Clinical significance of hysterography in the diagnosis of choriocarcinoma and invasive mole.

From 1963 through 1988, a total of 194 hysterographies were performed for 111 patients. Three types of abnormalities were observed on the hysterogram: filling defect, intramural invasion of the uterine wall by the contrast medium; and intravasation of the contrast medium into the pelvic veins. The pathology and clinical significance of three types of abnormalities were studied. The results showed that hysterography demonstrated better images than pelvic arteriography and B-scan for the diagnosis of choriocarcinoma and invasive mole, especially when combined with B-scan/or pelvic arteriography, a greater accuracy was achieved.

     

Evaluation of domestic plasma (1 -3)-β-D-glucan detection reagent in diagnosis of invasive fungal disease

目的 观察国产血浆(1-3)-β-D葡聚糖检测试剂对侵袭性真菌病(IFD)的诊断效果.方法 筛选2009年4月-2011年6月上海交通大学医学院附属新华医院疑似IFD病例,根据欧洲癌症研究和治疗组织/真菌病研究组(EORTC/MSG)的IFD诊断标准定义,甄选出57例确诊IFD和6例拟诊IFD的真阳性病例为IFD组,100例非IFD真阴性病例为对照组,应用国产血浆(1-3)-β-D葡聚糖检测试剂定量检测血浆中(1-3)-β-D葡聚糖的质量浓度,并进行组间比较.绘制受试者工作特征(ROC)曲线,分析利用血浆(1-3)-β-D葡聚糖水平诊断IFD的最佳临界值.结果 两组的血浆(1-3)-β-D葡聚糖水平皆为非正态分布,峰度系数＞0、偏度系数＞0,呈正偏态分布.对照组和IFD组血浆(1-3)-β-D葡聚糖质量浓度分别为(33.62±5.0) pg/mL和(373.82±125.5) pg/mL,两组比较差异有统计学意义(P＜0.001).ROC曲线分析结果显示:血浆(1-3)-β-D葡聚糖用于诊断IFD的最佳临界值为20.85,曲线下面积最大为0.857(P ＜0.05),95％ CI 0.792～0.923,灵敏度和特异度分别为77.8％和86.0％.结论 国产血浆(1-3)-β-D葡聚糖检测试剂对于IFD具有诊断应用价值.     

The value of PAPP-A in the diagnosis and prognosis of GTD

Objective: To investigate the value of PAPP-A (pregnancy assouated plasma protein-A) in the diagnosis and prognosis of gestational trophoblastic disease (GTD). Methods: The serum β-HCG (β-human chorionic gonadotropin) and PAPP-A levels of 25 normal pregnant women, 28 patients with complete hydatidiform mole and 38 patients with invasive mole were measured by enzyme linked immunosorbent assay (ELISA) during the periods of diagnosis, treatment and follow-up. Results: Compared with control group, patients with complete mole and invasive mole had higher levels of β-HCG (P ＜ 0.01 ). But there was no significant difference between the complete and invasive mole group (P ＞ 0.05). The PAPP-A level of complete mole group was significantly higher than that of control group (P ＜ 0.01). The PAPP-A level of invasive mole group was significantly higher than that of complete mole group and control group(P ＜ 0.05). In complete mole group, serum β-HCG and PAPP-A levels of the patients with malignant sequelae were significantly higher than those with benign sequelae (P ＜ 0.05). The β-HCG level had no relationship with the clinical stage of invasive mole. However, the PAPP-A level increased with clinical advancement of invasive mole. The levels of β-HCG and PAPP-A gradually decreased after evacuation in patients with complete moles, but maintained positive or even increased in patients with subsequent malignancy. Conclusion: The PAPP-A level can give us some help not only in early diagnosis of hydatidiform mole and invasive mole, but also in the prognosis of malignant sequelae.     

Speciation of fungi using real time PCR with molecular beacons: Can we solve the enigma of diagnosis of invasive fungal disease?

BackgroundInvasive fungal diseases (IFDs) are difficult to diagnose and associated with high mortality rates, especially in the immunosuppressed. Species of Aspergillus and Candida are the cause of majority of invasive fungal disease however IFDs are also caused by Fusarium, Zygomycetes, Trichosporon, etc. Early detection is crucial for appropriate antifungal therapy. Blood cultures usually fail to isolate filamentous fungi, while detection of circulating beta-d-glucan or galactomannan antigens show variable sensitivity and specificity. There is a need of reliable, sensitive and specific diagnostic tests for IFDs.MethodsA real-time Polymerase Chain Reaction (PCR) assay with a universal primer/molecular beacon system was developed for detecting and speciating most of the pathogenic fungi implicated in IFD. A single-reaction assay was designed targeting a carefully selected region of the ITS2 and ITS5 subunits of the fungal rDNA gene along with four molecular beacons capable of differential hybridization to the amplicons of different species. This generated a signature set of melting temperatures using the standard strains. The assay was tested on clinical specimens from patients with suspected invasive fungal disease.ResultsThe assay was tested on 72 clinical samples and 72 healthy controls. Of these, 22 clinical samples (6/8 proven; 13/29 probable; 3/35 possible IFD, classified by the EORTC/MSG criteria) were positive by PCR and generated a set of melting temperatures enabling identification of the causative fungus. The assay was negative in all healthy controls.ConclusionThe molecular beacon assay is a promising tool providing a rapid method for detection and monitoring of invasive fungal disease in immunosuppressed patients.     

Comparison of Coombs’and mmunocapture-agglutination tests in the diagnosis of brucellosis

BrucellosisisanimportantzoonoticdiseasecausedbybacteriaofthegenusBrucellaencounteredinanimalssuchascows, sheep, goatsandpigsaswellasinhumans Itisoneofthemostwidelyseeninfectionsandnearlyhalfamillioncasesaredeclaredannually EndemicinfectionsoccurespeciallyintheMediterranean,MiddleEast, LatinAmericaandAsia 1　Seropositivenessratiosvarybetween 2% and 12% inTurkey 2 　TheaverageannualnumberofcasesdeclaredtotheTurkishMinistryofHealthbetween1991and2000was9000 3Differentclinicaloutcomesareobserv…     

Comparison of Coombs’ and immunocapture-agglutination tests in the diagnosis of brucellosis

Brucellosis is an important zoonotic disease caused by bacteria of the genus Brucella encountered in animals such as cows, sheep, goats and pigs as well as in humans. It is one of the most widely seen infections and nearly half a million cases are declared annually. Endemic infections occur especially in the Mediterranean, Middle East, Latin America and Asia.     

Clinical significance of survivin in the diagnosis and prognosis of endometrial carcinoma

Objective： To investigate the clinical significance of survivin in endometrial carcinoma and to investigate the relationship between the expression of survivin and Ki-67. Methods： Immunohistochemical S-P （streptavidin-biotin-peroxidase complex）method was performed to detect the expression of survivin and Ki-67 antigen in 15 cases of normal endometrium, 21 cases of endometrial simple and complex hyperplasia, 22 cases of endometrial atypical hyperplasia, and 61 cases of endometrial carcinoma. Results： Survivin was hardly detected in some normal endometrium in the proliferative phase and in the secretory phase. However, the level of survivin expression in atypical hyperplasia endometrium（72.73%）was higher than that in normal en- dometrium （7.14%）（P 〈 0.05）, including simple and complex hyperplasia （42.38%）（P 〈 0.01 ）, and was lower than that in endometrial carcinoma（90.17%）（P 〈 0.05）. Moreover, significant correlation was present between the expression of survivin and the characteristics of endometrial carcinoma, including clinical stage, histological grade and the presence of invasion to myometrium （P 〈 0.05）. In addition, Ki-67 antigen expression was positively correlated with survivin expression in all specimen. Ki-67 labeled indexes （LIs）in hyperplasia endometrium were significantly lower than those in atypical hyperplasia endometrium and endometrial carcinoma （P 〈 0.01 ）, while there was no significant difference in Ki-67 LIs between atypical hyperplasia endometrium and endometrial carcinoma（P 〉 0.05）. There was no significant relationship between Ki-67 LIs and the characteristics of endometrial carcinoma, including histological grade, clinical stage or the invasion to myometrium（P 〉 0.05）. Conclusion： Survivin may participate in the onset and progression of endometrial carcinoma through inhibiting apoptosis and promoting proliferation. Survivin expression is correlated with the malignant degree and prognosis of tumor. Ki-67 is also associated with carcinogenesis and progression of endometrial carcinoma. The results suggest that survivin could be a diagnostic and prognostic marker for endometrial carcinoma and might provide pathways to treat the patients with recurrent or refractory or rudimental endometrial carcinoma.     

Mucins in the diagnosis and differential diagnosis of pancreatic cystic neoplasms: report of 40 cases

Cystic neoplasms of the pancreas account for 10% to 15% of all cystic pancreatic lesions.The majority （85% to 90%） of cystic lesions of the pancreas are pseudocysts. Although cystic neoplasms of the pancreas are rare, they range from benign to malignant neoplasms. The clinical challenge is the differential diagnosis and management of the cystic neoplasms, which represent 10% to 25% of primary pancreatic neoplasms. Pancreatic neoplasms and tumour like lesions with cystic features have been recently reviewed. The incidence of pancreatic cystic neoplasms reported is variable. Because there is no large, systematic study on tne cases from China comparing the incidence and biology of cystic neoplasms of pancreas to that of Western series, we reviewed all the cases of cystic neoplasms from Zhongshan Hospital over 6 years. Most of the neoplasms in our series were classified according to the recent World Health Organization （WHO） classification.     

Current means in the diagnosis and treatment of oral and maxillofacial tumors in China.

Oral and maxillofacial tumors (OMT) constitute a great number in tumors of head and neck as a whole. The incidence of OMT in China is rather low. but. owing to our big population, the absolute number of the patients is high. The diagnosis and treatment of OMT in China with special emphasis on malignancies are briefly introduced below.     

Endoscopic ultrasonography and submucosal resection in the diagnosis and treatment of rectal carcinoid tumors

Rectal carcinoid tumors are often diagnosed as .submucosal tumors on radiological or endoscopic examinations. Usually, its definite size and character, the infiltration of muscularis propria and vessels can not be correctly diagnosed preoperatively. In recent years, endoscopic ultrasonography （EUS） has been used in the diagnosis of submucosal tumors of the gastrointestinal tracts , Conventional endoscopic polypectomy allows local excision of local tumors, but is often associated with tumor involvement of the resection margin necessitates further interventions.[第一段]     

Significance of aberrant melanosomes in the diagnosis of malignant melanoma

In order to clarify the significance of the aberrant melanosomes in thediagnosis of malignant melanoma,17 cases of malignant melanoma were studied with elec-tron microscopy,and 30 cases of nevus were studied likewise for comparison.Aberrantmelanosomes were present in 12 cases of pigmented and 2 cases of amelanotic malignantmelanoma.They were also found in 4 cases of congenital nevus.The findings suggest thatthe presence of aberrant melanosomes is of significance for the diagnosis of malignantmelanoma but this has been overemphasized.It is believed that the diagnosis of malignantmelanoma depends upon a comprehensive judgement of all the ultrastructural findings un-der electron microscopy.     

Characterization of the highly invasive subline of the human rectal adenocarcinoma in vitro

Ｃｈａｒａｃｔｅｒｉｚａｔｉｏｎｏｆｔｈｅｈｉｇｈｌｙｉｎｖａｓｉｖｅｓｕｂｌｉｎｅｏｆｔｈｅｈｕｍａｎｒｅｃｔａｌａｄｅｎｏｃａｒｃｉｎｏｍａｉｎｖｉｔｒｏ￥ＬｉＸｕｅｎｏｎｇ（李学农）；ＺｈｕＭｅｉｇａｎｇ（朱梅钢）；ＬｉＣｈｕｎｄｅ（李春德）（...     

Role of MR imaging in the diagnosis of intracranial germinoma

Objective: To investigate the role of MRI in the diagnosis of intracranial germinoma. Methods: MRI features of 19 cases of intracranial germinoma confirmed by operations and pathological findings were analyzed retrospectively. Results: Germinomas were found in the seUar region in 10 patients (including 5 males and 5 females), in the pineal region in 6 and in the thalamus and basal ganglia in 3, the 9 patients in the latter 2 groups all being males. The characteristic MRI findings of intracranial germinomas were as follows : ( 1 ) Lesions were isointense or slightly hypointense on TlWI while isointense or slightly hyperintense on T2WI. The germinomas in the seUar region and pineal region showed no edema, but lesions in the thalamus basal ganglia showed mild to moderate edema and space-occupying effects. (2) Homogeneous or inhomogeneous Gd-DTPA enhancement were seen in most of the tumors. Conclusion:Muhiaxial imaging and Gd-DTPA enhancement in MRI are helpful in the diagnosis and differentiation of intracranial germinomas on the basis of the patients gender, the location of the tumor and its imaging characteristics.     

An update of molecular pathogenesis and diagnosis of myeloproliferative disorders in the JAK2 era

Myeloproliferative disorders （MPD） are clonal haematopoietic stem cell disorders characterized by proliferation of one or more myeloid cell lineages in the bone marrow and increased numbers of mature and immature cells in the peripheral blood. MPDs are classified into five categories： polycythemia vera （PV）, essential thrombocythaemia （ET）, idiopathic myelofibrosis （IMF）, chronic myelogenous leukaemia （CML） and atypical MPD. The atypical MPD includes chronic myelomonocytic leukaemia, juvenile myelomonocytic leukaemia, chronic neutrophilic leukaemia, chronic eosinophilic leukaemia, chronic basophilic leukaemia, hypereosinophilic syndrome, systemic mastocytosis, atypical CML and unclassifiable cases.1-3 Apart from the Philadelphia chromosome and BCR-ABL fusion gene as the characteristic genetic abnormality of CML, the molecular pathogenesis of most MPDs such as PV, ET and IMF has not been described. Nonspecific cytogenetic abnormalities were found at diagnosis in numerous patients including deletions of the long arms of chromosome 20 and chromosome 13,     

Validation of the China’s maternal and child mortality surveillance in the diagnosis of infant deaths in two counties in Guizhou Province

The infant mortality rate in China declined from 50.2‰ to 13.8‰ between 1991 and 2009.1 Although China has made good progress,there were still about 190 thousand infants who died in 2009.Reliable birth and death registration and the causes of death in populations are essential for public health planning.The National Maternal and Child Mortality Surveillance System （MCMS） is the major system to register maternal and infant deaths.It samples 126 districts and 210 counties,totally 336 sites,covering 12% of counties and 9% of the population.Causes of deaths are determined by the attending clinician.For those who die out hospital or clinic,a community health provider will be asked to visit that family and make a decision as to the cause of death.     

Study of hypoechoic nodule diagnosis of BPH in outer gland of the prostate by TRUS and autopsy

Study of hypoechoic nodule diagnosis of BPH in outer gland of the prostate by TRUS and autopsy@汪娜$Dept Ultrasound,Gener Hosp PLA,Beijing 100853     

Use of MG series monoclonal antibodies in the diagnosis and experimental targeting therapy of gastric cancer

In order to facilitate carly diagnosis and improve the treatment of gastric cancer, 12 murine hybridoma cell linescapable of producing monoclonal antibodies (mAb) against gastric cancer were established These monoclonalantibodies were used in histopathological diagnosis, cytological and serological diagnosis, andradioimmunoimaging (RII). Also, immunoconjugates and immunoliposomcs were by linking these     

Comparison of seven screening methods in the diagnosis of bladder cancer

Background We compared the validity （evaluated by sensitivity and specificity）, reliability （evaluated by reproducibility） and yield （evaluated by predictive value, examining complexity and cost） of individual and combined tests for bladder tumour antigen stat （BTAstat）, nuclear matrix protein 22 （NMP22）, hyaluronic acid （HA）, survivin, CD44v6, vascular endothelial growth factor （VEGF）, and voided urine cytology （VUC） in detecting bladder cancer. And at the same time we evaluated the clinical value of these seven detecting methods in the diagnosis of bladder cancer. Methods The six markers and VUC were detected in the urine of cancer group （151 patients with bladder cancer） and two control groups （50 patients with benign urological diseases and 50 healthy controls）. The sensitivity, specificity, predictive value, reproducibility, examining complexity and checking cost of each marker and combined markers were calculated. Results There was a significant difference between bladder cancer group and the two control groups. The sensitivity, specificity and positive predictive value were as follows： VUC （36.4%, 100.0%, 100%）, BTAstat （76.8%, 87.0%, 89.9%）, NMP22 （77.5%, 81.0%, 86.0%）, HA （82.8%, 83.0%, 88.0%）, survivin （70.2%, 85.0%, 87.6%）, CD44v6 （50.3%, 79.0%, 78.4%）, and VEGF （68.2%, 93.0%, 93.6%）. The highest sensitivities were 91.4% for NMP22＋BTAstat and HA＋NMP22, whereas the combined marker with the lowest sensitivity （62.3%） was VUC＋CD44v6. The highest specificity was 93.0% for the combined use of VUC＋VEGF and HA＋CD44v6 had the lowest specificity （73.0%）. The most convenient examining method was the detection for BTAstat, the lowest cost was the detection for HA, and the best reproducibility were the detection for BTAstat and VUC. Conclusions All the markers have obvious clinical value in diagnosis of bladder cancer. The use of BTAstat＋HA or NMP22＋BTAstat are better examining methods in terms of validity, reliability, and yield.