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Objective To investigate the clinical correlative factors and CT pulmonary angiography (CTPA) characteristics of secondary changes of chest in different types of acute pulmonary embolism. Methods One hundred and fifty-two cases with acute pulmonary embolism diagnosed by CTPA between January 2015 and October 2016 were retrospectively analyzed.They were divided into central(70 cases)and peripheral (82 cases) groups according to the embolization site. The clinical characteristics (including gender, age, risk stratification, etc.), laboratory findings (including D-dimer, etc.) and secondary imaging findings(including enlargement of the main pulmonary artery and enlargement of right heart,etc.)of the two groups were recorded. The parameters including patient age, body mass index, length of hospital stay and laboratory findings between the two groups were compared using independent sample t test or Mann-Whitney U test. The other variables including the clinical characteristics such as gender, smoking history, etc. and secondary imaging findings between the two groups were analyzed by χ2 test and Fisher exact test.Results The high,moderate and low-risk patients were 7,33,30 cases,respectively in the central group,and 2,16, 64 cases, respectively in the peripheral group. The percentages of moderate and high-risk patients in the central group were higher than peripheral group,the difference of risk stratification between the two groups was statistically significant(P<0.001).In the choice of clinical treatment,there were 5 cases of thrombolytic therapy in the central group and 0 cases in the peripheral group, and the difference was statistically significant (P= 0.019). The other differences of clinical characteristics such as gender and age were not statistically significant(P>0.05).The cardiac troponin I was 0.03(0.01,0.11)μg/L in the central group and 0.01 (0,0.04) μg/L in the peripheral group, and the difference was statistically significant (Z=-2.799, P=0.005).The other laboratory findings such as D-dimer were not statistically significant between the two groups (P>0.05). Among the various secondary changes of the chest on CTPA, the cases of enlargement of the main pulmonary artery,enlargement of right heart,pulmonary infarction,mosaic perfusion were 47,41, 23, 24 cases, respectively in the central group, and 20, 11, 11, 15 cases, respectively in the peripheral group.The percentages of these signs were higher in the central group than peripheral group,the differences were statistically significant (χ2= 28.002,34.214,8.221,5.064, P<0.05). Conclusions Central acute pulmonary embolism is more dangerous and more likely to cause a series of secondary changes.Determining the type of embolism has certain value for clinical doctors to judge the prognosis and choose the treatment.
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A 53-year-old male patient was admitted to the hospital on March 26, 2006. Ten years prior to the presentation, a small furuncle developed on the dorsum of his right hand, and subsided after 2-week treatment with erythromycin ointment; one month later, a broadbean-sized cutaneous ulcer developed on the dorsum of the same hand. After anti-infective treatment, the ulcer healed while the lesional skin thickened, and long-term topical treatment with compound dexamethasone acetate cream showed no obvious effect Dermatological examination revealed an irregular verrucous plaque measuring 2.5 cm × 4 cm with little exudation on the dorsum of the right hand. KOH preparation of the skin lesion revealed brown spores. Sabouraud's dextrose agar culture grew restricted, velvety and dark green colony, and microscopy revealed branched, globular conidiophores generated by cladospores. DNA sequencing showed that the isolate was different from Cladosporium sphaerospermum (AB100654) by 2 bases in the sequence of D1/D2 region of 26S rDNA, from Cladosporium sphaerospermum (AY625063) by 5 bases in the sequence of internal transcribed spacer 1 and 2 (ITS 1 and ITS 2), but fully consistent with Cladosporium sphaerospermum (AM 176719) in the sequence of ITS region. The isolate was identified as Cladosporium sphaerospermum. Hematoxylin-eosin stain of the lesional tissue revealed granulomatous changes,and PAS stain demonstrated brown spores. A diagnosis of phaeohyphomycosis was made. Antifungal susceptibility testing indicated that the isolate was highly sensitive to itraconazole. The lesion obviously subsided after treatment with oral itraconazole 0.2 g once daily for 8 weeks, but the patient was lost to follow up 2 months later.
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Objective To investigate the effect of different concentrations of arsenic trioxide (As2O3,ATO) on neurokinin A (NKA) in renal tissue of BXSB mice and explore its clinical value.Methods Fifty BXSB mice (twelve weeks old and weighted 23～26 g) were randomly divided into control group,systemic lupus erythematosus (SLE) group,and therapeutic group of three different concentrations of ATO.All biochemical indicators were analyzed before and after treatment.The pathology of renal tissue was examined by immunohistochemistry.The concentration of NKA in renal tissues was detected by ELISA and the concentration of NKA mRNA was detected by RT-PCR.Results The concentration of NKA in SLE group in renal tissue (299±26) pg/g was significantly higher than that of normal control group (122±7) pg/g (P＜0.05).The concentration of NKA in the SLE group in renal tissue was significantly higher than that of three different concentrations of ATO in low-dose group (151±14) pg/g,moderate--dose group (147±9) pg/g and in highdose group (155±14) pg/g (P＜0.05).No difference was found between three different dosages of ATO treatment groups and normal control groups (P＞0.05).There were no significant differences among three different dosages of ATO treatment group (P＞0.05).The side effects in low-dose group were significantly lower than those of moderate and high-dosage groups (P＜0.05).Conclustion NKA concentration expressed in the renal tissues in the SLE group is higher than that in the control group.Decreasing the concentrations of NKA mRNA in renal tissues may be one of the important mechanisms of ATO in treating SLE.Low-dosage ATO is safe and effective to treat SLE and has therapeutic potentials.
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Objective To investigate the effect of meridian point cosmetic therapy of traditional Chinese medicine(TCM)on acne.Methods 80 cases of acne patients were selected and divided into the treatment group(50 cases)and the control group(30 cases).The treatment group was given medication by differentiation of symptoms and signs and designed a complete treatment scheme by the demonstration of health analysis curve through test by balanced cosmetic equipment and meridian point of TCM.The control group only received extravenous medication.The effect of the two groups was observed after 2 months' treatment.Results The total effeetive rate in the treatment group was 94.0%,which was superior to that of the control group(73.3%),x2=11.08,P＜0.05. Conclusion Application of meridian point cosmetic therapy of TCM could facilitated the diagnosis and treatment by differentiation of symptoms and signs and thus improve the curing rate.
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Objective To observe the changes of mononuclear cell (MNCs) apoptosis and the level of inflammatory cytokines and adhesion molecules in patients with systemic lupus erythematosus (SLE) and to study the relationship between them. Methods The apoptosis of MNCs in 22 patients with SLE at the active stage and 10 patients with SLE at remission and 10 healthy controls were determined with flow cytometry. The inflammatory cytokines and the adhesion molecules were tested with ELISA method. Results The percentage of MNCs apoptosis in the patients with SLE at the active stage was significantly lower than that of healthy con- trols and the patients with SLE at remission. There was no significance difference of MNCs apoptosis between healthy controls and patients with SLE at remission. The levels of IL- 8, TNF-?, IL- 6 , NO, P- sel and ICAM- 1 in patients with SLE at the active stage were significantly higher than that of healthy controls and the pa- tients with SLE at remission, and the increased levels of inflammatory cytokines and adhesion molecules in ac- tive SLE patients were negatively correlated to the percentage of MNCs apoptosis and positively correlated to the severity of SLE. Conclusion The data demonstrates that there is a promote apoptotic process of MNCs in active SLE. The high expression of inflammatory cytokines and adhesion molecules may play an important role of promoting MNCs apoptosis which reduces the functional life span of MNCs. For this reason, modulating the expression of cytokines and adhesion molecules and moderately controlling the apoptosis of MNCs may be a new therapeutic target for SLE treatment.
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Objective To study the relationship between cell apoptosis and mRNA expression of c-fos and BNIPl in cutaneous squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). Methods Cell apoptosis and mRNA expression of c-fos and BNIP1 in 48 SCCs and 41 BCCs were determined by TUNEL and in situ hybridization, respectively. Results Apoptosis index (AI) and c-fos mRNA expression in SCCs were higher than those in BCCs (P 0.05). AI was significantly higher in well-differentiated SCCs than in poorly differentiated SCCs (P
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Objective To explore relationship between the changes of mononuclear cells (MNCS) apoptosis and the levels of inflammatory cytokines and adhesion molecules in patients with systemic lupus erythematosus(SLE). Methods The apoptotic rates of MNCS in 32 patients with SLE and 10 healthy subjects were detected with flow cytometry, and the plasma levels of inflammatory cytokines(IL-8, IL-6,TNF-? and NO) and adhesion molecules(P-Sel, ICAM-1) were assayed with ELISA. Results The percentage of MNCS apoptosis in the patients with active stage of SLE was obviously higher than that in healthy subjects and patients with remission stage of SLE, and there was no significant difference in the percentage of MNCS apoptosis between healthy subjects and patients with remission stage of SLE. The levels of plasma IL-8, TNF-?, IL-6, NO, P-sel and ICAM-1 in patients with active stage of SLE were significantly higher than those in healthy subjects and the patients with remission stage of SLE, and were positively correlated with the percentage of MNCS apoptosis and the severity of SLE.There was no significant difference in the levels of plasma inflammatory cytokines and adhesion molecules between patients with remission stage of SLE and healthy subjects. Conclusion The apoptotic rate of MNCS increased in the patients with active SLE, and was closely associated with the severity and efficacy of SLE. The high expressions of inflammatory cytokines and adhesion molecules may be the reason of MNCS apoptotic increase. Appropriately regulating the expression of cytokines and adhesion molecules, and moderately controlling the apoptosis of MNCS may improve the prognosis of SLE.