Objective To evaluate the diagnostic value of ELISA using AgB in cystic echinococcosis (CE). Methods Such databases as PubMed, EMbase, The Cochrane Library, EBSCO, CBM, CNKI, WanFang Data and MedaLink were retrieved on computer, and the relevant journals were also manually searched to collect the trials on ELISA using AgB in diagnosis of CE. The retrieval time was from inception to July 5th, 2012. Two reviewers independently screened the literature, extracted the data and assessed the quality according to QUADAS. Then the meta-analysis was conducted by using Meta-Disc 1.4 software. Results A total of 8 studies were included, and there were 562 CE patients diagnosed by gold standard, 434 suspected cases and 303 healthy people. There were no threshold effects among those 8 studies (the spearman’s correlation coefficient of log sensitivity to log 1-specificity was 0.527, P=0.400 1). The meta-analysis of DerSimonia-Laird showed that, the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio was 0.76 (95%CI 0.73 to 0.79), 0.84 (95%CI 0.82 to 0.86), 5.20 (95%CI 3.59 to 7.55), 0.26 (95%CI 0.18 to 0.35), 23.93 (95%CI 12.35 to 46.39), respectively. And the AUC of SROC was 0.889 7 (Q=0.820 4). Conclusion ELISA using natural AgB and rAgB has greater diagnostic value in detecting CE.
From September 1988 to May 1985, 67 cases of thyroid cysts were treated with aspiration and ethanol injection. Patients were followed up clinically and ultrasonically 6 month to 4 years after treatment. Cure was defined as complete disappealance of the cyst or presence of a residual fibrotic mass less than 1 cm in diameter, effectiveness was defined as the residual mass less than 50% of the original one. After one to three injections, 27 out of 36 patients of thyroid adnoma with cystic change (75 %)were cured, the effective rate was 88.2%. The cure rate of nodular goiter with cystic change was 50%(14 out of 28 cases, while the effective rate was 82%.No serious complication occurred in this series. During the period of following up, no malignant change was found. The results suggest that aspiration of thyroid cyst with ethanol injection is a simple, well tolerated and low cost technique.
Objective To investigate the clinical significance of serum cystatin C ( Cys C) in patients with non-small cell lung cancer ( NSCLC) .Methods The serumlevel of cystatin C was determined by enzyme linked immunosorbent assay ( ELISA) in patients with NSCLC, patients with benign lung diseases, and normal controls. Results The serum level of Cys C in the NSCLC patients was much higher than those in the patients with benign lung diseases and the normal control subjects [ ( 1.47 ±0.78) mg/L vs. ( 1.04 ±0.51) mg/L and ( 1.06 ±0.36) mg/L, Plt;0.01] . The level of Cys C in the NSCLC patients was significantly related to clinical stage [ TNM stage -Ⅱ vs. Ⅲ-Ⅳ: ( 1.38 ±0.88) mg/L vs. ( 1.57 ± 0.79) mg/L] , lymph node metastasis [ metastatic vs. non-metastatic: ( 1.83 ±0.97) mg/L vs. ( 1.06 ± 0.39) mg/L] , and differentiation degree [ medium-high differentiation vs. low differentiation: ( 1.63 ± 0.73) mg/L vs. ( 1.26 ±0.48) mg/L] ( all Plt;0.05) . However no correlation of Cys C with gender, age, and histological type was revealed ( Pgt;0.05) . Conclusion Cys C may contribute to the occurrence and development of NSCLC.
Objective To investigate the temporal and spatial expression pattern of Caspase3、Bax and Bclxl in NmethylNnitrosourea (MNU) damaged rat retina. Methods Twenty-four 50 dayold female Sprague-Dawley rats (n=24) received single intraperitoneal injection of MNU 40 mg/kg and were examined at 1, 3, 7 and 10 days after MNU treatment (6 rats sacrificed at each timepoint). As control, six rats were injected with saline (5 ml/kg) and sacrificed 3d after injection. Expressions of Caspase-3 and bax and bcl-xl were detected by RTPCR and immunofluorescence assays, photoreceptor cell apoptosis was measured by terminal deoxynucleotidyl transferasemediated deoxyuridine triphosphatedigoxigenin nick-end labeling (TUNEL). Results Animal models were successful established and confirmed by pathological studies. RTPCR results indicated that caspase3 and bax upregulated at 1 d (caspase-3 RA =83.23plusmn;8.11，P= 0.009; bax-RA=72.73plusmn;9.46，P=0.004) and peaked at 3 d （caspase-3 RA=140.48plusmn;18.40，P=0.000；bax-RA=102.36plusmn;13.97，P=0.001）compared with control (caspase-3 RA=62.45plusmn;7.65; bax-RA =46.53plusmn;4.41). Bcl-xl expression increased and peaked at 3d (3d RA=79.83plusmn;5.58, P=0.000 vs control 45.98plusmn;3.06). It was noted that the ratios of bax / bclxl expression at 1 d, 3 d and 7 d after MNU injection were enhanced (1 d 1.15plusmn;0.14, P= 0.143; 3 d 1.28plusmn;0.16, P=0.001; 7 d 1.17plusmn;0.08, P= 0.079, vs control 1.01plusmn;0.09), and at 3 d the ratio reached the peak, whereas at10 d bax / bcl-xl ratio (0.73plusmn;0.07, P= 0.001) was decreased compared with the control. Immunofluorescence assays demonstrated that the changes of bax, bclxl and caspases3 protein expressions coincided with their RTPCR results respectively. The Bax positive cells were detected in the outer nuclear layer; while caspase3 and bclxl positive cells emerged in several layers of retina included the pigment epithelium layer, the photoreceptor cell inner segments, the outer nuclear layer, the outer plexiform layer, the inner plexiform layer and the ganglion cell layer. Photoreceptor cell apoptosis was only detected in the outer nuclear layer and peaked at 3 d in MNU treated rats (AI= 76.97plusmn;5.83, P= 0.000 vs control 0.00 plusmn; 0.00). Conclusions These data suggest that bax and bcl-xl and caspases3 may involve in the MNUinduced rat photoreceptor cell apoptosis.
Objective To observe the efficiency and safety of a single intravi treal injection of Bevacizumab (Avastin) in patients with diabetic macular edema. Methods Prospective, open label study of 18 eyes of 18 patients with diabetic macular edema which was diagnosed by examination of regular inspection, fundus fluorescein angiography(FFA) and optic coherence tomography(OCT). The patients without general or partial surgery contraindications, aged from 34-75 years with a mean age of 54plusmn;11 years. The best corrected visual acuity of logMAR was 1.023plusmn;0.45 and the retinal thickness of macular foveal was 486 mu;m before the treatment. The eyes have intravitreal injection with Bevacizumab at dose 1.5 mg (0. 06 ml). After the treatment, the follow-up period ranging from 12 to 20 weeks (m e an 16plusmn;4 weeks). The changes of visual acuity, intraocular pressure, OCT and FFA before and after the treatment were observed and analyzed. Results All 18 patients had a mean logMAR BCVA of 1.023plusmn;0.45 at baseline and at the follow-up weeks 1, 4, 12, the mean logMAR BCVA was significantly improved as 0.864plusmn;0.48 （P=0.001）, 0.739plusmn;0.51 (P=0.003), 0.792plusmn;0.50 (P=0.015) respectively, and the differences are statistically significant compared with before. Sixteen eyes (88.9%) had a improved or stable visual acuity, the BCVA increased 2 lines (0.2 logMAR vision) or better in 10 eyes (55.6%) and decreased in 2 eyes at 12 weeks after injection. OCT demonstrated that retinal thickness of macular foveal decreased from 486 mu;m to 413 mu;m at 4 weeks, decreased to 383mu;m at 12 weeks（P=0.002， P=0.001）, and the differences are statistically significant compared with before. There are remarkable resolution of central retinal edema in 13 eyes (72.2%) at 12 weeks after the injection. No local or systemic adverse events were observed in any patients. Conclusions The preliminary result in our observati on showed that int ravitreal injection of Bevacizumab therapy was well tolerated with a significant improvement in BCVA and decrease in macular edema for patients with diabetic macular edema. A randomly controlled multicenter clinical trial is necessary. (Chin J Ocul Fundus Dis,2008,24:172-175)
Objective To explore the frequency, clinical features, and characteristics of results of fundus fluorescein angiography (FFA) of uveitis related cystoid macular edema (CME). Methods The clinical data and FFA results of 67 patients (106 eyes) with posterior uveitis examined in our hospital from July 2002 to June 2005 were collected. The clinical features and characteristics of FFA images of CME were observed and analyzed. Results Among the106 eyes of 67 patients with uveitis,the CME was observed in 28 eyes (26.4%) of 18 patients, including 7 males and 11 females with the average age of (42.5plusmn;10.8) years. The dark area due to the choroidal fluorescence blocked by the macular edema was found at the early FFA phase, and th en followed by the punctate and sheetlike leakage of fluorescein; the capillar y was dilated at the venous phase, and the typical petaloid appearance was seen at the late phase because the fluorescein cumulated in several small vesicles in the macular area. After treated by corticosteroids and topical non-steroidal anti-inflammatory medicine and carbonic anhydrase inhibitors, the extent of CME diminished, and the visual acuity improved in varying degrees. Conclusi ons Uveitis may seriously harm the visual function, in which CME induces the damage of visual acuity. Early detection and timely treatment may prevent thepermanent visual damage. (Chin J Ocul Fundus Dis, 2006, 22: 394-396)
Objective To evaluate the effectiveness and safety of chemotherapeutics bladder irrigation (CBI) after transurethral resection (TR) in the treatment of cystitis glandularis (CG). Methods Databases including MEDLINE, The Cochrane Library, EMbase, VIP, CNKI and CBM were searched from January 2001 to November 2011 to collect randomized controlled trials (RCTs) and case-control studies (CCSs) on pirarubicin or mitomycin bladder irrigation after TR in the treatment of CG. Two reviewers independently screened articles according to the inclusion and exclusion criteria, extracted data and evaluated the quality of the included studies. Then meta-analysis was performed using RevMan 5.0. Results A total of 11 articles involving 5 RCTs and 6 CCSs were included. Among the total 1032 patients involved, 497 patients were in the control group treated by TR alone, while the other 535 patients were in the treatment group given CBI after RT. There were two subgroups, one involving 347 patients irrigated by pirarubicin in 7 studies, and the other involving 188 patients irrigated by mitomycin in 4 studies. The results of meta-analysis showed: (a) pirarubicin bladder irrigation after TR could increase both short-term and long-term cure rates and decrease both short-term and long-term relapse rates, but no significant differences were found in both short-term and long-term improvement rates, compared with the control group. As for the safety, pirarubicin was similar to the control group in the incidence of urinary irritation, but it was superior in the incidence of bloody urine; and (b) mitomycin bladder irrigation after TR could increase long-term cure rate and decrease long-term relapse rate, but no significant differences were found in short-term cure rate and short-term improvement rate, compared with the control group. Mitomycin was similar to the control group in incidence of urinary irritation and bloody urine. Sensitivity analyses indicated the outcomes regarding to some indexes in different studies were inconsistent. Conclusion Based on the current evidence, pirarubicin or mitomycin bladder irrigation after TR can increase long-term cure rate and decrease long-term relapse rate in treating CG, but pirarubicin tends to easily cause bloody urine. For the inconsistent outcomes of different studies, the results of this meta-analysis are instable and highly possible to be inconsistent to the future outcomes, hereby it is uncertain of the better effectiveness of CBI after, TR compared with TR alone, and more high-quality and large-scale RCTs are needed to be performed.
Objective To investigate the association of the polymorphism of the cystathionine β synthase (CBS) T833C, CBS 844ins68 and cerebral arterial thrombosis in Chinese population. Methods We electronically searched CBM, CNKI, Wanfang database, VIP and PubMed from 1999 to February 2010 to collect case studies on CBS polymorphism and cerebral arterial thrombosis of the Chinese. We evaluated the quality of the included studies and the extracted data. RevMan 4.2 was used for meta-analyses. Results We identified 4 case-control studies on association of CBS T833 polymorphism and cerebral arterial thrombosis of the Chinese. In Shandong subgroup, the Chinese people with TC+CC genotypes of T833C had higher risk of cerebral arterial thrombosis at OR 5.01 and 95%CI 2.63 to 9.53 (Plt;0.000 01). In non-Shandong subgroup, higher risk of cerebral arterial thrombosis was found in the Chinese people with genotype of CT+CC at OR 0.95 and 95%CI 0.60 to 1.50 (P=0.82). Meta-analyses of the 4 case studies showed there were no significant differences in the risk of cerebral arterial thrombosis between people with genotype of DI and II and people with genotype of DD at OR 1.20 and 95%CI 0.72 to 1.99 (P=0.49). Conclusion Our findings suggest that in Chinese population, CBS T833C polymorphisms might be associated with cerebral arterial thrombosis in Shandong subgroup; 844ins68 polymorphisms does not increase the risk of cerebral arterial thrombosis for the Chinese.
Objective To evaluate the urine cytology silver staining combined with ultrasonography（USG）in the detection of bladder transitional cell carcinoma （TCC） recurrence after transurethral resection of bladder tumor（TURBT）in terms of sensitivity and specificity. Methods Cystoscopy was used as “gold standard”. Urine cytology combined with USG or cystoscopy was measured separately and blindly. AgNORs protein stained by silver were used in cytology with Kappa of inter-observers 0.81. For the USG, the patients were scanned with trans-rectal probe with Kappa of inter-observers 0.76. The results of urine cytology combined with USG （Positive when urine cytology and/or USG positive. Negative when both urine cytology and USG negative） were compared with “gold standard”. Results The 148 consecutive superficial TCC patients with TURBT one year previously were included in this study. Fifty seven recurrenced cases were detected. Recurrence rate was 38.51%. The sensitivity and specificity of urine cytology silver stain were 89.47% （95% CI 0.82 to 0.98） and 87.91% （95% CI 0.81 to 0.95）. Area under ROC curve was 82.22%. The sensitivity and specificity of USG were 57.90% （95% CI 0.45 to 0.71 ） and 90. 11% （ 95% CI 0.84 to 0.96）. Area under ROC curve was 73.13% . The sensitivity was improved to 94. 74% （95% CI 0.89 to 1.00） when cytology combined with USG. But specificity decreased to 84. 62% （95% CI 0.77 to 0.92 ）. Area under ROC curve was improved to 98.28%. Conclusions Urine cytology silver stain combined with USG improves the high sensitivity for follow-up TCC patients after TURBT. The non-invasive protocol is suggested.
Objective To discuss the surgical indication of mammotome （MMT） operation and its auxiliary diagnosis value on breast cysts. Methods Seventy-eight patients with breast cysts from May 2010 to November 2011 in this hospital were enrolled. Excision and biopsy were performed according to the following guidelines：Single cyst with inhomogeneous interna echoes and diameter at least 1 cm；Multiple cysts associated with irregular megalgia， localized thickening of breast or ineffective drug treatment after three months；High risk of breast cancer；Hypoechoic nodules and laticifers exaggerated cysts；Ultrasonography showed disorderly echo and abundant blood supply in glandular tissues around the lesions. The result of preoperative ultrasound was compared with that of postoperative pathology diagnosis. Results In these 78 breast cysts patients with preoperative ultrasound diagnosis， 40 cases were breast multiple cysts， 38 cases were multiple cysts plus untouchable hypoecho nodules；42 cases were high risk lesions， and the other 36 cases were low risk lesions. Postoperative pathology diagnosis revealed 27 cases of cystic hyperplasia， 2 cases of atypical hyperplasia， and 1 case of breast cancer in the ultrasonic high risk lesions， and 19 cases of cystic hyperplasia in the ultrasonic low risk lesions. Ultrasound diagnostic accuracy rate was 60.26%（47/78）， sensitivity was 61.22%（30/49）， and specificity was 58.62%（17/29）. The number of resection lesions was 13.00±8.16， the time of operation was （74.25±22.68） min. The average hospital stay was 1 d after surgery. The local hematoma occurred in 2 cases and no other complications occurred during one month of follow-up. Conclusions The guidelines of MMT protocoled according to clinical manifestation of breast cyst patients and imaging of high-frequency ultrasound in author’s department are simple and utility. Minimal excision and biopsy via MMT can confirm the histological type and help for early diagnosis of breast cancer and precancerous lesion. It is important and necessary to standardize the surgical indications of MMT in the clinical work.