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Objective:Investigate the prognostic value of high density lipoprotein (HDL) level in patients with streptococcal bloodstream infection.Methods:A total of 698 patients with streptococcal bloodstream infection admitted to the First Affiliated Hospital of Zhengzhou University from January 2015 to December 2019 were enrolled. Serum lipid and other clinical data of patients with positive blood culture within 48 h were recorded. The patients were followed up by telephone from January to March in 2020, and the end-point events were recorded, which were all-cause death 60 days after the diagnosis of streptococcal bloodstream infection. The patients were divided into two groups according to the levels of HDL: low HDL group (HDL ≤0.84 mmol/L) and high HDL group (HDL > 0.84 mmol/L). Univariate and multivariate Cox regression analysis were used to analyze the 60-day prognostic factors of patients with streptococcus bloodstream infection. The receiver operating characteristic (ROC) curve was used to explore predictive value of HDL level for 60-day prognosis of patients. Kaplan-Meier survival curve was used to compare the cumulative survival of patients with different HDL levels.Results:(1) A total of 491 patients were enrolled according to the inclusion criteria, and 461 patients were followed up successfully, with a follow-up rate of 93.89%. There were 373 survival patients and 88 death patients at 60 days, with a 60-day mortality rate of 19.09% (88/461). (2) There were significant differences in age, total cholesterol (TC), HDL, low density lipoprotein (LDL), platelets, albumin, fibrinogen, triglyceride (TG), creatinine, alanine aminotransferase, aspartate aminotransferase, white blood cell, PCT, total bilirubin, direct bilirubin, and respiratory failure and shock between the survival group and death group. (3) Multivariate Cox regression analysis showed that HDL ( RR=1.922, 95% CI: 1.186-3.117, P=0.008), aspartate aminotransferase ( RR=1.953, 95% CI: 1.233-3.094, P=0.004), shock ( RR=15.196, 95% CI: 6.953-33.211, P< 0.001), and respiratory failure ( RR=9.509, 95% CI: 4.232-21.367, P < 0.001) were independent risk factors for 60-day mortality of patients with streptococcal bloodstream infection. (4) The ROC curve analysis showed that HDL alone had a certain value in predicting the 60-day prognosis of patients with streptococcal bloodstream infection. The area under ROC curve (AUC) was 0.602, and the AUC of the combined predictive value of HDL, aspartate aminotransferase, shock and respiratory failure was 0.960, with a sensitivity of 92% and a specificity of 92%. (5) Kaplan-Meier survival curve analysis showed that the cumulative survival rate of patients without endpoint event in the HDL > 0.84 mmol/L group was higher than that in the HDL ≤ 0.84 mmol/L group, but without statistically significant difference (Log-Rank test: χ20.843, P<0.358). Conclusions:Patients with low HDL level of streptococcal bloodstream infection have an increased risk of 60-day death. HDL is an independent risk factor for 60-day death in patients with streptococcal bloodstream infection, and can be used as an indicator to evaluate the prognosis of patients with streptococcal bloodstream infection.
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Objective@#To prospectively investigate the feasibility of shear wave elastography (SWE) as a new quantitative and objective method for evaluating the stiffness of the gastrocnemius medialis (GM) muscle during passive stretching in patients with Parkinson’s disease (PD). @*Materials and Methods@#SWE of the GM muscle was performed in 28 patients with PD [13 female and 15 male; mean age ± standard deviation (SD): 63.0 ± 8.5 years] and 12 healthy controls (5 female and 7 male; mean age ± SD: 59.3 ± 6.4 years) during passive ankle rotation. A Young’s modulus-ankle angle curve was constructed. The GM slack angle and baseline Young’s modulus (E 0) were compared between the markedly symptomatic and mildly symptomatic sides of patients with PD, and healthy controls. Additionally, the correlation between the GM slack angle and the severity of rigidity, and the observer reproducibility of SWE in determining the GM slack angle were evaluated. @*Results@#The GM slack angle was smaller on both the markedly and mildly symptomatic sides in patients with PD than in healthy controls (mean ± SD of -29.13° ± 3.79° and -25.65° ± 3.39°, respectively, vs. -21.22° ± 3.52°; p < 0.001 and p = 0.006, respectively). Additionally, in patients with PD, the GM slack angle on the markedly symptomatic side was smaller than that on the mildly symptomatic side (p = 0.003). The E 0 value was lower on both the markedly and mildly symptomatic sides in patients with PD than in healthy controls (mean ± SD of 10.11 ± 2.85 kPa and 10.08 ± 1.88 kPa, respectively, vs. 12.23 ± 1.02 kPa; p = 0.012 and p < 0.001, respectively). However, no significant difference was found between the markedly and mildly symptomatic sides in patients with PD (p = 0.634). A negative linear relationship was observed between the GM slack angle and lower limb rigidity score on the markedly symptomatic side in patients with PD (r = -0.719; p < 0.001). The intraclass correlation coefficients for observer reproducibility of SWE ranged from 0.880 to 0.951. @*Conclusion@#The slack angle determined by SWE may be a useful quantitative and reproducible method for evaluating muscle stiffness in patients with PD.
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Platelet-rich plasma (PRP), the concentration of platelet and plasma, is rich of a variety of growth factors.It plays an important role in anti-inflammatory and tissue regeneration, and has gradually been used in cosmetology in the recent years.This paper introduces the application of PRP in facial rejuvenation, acne and alopecia treatment, as well as improving the survival rate of autologous fat transplantation. The side effects and prospectives of PRP application in cosmetology were also summarized.
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Objective@#To investigate the efficacy and outcome of transcatheter patent foramen ovale (PFO) closure in patients with cryptogenic stroke (CS).@*Methods@#Sixty consecutive patients with cryptogenic stroke who undertook transcatheter PFO closure between May 2015 and September 2017 in Beijing Tiantan Hospital were enrolled in this prospective study.Transcranial Doppler (TCD) bubble test was performed and right-left shunt(RLS) was confirmed in all patients.Closure success rate,effective closure rate, complications, recurrence of ischemic stroke and new onset atrial fibrillation were evaluated.@*Results@#A total of 60 patients (42 male,age range 24-68 (47±11)years) were included in the study.PFO size (motionless state) was (1.6±0.6)mm.RLS before closure was graded and 11 patients had moderate RLS and 48 patients had large RLS (include 41 patients who experienced shower or curtain effect).Closure success rate was 100% (60/60).No severe complications were observed.At 6 months,45 patients completed TCD bubble test.Of these, 4 patients suffered from moderate to large residual and thus effective closure rate was 91%(41/45).The mean follow-up period was 2-29 (median 12) months. During the follow-up, only 1 patient experienced recurrent cerebral infarction.New onset atrial fibrillation was not detected.@*Conclusion@#Transcatheter PFO closure is effective,safe and related with a good outcome in reduction of recurrent CS for patients with PFO.
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Purpose To discuss the clinical value of applying tissue motion tracking of mitral annular displacement (TMAD) technique to evaluate left ventricular global systolic function in patients with coronary heart disease. Materials and Methods Sixty patients with coronary heart disease who had at least one coronary stenosis ≥70% confirmed by coronary angiography were selected, and 35 healthy volunteer were enrolled as the control group. Three to five sequential two-dimensional dynamic images of cardiac cycle of four-chamber, three-chamber, and two-chamber apex cordis were collected and stored, and Qlab 7.0 software was used for off-line analysis. Maximal systolic displacement (Ds) of mitral annulus in six sites, systolic displacement of the middle point (D-mid) and left ventricular longitudinal fractional shortening (FSL) were measured and calculated for mean value respectively, which were then used for correlation analysis with left ventricular ejection fraction (LVEF) measured by simplified dual plane Simpson. Results ①Compared with control group, the mean value of Ds, D-mid and FSL of group A and B were significantly decreased, the difference of which was statistically significant (P<0.05). Compared with group A, the mitral annulus displacement parameters of group B decreased, the difference of which was statistically significant (P<0.05). ②Compared the time used for the two measuring methods: TMAD technology significantly reduced the measuring time compared to the two-dimensional dual plane Simpson's method (P<0.001). ③The mean values of Ds, D-mid and FSL in the control and coronary heart disease groups were all correlated with LVEF (r=0.77, 0.75, 0.78, P<0.001; r=0.78, 0.79, 0.78, P<0.001). ④Repeatability test: the intra-observer ICC values of the mean values of Ds, D-mid and FSL were 0.87, 0.85 and 0.93 respectively, and the inter-observer ICC values were 0.84, 0.84 and 0.88 respectively. Conclusion TMAD technology is time-saving, accurate and reproducible, which can be used to evaluate left ventricular systolic function in patients with coronary heart disease.
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Objective To optimize the lateral position of the operation,to improve the comfort of the lateral decubitus patients, to expose the incision adequately, and to improve the nursing quality of lateral decubitus surgery. Methods A total of 60 cases of thoracic surgery patients with lateral decubitus were divided into the control group and the test group according to the random number table method, 30 cases each. The control group used traditional lateral decubitus placement method, experimental group through the method and fixed on the traditional method of placing lateral limbs was improved, used in thoracic surgery especially in thoracoscopic surgery. The effect was compared between two groups. Results The time between the experimental group and the control group was respectively (5.6 ± 0.7), (9.0 ± 0.5) min, and the difference between the two groups was statistically significant (t = 26.944, P <0.01). In the two groups, the muscle soreness of 24 – 48 h after operation was 1 and 12 cases, and 2 groups were statistically significant(χ2=13.35,P<0.01).The postoperative satisfaction of the two groups of surgeons, anesthesiologists and nurses was statistically significant (Z =- 2.573, P < 0.01). Conclusions The modified lateral application in thoracic surgery is superior than the traditional lateral position, lateral position display method of time and labor saving, energy saving, expand the operation field,improve patient comfort,reduce costs,and improve the safety of nursing quality in operation room.
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Objective·To construct recombinant mycobacteriophage TM4-RpfE to lay a foundation for experimental research about how to eradicate Mycobacterium tuberculosis in combination with anti-tuberculosis drugs,and how to shorten treatment for tuberculosis ultimately.Methods·Electrotransformation was used to introduce pJV53 plasmid into Mycobacterium smegmatis to prepare recombinant engineering bacteria.After amplification of hsp60-RpfE fusion gene by overlap PCR,a long gene fragment (homologous +hsp60-RpfE+homologous,HHRH) was amplified by multi-step overlap PCR.The DNA of mycobaeteriophage TM4 and HHRH fragment were cotransfected into the recombinant engineering bacteria by electrotransformation,then the recombinant phage from the single primary plaques were confirmed by PCR and sequencing.SDS-PAGE was used to analyze the protein expression in recombinant phage.Results·The hsp60-RpfE fusion gene at the length of 901 bp and HHRH fragment at the length of 1 873 bp were identified by overlap PCR.The PCR product produced 955 bp and 301 bp DNA bands in the first generation plaques colony.SDS-PAGE analysis showed a specific protein band at 21 000 in the recombinant phages.Conclusion·The recombinant mycobacterium phage TM4-RpfE was successfully constructed and the expression of target gene RpfE was initially verified.
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Objective To investigate the imaging features in CT/MR of pancreatic neuroendocrine tumors(PNETs) with multiple lesions and further deepen the understanding of this disease .Methods A retrospective review of 12 PNETs patients′radiological data with pancreatic tumors′numbers≥2 and confirmed by surgery or fine needle aspiration biopsy in Changhai Hospital were conducted .Five cases underwent pancreatic CT plain and enhanced scan , 2 cases underwent MRI plain and enhanced scan , and 5 cases underwent both CT and MRI scan .Results There were totally 46 lesions in 12 patients.There were 29 (63.0%) lesions located in the pancreatic head and neck , and 17(37.0%) lesions located in body and tail of pancreas.The sizes of the lesions ranged from 0.8 to 9.5 cm,and the median size was 2.9 cm.Forty-four (95.7%) of the tumors was round or oval , and 2 ( 4.3%) was lobulated;44 ( 95.7%) mass solid and 2 (4.3%) was cystic.CT plain scan detected punctate , crescent or nodular calcification in 8(17.4%) lesions;enhanced scan found 42 lesions(91.4%) were markedly enhanced in the arterial phase , 2 lesions (4.3%) were markedly enhanced in the pancreatic phase;2 lesions (4.3%) were slightly enhanced and the degree of enhancement was lower than that of the normal pancreas .Four cases (33.3%) had dilatation of pancreatic duct and/or the bile duct, 4 cases (33.3%) had distant organ metastasis, 2 cases (16.7%) had lymph node metastasis, and 3 cases (25.0%) had vascular invasion .Conclusions PNETs can be multiple and vary in the size.Most of the lesions are round or oval solid lesions and the malignant signs for organ metastasis can be found occasionally .In dynamic enhanced scanning , the obvious enhancement of the solid portion in the tumor and the higher enhancement degree than that of normal pancreas is the main characteristic .
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Objective To investigate the clinical efficacy of Pingchuan cataplasm combined with hyperthermia therapy for stable chronic obstructive pulmonary disease (COPD) with qi deficiency syndrome of both lung and spleen. Methods Sixty patients of stable COPD with TCM syndrome of qi deficiency of both lung and spleen were selected and randomized into treatment group and control group, 30 cases in each group. Based on conventional treatment, the treatment group was treated by Pingchuan cataplasm combined with hyperthermia, and the control group was given analog stick applicator without additional heat treatment. After 6 weeks of treatment, the TCM symptom score and the time of the first exacerbation after treatment were observed. Results Compared with the control group, Pingchuan cataplasm can reduce the patients’ TCM symptom score (F=9.843, P=0.003), and extend the interval of acute exacerbation after treatment (F=4.451, P=0.040). Conclusion Pingchuan cataplasm combined with hyperthermia applicator can improve symptoms and reduce the frequency of acute exacerbation, thus can treat and prevent the acute exacerbation of COPD.
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Objective To explore the ultrasonographic characteristics of internal jugular vein(IJV) valve insufficiency and reflux.Methods 40 healthy volunteers' bilateral IJVs were study subjects.The inner diameter,valve morphological feature,reflux distance and hemodynamic parameters in IJV were detected by color Doppler ultrasound (CDU),the contrast agents transvalvular regurgitation in IJV was monitored by contrast-enhanced ultrasound (CEUS) (with low mechanical index,MI 0.10),then analyse the results of two methods.Results Of 80 investigated IJVs,1 vein was excluded due to absence of its left valve,so 79 veins were evaluated in the study.The IJV's inner diameter on the right side was larger than on the left side,but there was no significant difference (P ＞0.05).The detection rate of IJV valve insufficiency was 31.6％ (25/79),which was higher on the right than that on the left,but without significant difference (P ＞ 0.05).The detection rate of IJV valve insufficiency was significantly higher in the group of greater than or equal to 50 years old than that in less than 50 years old(P ＜0.05).The reflux distance in IJV displayed by CDU was associated with IJV valve's function.Compaired with sufficient valves,the reflux duration time in insufficient valves during quiet respiration showed no significant difference (P ＞0.05).During Valsalvalike manoeuvres and quiet respiration,the reflux duration time in sufficient valves showed no significant difference (P ＞ 0.05).The reflux duration time in insufficient valves during Valsalva-like manoeuvres showed significantly higher than that during quiet respiration (P ＜0.01).Compaired with sufficient valves,the peak flow velocity of reflux flow in insufficient valves was significantly prolonged during quiet respiration and Valsalva-like manoeuvres (P ＜0.05,P ＜0.01,respectively).Conclusions The incidence rate of IJV valve insufficiency and reflux is high in healthy individuals.During quiet respiration and/or Valsalva-like manoeuvres,detecting the reflux distance,reflux duration time and peak flow velocity of reflux flow by CDU are valuable in evaluating IJV valve insufficiency and the degree of IJV reflux.
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Objective To observe computed tomography features of neuroendocrine tumor of the pancreas.Methods Computed tomography scans for 28 patients with pathologically proven neuroendocrine tumor of the pancreas were retrospectively analyzed.The data of tumor locations,diameters of the tumor and internal composition,pattern of enhancement,changes of biliary and pancreatic duct,and lymphatic metastasis,remote metastasis were recorded.Results A total of 32 lesions were detected,24 lesions were single lesions,while 4 lesions were multiple lesions (2 lesions within pancreas).The shapes of these lesions were nodule-like or mass-like.Eighteen lesions were located in pancreatic tail,10 in pancreatic head,2 in pancreatic body,and 2 between pancreatic tail and body.Among the lesions located in pancreatic head,pancreatic duct dilation were detected in 5 cases,bile duct dilation in 1 case,both biliary and pancreatic duct dilation in 2 cases,and no dilation in the remaining 2 cases.The diameters of the tumor ranged from 1.0 to 20.0cm (mean5.1 cm),and the size was ＜2 cmin 1 case,2 ～5 cm in 23 cases; ＞5 cm in 8 cases.After enhancement,the lesions were enhanced to different degrees,and the peak value occurred in the pancreatic phase.Twenty-three lesions invaded adjacent vessels or organs,and lymphatic metastasis was observed in 5 cases,remote metastasis were recorded in 6 cases.Conclusions Neuroendocrine tumor of the pancreas has certain features on computed tomography.It is highly likely to make the pre-operative diagnosis when clinical data is also taken into consideration.
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This study was aimed to evaluate the number of acute exacerbation of chronic obstructive pulmonary disease (COPD) and quality of life with family pulmonary rehabilitation exercise. Randomized controlled method 584 was used in the study. The COPD patients in the stability drug treatment were divided into the treatment group and control group. The treatment group A was given health education and pulmonary rehabilitation training in the family. And the treatment group B was given health education and treatment of pulmonary rehabilitation training in the family with acupoint application therapy. Health education was given in the control group. Changes on the number of acute exacerbation of COPD and quality of life were observed. The intervention time was one year. The results showed that patients after one-year pulmonary rehabilitation exercise in the family, the acute exacerbation (AECOPD) times of treatment group A and group B were obviously decreased (P < 0.01) compared to pre-treatment. The OR value was (0.79, 2.02) and (0.59, 2.11), respectively. The quality of life of treatment group A and group B was obviously improved (P < 0.05). The OR value was (3.39, 10.11) and (4.23, 9.57), respectively. Compared to the control group, the quality of life in treatment group B was obviously improved (P < 0.05). The OR value was (0.59, 7.78). It was concluded that the pulmonary rehabilitation exercise in the family can decrease the number of AECOPD and improve the quality of life of patients, reduce the risk of COPD patients in the future. This method is worth popularizing in the clinical and community practice.
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This article was aimed to evaluate clinical efficacy of the pulmonary rehabilitation health education guidance mode. The CAT assessment tool was used for evaluation of stable chronic obstructive pulmonary disease (COPD) inpatients and outpatients in the Respiratory Department, Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University. A total of 80 stable COPD patients were randomized divided into the treatment group and control group. In the treatment group, stable COPD patients received pulmonary rehabilitation health education guidance. And then the quality of life was evaluated. The results showed that compared with the control group, after 48-week health education intervention, the CAT score and dyspnea index scale score of 40 patients in the treatment group were decreased with significant difference (P < 0.05). It was concluded that the guidance mode of pulmonary rehabilitation health education was conducive to improving the quality of life of pa-tients with COPD, decreasing the dyspnea index score, and improving exercise tolerance in patients to a certain extent. This pattern can be implemented in the optimization of future clinical practice and nursing.
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Objective To investigate the CT radiological features of pancreatic cystadenomas and cystadenocarcinomas. Methods The CT scans from 39 patients with pathologically proven cystic pancreatic tumors (21 cases of serous cystadenomas, 12 cases of mucinous cystadenomas, and 6 cases of mucinous cystadenocarcinomas) were retrospectively analyzed. Tumor location, the number of cyst (polycystic or not) , diameter of the largest cyst, features of the cyst wall, partition within cyst, border of tumor, and the relationship between tumors and pancreatic duct were recorded. Results In 21 patients with serous cystadenomas, tumors were located at the pancreatic head and neck areas in 17 cases, at the pancreatic body and tail areas in 5 cases, and 1 case was multiple. All 21 cases were polycystic; the median diameter of the largest cyst was 1.77 cm; calcification was seen in cyst wall or partition in 4 cases and soft tissue was seen in 7 cases; mild pancreatic duct dilatation was found in 10 cases. In 12 patients with mucinous cystadenomas, tumors were located at the pancreatic head and neck areas in 6 cases, at the pancreatic body and tail areas in6 cases; 4 cases were polycystic; the median diameter of the largest cyst was 4.88cm; calcification was seen in 1 case and soft tissue was seen in 6 cases; pancreatic duct dilatation was found in 2 cases and mild duct dilatation was found in 3 cases. In 6 patients with mucinous cystadenocarcinomas, tumors were located at the pancreatic body and tail areas in 5 cases, tumor was located at the pancreatic head and neck areas in 1 case; 4 cases were polycystic; the median diameter of the largest cyst was 5.09 cm; calcification was seen in 1 case and soft tissue was seen in 5 cases; duct dilatation was found in 1 case. In all cases, there was no pancreatic duct communication. After enhancement, the soft tissue and partition of lesion was enhanced to gome extent. Conclusions There are CT radiological features of pancreatic cystadenomas and cystadenocarcinomas. However, there are still some atypical CT appearances that may challenge the diagnosis.
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ObjectiveTo explore the value of intraoperative contrast-enhanced ultrasonography in distinguishing gliomas,peritumorous cerebral edema and peripheral normal cerebral tissues,and grading cerebral gliomas.MethodsIntraoperative contrast-enhanced ultrasonic imaging in 80 patients diagnosed cerebral gliomas were studied retrospectively.The blood perfusion patterns of gliomas,peritumorous cerebral edema and peripheral normal cerebral tissues were observed closely after contrast and parameters were recorded.ResultsAfter contrast-enhanced ultrasound,peripheral normal cerebral tissues showed homogeneous enhancement,the tumor tissues and peritumorous cerebral edema of high-grade gliomas (HGG) showed high enhancement,but peritumorous cerebral edema of low-grade gliomas (LGG) showed nearly homogeneous enhancement.Absolute peak intensity(API) of the tumor tissues were higher than those of peripheral normal cerebral tissues and peritumorous cerebral edema ( P ＜0.05).Time to peak (TTP) of the tumor tissues in HGG were shorter than those of peripheral normal cerebral tissues and peritumorous cerebral edema ( P ＜ 0.05).TTP of the tumor tissues in LGG compared with those of peripheral normal cerebral tissues and peritumorous cerebral edema,two groups had no statistical significance ( P ＞ 0.05).ConclusionsIntraoperative contrast-enhanced ultrasonography can reflect the boundary of the brain edema,which is useful to guide surgical resection effectively and helpful to grade cerebral gliomas.
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Methods Acute attack of asthma patients with 84 patients, divided into virtual Asthma Group, the other card-based group, another non-choice of 63 patients with asthma, as a control group. Detection of all selected in the peripheral blood TXA2; TPA, PAI; blood coagulation. Results ①asthma group and control group case-control study results: OR=2.950, 95% CI (1.504, 5.785) exposure risk of the disease as non-exposed group of 2.95 times. ②Asthma group and the control group between the various indicators of hemorheology, in addition to TPA (P＞0.05) no significant difference. Ms indicators are significant differences (P＜0.05), suggested that asthma in the blood change detection indicators relative to the control group have changed significantly. Conclusion ①"Stasis" and asthma-related, "Stasis" Asthma is a major cause of morbidity. ②From stasis treatment of asthma, Huoxue Huayu Prescription provide the basis for the treatment of asthma.
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Objective To evaluate the correlation between spiral CT ( SCT ) features and expression of cyclooxygenase-2 , nm23 in esophageal carcinoma.Methods Spiral CT scans were preformed in 44 patients with esophageal carcinoma before operation, and the results were compared with that of operation and pathology. Immunohistochemical streptavidin peroxidase conjugate method was used to analyze the expression of Cox-2 and nm23 in esophageal carcinoma. Statistical analysis was performed with SPSS 12.0 software. Results (1) The accuracy of spiral CT scan in judging adjacent- infiltration and lymph node metastasis in 44 patients was 88.6%(39 of 44) and 90.9% (40 of 44) respectively,there was significant coincidence with operation and pathology(P