid fish.     

How Does The AJCC/TNM Staging System Eighth Edition Perform in Thyroid Cancer at A Major Middle Eastern Medical Center?

ObjectiveThe American Joint Committee on Cancer tumor node metastasis (TNM) staging system eighth edition (TNM-8) for differentiated thyroid cancer (DTC) has been introduced as a replacement for tumor node metastasis staging system seventh edition (TNM-7). We present the first study from a Middle Eastern population comparing these 2 versions of the TNM staging system.MethodsWe compared TNM-8 with TNM-7 in 701 patients with DTC seen during a 3-year period with a median age of 37 years (6-83) and a female-to-male ratio of 558 (79.6%) to 143 (20.4%).ResultsThe number (%) of patients within each stage in TNM-7 and TNM-8, respectively, are as follows: stage I = 503 (71.6%) and 583 (83.2%), stage II = 52 (7.4%) and 81 (11.4%), stage III = 53 (7.6%) and 6 (0.9%), and stage IV = 93 (13.2%) and 31 (4.6%). Overall, 172 patients (24.5%) were downstaged in TNM-8 compared to that in TNM-7, as follows: 26, 30, and 24 patients from stages II, III, and IV in TNM-7 to stage I in TNM-8; 23 and 32 patients from TNM-7 stages III and IV to TNM-8 stage II; 6 patients from stage IVa in TNM-7 to stage III in TNM-8; and 31 patients from stage IVc in TNM-7 to stage IVb in TNM-8. TNM-7 and TNM-8 predicted the long-term outcome well (median follow-up, 7.9 years), but Kaplan-Meier analysis showed better separation of cancer-specific survival in TNM-8 compared to TNM-7.ConclusionsCompared with TNM-7, TNM-8 approximately downstaged a quarter of DTC patients and was more robust in separating the outcome of different stages over time.