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Objective To explore the predictive value of different CT signs in surgical treatment in patients with acute closed intestinal and mesenteric injury.Methods The CT data and follow-up results of 120 patients with acute closed intestinal and mesenteric injury(including 58 cases of surgical treatment and 62 cases of conservative treatment)were analyzed retrospectively.The diagnostic value and prognostic value in surgical treatment of different CT signs were analyzed.Results There were significant differences between the operation group and the conservative treatment group in mesenteric vascular amputation,mesenteric hematoma,vascular contrast agent extravasation, intestinal wall defect,pneumoperitoneum and peritoneal effusion (χ2＝4.69,P＝0.03;χ2＝21.40,P＜0.001;χ2＝13.95,P＜0.001 ;χ2＝11.34,P＝0.001;χ2＝80.65,P＜0.001).The CT signs of intraperitoneal effusion had the highest sensitivity for intestinal and mesenteric injury,and vascular contrast agent extravasation and intestinal wall defect had the highest specificity for surgical predictability of intestinal and mesenteric injury.ROC curves showed that abdominal gas accumulation had the highest predictive value for intestinal and mesenteric injuries (AUC＝0.92,95%CI:0.87－0.97),followed by mesenteric hematoma (AUC＝0.73,95%CI:0.64－0.82).Conclusion Intraperitoneal effusion has the highest sensitivity for intestinal and mesenteric inj ury,and vascular contrast agent extravasation and intestinal wall defect have the highest specificity for surgical predictability of intestinal and mesenteric injury.The overall value of intraperitoneal gas in predicting intestinal and mesenteric injury is highest.Combining different CT signs can improve the accuracy of clinical intervention for acute closed intestinal and mesenteric injury.
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Objective To study the value of MSCT angiography(MSCTA)in diagnosing lower extremities arterial disease (LEAD) of diabetic foot ulcers and analyze the possible influential factors on the onset of diabetic foot ulcers.Methods 80 diabetic patients for MSCTA examination were divided into two groups by whether combined with foot ulcers.The tibial artery calcification score (TACS) and peripheral arterial occlusion index (PAOI) were calculated and the possible risk factors of diabetic foot ulcer were analyzed.Results There were 30 cases suffered with foot ulcer and 18 cases occurred lower extremity arterial occlusion (LEAO), the average PAOI was 4.40(3.60, 5.75).Non-foot ulcer cases were 50, and there were 8 cases suffered with LEAO, the average PAOI was 2.05(1.43, 3.10).Compared to patients without foot ulcer, patients with foot ulcer were older, had a lower BMI, and were more likely to have a history of tobacco use.They usually had higher TACS and severer peripheral arterial occlusive disease (PAOD).Stepwise regression model showed that foot ulcers had significant correlation with TACS and PAOI.Partial correlation analysis showed TACS was independent from PAOI in impacting diabetic foot ulcer.Conclusion MSCTA has important clinical value in diagnosing and valuing diabetic foot ulcer LEAD.Age, smoking history,BMI,TACS and PAOI affect the incidence of diabetic foot ulcers, and TACS and PAOI are the independent risk factors for diabetic foot ulcers.
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Objective To explore CTA characteristics of diabetic lower extremities arterial disease (LEAD) with different Fontaine stage.Methods Data of 100 patients clinically diagnosed as diabetic LEAD and underwent lower limbs arterial CTA were analyzed retrospectively.The patients were classified into grade Ⅰ-Ⅳ according to Fontaine classifications.Lower extremities arteries were graded according to CTA.Stenosis degree of lower extremity arteries in different Fontaine stages were analyzed.Results The grades of lower extremity arteries stenosis in different Fontaine stages had statistically significant difference (x2 =186.24,P＜0.001).There had statistically significant difference of stenosis degree in different lower extremity arterial levels among different Fontaine stages (superior genicular artery:x2 =69.24,P＜0.001;inferior genicular artery:x2 =111.59,P＜0.001;dorsalis pedis and arteriae plantaris:x2 =94.15,P＜0.001).Grades of stenosis between superior genicular arteries and inferior genicular arteries,superior genicular arteries and dorsalis pedis and arteriae plantaris had statistically significant differences (Z=12.59,P＜0.001;Z=10.47,P＜0.001).There was statistically significant difference of stenosis grades between inferior genicular artery and dorsalis pedis and arteriae plantaris (Z=12.66,P＜0.001).Occluded inferior genicular arteries usually associated with collateral vessels.Conclusion CTA can reflect the clinical stages of LEAD,which is the ideal method in diagnosing of diabetic LEAD.
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Objective To investigate the effect of self-made Guben Pingchuan Huatan decoction on curative effect and laboratory indexes of patients with chronic obstructive pulmonary disease .Methods 98 patients with chronic obstructive pulmonary disease (COPD) in stable stage in our hospital from September 2014 to September 2016 were selected and divided into observation group with 49 cases and control group with 49 cases according to the random number table method .The control group was given tiotropi-um bromide treatment ,while the observation group were given the basic treatment the same as the control group with the combina-tion of self-made Guben Pingchuan Huatan decoction .Two groups were treated for a period of 3 months .The therapeutic effects of the two groups were compared ,and the changes of pulmonary function ,6MWT and serum inflammatory factors before and after treatment were compared .Results The total effective rate in the observation group was higher than that in the control group (P<0 .05);FEV1 expected value ,PEF and FEV1/FVC value of the two groups after treatment were increased (P<0 .05);FEV1 expec-ted value ,PEF and FEV1/FVC value of the observation group were higher than those of the control group after treatment ,and the difference was statistically significant (P<0 .05);6MWT of two groups after treatment was increased (P<0 .05);6MWT of the observation group after treatment was higher than that of the control group ,and the difference was statistically significant (P<0 .05);IL-6 ,IL-8 and MMP-9 levels were decreased after treatment in two groups (P<0 .05);IL-6 ,IL-8 and MMP-9 levels of the observation group were lower than those of the control group ,and the difference was statistically significant (P<0 .05) .Conclusion The self-made Guben Pingchuan Huatan decoction has a remarkable curative effect on chronic obstructive pulmonary disease ,and can significantly improve the pulmonary function of patients ,and lower serum inflammatory cytokines IL-6 ,IL-8 and MMP-9 levels , thereby reducing the inflammatory state of patients .
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<p><b>OBJECTIVE</b>To investigate the genetic variation and typing of hepatitis B virus (HBV) in patients with chronic hepatitis B in relation to HBeAg status.</p><p><b>METHODS</b>Fluorescence quantitative polymerase chain reaction (PCR) was employed to detect serum HBV DNA in patients with chronic hepatitis B negative for HBeAg. Real-time fluorescent PCR and PCR-reverse dot blot hybridization were used to detect HBV genotypes and mutations, respectively.</p><p><b>RESULTS</b>Of the 389 patients, 214 (55.01%) were positive and 175 (44.99%) were negative for HBV DNA; 102 (26.22%) had a HBV DNA copy number of 1×10(3), and 41 (10.54%) had a copy number of 1×10(4) (Χ(2)=226.6729, P<0.001). Of the 21 patients with a HBV DNA load of 1×10(5), 15 (71.43%) were found to have precore mutations, and 11 (52.38%) had basic core promoter (BCP) mutations; a higher HBV-DNA load was associated with an increased incidence of HBV mutations. In the 214 patients positive for HBV DNA, HBV genotypes A, B, C, D and the mixed type were found in 6 (2.80%), 84 (39.25%), 106 (49.53%), and 7 (3.27%), and 11 (5.14%) patients, who showed precore mutation rates of 16.67% (1 case), 36.90% (31 cases), 44.34% (47 cases), 0, and 0, and BCP mutation rates of 0, 19.05% ( 16 cases), 26.42% (28 cases), 0, and 0, respectively, demonstrating significant differences in HBV mutations between the genotype groups (P<0.001).</p><p><b>CONCLUSION</b>HBeAg-negative and HBV DNA-positive patients with chronic hepatitis B have a relatively low HBV replication level, and HBV DNA load is associated with HBV mutations. The B and C genotypes are more likely to have HBV mutations in HBeAg-negative patients.</p>
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Female , Humans , Male , DNA, Viral , Blood , Genotype , Hepatitis B e Antigens , Blood , Hepatitis B virus , Classification , Genetics , Hepatitis B, Chronic , Blood , Virology , Mutation , Promoter Regions, Genetic , Viral Core Proteins , Genetics , Viral LoadABSTRACT
Objective To evaluate the combination influence of the factors such as the ways to putting into the water, addition with multienzyme and temperature of water on the cleaning effect of ultrasonic cleaning of the curettage-aspiration device for uterine cavity. So that we can find out the best condition for cleaning, and provide the scientific evidence for the formulation of the norm of ultrasonic cleaning of the curettage-aspiration device for uterine cavity. Methods According to the factorial design with triple pathogens, three factors were chosen to complete the ultrasonic cleaning of the curettage-aspiration device for uterine cavity, including the sequence of putting into water, addition with multienzyme or not and the temperature of cleaning. The cleaning effect was detected by adopting the eye-measurement or with the hemoglobin reagent. Results The sequence of putting into water first or next had little influence on ultrasonic cleaning;the effect of addition with multienzyme was more significant than without it;the effect of water temperature at 35 centi-degree or 40 centi-degree had no difference. Conclusions It had good benefits for the cleaning effect when the ultrasonic cleaning of the curettage-aspiration device for uterine cavity added multienzyme to the cleansing solution, while the sequence of putting into water first or next and the temperature of water at 35 centi-degree or 40centi-degree shows little influence on the cleaning effect.