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Objective:To explore the value of monocyte subsets and CD64 expression in the diagnosis and prognosis of sepsis.Methods:A prospective case-control study was designed. 30 septic patients and 30 non-septic patients who were admitted to the intensive care unit (ICU) of the PLA Army Characteristic Medical Center from March 2021 to March 2022 were enrolled. After 1, 3, and 5 days of ICU admission, peripheral blood samples were taken from patients. Flow cytometry was used to detect the proportion of monocyte subsets and the expression level of CD64 on the surface, and the difference of expression between patients in two group was analyzed. The risk variables for sepsis were analyzed using single-factor and multi-factor Logistic regression. The diagnostic efficacy of each risk factor for sepsis was determined using the receiver operator characteristic curve (ROC curve).Results:One day after ICU admission, the proportions of monocytes and classic monocytes in white blood cells (WBC) of septic patients were significantly lower than those of non-septic patients [proportion of monocytes to WBC: (4.13±2.03)% vs. (6.53±3.90)%, proportion of classic monocytes to WBC: 1.97 (1.43, 2.83)% vs. 3.37 (1.71, 5.98)%, both P < 0.05]. The proportion of non-classical monocytes in monocytes was significantly higher in septic patients than that in non-septic patients [(11.42±9.19)% vs. (6.57±4.23)%, P < 0.05]. The levels of CD64 expression in monocytes, classic monocytes, intermediate monocytes and non-classic monocytes were significantly higher in sepsis patients than those in non-septic patients [mean fluorescence intensity (MFI): 13.10±6.01 vs. 9.84±2.83 for monocytes, 13.58±5.98 vs. 10.03±2.84 for classic monocytes, 13.48±6.35 vs. 10.22±2.99 for intermediate monocytes, 8.21±5.52 vs. 5.79±2.67 for non-classic monocytes, all P < 0.05]. Multivariate Logistic regression research showed that CD64 in typical monocytes [odds ratio ( OR) = 1.299, 95% confidence interval (95% CI) was 1.027-1.471, P = 0.025] and the proportion of non-typical monocytes in monocytes ( OR = 1.348, 95% CI was 1.034-1.758, P = 0.027) were the independent risk factors for sepsis. ROC curve showed that the area under the ROC curve (AUC) of CD64 expression of classical monocytes, the fraction of non-classical monocytes in monocytes, and procalcitonin (PCT) in the diagnosis of sepsis was 0.871. A correlation analysis revealed a negative relationship between the acute physiology and chronic health status evaluation Ⅱ (APACHE Ⅱ) on the first, third, and fifth days following ICU admission and the expression level of CD64 in patients' classic monocytes ( r values were -0.264, -0.428 and -0.368, respectively, all P < 0.05). Conclusions:Combining the proportion of non-classical monocytes in monocytes, the level of plasma PCT, and the CD64 expression of classic monocytes in peripheral blood has good efficacy in identifying sepsis and assessing its severity.
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The series of YY/T 0987 standards converted from the corresponding ASTM (American Society for Testing and Materials) standards regulate the marking medical devices and testing methods for passive implants in the magnetic resonance environment. Along with the advancement of scientific cognition and the development of technology, the ASTM continuously amends and updates standards. This article studies the new version of ASTM standards and analyzes the advancing parts newly added as compared to the current YY/T 0987-2016 standard and eventually pinpoints some problems that remained to be solved. Except for the standard for image artifacts, this study found out that other standards had also been constantly updated, such as the standard of ASTM F2503 for marking medical devices extends its referenced documents and adds some ISO standards in, meanwhile, the test method on magnetically induced displacement force, radio frequency induced heating and magnetically induced torque also had been significantly adjusted and improved accordingly. This article recommends that domestic standards need to keep pace with the latest edition of ASTM F standards and to supplement new research achievements timely, just in order to provide a better normalization, guidance and support to the development of Chinese passive implants industry.
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Magnetic Resonance Imaging , Magnetic Resonance Spectroscopy , Prostheses and Implants , Radio Waves , Torque , United StatesABSTRACT
@#Abstract: Objective To understand the distribution and drug resistance of common pathogens of fungal bloodstream infection in Sichuan, and to provide reference for clinicians to empirically treat fungal bloodstream infection. Methods From November 1, 2019 to December 31, 2020, fungal strains isolated from blood culture of patients diagnosed with bloodstream infection in 19 tertiary first-class general hospitals in Sichuan Province were collected for mass spectrometry identification and drug susceptibility, and the results were statistically analyzed, along with a retrospective analysis of clinical data. Results A total of 255 fungal strains were received and identified by mass spectrometry, 215 strains of Candida spp (84.3%), 28 strains of Cryptococcus neoformans (11.0%), 4 strains of Talaromyces marneffei (1.6%) and 8 strains of others (3.1%). Among the Candida spp 90 strains of Candida albicans, 39 strains of Candida parapsilosis complex, 36 strains of Candida glabrata, 33 strains of Candida tropicalis, 8 strains of Candida guilliermondii, and 9 strains of other Candida. In the department, the ICU was predominant, accounting for 35.7%. The top four Candida (Candida albicans, Candida parapsilosis complex, Candida glabrata, Candida tropicalis) were analyzed for drug sensitivity, Candida albicans and Candida parapsilosis complex group were more sensitive to antifungal drugs, the sensitivity rates of Candida albicans to fluconazole, voriconazole, anidulafungin, caspofungin, micarafungin were 89.2%, 92.8%, 97.6%, 97.6%, 96.4%, respectively. The sensitivity rates of Candida parapsilosis to fluconazole and voriconazole were 89.7% and 94.9%, and to anidulafungin, caspofungin and micafungin were all 100%. Echinocandins had stronger antibacterial activity against Candida spp., Candida parapsilosis complex and Candida tropicalis had 100% sensitivity to echinocandins, Candida albicans had more than 95% sensitivity to echinocandins, and Candida glabrata had about 90% sensitivity to echinocandins. Candida tropicalis was less sensitive to fluconazole and voriconazole with 66.7% and 54.5%, and the sensitivity of Candida glabrata to fluconazole was mainly concentrated in susceptible dose dependent (SDD), accounting for 91.4%. The four Candida species did not show resistance to amphotericin B, all of them showed wild-type strains, Candida tropicalis showed the highest non-wild-type rate to posaconazole and itraconazole with 21.2% and 36.4%, and the drug sensitivity results of Cryptococcus neoformans showed that 4 out of 23 strains showed resistance to amphotericin B (non-wild-type) and 3 strains showed resistance to fluconazole (non-wild-type). Conclusions The fungus of bloodstream infection is mainly Candida spp.. Among of them, Candida albicans accounts for the highest percentage, echinocandins have good antibacterial effect on Candida, Candida is sensitive to amphotericin B as wild type, but Candida tropicalis has slightly higher resistance rate to fluconazole and voriconazole, and the non-wild type rate of Cryptococcus neoformans to amphotericin B is increasing, and clinicians should pay high attention to the rational use of antifungal drugs.
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Traumatic rib fractures are the most common injury in thoracic trauma. Previously，the patients with traumatic rib fractures were mostly treated non-surgically，of which 50%，especially those combined with flail chest presented chronic pain or chest wall deformities and over 30% had long-term disabilities，being unable to retain a full-time job. In the past two decades，thanks to the development of internal fixation material technology，the surgical treatment of rib fractures has achieved good outcomes. However，there are still some problems in clinical treatment，including inconsistency in surgical treatment and quality control in medical services. The current consensuses on the management of regional traumatic rib fractures published at home and abroad mainly focus on the guidance of the overall treatment decisions and plans，and relevant clinical guidelines abroad lacks progress in surgical treatment of rib fractures in recent years. Therefore，the Chinese Society of Traumatology affiliated to Chinese Medical Association and Chinese College of Trauma Surgeons affiliated to Chinese Medical Doctor Association，in conjunction with national multidisciplinary experts，formulate the Chinese Consensus for Surgical Treatment of Traumatic Rib Fractures（2021）following the principle of evidence-based medicine，scientific nature and practicality. This expert consensus puts forward some clear，applicable，and graded recommendations from aspects of preoperative imaging evaluation，surgical indications，timing of surgery，surgical methods，rib fracture sites for surgical fixation，internal fixation methods and material selections，treatment of combined injuries in rib fractures，in order to provide references for surgical treatment of traumatic rib fractures.
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Objective:To study the dynamic changes of cellular immune function in peripheral blood of trauma patients and its role in the evaluation of traumatic complications.Methods:A prospective cohort study design was conducted. Patients with blunt trauma admitted to Chongqing Emergency Medical Center from November 2019 to January 2020 were consecutively enrolled. The peripheral blood samples were collected at 1, 3, 5, 7, and 14 days after injury. The expressions of CD64, CD274, and CD279 on the surface of neutrophils, lymphocytes, and monocytes as well as CD3 +, CD4 + and CD8 + T lymphocyte subsets were measured by flow cytometry. The trauma patients were divided into different groups according to the injury severity score (ISS) and sepsis within 28 days after injury, respectively. The dynamic changes of cellular immune function in different time points after injury and differences between different groups were compared. Furthermore, the correlation with acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), sequential organ failure assessment (SOFA), and ISS were evaluated by Pearson correlation analysis. Results:A total of 42 patients with trauma were finally enrolled, containing 8 severe trauma patients with ISS greater than 25 scores, 17 patients with ISS between 16 and 25 scores, and 17 patients with ISS less than 16 scores. The sepsis morbidity rates were 14.3% (n = 6) within 28 days after injury. CD64 index and CD4 +T lymphocyte subsets were significantly increased at different time points after trauma (H = 15.464, P = 0.004; F = 2.491, P = 0.035). The CD64 index and positive rates of CD279 in neutrophils, lymphocytes, and monocytes were increased with the severity of injury at day 1 and day 3 after injury, respectively. At the first day after injury, CD64 index were 2.81±1.79, 1.77±0.92, 3.49±1.09; positive rate of CD279 in neutrophils were 1.40% (0.32%, 2.04%), 0.95% (0.44%, 2.70%), 12.73% (3.00%, 25.20%); positive rate of CD279 in lymphocytes were 3.77% (3.04%, 5.15%), 4.71% (4.08%, 6.32%), 8.01% (4.59%, 11.59%); positive rate of CD279 in monocytes were 0.57% (0.24%, 1.09%), 0.85% (0.22%, 1.25%), 6.74% (2.61%, 18.94%) from mild to severe injury groups, respectively. The CD64 index in severe injury group was significantly higher than that in moderate group, and the positive rates of CD279 in neutrophils, lymphocytes and monocytes of severe injury patients were higher than those in other two groups (all P < 0.05). At 3rd day after injury, compared to moderate group, severe injury patients had significantly higher CD64 index and positive rate of CD279 in lymphocytes [4.58±2.41 vs. 2.43±1.68, 7.35% (5.90%, 12.28%) vs. 4.63% (3.26%, 6.06%), both P < 0.05]. Compared with the non-sepsis patients, the sepsis patients had significantly higher CD64 index and positive rate of CD279 in monocytes at day 1 after injury [4.06±1.72 vs. 2.36±1.31, 3.29% (1.14%, 12.84%) vs. 0.67% (0.25%, 1.48%), both P < 0.05], and positive rate of CD279 in lymphocytes significantly higher at 3rd day after injury [8.73% (7.52%, 15.82%) vs. 4.67% (3.82%, 6.21%), P < 0.05]. In addition, correlation analysis showed that positive rate of CD279 in lymphocytes was positively correlated with SOFA and ISS, respectively (r values were 0.533 and 0.394, both P < 0.05), positive rate of CD279 in monocytes was positively correlated with APACHEⅡ, SOFA and ISS scores, respectively (r values were 0.579, 0.452 and 0.490, all P < 0.01), positive rate of CD279 in neutrophils was positively correlated with APACHEⅡ and ISS, respectively (r values were 0.358 and 0.388, both P < 0.05). Conclusions:CD64 index and CD279 expression in neutrophils, lymphocytes, and monocytes are significantly related to the severity and prognosis of trauma. Dynamic monitoring the cellular immune function may be helpful for assessing the prognosis of trauma patients.
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@#AIM:To explore the risk factors for diabetic retinopathy(DR)in patients with type 1 diabetes mellitus(T1DM).<p>METHODS: A total of 204 patients with T1DM in recent 10a were enrolled. The patients were divided into DR group(<i>n</i>=71)and non-DR group(<i>n</i>=133). The clinical information was collected and relevant biochemical indices were detected. Univariate and multivariate Logistic regression were used to assess the relationship between potential risk factors and DR/proliferative diabetic retinopathy(PDR). The value of risk factors in predicting DR/PDR was evaluated by drawing receiver operating characteristic curve(ROC).<p>RESULTS: The age of onset, longer duration of diabetes, HbA1c, hypertension, hyperlipidemia, diabetic nephropathy(DN), diabetic peripheral neuropathy(DPN)were related to DR(<i>P</i><0.05)in patients with T1DM. Longer duration of diabetes, body mass index(BMI), systolic blood pressure(SBP), hyperlipidemia, DN, DPN were related to PDR. Logistic regression analysis indicated that longer duration of diabetes(<i>OR</i>=1.130, <i>P</i><0.001)and HbA1c(<i>OR</i>=2.734, <i>P</i><0.001)were risk factors of DR. Longer duration of diabetes(<i>OR</i>=1.144, <i>P</i>=0.005)and DN(<i>OR</i>=6.500, <i>P</i>=0.001)were risk factors of PDR. The results of ROC curve analysis showed that the area under the curve(AUC)of the disease course and HbA1c predicting the occurrence of DR were 0.720 and 0.727, respectively. The cutoff values were 15.1a and 8.2%, respectively. The sensitivity was 50.7% and 76.1%, and the specificity was 86.5% and 59.4%, respectively. The AUC for predicting PDR was 0.713, the best cutoff value was 18.5a, the sensitivity was 73.9%, and the specificity was 60.4%.<p>CONCLUSION: Retinopathy is associated with age of onset in patients with T1DM. Duration of disease and hyperglycemia are the major influencing factor for DR. HbA1c is associated with DR. DN is associated with PDR occurrence.
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@#AIM:To explore the risk factors for diabetic retinopathy(DR)in patients with type 1 diabetes mellitus(T1DM).<p>METHODS: A total of 204 patients with T1DM in recent 10a were enrolled. The patients were divided into DR group(<i>n</i>=71)and non-DR group(<i>n</i>=133). The clinical information was collected and relevant biochemical indices were detected. Univariate and multivariate Logistic regression were used to assess the relationship between potential risk factors and DR/proliferative diabetic retinopathy(PDR). The value of risk factors in predicting DR/PDR was evaluated by drawing receiver operating characteristic curve(ROC).<p>RESULTS: The age of onset, longer duration of diabetes, HbA1c, hypertension, hyperlipidemia, diabetic nephropathy(DN), diabetic peripheral neuropathy(DPN)were related to DR(<i>P</i><0.05)in patients with T1DM. Longer duration of diabetes, body mass index(BMI), systolic blood pressure(SBP), hyperlipidemia, DN, DPN were related to PDR. Logistic regression analysis indicated that longer duration of diabetes(<i>OR</i>=1.130, <i>P</i><0.001)and HbA1c(<i>OR</i>=2.734, <i>P</i><0.001)were risk factors of DR. Longer duration of diabetes(<i>OR</i>=1.144, <i>P</i>=0.005)and DN(<i>OR</i>=6.500, <i>P</i>=0.001)were risk factors of PDR. The results of ROC curve analysis showed that the area under the curve(AUC)of the disease course and HbA1c predicting the occurrence of DR were 0.720 and 0.727, respectively. The cutoff values were 15.1a and 8.2%, respectively. The sensitivity was 50.7% and 76.1%, and the specificity was 86.5% and 59.4%, respectively. The AUC for predicting PDR was 0.713, the best cutoff value was 18.5a, the sensitivity was 73.9%, and the specificity was 60.4%.<p>CONCLUSION: Retinopathy is associated with age of onset in patients with T1DM. Duration of disease and hyperglycemia are the major influencing factor for DR. HbA1c is associated with DR. DN is associated with PDR occurrence.
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@#【Objective】To constructset-up errors distribution prediction model for pelvic tumors patients radiotherapy of Varian NovalisTX medical linear accelerator.【Methods】The IGRT set-up errors data of 30 pelvic tumor patients after radiotherapywere analyzed，and Gaussian Mixtures was used to construct the errors distribution prediction model and to solve the model parameters.【Results】The set-up errors is mainly concentrated in four central points of μ1~μ4. The coordinates of each central points shows that the offsets of vertical（-3.88~4.28）mm and Longitudinal（-2.41~1.54）mm were larger than that of lateral（-1.85~0.72）mm. The possibility of offsets clustering near μ2 and μ4（0.301，0.310）is greater than μ1 and μ3（0.190，0.196）. And the standard deviation of set- up errors can be up to 5.2 mm.【Conclusions】The Gaussian Mixtures Model made quantitative description and prediction analys is for the set- up errors distribution，which provide references for set-up errors control and planning target expansion of pelvic tumor radiotherapy in the absence of IGRT.
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AIM: To investigate the difference between anterior corneal astigmatism axis and total corneal astigmatism axis, and the related factors.?METHODS: The anterior corneal astigmatism axis and total corneal astigmatism axis in 789 patients(1141 eyes) of China Medical University Eye Hospital were detected by Petacam and recorded the corresponding age, value of astigmatism, anterior chamber depth, corneal thickness, refraction of cornea and anylized statistically.?RESULTS:We found age was positively correlated with the difference of the anterior corneal astigmatism axis and total corneal astigmatism axis(r=0. 139, P<0. 001). The value of astigmatism was negatively correlated with the difference of the anterior corneal astigmatism axis and total corneal astigmatism axis(r=-0. 293, P<0. 05). The anterior chamber depth was negatively correlated with the difference of the anterior corneal astigmatism axis and total corneal astigmatism axis ( r=-0. 067, P<0. 05). And the corneal thickness, refraction of cornea was not significantly correlated with the difference of the anterior corneal astigmatism axis and total corneal astigmatism axis.?CONCLUSION: There is significant difference in the anterior corneal astigmatism axis and total corneal astigmatism axis, and is positively correlated with age, and is negatively correlated with value of astigmatism and the depth of anterior chamber.
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<p><b>Background</b>Serum cryptococcal antigen (CrAg) test is the most used noninvasive method to detect cryptococcal infection. However, false-negative CrAg test is not uncommon in clinical practice. Then, the aim of this study was to investigate the factors associated with false-negative CrAg test among non-human immunodeficiency virus (HIV) adult patients with pulmonary cryptococcosis and its clinical features.</p><p><b>Methods</b>One hundred and fourteen non-HIV adult patients with pulmonary cryptococcosis, proven by biopsy, were retrospectively reviewed. Finally, 85 patients were enrolled; 56 were CrAg positive (CrAg+ group) and 29 were negative (CrAg- group). It was a cross-sectional study. Then, baseline characteristics, underlying diseases, clinical symptoms, laboratory findings, and chest radiological findings were reviewed and analyzed. Chi-square test was used to analyze categorical variable. Odds ratio (OR) was used to measure correlation. Student's t- test was obtained to analyze continuous variable.</p><p><b>Results</b>No difference in baseline characteristics, underlying diseases, clinical symptoms, and laboratory findings were found between two groups (P > 0.05 in all). Nevertheless, diffuse extent lesion was 82.1% in CrAg+ group and 10.3% in CrAg- group (χ = 40.34, P < 0.001; OR = 39.87).</p><p><b>Conclusions</b>Among patients with limited pulmonary involvement, a negative serum CrAg does not preclude the diagnosis of pulmonary cryptococcosis. However, among patients with extensive pulmonary involvement, serum CrAg is a useful diagnostic tool for pulmonary cryptococcosis. Furthermore, we also noticed that the untypical and mild presentations with extensive pulmonary lesion might be the features of pulmonary cryptococcosis, which needs further investigation.</p>
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Adolescent , Adult , Humans , Male , Cross-Sectional Studies , Cryptococcosis , Allergy and Immunology , Pathology , Lung Diseases , Allergy and Immunology , Pathology , Retrospective StudiesABSTRACT
@#AIM: To investigate the effects of par plana vitrectomy(PPV)+ inner limiting membrane(ILM)flat covering + vitreous cavity disinfected air filling and PPV + ILM stripping + vitreous cavity disinfected air filling on giant idiopathic macular hole(IMH)and high myopia macular hole(MH). <p>METHODS: The clinical data of giant IMH 40 eyes and giant high myopia MH 40 eyes were compared. Twenty patients with giant IMH underwent traditional ILM removal(Group A1), the remaining 20 underwent ILM flat transplantation(Group A2); 20 underwent traditional ILM removal(Group B1)for giant high myopic MH, and the remaining 20 underwent ILM flat transplantation(Group B2). The closure rate of MH and the improvement of best corrected visual acuity(BCVA)before and after operation were compared and analyzed. <p>RESULTS: There were significant differences in BCVA before and after operation in Group A(<i>F</i>=96.193, <i>P</i><0.001), between A1 and A2(<i>F</i>=4.971, <i>P</i>=0.03), and the interaction between different time points and groups after operation(<i>F</i>=18.772, <i>P</i><0.001). The results showed that there were significant differences of the two groups between any two time point(<i>P</i><0.05). The <i>t</i>-test results between the two groups at different time showed that there was no difference in preoperative vision between A1 and A2(<i>P</i>>0.05). There were significant differences in preoperative visual acuity between the two groups at 1, 3 and 6mo after operation(<i>P</i><0.05). There were significant differences in different time points before and after BCVA in Group B(<i>F</i>=136.150, <i>P</i><0.001), B1 and B2(<i>F</i>=5.179, <i>P</i>=0.029), and the interaction between different time points and groups after BCVA(<i>F</i>=7.079, <i>P</i>=0.001). The results showed that there were significant differences of the two groups between any two time point(<i>P</i><0.05). The results of <i>t</i>-test between the two groups at different time showed that there was no difference in preoperative visual acuity between B1 and B2(<i>P</i>>0.05), but there was significant difference in 1, 3 and 6mo after operation(<i>P</i><0.05). After 6-month follow-up, the closure rate of Group A1 was 80%, attached rate was 20%, closure rate of Group A2 was 100%. There was no significant difference in closure rate between Group A1 and Group A2(<i>P</i>=0.053). The closure rate of Group B1 was 70%, attached rate was 30%, closure rate of Group B2 was 90%, attached rate was 10%. There was no significant difference in closure rate between Group B1 and Group B2(<i>P</i>=0.118). There was significant difference in closure rate between retinal initial membrane stripping group and plaster group(75% <i>vs</i> 95%, <i>χ<sup>2</sup></i>=4.057, <i>P</i><0.05).<p>CONCLUSION: For giant IMH and giant high myopia MH, there was significant difference in closure rate and BCVA improvement between ILM stripping group and covering group, on which the former is better.
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Objective It is rarely reported whether myricetin inhibits the activation and function of cardiac fibroblasts and thereby prevents myocardial fibrosis. This study was to investigate the effects of myricetin on the activation,proliferation and secretion of cardiac fibroblasts and its possible molecular mechanisms. Methods Fibroblasts isolated from 1-3 days old rats were cultured and their activation,proliferation and secretion were induced with the transforming growth factor (TGF). The fibroblasts were incubated with myricetin at different concentrations of 1,3,10,30 and 100 μmol/L for 24 hours followed by detection of their proliferation with the CKK8 kit,the transcription levels of fibrotic factors by RT-PCR and the expression levels of α-SMA and signal proteins by immunoflu-orescence staining and Western blot,respectively. Results The expression of α-SMA was significantly up-regulated in the cardiac fi- broblasts of the rats in the TGF-β,30 μmol/L myricetin+TGF-β and 100 μmol/L myricetin+TGF-β groups as compared with that in the control group (P<0.05) but down-regulated in the 30 μmol/L myricetin+TGF-β and 100 μmol/L myricetin+TGF-β groups in com-parison with that in the TGF-β group (P<0.05). At 48 hours,the transcription levels of collagenⅠ,collagenⅢ,fibronectin and con-nective tissue growth factor were markedly higher in the TGF-β,30 μmol/L myricetin+TGF-β and 100 μmol/L myricetin+TGF-β groups than in the control group (P<0.05) but lower in the 30 μmol/L myricetin+TGF-β and 100 μmol/L myricetin+TGF-β groups than in the TGF-β group (P<0.05). The phosphorylation levels of smad2 and smad3 were remarkably elevated in the TGF-β,30 μmol/L myricetin+TGF-β and 100 μmol/L myricetin+TGF-β groups and the expression of smad4 reduced in the TGF-β group as com-pared with the control group (P<0.05). The levels of smad2,smad3 and smad4 were all significantly decreased in the 30 μmol/L myr-icetin+TGF-β and the 100 μmol/L myricetin+TGF-β groups in comparison with the TGF-β group (P<0.05). Conclusion Myricetin suppresses the activation,proliferation and secretion of cardiac fibroblasts induced by TGF-β via inhibiting the smad signaling pathway.
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Objective To study the requirements for defibrillation protection testing and marking of the multi-parameter monitor to facilitate the manufacturer to understand related standards and design products rationally.Methods The background and principle were described for defibrillation protection testing of the monitor.The requirements of related standards were analyzed for defibrillation protection testing and marking,and the defibrillation protection flow was explored during the clinical application of the monitor.Results The multi-parameter monitor might be damaged in case of the monitor's deficiencies in the the defibrillation protection,even patient's failure in the defibrillation protection or death might occur,and the electrical shock could be caused also to medical staffs.Conclusion The defibrillation protection is of great significance for the multi-parameter monitor,and considerations have to be posed on standards requirements and the monitor's clinical application so as to decrease its use risks.
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<p><b>OBJECTIVE</b>To investigate the clinical value of ultrasound-guided laser thermal ablation (LTA) in the treatment of small liver cancer at high-risk sites.</p><p><b>METHODS</b>A total of 73 lesions ablated with LTA in 68 patients with small liver cancer. After the operation, the rates of complete ablation were compared between patients with lesions of different sizes and at different sites using contrast-enhanced ultrasound and the complications were recorded during the follow-up.</p><p><b>RESULTS</b>The complete ablation rates for carcinomas ≤1 cm, 1-2 cm, and 2-3 cm were 100%, 86.4%, and 82.7%, respectively, showing no significant differences among them (P>0.05). The complete ablation rates of lesions were similar between the high-risk and low-risk groups (85.7% vs 92.1%; P>0.05). The two groups showed no significant difference in the incidence of complications (9.1% vs 5.7%; P>0.05).</p><p><b>CONCLUSION</b>Ultrasound-guided LTA can be a good option for treatment of small liver cancers at high-risk sites.</p>
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Humans , Contrast Media , Follow-Up Studies , Laser Therapy , Methods , Lasers , Liver Neoplasms , Therapeutics , Treatment Outcome , Ultrasonic TherapyABSTRACT
Objective To analyze the clinical performance of chemiluminescence immunoassay (CLIA)in determination of trepo‐nema pallidum antibody(TP antibody) .Methods The results detected by enzyme‐linked immunosorbent assay( ELISA)were regar‐ded as relative standards ,and results detected by treponema pallidum particle assay (TPPA) were regarded as recognition criteria . 2 223 serum samples of outpatients and inpatients were collected ,and TP antibodies were detected by CLIA and ELISA method re‐spectively ,and followed by confirmation of TPPA test .Results Among 2 223 serum samples ,53 samples were TP antibody positive detected by ELISA and 60 samples were TP antibody positive detected by CLIA ,and the positive incidence of TP antibody detected by the ELISA and CLIA method was 2 .34% and 2 .65% respectively .The positive predictive value ,sensitivity and specificity of the CLIA method was 98 .33% ,100 .00% and 99 .95% ,repectively .Conclusion The CLIA method could be considered adequate for screening of TP antibody in a large volume of samples ,with characteristics of automatic ,quantitative and short turn around time .
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Invasive airway aspergillosis [IAA] is a rarely reported type of invasive pulmonary aspergillosis [IPA]. In most patients, IAA is associated with immune dysfunction or other underlying diseases. It is very rare in patients with normal immune function and without pre-existing diseases. We describe here, a previously healthy 58-year-old male farmer who presented to our department with cough and bloody sputum associated with shortness of breath and who was diagnosed with IAA despite having no apparent immunodeficiency
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Objective: To prepare the pH-dependent astragalus polvsaccharides colon-specific spray drying powder, with the intention of controlling drug release in the colon. Methods: Eudragit S100 water dispersion was used as a carrier to prepare astragalus polvsaccharides colon-specific spray drying powder by spray drying method and the in vitro dissolution of spray drying powder was performed. The structure characteristics of spray drying powder was analyzed by SEM. Results: When the ratio of drug to Eudragit S100 was 1:10, the drug in simulated gastric fluid did not release nearly and the accumulative drug-release percent in vitro at 4 h was less than 30.0%; But in the simulated colonic fluid, the accumulated drug release percent reached 90.0% within 1 h. Conclusion: The astragalus polysaccharides colon-specific spray drying powder had the characteristics as a colon-specific delivery system. The preparation process is simple and feasible.
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Objective: To evaluate the diagnostic performance of conventional ultrasound, compression elastography (CE) and acoustic radiation force impulse imaging (ARFI) in diff erential diagnosis of benign and malignant breast tumors. Methods: A total of 98 patients with liver lesions were included in the study. The images of conventional ultrasound, CE and the values of virtual touch tissue quantiifcation (VTQ) of breast lesions were obtained. hTe diagnostic performance of conventional ultrasound, CE and ARFI were assessed by using pathology as the gold standard, and then evaluate the diagnosis effciency of these three approaches in differential diagnosing benign and malignant breast tumors. Results: The specificity, sensitivity and accuracy in the diagnosis of malignant breast tumors for conventional ultrasound were 80.0%, 81.1% and 81.7%, respectively, whereas for CE elastic score were 85.7%, 86.7% and 86.3%, respectively. With a cutoff value of 3.71 for the SR, the sensitivity, speciifcity, accuracy in diagnosis of malignant breast tumors were 97.1%, 83.3% and 88.4%, respectively. With a cutoff value of 3.78 m/s for VTQ, the sensitivity, speciifcity, accuracy in diagnosis of malignant breast tumors were 94.3%, 91.7% and 92.6%, respectively. The difference in diagnosis efficiency among ARFI, CE and conventional ultrasound in differential diagnosis of benign and malignant breast tumors was signiifcant (P<0.05). Conclusion: Conventional ultrasound, CE and ARFI are all useful for the differential diagnosis of benign and malignant breast tumors. But the diagnosis effciency of ARFI is superior to CE and conventional ultrasound. The three approaches can help each other in differential diagnosis of benign and malignant breast tumors.
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@#Objective To observe the efficacy of a kind of complex composed of biphasic ceramic biologic bone (BCBB), bone morphogenetic protein (BMP) and basic fibroblast growth factor (bFGF) on the repair of necrotic areas of the femoral head. Methods The femoral head necrosis model of 64 femoral heads in 32 rabbits induced with microwave heating were randomly divided into four groups, which implanted with nothing (group A), BCBB/BMP (group B), BCBB/BMP/bFGF (group C) and with cancellous bone autograft (group D). The specimens were harvested separately at the end of 2, 4, 8 and 12 weeks after operation. 4 femoral heads were taken off at each interval in every group. A series of examinations were carried out including of naked eyes and gross anatomic observation, X-ray, histology, and blood vessel immunohistochemical staining. Results In group A, 1 femoral head collapsed by the end of 12 weeks, and there was only a little osteoid tissue formed. At the same time, a lot of new bone formed in group B and group C, and the boundary between the bone grafting area and the post bone still existed, but the boundary was unclear in group D, with the density consistent to the post bone. Under X-ray, the defect could be found and one femoral head collapsed in group A by the end of 12 weeks. The density of bone grafting area was high and the boundary to the post bone was unclear in group B and in group C. The density of bone grafting area was the same as the post bone and the boundary between them was unclear in group D. There was only a little osteoid tissue formed in group A by the end of 4 weeks. At the same time, there was a little new bone formed in group B, and BCBB was partly degraded. There was a lot of new bone formed in group C and group D, and BCBB was partly degraded in group C, but cancellous bone autograft was almost absorbed in group D. The new bone area by the end of 4, 8 and 12 weeks from more to less were: group C and group D (P>0.05), group B, and group A (P<0.05). At the end of 2, 4 and 8 weeks, the blood vessel area of group C was more than that of group A, group B, and group D (P<0.05). Conclusion The BCBB/BMP/bFGF complex can induced osteoinduction and revascularization, to repair rabbit femoral head necrosis as effective as cancellous bone autograft.
ABSTRACT
Objective To evaluate efficacy and safety of hormone combined mycophenolate mofetil (MMF) and tacrolimus (FK506) multiple targets treatment ,hormone combined intravenous cyclophosphamide pulse (IVC ) in the induction treatment of lupus nephritis .Methods The RCTs of MMF plus FK506 versus IVC in LN were searched from PubMed ,EMbase ,the Cochrane , CBM ,and CNKI .The literature were screened according to include and exclude standards ,evaluated the quality of the included stud-ies ,and performed meta-analyses using Revman 5 .1 software .Results It was identified 44 domestic RCTs papers including 331 pa-tients .Meta-analysis showed that multiple target therapy group had significantly superiority to IVC group in the induction treatment of Ⅴ + Ⅳ LN (RR=3 .94 ,95% CI 2 .10-7 .38 ,P<0 .01) ,while with no significant advantage for other pathological types of LN patients .Gastrointestinal reaction ,abnormal liver function ,the incidence of leukopenia ,menstrual disorders in multiple target thera-py group were significantly lower than that of IVC group for LN ,while the incidence of new hypertension group was significantly higher than the IVC group .Moreover ,multiple target therapy group could significantly reduce urine protein ,increase serum albumin and had a significantly higher anti-dsDNA negative conversion rate compared with IVC group .Conclusion Multiple target therapy is more effective than IVC for Ⅴ + Ⅳ LN in Chinese patients and with better security .Further large-scale RCTs are needed to con-firm these results .