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ObjectiveTo explore the effect of Baitouweng Tang （BTWT） on the apoptosis of human colorectal cancer HCT116 cells and decipher the underlying mechanism based on the Hedgehog （Hh） signaling pathway. MethodHCT116 cells were treated with BTWT （25， 50， 100， 200， 500， 750， and 1 000 mg·L-1） for 24 h， and then the cell proliferation was detected by methyl thiazolyl tetrazolium （MTT） colorimetry. Five groups were designed for the treatment of HCT116 cells， including a blank control group， BTWT groups （125， 250， and 500 mg·L-1）， and a positive control （5-fluorouracil， 5-FU， 40 mmol·L-1） group. The cell morphology was observed under an inverted microscope. The migration of the cells was detected by scratch test， and the apoptosis by Hoechest 33324/propidium iodide （PI） staining and flow cytometry. Western blot was employed to determine the protein levels of sonic hedgehog （SHh）， GLI family zinc finger protein 1 （Gli1）， smoothened （Smo）， suppressor of fused （SuFu）， cellular-myelocytomatosis viral oncogene （c-Myc）， and the apoptosis-related proteins B-cell lymphoma-2 （Bcl-2） and Bcl-2-associated X protein （Bax）. The quantitative real-time reverse transcription PCR （Real-time PCR） was employed to determine the mRNA levels of Bax， Bcl-2， SHh， Gli1， Smo， SuFu， and c-Myc. ResultCompared with the blank control group， BTWT changed the cell morphology （making the cell become round with dense nucleus）， inhibited the proliferation of HCT116 cells in a dose-dependent manner， decreased the ability of migration （P<0.05， P<0.01）， and increased apoptotic cells. Compared with the blank control group， BTWT （500 mg·L-1） treatment for 24 h up-regulated the protein and mRNA levels of Bax （P<0.05， P<0.01） and down-regulated the protein and mRNA levels of Bcl-2 in HCT116 cells （P<0.05， P<0.01）. Moreover， the treatment down-regulated the mRNA and protein levels of SHh， Gli1， Smo， and c-Myc （P<0.05， P<0.01） and up-regulated the mRNA and protein levels of SuFu （P<0.05， P<0.01）. ConclusionBTWT inhibited the proliferation and migration and induced the apoptosis of colorectal cancer HCT116 cells by down-regulating the Hh signaling pathway.
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Objective@#To identify predictors of pulmonary fibrosis development by combining follow-up thin-section CT findings and clinical features in patients discharged after treatment for COVID-19. @*Materials and Methods@#This retrospective study involved 32 confirmed COVID-19 patients who were divided into two groups according to the evidence of fibrosis on their latest follow-up CT imaging. Clinical data and CT imaging features of all the patients in different stages were collected and analyzed for comparison. @*Results@#The latest follow-up CT imaging showed fibrosis in 14 patients (male, 12; female, 2) and no fibrosis in 18 patients (male, 10; female, 8). Compared with the non-fibrosis group, the fibrosis group was older (median age: 54.0 years vs. 37.0 years, p = 0.008), and the median levels of C-reactive protein (53.4 mg/L vs. 10.0 mg/L, p = 0.002) and interleukin-6 (79.7 pg/L vs. 11.2 pg/L, p = 0.04) were also higher. The fibrosis group had a longer-term of hospitalization (19.5 days vs. 10.0 days, p = 0.001), pulsed steroid therapy (11.0 days vs. 5.0 days, p < 0.001), and antiviral therapy (12.0 days vs. 6.5 days, p = 0.012). More patients on the worst-state CT scan had an irregular interface (59.4% vs. 34.4%, p = 0.045) and a parenchymal band (71.9% vs. 28.1%, p < 0.001). On initial CT imaging, the irregular interface (57.1%) and parenchymal band (50.0%) were more common in the fibrosis group. On the worst-state CT imaging, interstitial thickening (78.6%), air bronchogram (57.1%), irregular interface (85.7%), coarse reticular pattern (28.6%), parenchymal band (92.9%), and pleural effusion (42.9%) were more common in the fibrosis group. @*Conclusion@#Fibrosis was more likely to develop in patients with severe clinical conditions, especially in patients with highinflammatory indicators. Interstitial thickening, irregular interface, coarse reticular pattern, and parenchymal band manifested in the process of the disease may be predictors of pulmonary fibrosis. Irregular interface and parenchymal band could predict the formation of pulmonary fibrosis early.
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Objective@#The current study reported a case series to illustrate the early computed tomography (CT) findings of coronavirus disease 2019 (COVID-19) in pediatric patients. @*Materials and Methods@#All pediatric patients who were diagnosed with COVID-19 and who underwent CT scan in Zhongnan Hospital of Wuhan University from January 20, 2020 to February 28, 2020 were included in the current study. Data on clinical and CT features were collected and analyzed. @*Results@#Four children were included in the current study. All of them were asymptomatic throughout the disease course (ranging from 7 days to 15 days), and none of them showed abnormalities in blood cell counts. Familial cluster was the main transmission pattern. Thin-section CT revealed abnormalities in three patients, and one patient did not present with any abnormal CT findings. Unilateral lung involvement was observed in two patients, and one patient showed bilateral lung involvement. In total, five small lesions were identified, including ground-glass opacity (n = 4) and consolidation (n = 1). All lesions had ill-defined margins with peripheral distribution and predilection of lower lobe. @*Conclusion@#Small patches of ground-glass opacity with subpleural distribution and unilateral lung involvement were common findings on CT scans of pediatric patients in the early stage of the disease.
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Since the outbreak of new coronavirus infection (COVID-19) in Wuhan, Hubei in December 2019, a total of 80 424 patients have been diagnosed until March 3, 2020, which has caused significant inpact in national health and economics. Module hospital played a vital role in effectively controlling the source of infection and cutting off the transmission channels.Compared with the CT room in a conventional hospital, the cabin CT is very different in terms of infection area settings, protective isolation measures and inspection procedures. This article covers CT room design, staffing responsibilities, division of infected areas, inspection procedures, protection and disinfection, and other aspects.
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Objective:In view of the shortage of new coronavirus nucleal acid test in the early COVID-19 outbreak, the application value of chest CT in screening COVID-19 patients was explored.Methods:Retrospective analysis was performed on the data of patients with fever who received chest CT and new coronavirus nucleal acid test during January 25, 2020 to February 2, 2020 in Zhongnan Hospital of Wuhan University. A total of 587 patients were enrolled, including 290 males and 297 females, aged from 11.0 to 96.0 (51.3±17.1) years old. Taking the nucleic acid test results as the gold standard, the sensitivity, specificity and rate of misdiagnosis of CT screening were calculated.Results:Among the 587 patients, there were 433 positive cases (73.8%, 433/587) and 154 negative cases (26.2%, 154/587) of novel coronavirus nucleic acid test. Using CT screening, 494 cases (84.2%, 494/587) were positive and 93 cases (15.8%, 93/587) were negative. The sensitivity of CT screening was 97.7% (423/433), specificity was 53.9% (83/154) and rate of misdiagnosis was 2.3% (10/433).Conclusions:In the early COVID-19 outbreak, CT screening has the advantages of high sensitivity and low rate of misdiagnosis, which can compensate for the shortage of new coronavirus nucleal acid test and can be used as a rapid screening for early prevention and control.
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Objective@#In view of the difficulty of the shortage of new coronavirus nucleal acid test in the early COVID-19 outbreak, to explore the application value of chest CT in screening COVID-19 patients.@*Methods@#Retrospective analysis was performed on the data of patients with fever who received chest CT and new coronavirus nucleal acid test during January 25, 2020 to February 2, 2020 in Zhongnan Hospital of Wuhan University. A total of 587 patients were enrolled, including 290 males and 297 females, aged from 11.0 to 96.0 (51.3±17.1) years old. Take the nucleic acid test results as the gold standard, the sensitivity, specificity and rate of missed diagnosis of CT screening COVID-19 were calculated.@*Results@#Among the 587 patients, there were 433 positive cases (73.8%, 433/587) and 154 negative cases (26.2%, 154/587) of novel coronavirus nucleic acid test. Using CT screening, 494 cases (84.2%, 494/587) were positive and 93 cases (15.8%, 93/587) were negative. The sensitivity of CT screening COVID-19 was 97.7% (423/433), specificity was 53.9% (83/154) and rate of missed diagnosis was 2.3% (10/433).@*Conclusions@#In the early COVID-19 outbreak, CT screening has the advantages of high sensitivity and low rate of missed diagnosis of COVID-19, which can compensate for the shortage of new coronavirus nucleal acid test and can be used as the basis for rapid screening for early prevention and control of COVID-19 outbreak.
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Objective To investigate the therapeutic effect and analgesic mechanism of percutaneous vertebral angioplasty in the treatment of painful osteoporotic thoracolumbar vertebral compression fracture.Methods80 cases of patients with painful osteoporotic thoracolumbar vertebral compression fracture in Shaoxing second hospital from May 2014 to May 2016 were selected, they were randomly divided into percutaneous vertebroplasty group (40 cases) and conservative treatment group (40 cases) two groups, the clinical efficacy, VAS scores and ODI scores of the two groups were statistically analyzed.ResultsThe total treatment effective rate of the percutaneous vertebroplasty group 95% (38/40) was significantly higher than the conservative treatment group (30/40) (P<0.05);The VAS scores and ODI scores of the two groups after treatment were significantly lower than before treatment (P<0.05);The differences of VAS scores and ODI scores before treatment between the two groups were not significant.The VAS score and ODI score after treatment of the percutaneous vertebroplasty group were significantly lower than the conservative treatment group (P<0.05).ConclusionThe therapeutic effect of percutaneous vertebral angioplasty in the treatment of painful osteoporotic thoracolumbar vertebral compression fractures is more significant than conservative treatment, it has better analgesic effect, so is worthy of promotion in the clinical.
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OBJECTIVE:To investigate the effects of minocycline on clinical indexes,inflammatory factors and blood glucose of patients with moderate and severe chronic periodontitis complicated with type 2 diabetes(T2DM). METHODS:A total of 125 patients with moderate and severe chronic periodontitis complicated with T2DM selected from our hospital during Feb. 2013-Aug. 2015 were divided into control group(63 cases)and observation group(62 cases)according to random number table. Both groups were periodental non-surgical treatment as scaling and root planning. Control group was given iodine glycerin to fill periodontal pockets after surgery,2-4 times/d. Observation group was given Minocycline hydrochloride ointment,once a week,after surgery. Both groups were treated for 4 weeks. The levels of clinical indexes [probing depth,clinical attachment level(CAL),probing bleeding rate],serum inflammatory factors(CRP,TNF-α)and blood glucose(fasting blood glucose,glycosylated hemoglobin) were observed in 2 groups before treatment,3 months after treatment,and the occurrence of ADR was recorded. RESULTS:Be-fore treatment,there was no statistical significance in clinical indexes,serum inflammatory factors and blood glucose levels be-tween 2 groups(P>0.05). Three months after treatment,probing depth,probing bleeding rate and serum inflammatory factor lev-els of 2 groups were decreased significantly,and the observation group was significantly lower than the control group,with statisti-cal significance(P0.05). The levels of fasting blood glucose in 2 groups were decreased,with statistical significance(P0.05). Compared to before treatment,the level of glycosylated hemoglobin in control group was decreased,without statistical significance(P>0.05);the level of glycosylated hemo-globin in observation group was decreased significantly,and the observation group was significantly lower than the control group, with statistical significance(P0.05). CONCLUSIONS:For moderate and severe chronic periodontitis complicated with T2DM,minocycline effectively improves clinical indexes of periodontitis,reduces serum inflammatory factors and blood glucose with good safety.
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Objective To evaluate the relationship between 1H-MRS features of brain glioma and its pathological grade and invasiveness, and the correlation between those features and the expression of VEGF, MMP-9 and uPA.Methods The brain gliomas in 55 patients confirmed by pathology were divided into two groups: high grade and low one.An analysis of intragroup and intergroup differences in some metabolite ratios of 1H-MRS in the tumor parenchyma was conducted.The expression of MMP-9,VEGF and uPA in brain glioma was detected,and the correlation between the above three parameters and changes in metabolite ratios of 1H-MRS were explored.Results There was significant difference and correlation in Cho/Cr and Cho/NAA ratio in the tumor parenchyma between high and low grade(P0.05).Conclusion VEGF and MMP-9 play an important role in the development of brain glioma.Cho/Cr and Cho/NAA ratios provide an important reference for preoperative grading of brain gliomas and indirectly reflect the expression of VEGF and MMP-9.
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OBJECTIVE@#To explore the mechanism, clinical characterization, diagnosis and therapeutic approach of vocal process granuloma(VPG) induced by gastroesophageal reflux.@*METHOD@#We performed a retrospective review of 4 cases.@*RESULT@#In 4 male cases, 3 cases had no obvious symptoms of stomach and esophagus and 1 case had symptoms of bloating and acid reflux. Additionally, 4 cases in which lesions were all located to the left side were diagnosed by trial therapy with proton pump inhibitors (PPIs) with good responding. 2 of 4 cases were relapsed after operations. Meanwhile 4 patients were treated by Rabeprazole for acid suppression therapy and 3 cases were cured and 1 invalid case was cured by Pantoprazole. All patients were followed up for 4-48 months with no recurrence.@*CONCLUSION@#Gastroesophageal reflux is an important pathogenic factor to the VPG. The majority of patients with VPG do not have gastroesophageal reflux symptoms. Besides, most lesions located in the left are associated with sleeping position. The diagnosis is mainly based on the laryngoscope examination and trial of acid suppression therapy. Moreover, recurrence risk is high-with simple operation in VPG therefore the main treatment is a antireflux and it is also valid by replacing byother PPI treatment. The treatment must be long enough. Meanwhile, the comprehensive treatment should be noticed.
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Humans , Male , 2-Pyridinylmethylsulfinylbenzimidazoles , Therapeutic Uses , Arytenoid Cartilage , Pathology , Gastroesophageal Reflux , Drug Therapy , Granuloma , Pantoprazole , Proton Pump Inhibitors , Therapeutic Uses , Retrospective Studies , Treatment OutcomeABSTRACT
Objective To observe the effects of Donepezil on cognitive function of delyed ephalophthy after acute carbon monoxide poisoning ( DEACMP) .Methods Eighty patients with DEACMP were randomly divided into control group ( 40 cases ) and treatment group ( 40 cases ) .The control group was given treatment of regular medicine, placebo and hyperbaric oxygenation.The treatment group was given treatment of regular medicine, Donepezil and hyperbaric oxygenation.The dose of Donepezil was 5.0 mg per night, and 90 d was a period of treatment.The cognitive function of patients was evaluated respectively by MMSE and Barthel Index rating scale ( BI) .And the results were compared between the two groups.Results Compared with before treatment, the MMSE and BI scores of the two groups after treatment were significantly increased (P<0.05 -0.01).And after the treatment, the MMSE and BI scores of the treatment group were significantly higher than those in the control group (P<0.05-0.01).Conclusion Donepezil can greatly improve the cognitive function of DEACMP patients, it is worthy to be clinical promoted.
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ObjectiveTo investigate the correlation between electro-acupunctured point Houxi(SI3)and activated brain function areas, contrast the images produced with electroacupuncture at left and right points Houxi and make a comparison with electroacupuncture at point Hegu(LI4)in patients with peripheral facial paralysis.MethodPatients with peripheral facial paralysis, six on the left side and six on the right side, were enrolled as subjects. A scan of the whole brain was taken using fMRI during electroacupuncture stimulation. The images were processed using SPM software. An analysis using at-test (P<0.01) showed differences in brain functional images produced with electroacupuncture at different points.ResultElectroacupuncture at left point Houxi increased the signals of brain regions: rightcaudate nucleus, right cingulate gyrus, right parahippocampal gyrus, right superior temporal gyrus, the brainstem and the cerebellar vermis. Electroacupuncture at right point Houxi increased the signals of brain regions: right medial frontal gyrus, left middle frontal gyrus, left anterior cingulate gyrus, rightcingulate gyrus and right superior temporal gyrus.ConclusionThere is a difference in the image between electroacupuncture at point Houxi and at point Hegu or Dicang(ST4). There is also a larger difference in the image between bilateral points Houxi. The brain regions with high-frequency or low-frequency signals are not consistent. The results further prove the scientificalness of “Point Hegu is indicated for diseasesin the face and mouth” and also show that the cognominal acupoints on the two sides ofthe human body may have some differences, e.g. the conduction pathways are not completely the same and the therapeutic effects are not completely consistent.
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Objective To investigate the effect of continuous positive airway pressure therapy (CPAP) on heart rhythm and blood pressure variability in primary hypertensive patients with obstructive sleep apnea/hypopnea syndrome (OSAHS).Methods Ninety seven patients with OSAHS and primary hypertension were randomly divided into treatment group (n =49) and control group (n =48).Patients in control group receive antihypertensive medication only,while patients in treatment group received antihypertensive medication in combination with CPAP therapy for 4 weeks.The dynamic electrocardiogram (ESG) and ambulatory blood pressure for 24 h were measured before and after treatment in both groups.Results After CPAP treatment,the night index of standard deviation of the average NN intervals (SDANNniGHt) in treatment group was (89.0 ± 21.4) ms,while the day and night index of square root of the mean squared differences of successive NN intervals (rMSSDday and rMSSDnight) was (35.9 ± 17.2) ms and (45.7 ± 18.3) ms respectively.Compared with those before treatment,the index of SDANNnight was decreased and the indexes of rMSSDday and rMSSDnight were increased (P ＜ 0.01).Compared with control group,the SDANNnight was decreased,and the rMSSDday and rMSSDnight were increased (P ＜ 0.01,P ＜ 0.05).After CPAP treatment,the night index of low-frequency power (LFnight) in treatment group was (15.3 ± 5.7) ms,which was lower than that before treatment,and the night index of high-frequency power (HFnigh) was (16.3-± 8.1)ms,which was higher than that before treatment (P ＜ 0.01);the LFnight in treatment group was decreased and the HFnight was increased (P ＜ 0.01).After CPAP treatment,the day and night indexes of systolic blood pressure (SBPday and SBPnight) and the night indexes of diastolic blood pressure (DBPnigh) t in treatment group were (136.1 ± 13.4) mmHg,(128.7 ± 9.8) mmHg (1 mmHg =0.133 kPa),and(83.7 ±7.2)mmHg respectivley,which were all lower than those in control group (P ＜ 0.05 or P ＜ 0.01).The incidences of morning peak blood pressure and non-dipper hypertension in control group were significantly higher than those in treatment group (P ＜ 0.01).Conclusion CPAP therapy can effectively adjust the heart rate and blood pressure levels in patients with OSAHS and primary hypertension,especially in the night.
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Objective To investigate the therapeutic effect of laparoscopic radical resection of rectal carcinoma via natural orificespecimen extraction(NOSE). Methods Laparoscopic resection of rec-tal carcinoma was performed using NOSE technique in 35 cases of rectal cancer from October 2013 to 2015 July. Analysis of clinical data,postoperative exhaust time,the number of resected lymph node,and anastomotic leakage rate was conducted. Results All 35 cases underwent laparoscopic radical resection of rectal cancer with successful anus preservation. There were no preventive transverse colostomy. Among them,the success rate of laparoscopic radical resection via NOSE for rectal cancer was 85. 71%(30 /35). The operation duration ranged from 105 to 186 min(mean 129. 50 min). Anal exhaust time was 22 to 80 h(average 38. 13 h). Postoperative hospital stay lasted for 9 ~ 21 days(mean 10. 27 d). Anas-tomotic leakage occurred in 1 case and puncture infection in 2 cases. Conclusion Laparoscopic radical resec-tion of rectal carcinoma in middle and low rectal cancer is safe and reliable,which is worthy of being spread.
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AIM: To explore the role of PI3K/Akt/nNOS in Zhouluotong extract resisting diabetic peripheral neuropathy.METHODS:The Schwann cells were divided into normal group ( D-glucose 25 mmol/L) , model group ( D-glucose 100 mmol/L) , Zhouluotong extract Z-6 +high glucose group, Zhouluotong +high glucose group, mecobalamine+high glucose group.The viability, nitric oxide content and the Ca2+-ATPase activity in Schwann cells were determined by Cell Counting Kit-8 , nitric oxide assay kit and Ca2+-ATPase assay kit, respectively.The apoptosis of Schwann cells were analyzed by flow cytometry.The expression of Bcl-2, Bcl-xL, Bax, Bak and caspase-3, and the phosphorylation levels of nNOS and Akt were determined by Western blotting.The signal pathway of PI3K/Akt was explored by dominant negative PI3K and Akt (δp85 and DN-Akt) transient transfection assay.RESULTS:Under high-glucose culture, the cell viability, nitric oxide content in culture supernatant, the expression of Bcl-2 and Bcl-xL, and the phosphorylation levels of Akt and nNOS in the Schwann cells were significantly increased.The cell apoptosis, the expression of Bax, Bak and caspase 3 in the Schwann cells were significantly decreased by Zhouluotong extract Z-6, compared with model group.In-creased nitric oxide content and the up-regulation of nNOS were observed.However, the effects of blocking PI3K/Akt, the upstream pathway of nNOS , by transfection with DN-δp85 on Akt phosphorylation in the Schwann cells was still unclear. CONCLUSION:Zhouluotong extract Z-6 changes the phosphorylation of nNOS, and the expression of anti-apoptotic fac-tors , caspase-3 and pro-apoptotic factors in Schwann cells under high-glucose culture, thus reducing apoptosis and elevating viability.The relationship to PI3K/Akt/nNOS pathway needs further investigation.
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Objective To discuss the postoperative complications of hypertensive intracerebral hemorrhage treated with freehand drilling skull minimally invasive puncture drainage therapy .Methods The clinical data of 158 patients with hypertensive intracerebral hemorrhage were retrospectively analyzed .The incidence rate ,causes and preventative measures of the postoperative complications of hypertensive intracerebral hemorrhage treated with free -hand drilling skull minimally invasive puncture drainage therapy were analyzed .Results 10 cases of scalp bleeding , 4 cases of epidural hemorrhage , 9 cases of puncture pathway bleeding , 24 cases of secondary bleeding , 1 case of intracranial infection,3 cases of low intracranial pressure ,5 cases of pneumoencephalos and 2 cases died.Conclusion Freehand drilling skull minimally invasive puncture drainage leads to less complications and so far it is a safe and effective therapy for hypertensive intracerebral hemorrhage .
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BACKGROUND: Spinocerebel ar ataxia is a common neurodegenerative disease characterized by slowly progressive movement incoordination of the limbs. It responds badly to common medication. OBJECTIVE: To observe the clinical effect of autologous bone marrow mesenchymal stem cells and al ogeneic umbilical cord mesenchymal stem cells tranfusion in the treatment of spinocerebel ar ataxia. METHODS: A total of 27 spinocerebel ar ataxia patients treated with mesenchymal stem cells treatment were included for comprehensive statistical analysis. Among these patients, six patients received autologous bone marrow mesenchymal stem cells lumbar puncture treatment and 21 patients received al ogeneic umbilical cord mesenchymal stem cells lumbar puncture treatment combined with intravenous infusion. The neurologic function of the patients in the two groups was evaluated with International Cooperative Ataxia Rating Scale before and after treatment. RESULTS AND CONCLUSION: There was no obvious adverse effect in the 27 spinocerebel ar ataxia patients during, before or after mesenchymal stem cells treatment. The effect of autologous bone marrow mesenchymal stem cells in six patents was not significant; for the other 21 patients treated with al ogeneic umbilical cord mesenchymal stem cells transfusion, the subjective symptoms of the patients were improved, and the International Cooperative Ataxia Rating Scale scores were decreased significantly at 3 months after treatment when compared with those before treatment (P < 0.05). The results suggest that umbilical cord mesenchymal stem cells treatment is safe and able to ameliorate the clinical symptoms and improve life quality of spinocerebel ar ataxia patients to some extent.
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To evaluate the diagnostic accuracy of dual-source computed tomography [DSCT] in the diagnosis of coronary artery stenoses by comparing with conventional coronary angiography [CCA]. CCA and DSCT were performed in 64 patients with suspected coronary artery disease [CAD] respectively [46 male, 18 female, age from 48 to 82 years old, mean 68.18 years]. Various postprocessing reconstructions of coronary artery and its branches, such as volumetric imaging, multi-planar reconstruction, curved planar reconstruction, maximum intensity projection were used. The coronary segments, with statistical evaluations combined with its diameter >/=1.5mm were collected to analyze the diagnosis accuracy of DSCT on coronary artery stenoses, with CCA as the gold standard. About 4.14% of coronary artery segments could not be evaluated, while 95.86% were evaluable arteries, the sensitivity, specificity, positive and negative predictive value of DSCT for detecting coronary artery stenoses were, 93.58%, 99.61%, 95.31% and 99.48% respectively. There were no significant differences in the diagnostic accuracy of coronary artery stenoses between DSCT and CCA. DSCT is a reliable tool that is accurately appropriate for patients with CAD, as it has a higher accuracy and specificity, which is valuable in the screening of CAD
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Humans , Male , Female , Tomography, X-Ray Computed , Coronary Angiography , Retrospective StudiesABSTRACT
An investigation on pathogens was performed on 219 consecutive adult inpatients with community-acquired pneumonia (CAP) from November 2008 to August 2009 in Hebei Province.Sputum samples from all patients in acute phase were collected for multiplex polymerase chain reaction (PCR) detection. Pathogens were identified in 125 patients. Streptococcus pneumoniae was the most common pathogen isolated in 75 cases (60％) ; influenza A virus was the most common virus isolated in 32 cases (26％) ; and mixed infection were found in 31 patients (25％). Streptococcus pneumoniae species were more frequent among patients aged ≤30 and 51 -70; Haemophilus influenzae species were more frequent among patients with coexisting disease; the percent of Mycoplasma pneumoniae species infections in the lowrisk groups( Ⅰ - Ⅱ ) was higher than patients in the high-risk groups ( Ⅲ - V ).The percent of virus pneumoniae species infections in patients with coexisting disease trended to higher than patients without coexisting disease,but the difference was not statistically significant ( P ＞ 0.05 ).The results indicate that Streptococcus pneumoniae remains the major bacteria,Viruses are frequently detected in CAP with influenza A virus being the most common one; and mixed infection should not be ignored.The age and underlying diseases are important factors influencing the distribution of pathogens.
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ObjectiveTo investigate the central nervous system mechanisms of active of movement switch in the patients with Tourette' s syndrome( TS),and to explore the possible underlying distinct neural networks for tic trigger and generation. Methods Participants were 14 patients with TS and 14 age- and gender-matched healthy volunteers with no history of physical,psychiatric or neurological disease: All patients were assessed with functional magnetic resonances imaging (fMRI)of the brain during the intermittent performance of finger-tapping switch tasks,Blood-oxygen-level dependent-fMRI was performed using a 3.0 Tesla MR.The area over which the activation was distributed was calculated,and the activation volumes were also compared between the patients with TS and the control subjects.ResultsThe regions activated in the patients with TS and in the volunteers were similar in several brain regions,including contralateral precentral and postcentral gyrus,contralateral mesia pre-front gyrus,contralateral cingulate gyrus,contralateral insula and ipsilataral cerebellum. There were also many different activation areas between the patients and the control subjects. The patients with TS demonstrated more significant and extended activation in the contralateral pre- and postcentral gyrus than the healthy volunteers.The volume of the left pre- and postcentral gyrus of the TS patients was (8.024 ±0.071 ) cm3,while the volume of the left pre-and postcentral gyrus of the control subjects was ( 6.480 ± 0.026) cm3 ( t =3.026,P ＜ 0.01 ) ; The volume of the right pre- and postcentral gyrus was (6.192 ± 0.019) cm3 in the TS cases,while there was (5.608 ±0.037) cm3 in the control subjects (t =2.752,P ＜0.05).There were significant differences in the volumes of bilateral pre- and postcetral gyrus between the TS and control subjects. The activations of conralateral thalamus without contralateral insula were found in the patients with TS. Conversely, the contralateral insula activation without thalamus activation could be found in the healthy volunteers.ConclusionThe thalamus might play an important role in the aetiological and physiopathologic mechanisms of the TS. The thalamus along with the parietal cortex,cingulate cortex and insular cortex appear to constitute a distinct neural network for tic trigger and generation.