Effect of continuous positive airway pressure on nocturnal blood pressure in patients complicated with obstructive sleep apnea-hypopnea syndrome and different circadian rhythms of hypertension / 中华健康管理学杂志

Objectives:To analysis the effect of continuous positive airway pressure (CPAP) on nocturnal blood pressure in patients complicated with obstructive sleep apnea-hypopnea syndrome (OSAHS) and different circadian rhythms of hypertension.Methods:A total of 61 eligible patients were monitored by overnight polysomnography (PSG) at the Sleep Center of the Affiliated Huaian No.1 People′s Hospital of Nanjing Medical University between January 2020 and April 2021. During the period of PSG monitoring, continuous non-invasive blood pressure (BP) and heart rate variability (HRV) were monitored simultaneously. Frequency domain analysis was used to measure HRV and low/high frequency was used to indirectly reflect sympathetic activity. According to the nighttime systolic BP decrease rate, patients were divided into three groups: dipper pattern (descent rate ≥10%), non-dipper pattern (descent rate was less than 10% but higher than 0) and reverse dipper pattern (descent rate≤0). The PSG parameters, BP data as well as sympathetic activity etc. were compared within and among groups before and after CPAP treatment. Multiple linear regression analyses were used to explore the influencing factors of antihypertensive effect of CPAP.Results:There were no significant differences in awake systolic BP (SBP) values, the severity of OSAHS, ESS scores, awake sympathetic activity and the other baseline data among the three groups. After CPAP treatment, the mean value of asleep BP in entire group showed a modest decline as compared to the baseline values [SBP decreased 4.6 mmHg (1 mmHg=0.133 kPa); diastolic blood pressure (DBP) decreased 2.4 mmHg, both P<0.001]. Subgroup analysis showed a significant reduction in asleep SBP of 11.1 mmHg and DBP of 4.9 mmHg (both P<0.001) in reverse dipper group, respectively, compared with the baseline values. While in dipper and non-dipper group, there were no significant differences before and after CPAP treatment in terms of BP (both P>0.05). In addition, there was no difference in awake sympathetic activity among three groups, while sleep sympathetic activity showed a gradual increasing trend. Sleep sympathetic activity decreased significantly from baseline after CPAP treatment in reverse dipper group ( P<0.001), while no differences were found in the other two groups before and after treatment. After controlling for baseline data such as age etc., the line regression model showed that the antihypertensive effect of CPAP was correlated with reverse dipper (SBP: β=0.548, P=0.002; DBP: β=0.454, P=0.013) and the improvement of nocturnal MpO 2 (SBP: β=0.410, P=0.046), but not with the severity of OSAHS, daytime sleepiness, or baseline BP values. Conclusion:For patients with moderate to severe OSAHS and hypertension, reverse dipper is an effective indicator to predict the antihypertensive effect of CPAP therapy.

False-Negative Results of Real-Time Reverse-Transcriptase Polymerase Chain Reaction for Severe Acute Respiratory Syndrome Coronavirus 2: Role of Deep-Learning-Based CT Diagnosis and Insights from Two Cases

The epidemic of 2019 novel coronavirus, later named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is still gradually spreading worldwide. The nucleic acid test or genetic sequencing serves as the gold standard method for confirmation of infection, yet several recent studies have reported false-negative results of real-time reverse-transcriptase polymerase chain reaction (rRT-PCR). Here, we report two representative false-negative cases and discuss the supplementary role of clinical data with rRT-PCR, including laboratory examination results and computed tomography features. Coinfection with SARS-COV-2 and other viruses has been discussed as well.

Neuroprotective potential of imatinib in global ischemia-reperfusion-induced cerebral injury: possible role of Janus-activated kinase 2/signal transducer and activator of transcription 3 and connexin 43

The present study was aimed to explore the neuroprotective role of imatinib in global ischemia-reperfusion-induced cerebral injury along with possible mechanisms. Global ischemia was induced in mice by bilateral carotid artery occlusion for 20 min, which was followed by reperfusion for 24 h by restoring the blood flow to the brain. The extent of cerebral injury was assessed after 24 h of global ischemia by measuring the locomotor activity (actophotometer test), motor coordination (inclined beam walking test), neurological severity score, learning and memory (object recognition test) and cerebral infarction (triphenyl tetrazolium chloride stain). Ischemia-reperfusion injury produced significant cerebral infarction, impaired the behavioral parameters and decreased the expression of connexin 43 and phosphorylated signal transducer and activator of transcription 3 (p-STAT3) in the brain. A single dose administration of imatinib (20 and 40 mg/kg) attenuated ischemia-reperfusion-induced behavioral deficits and the extent of cerebral infarction along with the restoration of connexin 43 and p-STAT3 levels. However, administration of AG490, a selective Janus-activated kinase 2 (JAK2)/STAT3 inhibitor, abolished the neuroprotective actions of imatinib and decreased the expression of connexin 43 and p-STAT3. It is concluded that imatinib has the potential of attenuating global ischemia-reperfusion-induced cerebral injury, which may be possibly attributed to activation of JAK2/STAT3 signaling pathway along with the increase in the expression of connexin 43.

Establishment and preliminary validation of a diagnostic prediction model for esophageal squamous cell carcinoma based on MALDI-TOF MS / 临床检验杂志

Objective@#To establish a diagnostic prediction model for esophageal squamous cell carcinoma (ESCC) and search the potential biomarkers of ESCC. @*Methods@#Serum samples from 59 patients with ESCC and 57 healthy controls were collected, and randomly divided into the training group (44 patients and 42 healthy controls) and validation group (15 patients and 15 healthy controls). Serum proteins/peptides were extracted and purified with weak cation-exchange chromatography Magnetic Beads (WCX-MB), and detected by the matrix-assisted laser desorption / ionization time-of-flight mass spectrometry (MALDI-TOF MS). Then the differentially expressed proteins/peptides were screened out, and a diagnostic prediction model for ESCC was established and preliminarily validated. @*Results@#The ClinProTools software identified 31 differential peptide peaks (P＜0.05), among which 18 peaks had significant difference (P＜0.01). Compared with healthy controls, 8 peaks were up-regulated in ESCC patients, while 10 peaks were down-regulated. Among them, the areas under the receiver operating characteristics (ROC) curve (AUC ROC ) of m/z 2 660.84 and m/z 5 336.49 peaks were 0.95 and 0.91, respectively, and their expressions were up-regulated in ESCC patients. The validation results showed that the accuracy, sensitivity and specificity of the diagnostic prediction model established by the genetic algorithm (GA) were 93.10%, 92.90% and 93.30%, respectively. @*Conclusion@#The established diagnostic prediction model may be used for the auxiliary diagnosis of ESCC. Two peptide peaks of m/z 2 660.84 and m/z 5 336.49 may be the potential biomarkers of ESCC.

Application of fast track surgery in Ttonsillectomy or adenoidectomy perioperative nursing / 中国实用护理杂志

Objective To explore the application effect of fast track surgery in tonsillectomy or adenoidectomy perioperative nursing. Methods Totally 123 Patients with tonsillectomy or adenoidectomy were selected as study group to receive the nursing care under the guidance of the concept of fast track surgery.74 patients with the same surgery from early clinical data who were treated by traditional nursing care were selected as control group. Postoperative pain score, length of hospital stay, the incidence of complications and the families of children with satisfaction were compared between the two groups. Results The average hospital stay was(4.56±1.28)d in the study group and(6.32±1.56)d in the control group. The difference was statistically significant (t=2.35, P<0.01). The postoperative hospital stay was (2.37±1.17)d,the control group was(3.18±1.34)d,the difference between the two groups was statistically significant(t=1.97,P<0.05).Pain score in the study group was 1.73±0.91,in the control group was 3.77± 0.84,the difference between the two groups was statistically significant(t=20.37,P<0.01).There was no significant difference in the incidence of complications between the two groups(P>0.05),and there were statistically significant differences in the satisfaction of children and their families (χ2=23.05,P<0.01). Conclusion Application of fast track surgery concept in the perioperative care of pediatric tonsil adenoidectomy can relieve postoperative pain,shorten the length of hospital stay,improve the satisfaction degree of the patients and their families and is worth of being generalized.

Clinical Evaluation of A New Pathological Classification for Non-small Cell Lung Cancer Based on Histogenesis of Bronchial Tree / 中国肺癌杂志

BACKGROUND@#Due in part to remarkable advances over the past decade in our understanding of lung cancer, there is a pressing need for a revised classification. The aim of this study was to explore and verify the clinical significance of a new molecular classification of non-small cell lung cancer (NSCLC) on the basis of anatomic site of bronchial tree.@*METHODS@#Double-immunohistochemistry were performed in 105 tumor samples paring with normal lung tissue from non-small cell lung cancer patients by using monoclonal antibody of P63/NapsinA and TTF-1/CK7. By comprehensively analyzing the express profiles of tumors and normal lung tissues, histological characteristics we proposed a brand new pathological classification based on histogenesis for NSCLC and divided them as: bronchiole epithelial cell carcinoma, bronchiole-alveolar cell carcinoma, alveolar cell carcinoma and secretory adenocarcinoma. And to analyze the relationship between this classification and epidermal growth factor receptor (EGFR) mutation and ognosis.@*RESULTS@#Further investigation revealed that our new classification showed strong relevancy with EGFR mutations and effective indicators for prognosis.@*CONCLUSIONS@#The classification system for NSCLC proposed by our research group is convenient for pathological diagnosis and valuable in clinical application.

Evaluation of risk factors and prognosis on diodone-induced acute kidney injury according to ESUR and KDIGO criteria / 中南大学学报(医学版)

OBJECTIVE@#To investigate the incidence, risk factors and prognosis for contrast-induced acute kidney injury (CI-AKI) according to ESUR and KDIGO criteria in patients undergoing angiography.
@*METHODS@#We evaluated 260 patients undergoing angiography and/or intervention therapy from April 2011 to January 2012 in the Second Xiangya Hospital of Central South University. All patients received low-osmolality contrast agent (ioversol). Serum creatinine was measured before angiography or at 48 or 72 h after procedure. The multivariate logistic regression was used to analyze the risk factors of CI-AKI. The major adverse events were observed in a year of follow-up.
@*RESULTS@#Among the 260 patients, 23 experienced CI-AKI and the incidence was 8.8% according to ESUR criteria. Twelve patients experienced CI-AKI and the incidence was 4.6% according to KDIGO criteria. The multivariate logistic regression analysis showed that diabetes mellitus and dehydration were the independent risk factors for CI-AKI according to ESUR criteria; In another KDIGO criteria, chronic kidney disease (CKD), hypercholesterolemia and diabetes mellitus were the independent risk factors for CI-AKI. The prognosis study showed that the mortality of patients with CI-AKI were significantly higher than those without CI-AKI (P<0.05).
@*CONCLUSION@#The incidence of CI-AKI is associated with diagnostic criteria. Diabetes mellitus, CKD, dehydration and hypercholesterolemia were the independent risk factors for CI-AKI. CI-AKI is a relevant factor for mortality in a year after angiography and/or intervention therapy.

Hearing Screening and Follow-up of High Risk Infant / 中国康复理论与实践

Objective To explore the hearing screening, and the change and outcome of hearing impairment of high risk infants. Meth-ods From March, 2015 to March, 2016, 336 high risk infants were screened with otoacoustic emissions (OAE), auditory brainstem response (ABR) and brainstem auditory evoked-potential (BAEP) 0-1, 3, 6, 12 months after born, respectively. Results Among the 336 high risk in-fants, 29 failed the examinations within the 1st month, 37 cases failed in the 3rd month, 27 cases recovered in the 9th month, and 7 cases re-covered in the 12th month, 3 cases were finally diagnosed as deafness (0.89%). Conclusion OAE, ABR combining with BAEP examination may obtain comprehensive diagnosis of hearing impairment for high risk infants, continuous listening comprehension monitoring can effec-tively dynamically observe the hearing impairment, changes and outcome of high risk infants.

Findings of MRI in Perihip Heterotopic Ossification / 中国康复理论与实践

Objective To investigate the MRI findings of perihip heterotopic ossification (HO) in the early, mid and late stages. Meth-ods The MRI of 44 inpatients with HO from February, 2011 to September, 2013 were reviewed, in which 20 cases (28 joints) were in early stage, 18 cases (24 joints) in mid stage and 6 cases (8 joints) in late stage. For the enhanced T1WI, 9 cases (11 joints) were in early stage, 6 cases (7 joints) in mid stage, and 3 cases (4 joints) in late stage. Theχ2 trend test was used to evaluate the MRI signal change with the HO maturity. Results With the maturity of hip HO, the signal intensity of T2WI reduced (χ2=16.773, P<0.001), fat signal on T1WI increased, the enhancement reduced (χ2=16.048, P=0.007). Conclusion The MRI findings of perihip HO are characteristic in MRI in all the stages. MRI is useful for the diagnosis of perihip HO, especially for the early HO.

MLL-SEPT5 Fusion Transcript in Two de novo Acute Myeloid Leukemia Patients With t(11;22)(q23;q11)

No abstract available.

Clinical treatment for elderly community-acquired pneumonia and its prognosis analysis / 中华老年医学杂志

Objective To observe the relationship between clinical medication and the prognosis in elderly community-acquired pneumonia (CAP).Methods A prospective randomized controlled single-blind study in Tianjin Hospital Internal Medicine.A total of 160 elderly patients with CAP were selected from January 2011 and January 2015.According to the computer,patients were randomly divided into treatment group and control group,80 cases in each group.Treatment group adopted routine treatment and moderate amount of glucocorticoids in combination with a low-dose of diuretic,and the control group only received routine treatment.In two groups of patients,we observed the initial treatment effect,change in pulse oxygen saturation,the rate of invasive test,the incidence of adverse reactions,mortality rate,total hospital stay,etc.Results Compared with control group,the initial treatment was better,the improvement rate in SPO2 was increased,and the rate of invasive test was decreased in treatment group 72 hours after treatment (x2 =6.234,3.906 and 7.059,respectively,P=0.013,0.048 and 0.008).After the overall prognosis and outcome analysis,compared with control group,the percentage of patients transferred to the intensive care unit,the mortality rate was decreased (x2=4.783 and 4.737,P=0.029 and 0.030),hospitalization cost was declined,and the total hospital stay was shorted (x2 =-72.087 and-5.127,both P＜0.0001).There was no statistically significant difference in the incidence of adverse reactions such as electrolyte disorder and mental disorder(both P＞0.05).Conclusions Corticosteroids in combination with a low-dose of diuretic for the auxiliary treatment of elderly CAP can reduce the mortality rate,decrease the rate of invasive test,and shorten the duration of hospitalization,with no obvious increase of adverse events,and it help to improve the prognosis of CAP patients.

A study on feasibility of emergency bedside ultrasound-guided central venous catheterization / 中华危重病急救医学

ObjectiveTo evaluate the feasibility and clinical significance of emergency bedside ultrasound-guided central venous catheterization performed by emergency department doctors.Methods The clinical data of 216 patients, who underwent central venous catheterization in the Department of Emergency of Shengjing Hospital of China Medical University from January 2009 to June 2014 were retrospectively analyzed. All the patients received femoral vein puncture or internal jugular vein catheterization. The patients were divided into three groups according to the method of catheterization: 72 patients received emergency ultrasound-guided central venous catheterization by emergency doctors independently were assigned as A group, 72 patients underwent catheterization by emergency doctors after being demarcated by ultrasound doctors served as B group, and 72 patients who underwent catheterization method guided by traditional landmark served as C group. Success rate, time spent for catheterization, number of attempts for intubation, and incidence of complications were compared among three groups.Results As compared with that of groups B and C, a higher success rate [98.61% (71/72) vs. 83.33% (60/72), 73.61% (53/72), bothP 0.05].Conclusion Emergency bedside ultrasound-guided catheterization resulted in higher success rate and less related complication, therefore it can be recommended for widely application in emergency department treatment.

Effect of Early Intervention on General Movements in Preterm Infants during Fidgety Movement / 中国康复理论与实践

Objective To investigate the effect of early intervention on general movements (GM) in preterm infants during fidgety move-ment. Methods 315 preterm infants during fidgety movement period were divided into intervention group (n=160) and control group (n=155). The intervention group accepted very early intervention program consisted of hospital intervention and family intervention, and the control group accepted routine treatment and nursing. The incidences of different kinds of GMs were compared. Results There is no statisti-cal difference (χ2=0.641, P=0.726) in writhing movement before intervention, and the fidgety movement presented more in the intervention group than in the control group (χ2=8.710, P=0.003), while the absence of fidgety movement was significantly fewer (χ2=5.685, P=0.017) af-ter intervention. Conclusion Very early intervention can reduce the incidence of absence of fidgety movement and improve fidgety move-ment.

Chemokine receptor CXCR7 and tumor / 国际肿瘤学杂志

CXCR7 is a new receptor of chemokine CXCL12 after CXCR4.The present study shows that CXCL12/CXCR7 biological axis has important influence to the development of a variety of tumors,similar to CXCL12/CXCR4 biological axis.CXCR7 is present in many kinds of tumor tissues and tumor cells widely,and plays an important role in tumor cells growth,proliferation,adhesion and migration.Restraining CXCR7 expression or blocking the CXCR7 signaling pathways may offer new strategies for the treatment of tumors.

The analysis of sacrococcygeal microcirculation in complete spinal cord injury patients / 中国实用护理杂志

Objective To assess the sacrococcygeal microcirculation and the change trend of complete spinal cord injury patients,and in order to provide evidence for turn-over time of spinal cord injury patients.Methods The spinal cord injury patients that met the inclusion criteria were set as the experimental group,patients with orthopedic trauma were named as the similar control group.And certain healthy volunteers were named as the healthy control group.The sacrococcygeal microcirculation of supine position for 1h,and lateral position for 0.5 h was monitored using Doppler blood flow monitor system,then take load period 0min、15m in 、30min、45min、60min,recovery period 0min、15min、30min as research points,the blood perfusion value and the change trend were monitored and analyzed.Results The sacrococcygeal microcirculation in SCI patients were significantly less than two control groups after 30min in supine position,and the blood flow increased at first and then decreased within one hour.While the healthy subjects increased gradually within one hour.Conclusions The time of position change for SCI patients should be reassessed,the interval should be controlled in one hour.

Application of Magnetic Resonance Diffusion Tensor Imaging in Intracerebral Hemorrhage (review) / 中国康复理论与实践

@#Intracerebral hemorrhage is a disease with high mortality and morbidity. This article discussed the application of magnetic resonance diffusion tensor imaging for intracerebral hemorrhage clinical research, and its limitations and prospect.

Imaging Features of Charcot Neuroarthropathy: 9 Cases Report / 中国康复理论与实践

@#ObjectiveTo investigate the imaging findings of Charcot neuroarthropathy. Methods9 cases with Charcot neuroarthropathy determined clinically or pathologically were reviewed. ResultsThe findings of X-ray and CT including: soft tissue swelling in 9 cases, bone absorption in 5, bone proliferation in 7, periosteal reaction in 7, ectopic calcification or ossification in 9, luxation or semiluxation in 4. For MRI: soft tissue swelling, edema of joint capsule in 2, bone marrow dropsy in 1, sclerotin damage in 1. The joint capsule and periarticular soft tissue unevenly enhanced after Gd-DTPA. Nuclear medicine displayed radioactivity aggregation in 1 case. ConclusionX-rays plain film is the first choice for the diagnosis of Charcot neuroarthropathy, while CT, MRI and nuclear medicine may be helpful.

The feasibility and accuracy of enhanced MR pulmonary perfusion imaging in evaluating therapeutic effect of pulmonary embolism / 中华放射学杂志

Objective To investigate the feasibility and accuracy of enhanced magnetic resonance pulmonary perfusion imaging(MRPP) in the diagnosis and follow-up of pulmonary embolism(PE). Methods Sixty patients suspected of PE underwent MRPP. Twenty-seven patients also underwent radionuclide perfusion imaging. 22 patients repeated MRPP examination after 3 day to 1 month anticoagulation or thrombolytic therapy. The feasibility and accuracy of MRPP in the diagnosis and follow-up of PE were evaluated according to the transformation rate of signal (TROS), time-signal curve and some parameters of main pulmonary artery(such as peak value of flow,mean flow velocity and flow rate). The t test and rank sum test were used for the statistics. Results MRPP showed a high agreement with radionuclide perfusion imaging. TROS was (2. 86 ± 2. 48 ) vs ( 6. 72 ± 2. 54) ( t = 3. 370, P ＜ 0. 01 ), the peak time was ( 13.98 ±5.60) vs ( 12. 33 ± 3.63 ) s ( t = 3. 930, P ＜ 0. 01 ), the peak value of main pulmonary blood flow was (60.39 ± 15. 17) vs (69.93±13.22) cm/s(t=2.930, P＜0. 01) and mean flow velocity (11.68±5.46) vs ( 13.54 ± 4. 18 ) cm/s ( t = 2. 380, P ＜ 0. 05 ) before and after anticoagulation or thrombolytic therapy. The flow rate per unit was (80. 57 ± 24. 87) vs ( 85.48 ± 11.81 ) ml/s ( t = 0. 86,P ＞ 0. 05 ) . Conclusion MRPP shows a high agreement with radionuclide perfusion imaging and is a useful method for the diagnosis and follow-up of PE.

Therapeutic effects of multi-dose activated charcoal on the acute dichlorvos poisoning in rats / 中华急诊医学杂志

Objective To assess the therapeutic effects of activated charcoal on the acute dichlorvos poisoning in rats. Method Thirty male clean grade Wistar rats were randomly (random number) divided into three groups: control group (group A, n = 10), single dose activated charcoal group (group B, n = 10) and multi-dose activated charcoal (group C, n=10). The rats of group A were suffered from 35 mg/kg dichlorvos exposure by oral without activated charcoal and senna. The rats of group B received 35 mg/kg dichlorvos exposure by oral with 175 mg/kg activated charcoal given immediately after dichlorvos exposure and 35 mg/kg senna given half an hour later. In the group C, 35 mg/kg dichlorvos was given to rats by oral with 175 mg/kg activated charcoal given immediately after dichlorvos exposure and 35 mg/kg senna given half an hour later and then every four hours. Blood samples were collected from the carotid artery at different intervals after exposure. DDVP concentration and total blood acetyl-cholinesterase activity were detected. Differences in serum DDVP concentration, Cmax, AUC (0→∞ ), MRT and acetylcholinesterase among three groups were calculated by using ANOVA. Results Serum DDVP levels in single dose group and in multi-dose group were significantly different from those in control group (P < 0.05). The DDVP levels in multi-dose group were significantly different from those in single dose group 4 hours after exposure (P < 0.05). The AUC and Cmax in activated charcoal treatment groups were significantly different from those in control group (P < 0.05). There were no significant differences in MRT among three groups. Fours hours after exposure to dichlorvos,the levels of serum acetylcholinesterase in rats of group B and group C were significantly different from that in rats of group A (P < 0.05), and there was no significant difference in acetylcholinesteras between group B and group C (P > 0.05). Another four hours later, no differences in acetylcholinesterase were found a-mong three groups (P > 0.05). Conclusions The peak concentrations of dichlorvos in blood are lower in group B and group C, and the blood acetylcholinesterase inhibition is quelled by activated charcoal. Therefore, the effects of multi - dose of activated charcoal is better than that of single dose of activated charcoal.