Prediction of Pulmonary Disease Progression in Patients with COVID-19 Based on CT Radiomics / 中山大学学报(医学科学版)

ObjectivesBased on the changes of lung lesions in patients with COVID-19 at different stages， a nomogram model describing CT image features was established by radiomics method to explore its efficacy in predicting the progression of the disease. MethodsThis retrospective study enrolled 136 patients with COVID-19 pneumonia who received at least two CTs including three cohorts （training cohort and validation cohort 1 and 2）. Patients in the training cohort were divided into three groups according to time between onset of fever symptoms and the first CT. The clinical manifestations and CT features of each group were analyzed and compared. A nomogram to predict disease progression was constructed according to the CT features of the patients， and its performance was evaluated. ResultsThe training cohort consisted of 41 patients.A nomogram was generated to predict disease progression based on three CT features： irregular strip shadow， air bronchial sign， and the proportion of lesions with irregular shape ≥50%. AUC（95%CI）=0.906（0.817，0.995）.The C index of the training cohort was 0.906， and the C index of the internal verification was 0.892. AUC（95%CI）of the validation cohort 1 （34 cases） =0.889（0.793，0.984）；AUC（95%CI）of the validation cohort 2 （61 cases）=0.876（0.706，1.000）.The calibration curves show that the predicted values of the nomogram are in good agreement with the observed values. ConclusionThe nomogram model based on CT radiomics can predict the outcome of lung lesions in patients with high sensitivity and specificity.According to the changes of CT image characteristics of patients with COVID-19， lung lesions will be improved when the proportion of irregular cable shadow， air bronchogram and irregular lesions is greater than 50%.

Treatment of floating knee injury in children with elastic intramedullary nail / 中国骨伤

OBJECTIVE@#To observe the clinical effect of elastic intramedullary nail in minimally invasive treatment of floating knee injury in children.@*METHODS@#From January 2009 to September 2017, 11 children with floating knee injury were treated with one-off open reduction and elastic intramedullary nail or external fixator fixation, including 7 males and 4 females, aged 5.0 to 11.0 years, with an average age of 8.3 years. The treatment results were evaluated according to karlstrom's standard.@*RESULTS@#Eleven patients were followed up for 8 to 48 months, with an average of 28 months. All the fractures healed at one time, and there were no complications such as nonunion, malunion and serious dysfunction of knee joint. The length of the affected limb in 2 cases was 1.2 to 1.5 cm longer than that in the opposite side without shortening. According to Karlstrom scoring standard, 8 cases were excellent, 1 case was good and 2 cases were middle.@*CONCLUSION@#Elastic intramedullary nail minimally invasive treatment of floating knee injury in children is a safe and effective treatment, which can effectively reduce the fracture and promote bone healing, which is conducive to early functional recovery.

Ultrasound-guided minimal traverse-cross technique repair for acute closed Achilles tendon ruptures / 中国骨伤

OBJECTIVE@#To explore clinical effects of ultrasound-guided minimal traverse-cross technique repair for acute closed Achilles tendon ruptures.@*METHODS@#From January 2015 to March 2017, 20 patients with acute closed Achilles tendon rupture were treated by minimal traverse-cross technique repair with ultrasound guided. Among them, including 13 males and 7 females, aged from 28 to 49 years old with an average of(31.3 ±4.5) years old. All patients were single side injury. Fifteen patients on the left side and 5 patients were on the right side. The time from injury to operation ranged from 1 to 5 days with an average of (2.5±0.7) days. Operative time, postoperative complications were observed, and AOFAS score before and after operation at 12 months were compared.@*RESULTS@#All patients were followed up for 12 to 27 months with an average of(15.2±4.9) months. Operative time ranged from 33 to 65 min with an average of(43.7±5.6) min. Incision of one patient were continued oozing and improved after changing dressings, other patients were healed at stage I. No sural nerve irritation symptoms and palindromic rapture of heel tendon occurred. AOFAS score was improved from 65.2±7.4 before operation to 97.7±4.7 after operation at 12 months (t=22.5, <0.01); 18 patients got excellent results and 2 good.@*CONCLUSIONS@#Ultrasound-guided minimal traverse-cross technique repair for acute closed Achilles tendon ruptures, which promise minimal incision, protect sural nerve, ensure quality of tendon anastomosis and fixation, and is a ideal method for repairing acute closed Achilles tendon ruptures.

Affected Factors of Separating Erythrocytes by Discontinuous of Density Gradient Centrifugation / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To study the affected factors of the separation of red blood cells by discontinuous density gradient method, and to establish the optimal operating conditions of percoll for the separation of erythrocytes.</p><p><b>METHODS</b>The osmolality of different ratio of Percoll and 1.5 mol/L NaCl were 9:1, 10:1, 11:1, 12:1, 13:1 ratio, was detected respectively. The isotonic osmolality ratio was selected as optimum stock isotonic Percoll solution(SIP). Evaluation criteria: All the different density cells were separated sufficiently by centrifugation, there is little red cell retention and entrainment phenomena. The separation efficacy of different red cell suspension concentration, different centrifugal force, different centrifugal speed, different temperature and different time were compared.</p><p><b>RESULTS</b>The separation efficacy of red cell suspension concentration which not exceed 50% was better than above 50%, efficacy of 4 000×g was superior to 3 000×g and 2 000×g, 2-8 centrifugal acceleration and deceleration centrifugal could obtain the satisfactory efficacy, the 4 °C layered effect was more stable than room temperature, the separation effect of 20 min was better than 15 min and 10 min.</p><p><b>CONCLUSION</b>Percoll and 1.5 mol/L NaCl 12:1 to 11:1 can be used as stock isotonic percoll solution, preferentially selected 4 °C as centrifugal conditions. When conditions of separation was satisfied, the centrifugal acceleration and deceleration is 2-8, the optimal centrifugal effect can be obtained with the decrease of erythrocyte suspension concentration, with centrifugation time prolonging and centrifugal force increasing.</p>

Research achievements on biological activities of calycosin / 中国中药杂志

Calycosin, which is a kind of typical phytoestrogen, can bind with estrogen receptor and produce estrogen-like effects. Calycosin were reported to have antioxidant, anti-osteoporosis, anti-tumor and immunomodulating activities. This review covers biological activities and its mechanism of calycosin. It will provide a useful reference for clinical research and rational utilization of monomericompound.

Mini-open repair for the treatment of acute closed achilles tendon ruptures / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy of mini-open repair for the treatment of acute closed achilles tendon ruptures.</p><p><b>METHODS</b>From April 2012 and October 2013,14 patients (14 feet) with acute closed achilles tendon ruptures were treated in our department. They were 9 males and 5 females, with an average age of 30.5 years old (ranged, 25 to 49 years old). The interval between injury and operation ranged from 1 to 13 days (8 days on average). A longitudinal incision approximately 1.5 to 2.0 cm in length was made around the ruptured achilles tendon for mini-open repair after insertion of oval clamp. Postoperative rehabilitation was carried out.</p><p><b>RESULTS</b>The wounds healed at the first stage except 2 cases with slow recovery. All the patients were followed up for 6 to 24 months, with an average of 11 months. According to the ankle-hindfoot scoring system of American Orthopaedic Foot & Ankle Society (AOFAS),the score was 92.71 ± 6.58 (82 to 100).</p><p><b>CONCLUSION</b>The surgical treatment of acute achilles tendon rupture with mini-open repair has advantages of little invasion, a low rate of incision problems, quick function recovery, and simple operation, and it is suitable for primary hospital.</p>

The lateral superior genicular artery perforator iliotibial band flap for the treatment of scar contraction of popliteal fossa / 中国骨伤

<p><b>OBJECTIVE</b>To discuss clinical results of the lateral superior genicular artery perforator iliotibial band flap for the treatment of scar contracture of popliteal fossa.</p><p><b>METHODS</b>Form January 1999 to December 2011, 11 patients with scar contraction of popliteal fossa were treated with the lateral superior genicular artery perforator iliotibial band flap. Among the patients, 7 patients were male and 4 patients were female,ranging in age from 24 to 58 years old,with an average of 33 years old. The operation time ranged from 3 months to 1 year after trauma. Eight patients had injuries in the right side and 3 patients had the injuries in the left. Five patients had the injuries caused by traffic,3 patients had the injuries caused by hot compression and other 3 patients suffered from burns. The flap area ranged from 7.0 cm x 4.0 cm to 20.0 cm x 8.0 cm.</p><p><b>RESULTS</b>All the flaps survived. Three patients had epidermis necrosis. After 5 months to 2 years follow-up period,the knee function recovered,the flap shape was favorable and the skin firmness was moderated.</p><p><b>CONCLUSION</b>The lateral superior genicular artery perforator iliotibial band flap is a practical, simple and an ideal donor in the reconstruction of popliteal fossa scar contracture.</p>

Clinical applications of sternoclavicular hook plate for the treatment of sternoclavicular joint dislocation / 中国骨伤

<p><b>OBJECTIVE</b>To observe the clinical therapeutic effects of sternoclavicular hook plate for the treatment of sternoclavicular joint dislocation.</p><p><b>METHODS</b>From June 2010 to June 2012, 7 patients with sternoclavicular joint dislocation were treated with sternoclavicular hook plate fixation. Among the 7 patients, 5 patients were male and 2 patients were female, and the average age was 42.3 years, ranging from 38 to 54 years. The course of the disease ranged from 1 to 4 weeks. All the patients had trauma history. The clinical manifestations included: obvious swelling and pain of sternoclavicular joint, restricted shoulder joint activity. The sternoclavicular joint dislocation was proved by preoperative X-ray and CT. The postoperative curative effect was evaluated according to Rockwood scoring method.</p><p><b>RESULTS</b>According to Rockwood scoring method, the excellent results obtained in 6 cases, good in 1. There were no complications such as internal fixation loosening or broken, second dislocation, pain in the sternoclavicular joint, and deformity. The function of shoulder joint was good, and the limb activity was free and no pain appeared.</p><p><b>CONCLUSION</b>The sternoclavicular hook plate for the treatment of sternoclavicular joint dislocation has follow advantages: simple procedure, stable fixation, definite therapeutic effects.</p>

Treatment of atlantoaxial instability with C1-C2 posterior transarticular screw fixation / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the technique of C1-C2 transarticular screw fixation for atlantoaxial instability or dislocation.</p><p><b>METHODS</b>Among 14 patients with atlantoaxial instability, 10 were male and 4 patients were female, with an average age of 38.6 years ranging from 17 to 62 years. All patients were treated by internal fixation with transarticular screws.</p><p><b>RESULTS</b>There were 28 screws applied in 14 patients. All patients were followed up. The average follow-up period was 16 months (range, 9 to 35 months). The postoperative JOA score was ranging from 13.8 to 15.8 with the average score of (14.50 +/- 0.66) and the improved rate of (76.12 +/- 4.94)%. No spinal injury and vertical artery injury was found and osseous fusion was completed in all patients.</p><p><b>CONCLUSION</b>The technique of C1-C2 transarticular screw fixation is one of the best treatments for atlantoaxial instability. Without the help of structural bone graft and aided internal fixation, morselized cancellous bone graft can acquire effective osseous fusion.</p>

Slide platelet aggregation test used as a monitor for patient treated with anti-pletelet drugs / 中国实验血液学杂志

The aim was to verify the effectiveness of slide platelet aggregation test (SPAT) to monitor the inhibition effect of anti-platelet drugs. A group of eight healthy volunteers was examined for SPAT value and T(50) (time necessary for reaching 50% of total aggregation) induced by ADP, arachidonic acid (AA) and cationic propyl gallate (c-PG) respectively before and after administration of ASA in dose of 100 mg/day for 3 days. The group of 41 inpatients at the Department of Cardiovascular Disease treated with anti-platelet drugs and the group of 327 healthy blood donors were also examined for SPAT. The SPAT value of healthy volunteer samples stored at room temperature were measured hourly for four hours. The results showed that: (1) no significant difference was detected between the T(50) before and after ASA administration in health volunteer group when ADP was used as inducer, but a significant difference was detected in this group when AA or c-PG was used as inducer. There was significant linear correlation between SPAT value and T(50) induced by c-PG in health volunteer group before and after administration of ASA (r = 0.998, P = 0.000); (2) there was no significant difference between the SPAT value of health volunteer group before administration of ASA and the SPAT value of health blood donors group (P = 0.853), but there was a significant difference between the SPAT values before and after administration of ASA in health volunteer group (P = 0.000). There was significant difference when the SPAT value of the inpatients treated with anti-platelet drugs was compared with that of healthy blood donor group and with that of health volunteer group before and after administration of ASA (P = 0.000). The cut-off value of SPAT in health blood donor group was 44.6 +/- 11.7 seconds, reference value was from 21.1 seconds to 68.0 seconds; (3) there was no significant difference between SPAT values when platelets samples stored at room temperature for 1, 2, 3, 4 hours (P = 0.815). In conclusion, SPAT can rapidly monitor the inhibition effect of anti-platelet drugs and SPAT may have the similar clinic value with T(50) induced by c-PG.

Qualitative analysis of batch preparing cryopreserved fresh platelet rich plasma / 中国实验血液学杂志

To evaluate the efficiency and effectiveness of batch preparing cryopreserved fresh platelet-rich plasma (cryo-FPRP) derived from the volunteer donors, platelet count (Plt), mean platelet volume (MPV), platelet distribution width (PDW), plasma pH, plasma lactic acid concentration, and lactic dehydrogenase (LDH) concentration, germiculture, CD62p positive rate, PAC-1 positive rate, and the fluorescence intensity of platelet GPIb-IX-V were detected in ACD whole blood, fresh platelet-rich plasma (FPRP), FPRP with 5% dimethyl sulphoxide DMSO (DMSO-FPRP), and thawed cryopreserved FPRP (cryo-FPRP); the procoagulant activity of FPRP and cryo-FPR was determinated. The results showed that (1) 70 percentage of platelet were separated from the whole blood into FPRP, and the counts of residual erythrocyte and leucocyte were below 1 x 10(9), and below 1 x 10(7) per unit respectively. (2) The plasma pH, lactic acid concentration and PAC-1 positive rate retained a stable level during the preparing, storing and thawing process. (3) Plasma LDH concentration, platelet CD62p positive rate and GPIb-IX-V concentration in platelet surface were enhanced significantly after being frozen and thawing. (4) The plasma clotting time induced by cryo-FPRP were significantly shorter than that induced by FPRP. It is concluded that: (1) The batch platelet preparing process can efficiently obtain platelet from whole blood donated by volunteer, and the process didn't activate the platelet. (2) Cryopreservation can prevent lactic acid accumulation, pH reduce and activation of GPIIb/IIIa. (3) The membrane of partial platelets are affected by freezing and thawing. (4) The density of GPIb-IX-V complexes in platelet surface and its procoagulant activity are enhanced significantly after the FPRP freezing and thawing process.

Determination and comparison of anti-SARS antibody in children and adults / 中国实验血液学杂志

To investigate the positive rate of anti-SARS antibody in children and adults without SARS, 197 paediatric patients under 14 years old from inpatient and outpatient department of our hospital, 156 healthy children pupils from primary school, 453 adult patients over 18 years old from inpatient and outpatient department of our hospital and other 502 healthy adult blood donors were selected. Anti-SARS antibodies were determined by anti-SARS specific antibody detection kit and ELISA method. The results showed that both the positive rates of IgG antibody in paediatric patients and healthy children were about 2% (4/197 and 3/156), while the positive rates in adult patients and healthy adults were about 0.2% (1/453 and 1/502). The difference between the positive rates of children and adults was significant (chi(2) = 11.61, P < 0.001). IgM antibody was negative in all the samples. It is concluded that the anti-SARS IgG antibody positive rate in children was obvious higher than that in adults. This may be the cause why the cases with SARS in children is much less than in adults.

Detection of the anti-SARS-coronavirus specific antibody levels in 156 SARS patients / 中国实验血液学杂志

The objective of this study was to explore the development of IgG and IgM against SARS CoV and characteristics of changes of antibody titers in patients with severe acute respiratory syndrome (SARS) and to search the opportunity for collecting specific anti-serum from convalescent patients with SARS. The anti-SARS-coronavirus specific antibody levels in 156 SARS patients were measured with ELISA. The results showed that the total positive rates of IgG and IgM were 75.6% and 41.7% respectively, and the negative rate of both IgG and IgM was 23.7%. The average titers of IgG and IgM antibody in positive samples were 18.23 +/- 24.72 and 2.18 +/- 1.13, respectively. There was no significant correlation between the titers of IgG/IgM and sex, age, course of diseases and duration of body temperature recovery. It was concluded that not all SARS patients could produce the anti-SARS-coronavirus specific antibody. The titers of the anti-body are diversified even if the antibodies have been emerged in them. In order to obtain effective anti-serum, the titers of antibody must be tested just before collection of convalescent serum, and it ensures the therapeutic effect and provides a measurable index for clinical transfusion.

Effects of leukocyte elimination before storage on quality of red blood cell concentration / 中国实验血液学杂志

The objective of this study was to explore the possible effects of leukocyte elimination by filteration before storage on the quality of red blood cell concentrations (RCC) that prepared through two procedures. Eight units of red blood cell concentrations derived from whole blood after plasma separated (RCC1) and eight units of red blood cell concentrations derived from whole blood after platelet-rich plasma separated (RCC2) were divided randomly into filtered group and control group respectively. The RCC of filtered group were filtered by leukocyte deplete filter before storage. The control group didn't have any other treatments. These two groups were stored for five weeks at 4 degrees C according to AABB standard. Mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC) and plasma concentration of K(+) and lactate dehydrogenase (LDH), free hemoglobin (FHb), adenosine triphosphate (ATP) of red blood cell of all RCC were evaluated weekly, and bacteria contamination of all RCC was also detected after five weeks of storage. The results showed that there was no difference of MCV, MCH and MCHC and ATP level of red blood cell in all RCC of two groups, the ATP of red blood cell was lower than the control group on week 4 and 5. The average concentration of K(+) of the filtered group was less than the control group. The differences are significant except that of RCC1 stored till the third week. The plasma LDH concentration of filtered group was less than the control group, and the differences were exacerbate during the storing time prolonged. FHb release in the filtered group of RCC2 was significant less than that of control, but no significant difference was found between the two groups of RCC1. It was concluded that leukocyte elimination by filter before storage could be benefit to RCC preservation.

CD62p expression in platelet during the preparation course of Cryopreservated platelet-rich plasma / 中国实验血液学杂志

In order to explore the factors that affect CD62p expression in platelet during the whole course of cryopreservated platelets preparation, CD62p expression of platelet was evaluated by flow cytometry assay. The whole course of cryopreservated platelets preparation in order included whole blood collection, centrifugation for fresh platelet-rich plasma preparation, addition of dimethyl sulfoxide, and freeze in -80 degrees C refrigerator and thaw in 38 degrees C water bath. Result showed that the CD62p expressed slowly from whole blood collection to addition of dimethyl sulfoxide, but expressed abruptly after freeze and thaw and it occupied 82 per cent of the whole expression. It was concluded that the whole blood collection, centrifugation for fresh platelet enriched plasma preparation and addition of dimethyl sulfoxide were optimized in the whole course, but the damage to platelets in the whole course of cryopreservation could not be avoided. It suggests that improved techniques are needed to reduce the damage to cryopreservated platelets.

A fMRI study of item memory and source memory / 中华神经科杂志

Objective To examine the neural basis of item memory and source memory with fMRI approach.Methods Eight male and eight female healthy fight-handed native Chinese speakers were involved in this study.The item memory and source memory task were conducted with 504 highly frequent Chinese double-character words in the Block-designed experiment.Participants underwent such a double- round procedure as fMRI scanning following study.The fMRI data collected from a GE 1.5T MRI system were analyzed to generate corresponding activation maps for females and males respectively(P20)using statistical parametric mapping software(SPM).Results For females,item memory task activated the bilateral dorsolateral prefrontal cortex(BA6,the number of activated voxel clusters was 62 or 11 in the left and the right,respectively),source memory more activated the left dorsolateral prefrontal cortex(BA6/46,the number was 59).For males,item memory activated the right dorsolateral prefrontal cortex(BA6/46,the number was 64),source memory activated the bilateral dorsolateral prefrontal cortex(BA6,9 and 40 in the left and the right).Conclusion On the neural basis of item or source memory,there exists dissociation,which is that right dorsolateral prefrontal areas are more activated by item memory while left dorsolateral prefrontal areas by source memory.For the difference of gender,it is suggested that left dorsolateral prefrontal areas(BA6/46)are more activated in females while right dorsolateral prefrontal cortex(BA6/46)more in males.