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Medical microbiology experiment is faced with many problems in online teaching. This study adopts the teaching mode of online live broadcast + operation video + virtual experiment, and make up the operation gap to some extent through operation video and virtual experiment. The mode of assessment is subjective thinking question (closely following the operation process) + experiment design + literature review (focusing on the key technology or new technology of clinical assessment that cannot be carried out due to the limitation of conditions in traditional experiments, such as mass spectrometry, fluorescence quantitative PCR, and G-test), and it is helpful to understand students' mastery of teaching objectives, and the ability of comprehensive application and innovative thinking. The student questionnaire shows that most students hold a positive attitude towards the online experimental teaching mode, and the quality of students' homework shows that most students have a good learning effect.
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OBJECTIVE To establish the infrared fingerprints of Achyranthes bidentata from different producing areas ，and to conduct multivariate statistical analysis. METHODS The infrared fingerprints of 61 batches of A. bidentata samples were established by Spectrum for Window 3.02 and OMNIC 9.2 software. Taking the relative peak height of common peaks of infrared fingerprint as the variable ，the normal distribution analysis was carried out by Excel 2016 software；SPSS 22.0 software was used for cluster analysis and principal component analysis ，and the comprehensive score was calculated ；the orthogonal partial least squares-discriminant analysis was carried out by SIMCA 14.1 software，and the marker wave numbers affecting the quality of A. bidentata were screened by taking the variable importance in projection （VIP）＞1 as the standard. RESULTS The correlation coefficients of infrared spectra of 61 batches of A. bidentata samples were 0.967 2-0.997 7；there were 13 common peaks. The results of normal distribution analysis showed that the normal distribution curve of relative peak height of common peaks for A. bidentata from Henan and Hebei did not cross ，and the normal distribution curve of A. bidentata from Henan and Inner Mongolia crossed. The results of cluster analysis showed that when the distance between groups was 15，61 batches of A. bidentata samples could be clustered into 3 categories，including N 1-N12 were clustered into one category ，N13-N45 were clustered into one category，and N 46-N61 were clustered into one category. The results of principal component analysis showed that the cumulative variance contribution rate of the first three principal components was 91.121％；comprehensive score of qq.com A. bidentata （number N 40） in Jiabu village ，Jiaozuo City ， Henan Province was the highest （2.39）， and that of A.bidentata（number N 4）in Xin ’an village ，Anguo City ，Hebei Province was the lowest （－2.89）. The results of orthogonal 163.com partial least squares-discriminant analysis showed that 61 batches of A. bidentata samples were divided into three categories ，including N 1-N12 were clustered into one category ，N13-N28 were clustered into one category and N 29-N61 were clustered into one category. Seven marker wave numbers affecting the quality were selected. The corresponding wave numbers of VIP from large to small were 1 059，927，2 933，813，1 732，1 128 and 3 367 cm－1，1 732 cm－1 was the characteristic obsorption peak of saponins ，1 059，1 128，927 cm－1 were the characteristic obsorption peaks of glycosides. CONCLUSIONS Infrared fingerprint combined with normal distribution analysis ，cluster analysis ，principal component analysis and orthogonal partial least squares-discriminant analysis can be used to identify A. bidentata from different producing areas.
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Objective To explore the prognostic factors of the pathological complete response of internal mammary lymph node (ipCR) after neoadjuvant chemotherapy and its effect on breast cancer prognosis. Methods We retrospectively analyzed the clinical data of 70 patients with primary breast cancer with internal mammary lymph node metastasis who received neoadjuvant chemotherapy. Patients were divided into the ipCR group and non-ipCR group based on their postoperative pathology. χ2 test, Fisher, and Logistic regression were used for univariate and multivariate analysis. Meanwhile, the Kaplan-Meier curve and Cox regression were used for prognostic analysis. Results Of 70 patients, 31 obtained ipCR (44.3%). Univariate analysis showed that the expression levels of apCR, HR, and HER2 status were related to ipCR (P < 0.05). Multivariate analysis showed that age, apCR, and HER2 status were independent predictors of ipCR (P < 0.05). The average DFS of ipCR group was better than non-ipCR group (96.0 vs. 67.1 months, P < 0.05). The risk of recurrence and metastasis was 87% lower in the ipCR group than in the non-ipCR group (HR=0.13, 95%CI: 0.04-0.44, P < 0.01). ipCR, Ki67 expression level, and breast pCR (bpCR) were independent factors affecting patients' prognosis. Conclusion There is a correlation between clinico pathological factors and ipCR after neoadjuvant chemotherapy. ipCR can be used to predict the prognosis of patients with internal mammary lymph node metastasis.
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Objective To analyze the efficacy and safety of trastuzumab (H) and pertuzumab (P) combined with different chemotherapy regiments in neoadjuvant therapy for HER2-positive breast cancer. Methods We retrospectively analyzed the clinical data of the patients with HER2-positive breast cancer who received HP combined with chemotherapy as neoadjuvant therapy and completed surgery. The primary endpoint was total pathologic complete response (tpCR) (ypT0/isypN0), the secondary endpoints were breast pathologic complete response(bpCR) (ypT0/is) and axillary pathologic complete response (apCR) (ypN0), and the factors influencing pCR were analyzed. Results A total of 63 patients were included, of whom 23 were treated with TCbHP, 27 were treated with THP regimen, and 13 were treated with AC-THP. The overall tpCR rate was 65.1%, of which TCbHP was 73.9%, THP was 55.6%, and AC-THP was 69.2%. The tpCR rate of HR-negative patients was 79.2%, higher than that of HR-positive 56.4%. The overall bpCR rate was 69.8%, and apCR rate was 81.0%. Univariate analysis showed that HER2 status was a related factor affecting tpCR (P=0.023). The total effective rate by MRI was 87.3%. The level 3 and 4 toxicity of the TCbHP regimen was slightly higher than those of the THP and the AC-THP regimens. Conclusion HP combined with chemotherapy have achieved relatively high pCR. HER2 status is a related factor that affects tpCR. The adverse reactions are controllable.
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OBJECTIVE To investigate the eff ects of different habitat processing methods on the quality of Cyperus rotundus ， such as sun-drying after steaming ，sun-drying after boiling and direct sun-drying ，and to investigate the optimal habitat processing method of C. rotundus from the perspective of chemical component. METHODS The fingerprint of C. rotundus was established by high performance liquid chromatography （HPLC）combined with the Similarity Evaluation System for Chromatographic Fingerprint of TCM （2012 edition）. The similarity evaluation was conducted to determine the common peak. Cluster analysis （CA）combined with principal component analysis （PCA）and partial least squares-discriminant analysis （PLS-DA）was used to differentiate and compare C. rotundus treated by different habitat processing methods. And the contents of cyperrenone ，α-cyperone，luteolin and ferulic acid in C. rotundus were determined by HPLC. RESULTS There were 22 common peaks in the HPLC fingerprints of C. rotundus reated by different habitat processing methods ；their similarities were higher than 0.9；common peak 16 and common peak 20 were cyperrenone and α-cyperone. CA results showed that C. rotundus boiled for 4，8 and 12 min were clustered into one category，the rest of the samples clustered into one category. PCA results showed that comprehensive score of C. rotundus steamed for 10 and 15 min and boiled for 2 min were the highest. The steaming treatment had small effect on comprehensive score of samples，while the boiling treatment had a great effect on the quality of the samples ；the overall score of samples decreased sharply after boiling for 2 min. Results of PLS-DA showed that variable importance projection （VIP）of peak 20（α-cyperone），peak 16 （cyperrenone），peak 22，peak 17 and peak 22 in HPLC fingerprints were all higher than 1. The results of content determination showed that there was significant difference in the contents of α-cyperone，cyperrenone and luteolin in samples treated by different habitat processing methods.With the increase of steaming and boiling time ，the contents of α-cyperone，cyperrenone and luteolin showed a significant downward trend ，and boiling had a great impact on them. CONCLUSIONS Too long boiling treatment greatly；2019 destroys the chemical composition of C. rotundus ， andsteaming for 10，15 min or boiling for 2 min is the optimal processing method.
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Lower extremity artery disease (LEAD) is a progressive atherosclerotic process that results in progressive limb ischemia leading to life-altering claudication, nonhealing ulcers, limb amputation, which reduces the patient′s quality of life and even threatens life. SPECT can provide noninvasive quantitative evaluation of lower extremity blood perfusion with high sensitivity, and has advantages on patient management, such as early detection, severity evaluation, treatment protocol development and therapeutic effect monitoring. Moreover, radionuclide-labeled molecular targeting imaging agents can directly show ischemia-induced angiogenesis. This article reviews the application and progress of SPECT in LEAD.
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OBJECTIVE：To summarize and analyze t he clinical characteristics of acarbose-induced skin ADR ，and to provide reference for its therapy. METHODS ：Clinical pharmacists participated in the treatment of a patient with acarbose-induced skin ADR. The patient developed erythema multiforme several days after oral administration of Acarbose tablets （100 mg/d）. After consultation by dermatology and clinical pharmacy ，considering that the adverse reaction was related to acarbose ，clinical pharmacists suggested to stop the drug. Based on the above cases ，clinical pharmacists searched Wanfang database ，CNKI， PubMed，Embase and other databases to collect case reports of skin ADR caused by acarbose ，summarize its general situation （gender，age，usage and dosage ，etc.），latency，ADR（diagnosis and manifestation ），intervention and outcome ，etc. RESULTS ： The doctor adopted the pharmacist s’advice，stopped the use of acarbose ，and gave symptomatic treatment as Methylprednisolone sodium succinate for injection 40 mg（intravenous injection ，qd）+Medloratadine tablets 8.8 mg（oral administration ，qd）+Calamine lotion（for external use ）. The patient improved and was discharged after 10 days. A total of 12 literatures involving 12 patients were retrieved. Among the 13 patients included in the analysis （including the above clinical case and 12 literature cases ），there were 8 males and 5 females，and 8 patients of them aged 50 and over；the dosage of acarb ose in most patients was within the requirements of the drug instructions. The primary diseases of 12 patients were diabetes mellitus. The latency of skin ADR in 11 patients was within 6 days of administration. Among the 13 patients，the ADR were diagnosed as rash in 4 cases，pustulosis in 3 cases， erythema multiforme in 2 cases， urticaria in 2 cases， maculopapular rash in 1 case and lip swelling in 1 case. The ADR of 1 patient improved after drug withdrawal ，and 12 patients also improved after drug withdrawal and symptomatic treatment such as glucocorticoid or antihistamine. Acarbose was re-used in 2 patients after the improvement of first skin ADR ，and skin ADR occurred again ，and the ADR were improved after drug withdrawal and symptomatic treatment. CONCLUSIONS ：Skin ADR are acarbose-induced rare ADR ，mostly within 6 days of medication ，and are more likely to occur in middle-aged and older men. When the patients suffer from ADR ，the drug should be stopped in time and given glucocorticoids or antihistamines for symptomatic treatment. Clinical pharmacists should do a good job in drug publicity and education ，remind patients to closely monitor relevant indicators and ensure drug safety.
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OBJECTIVE：To explore the role of pharmacists i n developi ng the outpatient and emergency prescription pre-audit with the help of rational drug use software. METHODS ：With the help of rational drug use software ，outpatient and emergency prescription pre-aduit was conducted during Jan.-Apr. 2020；the intervention effects of irrational prescriptions were analyzed. The prescriptions from Sept. to Dec. in 2019 were included in the control group （only for post review ），and the prescriptions from Jan. to Apr. in 2020 were included in the intervention group （pre-audit and post review ）；the unreasonable prescriptions were compared before and after the intervention. The prescriptions intercepted by the software system from Nov. to Dec. in 2019 were further selected as the interception control group ，and the prescriptions intercepted from Jan. to Feb. in 2020 were selected as the interception intervention group ；the interception situation of prescriptions before and after the intervention was compared ，and the influence of pre-audit on physicians ’prescription behavior was evaluated. In addition ，108 992 prescriptions in Apr. 2020 were selected for post review using the traditional model （i.e. complete manual audit ）and the information model （i.e. software-assisted manual audit ）respectively；the effects of two models were compared. RESULTS ：From Jan. to Apr. in 2020，a total of 2 393 prescriptions were pre-audited by pharmacists ，among which 1 387 prescriptions were reasonable （57.96％）and 1 006 prescriptions were unreasonable and intervened （42.04％）. After pharmacist intervention ，983 prescriptions were modified by doctors ，and the success rate of intervention was 97.71％ . Compared with control group ，unreasonable rate of outpatient and emergency prescriptions，that of each type of prescriptions were all decreased significantly （P＜0.001）. Compared with interception control group（1 402 pieces），the number of intercepted prescriptions （721 pieces）was significantly reduced in interception intervention group （P＜0.001）. Compared with traditional model ， the number of prescriptions requiring manual post review and E-mail：xss306@126.com “false positive ” prescriptions were decreased significantly # under information model ， and the number of discovered unreasonable prescriptions were increased significantly （P＜ 0.001）. CONCLUSIONS ：With the help of rational drug use software ，prescription pre-audit by pharmacists can significantly improve reasonable rate of outpatient and emergency prescriptions. The work intensity of pharmacists in post review of prescriptions can be reduced and the accuracy of prescription review can be improved in the information mode.
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Objective:To review the practice of introducing nuclear medicine systematic courses into the standardized residency training in imaging specialty in recent years, and to explore the effect of nuclear medicine systematic courses on the training quality.Methods:A total of 105 residents participated in the training of nuclear medicine from 2015 to 2017 were enrolled in this study. During the training period, those who took the complete nuclear medicine systematic courses were assigned to the teaching group, and the other 52 residents who participated in the standardized residency training from 2012 to 2014 but not received the systematic courses were enrolled in the non-teaching group. The results of the completion examination, including the theoretical written test and the film reading skill test, were analyzed as the evaluation index to compare the differences between the results of two groups by the Mann-Whitney U test using SPSS 22.0.Results:The median scores of the theoretical test and the reading skill test in the teaching group were 93.52 (72.00-100.00) and 92.00 (70.00-98.00), respectively; while, the corresponding scores in the non-teaching group were 88.00 (64.00-96.00) and 90.00 (60.00-96.00), respectively. The scores of theoretical test and skill test in the teaching group were both significantly higher than those in the non-teaching group ( P=0.005, P=0.001). Conclusion:It is necessary and feasible to carry out comprehensive nuclear medicine systematic courses in the standardized residency training in imaging specialty, which can improve the theoretical basis and clinical skills of students and help to improve the overall training quality.
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Objective To investigate the expression level of hypoxia-inducible factor-lot (HIF-1ot) in gastric cancer and its relationship with clinicopathological characteristics and prognosis of patients with gastric cancer.Methods From March 3,2011 to September 28,2012,49 patients with gastric adenocarcinoma tissue chips were selected from pathology department of our hospital.They were matched with paracancerous tissues.The expression levels of HIF-1α were measured by immunohistochemistry method in gastric cancer tissues and paracancerous tissues chips.Kaplan-Meier was used to evaluate the progression-free survival (PFS) and overall survival (OS),and the Cox proportional hazards model was used to analyze whether HIF-1α was a prognostic factor.Results The high expression rate of HIF-1α protein in gastric cancer was significantly higher than that in paired para-carcinoma group (42.9％ vs.4.1％,x2 =20.509,P ＜ 0.001).The expression of HIF-1 α protein was related to TNM stage (x2 =4.601,P =0.032),vascular invasion (x2 =6.766,P =0.009) and degree of differentiation (x2 =7.969,P =0.005).Compared with patients with low expression of HIF-1α,the median PFS (16.2 months vs.27.3 months) and median OS (34.8 months vs.43.8 months) were shorter in the patients with high expression of HIF-1 α,and the differences were statistically significant (median PFS:x2 =4.661,P =0.002;median OS:x2 =6.903,P =0.009).The results of single factor analysis showed that overexpre-ssion of HIF-1α was correlated with PFS and OS (PFS:HR =4.461,95％ CI:1.969-10.802,P ＜0.001;OS:HR =3.109,95％CI:1.274-7.588,P =0.013).The results of Cox multivariate analysis showed that overexpression of HIF-1α was the independent risk factor that affected the survival and prognosis of patients with gastric cancer (PFS:HR =4.747,95％ CI:2.175-10.230,P ＜0.001;OS:HR =3.171,95％ CI:1.358-7.404,P =0.008).Conclusion The high expression rate of HIF-1α protein in gastric cancer tissues is significantly higher than that in paracancerous tissues.The expression of HIF-1α is associated with TNM stage,vascular invasion,degree of differentiation in patients with gastric cancer.The high expression of HIF-1α is associa-ted with the shorter median OS and PFS.The high expression of HIF-1α is an independent risk factor for the survival and prognosis of patients with gastric cancer,which is expected to be an independent marker of poor prognosis.
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Objective To investigate the clinical significance of 18 F?FDG PET/CT in assessment of Tomita score in spinal metastases. Methods From October 2012 to October 2015, a total of 77 patients (38 males, 39 females;average age:56.5 years) with suspicious spinal metastasis tumors underwent 18F?FDG PET/CT scan and were included in this retrospective study. Spinal metastasis were confirmed by pa?thology. Each patient was evaluated by the scoring system of Tomita according to the grade malignancy of pri?mary lesions and metastasis of organs and bones in PET/CT. Results Seventy?two patients were osteolytic metastases. Among them, only 23 patients received operative procedure. There were 2 patients with osteoblas?tic metastases, and 3 patients with both osteolytic and osteoblastic lesions. The average Tomita score of opera?tion group was 5.7. Two to three scores were assessed in 2 patients, 4-5 scores in 9 patients, 6-7 scores in 9 patients, and 8-10 scores in 3 patients. The average score of non?operation group was 8.8. One case got 2-3 scores, 2 patients got 4-5, 18 patients got 6-7, and 33 patients got 8-10. Conclusion PET/CT is a convenient and effective tool for assessment of Tomita score in patients with spinal metastases.
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Objective To evaluate the value of 18F-FDG PET/CT in diagnosis of renal cell carcinoma (RCC).Methods Totally 32 patients with RCC confirmed by pathology were analyzed retrospectively.The tumor diameter and maximum standard uptake values (SUVrmax) of different pathological types (clear and none clear RCC),different Fuhrman grades (high grade and low grade of clear RCC) and different clinical stages (distant and without distant metastases) were ana lyzed and compared.Results 32 RCC patients including 33 primary tumors,31 lesions were detected by PET/CT and 2 were false negative,the detection rate was 93.94％.The PET/CT findings of 31 primary lesions were mixed density soft tissue masses,and the 18F-FDG uptake accessible,above or below to the normal renal parenchyma;the other 2 lesions of PET/CT findings were normal.18F-FDG uptake of vein tumor thrombus in 8 cases and metastases in 19 cases were higher than the organs affected.The tumor diameter and SUVmax had no statistically significant difference in different pathological types and Fuhrman grades;The tumor diameter had no statistically significant difference,and SUVmax had statistically sig nificant (t=3.852,P=0.001) between different clinical stages.Conclusion The PET/CT findings of RCC primary lesion are varied,and small clear RCC with low Furhman grade may have no obvious abnormality and missed diagnosis;18F-FDG PET/CT has important value in the preoperative staging of RCC.
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OBJECTIVE@#To explore the role of calpain in pulmonary vascular remodeling in hypoxia-induced pulmonary hypertension and the underlying mechanisms. @*METHODS@#Sprague-Dawley rats were randomly divided into the hypoxia group and the normoxia control group. Right ventricular systolic pressure (RVSP) and mean pulmonary artery pressure (mPAP) were monitored by a method with right external jugular vein cannula. Right ventricular hypertrophy index was presented as the ratio of right ventricular weight to left ventricular weight (left ventricle plus septum weight). Levels of calpain-1, -2 and -4 mRNA in pulmonary artery were determined by real-time PCR. Levels of calpain-1, -2 and -4 protein were determined by Western blot. Primary rat pulmonary arterial smooth muscle cells (PASMCs) were divided into 4 groups: a normoxia control group, a normoxia+MDL28170 group, a hypoxia group and a hypoxia+MDL28170 group. Cell proliferation was detected by MTS and flow cytometry. Levels of Ki-67 and proliferating cell nuclear antigen (PCNA) mRNA were determined by real-time PCR. @*RESULTS@#RVSP, mPAP and right ventricular remodeling index were significantly elevated in the hypoxia group compared to those in the normoxia group. In the hypoxia group, pulmonary vascular remodeling was significantly developed, accompanied by up-regulation of calpain-1, -2 and -4. MDL28170 significantly inhibited hypoxia-induced proliferation of PASMCs concomitant with the suppression of Ki-67 and PCNA mRNA expression. @*CONCLUSION@#Calpain mediates vascular remodeling via promoting proliferation of PASMCs in hypoxia-induced pulmonary hypertension.
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Animals , Rats , Calpain , Genetics , Physiology , Cell Proliferation , Dipeptides , Physiology , Hypertension, Pulmonary , Genetics , Hypertrophy, Right Ventricular , Hypoxia , Ki-67 Antigen , Myocytes, Smooth Muscle , Physiology , Proliferating Cell Nuclear Antigen , Pulmonary Artery , Rats, Sprague-Dawley , Real-Time Polymerase Chain Reaction , Up-Regulation , Vascular Remodeling , Genetics , PhysiologyABSTRACT
Aim To explore micro RNAs-integrated pathogenic signaling to control endothelial-mesenchy-mal transition ( EndMT ) in pulmonary hypertension ( PH) by a network bioinformatic approach. Methods Literature-mining method was used to find PH-relat-ed genes and EndMT/EMT-related miRNAs. Bioinfor-matic prediction approach ( DIANA3 , Miranda4 , PicT-ar5 , TargetScan6 , miRDB7 and microT-CDS8 ) was used for miRNA target prediction. Hypergeometric a-nalysis was used to predict miRNAs related to EndMT in PH. The analysis of interactions between PH-rele-vant genes( PH network) was performed with the use of Biological General Repository for Interaction Datasets ( BioGRID ) . These miRNAs were ranked with the highest probability of substantial overlap among their gene targets in the PH-network, the relationship be-tween their targets and the PH functional categories which include hypoxia, inflammation, and transforming growth factor/BMP signaling. Then, the part of results was validated by animal experiment. Lastly the miR-NA-Target network was built using Cytocape 3 . Results List of 230 genes was compiled that were directly im-plicated in the development of PH and 189 miRNAs were related to EndMT in PH. Among 189 miRNAs, only 22 microRNAs(miR-let-7 family, miR-124, miR-130 family, miR-135, miR-144, miR-149, miR-155, miR-16-1, miR-17, miR-181 family, miR-182, miR-200 family, miR-204, miR-205, miR-21, miR-224, miR-27, miR-29 family, miR-301a, miR-31, miR-361 and miR-375) were related to hypoxia, inflamma-tion, and transforming growth factor/BMP signaling. Among these miRNAs, the levels of let-7g, miR-21, miR-124 and miR-130 family were significantly changed in the pulmonary artery in hypoxia-induced PH rats. Conclusions Among numerous miRNAs,22 of which may be involved in hypoxia, inflammation, and transforming growth factor/BMP signaling and re-lated to EndMT in PH by network bioinformatic ap-proach, which provides a theoretical basis for further investigation of EndMT in PH.
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PurposeThe increased radionuclide uptake of maxillary frontal process on bone scan is not uncommon but dififcult to diagnose with relatively rare research. This study aims to explore this phenomenon through investigating its biological behavior and causes.Materials and Methods Twenty-one patients with increased uptake of maxillary frontal process but without typical feature of metastasis on bone scan were retrospectively enrolled in the study. The scintigraphic features were evaluated and compared with the bone scans in the follow up. The corresponding CT imaging features including the lesions'location, number, size, shape and attenuation were analyzed.Results Seventeen patients had unilateral involvement and 4 had bilateral ones. One patient was found accompanied with other cranial lesions. All the lesions remained stable and no new lesions were detected on the following bone scans in 14 patients. Sixteen lesions with increased radionuclide uptake in 12 patients were detected on bone scintigraphy, 15 of which were positive on CT and 14 of which were located around the nasolacrimal canal at the base of frontal process. All the lesions were well demarcated with mean axial maximum diameter of 7.1 mm. Ten had homogeneous ground-glass density and 5 showed heterogeneous with internal lower attenuation.Conclusion Lesions of maxillary frontal process with increased radionuclide uptake detected on bone scan are likely to be benign. Fibrous dysplasia-like lesions might help account for abnormal uptake indicated by CT.
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Objective To differentiate between peri-prosthetic infection and aseptic loosening using quantitative analysis of triphasic bone scintigraphy.Methods Twenty-eight patients (9 males,19 females; mean age 67.5 years,range 49-80 years) with recurrent joint pain after arthroplasty were retrospectively assessed.All patients underwent triphasic bone scintigraphy.ROI of each joint was drawn and the ratios of affected to unaffected side were calculated.The ratios of blood flow phase,blood pool phase,static phase,Creactive protein (CRP) and erythrocyte sedimentation (ESR) were quantitatively analyzed by ROC curve.The final diagnosis was based on microbiological and histological examinations.The optimal cut-off value was chosen based on the ideal sensitivity and specificity.Results Nine patients were diagnosed as septic loosening,17 patients aseptic loosening,1 patient bursitis of hip joint and 1 patient suture reaction.Taking the positive results of blood flow phase or blood pool phase as standard for diagnosing septic loosening,the sensitivity,specificity and accuracy of bone scintigraphy were 7/9,78.9％ (15/19) and 78.6％ (22/28),respectively.The AUC of blood pool phase was 0.942,and the sensitivity and specificity were 8/9 and 78.9％(15/19),respectively,with the optimal cut-off value of 1.40.The AUCs of blood flow ratio and CRP were 0.816 and 0.795,with cut-off values of 1.53 and 1.20,respectively.The AUCs of static phase ratio and ESR were 0.474 and 0.722,respectively,both P＞0.05.Conclusions For the diagnosis of septic loosening,quantitative analysis of triphasic 99Tcm-MDP bone scintigraphy,particularly with the ratio of blood pool phase,is more accurate than qualitative analysis.
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Objective To investigate the pattern of outpatients traffic,orchestra service resources,and optimize service provision,for a harmonized outpatient service.Methods A baseline survey was made at the outpatient department in 30 days(six hours per day,7:00-11:00,and 13:00-15:00).On such basis,data of the hospital's HIS system within the last five years were called into play for statistics analysis and simulation test,for the purpose of shift scheduling and resources allocation optimization.Results This study discovered each January-February as the valley of clinic visits and each July-August as the peak.52-week data analysis of a year found that the days of daily registrations between 4000-5000 are up to 163 days,those over 5000 are up to 86 days,of which Mondays with over 5000 registrations are up to 35 days.Each Monday is found to be a peak of outpatient visits,with significant drop during Saturdays and Sundays; daily registrations peak between 7:00-10:00 in the morning,while the traffic rises again during 13:00-14:00 in the afternoon,yet up to 26 ％of the morning peak only.Conclusion Statistics analysis of the outpatient service and emergency service at the outpatient department can help identify their patterns of operations,for effective improvement of service provision,alleviation of peak hour workload,shorten patient waiting time and better patient satisfaction.
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Objective To investigate the clinical characteristics of general paresis of insane(GPI) and diagnostic value of laboratory and neuroimaging examinations.Methods The clinical data of 2 patients with GPI were analyzed retrospectively and the pertinent literatures were reviewed.Results The main clinical characteristics consisted of insidious onset,progressive dementia,mental disorder and epileptic seizure.These 2 patients were originally misdiagnosed.Both rapid plasma reagin test and treponema gelatin agglutination test in serum and cerebrospinal fluid were positive.Cranial MRI showed diffuse cerebral atrophy.Conclusions The clinical characteristics of GPI are varied and misdiagnosis rate is high at early stage of this disease.The diagnosis of GPI mainly depends on clinical characteristics,serum and cerebrospinal fluid examinations.
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Objective To observe the curative effects of Edaravone combined Batroxobin on treating pro-gressive cerebral infarction(PCI).Methods 50 patients with PCI were treated with Edaravone 30 mg intravenous drip twice a day for 14 d.Meanwhile,Batroxobin 10 BU on the first day,subsequently 5 BU intravenous drip,once for next day,total 4 times.European stroke scale(ESS),Barthel index and plasma fibrinogen(Fib) level were tested before and after treatment.Compared with the patients(control group) treated with Batroxobin only.Results The score of ESS in united treatment group on 7th,14th,21th day were obviously higher than those in the control group(all P