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Objective To explore the changes of serum angiopoietin-like protein 4(ANGPTL4)and NOD-like receptor protein 3(NLRP3)levels after traumatic brain injury(TBI)and their diagnostic value for sec-ondary massive cerebral infarction.Methods A total of 100 TBI patients admitted to the hospital from Au-gust 2019 to August 2021 were enrolled as the TBI group,meantime,100 healthy people in the hospital were enrolled as the control group.The serum levels of ANGPTL4 and NLRP3 were detected by enzyme-linked im-munosorbent assay(ELISA).The clinical characteristics of TBI patients with and without secondary massive cerebral infarction were compared.Receiver operating characteristic(ROC)curve was applied to analyze the serum levels of ANGPTL4 and NLRP3 on their diagnostic value for TBI patients with secondary massive cere-bral infarction.Multivariate Logistic regression analysis was applied to analyze the factors affecting the occur-rence of secondary massive cerebral infarction in TBI patients.Results The serum ANGPTL4 level in TBI group was lower than that in the control group,and the serum NLRP3 level was higher than that in the con-trol group(P<0.05).There were obvious differences in proportion of brain hernia,proportion of subarach-noid hemorrhage,serum levels of ANGPTL4 and NLRP3 between patients with secondary massive cerebral infarction and patients without secondary massive cerebral infarction(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of serum ANGPTL4 and NLRP3 in diagnosing secondary massive cere-bral infarction in TBI patients was 0.792 and 0.812 respectively,with sensitivity of 77.80%and 83.30%re-spectively,and specificity of 86.60%and 64.60%respectively.The sensitivity,the specificity and AUC of the combined detection were 83.30%,82.90%and 0.867 respectively.Multivariate Logistic regression analysis showed that serum NLRP3 level was a risk factor for TBI patients with secondary massive cerebral infarction(P<0.05).After treatment,it was found that serum ANGPTL4 level increased and NLRP3 level decreased in TBI patients(P<0.05).Conclusion The serum level of ANGPTL4 in TBI patients decreases,while the level of NLRP3 increases,and the level of ANGPTL4 in the serum of patients with secondary massive cerebral in-farction decreases and the level of NLRP3 increases,both of them are of great significance in the diagnosis of secondary massive cerebral infarction in TBI patients.
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Transverse sinus is an important pathway of intracranial venous reflux,which is also crucial for maintaining cerebral circulation and stabilizing intracranial pressure.Transverse sinus stenosis(TSS)is the most common variation of transverse sinus,which might lead to changes in sinus hemodynamics and pressure and closely related to idiopathic intracranial hypertension,pulsatile tinnitus and chronic headache.The progresses in imaging researches of transverse sinus stenosis were reviewed in this article.
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This paper summarized the experience in treating bronchiectasis with Mahuang Shengma Decoction （麻黄升麻汤）. The pathogenesis of bronchiectasis is “lung-spleen qi deficiency” as the root， and “phlegm-heat obstructing the lung” as the branch. The key point of treatment is to improve the internal environment of phlegm， heat， and deficiency. According to clinical experience， Mahuang Shengma Decoction is good at raising the yang qi to dissipate fire， clearing the upper and warming the lower， which is in accord with the pathogenesis of bronchiectasis. In clinical practice， Mahuang Shengma Decoction is usually used as the basic formula， and the heat-clearing medicinals and center-warming medicinals of the formula will be adjusted according to the abnormal exuberance of heat or cold of the pathogenesis； and the formula can also be modified in accordance with the symptoms. At the same time， importance should be attached to the application of Mahuang （Herba Ephedrae）， and its dosage should be flexibly adjusted according to the constraint degree of the pathogenic qi， so as to expel the constraint fire， bank up earth to generate metal， regulate heat and cold simultaneously， and treat both the root and the branch.
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[This corrects the article DOI: 10.1016/j.apsb.2021.09.004.].
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BACKGROUND@#The effect of arteriosclerotic intracranial arterial vessel wall enhancement (IAVWE) on downstream collateral flow found in vessel wall imaging (VWI) is not clear. Regardless of the mechanism underlying IAVWE on VWI, damage to the patient's nervous system caused by IAVWE is likely achieved by affecting downstream cerebral blood flow. The present study aimed to investigate the effect of arteriosclerotic IAVWE on downstream collateral flow.@*METHODS@#The present study recruited 63 consecutive patients at the Second Hospital of Hebei Medical University from January 2021 to November 2021 with underlying atherosclerotic diseases and unilateral middle cerebral artery (MCA) M1-segment stenosis who underwent an magnetic resonance scan within 3 days of symptom onset. The patients were divided into 4 groups according to IAVWE and the stenosis ratio (Group 1, n = 17; Group 2, n = 19; Group 3, n = 13; Group 4, n = 14), and downstream collateral flow was analyzed using three-dimensional pseudocontinuous arterial spin labeling (3D-pCASL) and RAPID software. The National Institutes of Health Stroke Scale (NIHSS) scores of the patients were also recorded. Two-factor multivariate analysis of variance using Pillai's trace was used as the main statistical method.@*RESULTS@#No statistically significant difference was found in baseline demographic characteristics among the groups. IAVWE, but not the stenosis ratio, had a statistically significant significance on the late-arriving retrograde flow proportion (LARFP), hypoperfusion intensity ratio (HIR), and NIHSS scores ( F = 20.941, P <0.001, Pillai's trace statistic = 0.567). The between-subject effects test showed that IAVWE had a significant effect on the three dependent variables: LARFP ( R2 = 0.088, F = 10.899, P = 0.002), HIR ( R2 = 0.234, F = 29.354, P <0.001), and NIHSS ( R2 = 114.339, F = 33.338, P <0.001).@*CONCLUSIONS@#Arteriosclerotic IAVWE significantly reduced downstream collateral flow and affected relevant neurological deficits. It was an independent factor affecting downstream collateral flow and NIHSS scores, which should be a focus of future studies.@*TRIAL REGISTRATION@#ChiCTR.org.cn, ChiCTR2100053661.
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Humans , Constriction, Pathologic/pathology , Magnetic Resonance Imaging/methods , Middle Cerebral Artery/pathology , Tomography, X-Ray ComputedABSTRACT
Long noncoding RNAs (lncRNAs) play a crucial regulatory role in the development and progression of multiple cancers. However, the potential mechanism by which lncRNAs affect the recurrence and metastasis of ovarian cancer remains unclear. In the current study, the lncRNA LOC646029 was markedly downregulated in metastatic ovarian tumors compared with primary tumors. Gain- and loss-of-function assays demonstrated that LOC646029 inhibits the proliferation, invasiveness, and metastasis of ovarian cancer cells in vivo and in vitro. Moreover, the downregulation of LOC646029 in metastatic ovarian tumors was strongly correlated with poor prognosis. Mechanistically, LOC646029 served as a miR-627-3p sponge to promote the expression of Sprouty-related EVH1 domain-containing protein 1, which is necessary for suppressing tumor metastasis and inhibiting KRAS signaling. Collectively, our results demonstrated that LOC646029 is involved in the progression and metastasis of ovarian cancer, which may be a potential prognostic biomarker.
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Humans , Female , MicroRNAs/metabolism , RNA, Long Noncoding/metabolism , RNA, Competitive Endogenous , Cell Line, Tumor , Ovarian Neoplasms/genetics , Cell Proliferation/genetics , Gene Expression Regulation, Neoplastic , Cell Movement/genetics , Adaptor Proteins, Signal Transducing/metabolismABSTRACT
The spread of coronavirus disease 2019 (COVID-19) throughout the world has resulted in stressful healthcare burdens and global health crises. Developing an effective measure to protect people from infection is an urgent need. The blockage of interaction between angiotensin-converting enzyme 2 (ACE2) and S protein is considered an essential target for anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) drugs. A full-length ACE2 protein could be a potential drug to block early entry of SARS-CoV-2 into host cells. In this study, a therapeutic strategy was developed by using extracellular vesicles (EVs) with decoy receptor ACE2 for neutralization of SARS-CoV-2. The EVs embedded with engineered ACE2 (EVs-ACE2) were prepared; the EVs-ACE2 were derived from an engineered cell line with stable ACE2 expression. The potential effect of the EVs-ACE2 on anti-SARS-CoV-2 was demonstrated by both in vitro and in vivo neutralization experiments using the pseudovirus with the S protein (S-pseudovirus). EVs-ACE2 can inhibit the infection of S-pseudovirus in various cells, and importantly, the mice treated with intranasal administration of EVs-ACE2 can suppress the entry of S-pseudovirus into the mucosal epithelium. Therefore, the intranasal EVs-ACE2 could be a preventive medicine to protect from SARS-CoV-2 infection. This EVs-based strategy offers a potential route to COVID-19 drug development.
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Objective:To re-identify the anatomical features of singular nerve canal (SNC) through observing and measuring the morphological characteristics of SNC using ultra-high resolution CT (U-HRCT).Methods:The U-HRCT images of 52 human head specimens (104 ears) from December 2019 to January 2020 were obtained. The best standard cross-sectional and coronal images of SNC were reconstructed. The morphology of the main trunk and branches of the SNC were observed. According to the number of turning points, the trunks of SNC were divided into single turning point type, double turning point type and no turning point type. According to the branch morphology, the branched SNC were divided into bifurcated type, confluent type, side branch type and bilateral branch type. The diameter, angle and length of each section of the posterior canal ampulla (PCA) of the main trunk, the turning point and the internal auditory meatus (IAM) were measured. Independent sample t test or Mann-Whitney U test was used to test group differences of main trunk diameter of the SNC with or without branches. Results:Totally 104 ears of 52 cases were divided into single turning point type of 79 ears, double turning point type of 20 ears and no turning point type of 5 ears. The bilateral morphological classification was the same in 30 cases (60 ears), including 24 cases of single turning point type (48 ears), 5 cases of double turning point type (10 ears), and 1 case of no turning point type (2 ears). The ear morphology on both sides was different in 22 cases (44 ears). The diameters of the PCA, the turning point and the IAM of SNC with single turning point type were (0.31±0.07), (0.40±0.10), (0.46±0.10) mm, respectively, and the angles were 60.5°±7.8°, 120.3°±9.6°, 38.3°±7.5° respectively. And the length of the PCA and the IAM in the SNC with single turning point type were (1.95±0.38), (2.31±0.68) mm, respectively. The diameters of the PCA, the turning point near the PCA, the turning point near the IAM and the IAM of SNC with double turning point type were (0.32±0.09), (0.38±0.09), (0.47±0.12), (0.47±0.13) mm, and the angle were 60.9° (57.3°, 64.9°), 117.9°±12.3°, 129.6°±12.4°, 41.7° (32.9°, 79.5°), respectively. The length of the PCA, the IAM and the distance between these two turning points were (1.78±0.31), 0.65 (0.46, 1.15), 0.96 (0.80, 1.15) mm, respectively. The diameters of the PCA and the IAM of SNC without turning point type were (0.20±0.01) and (0.50±0.12) mm. The angles with the PCA and the IAM in these cases were 58.4°±9.6° and 46.2°±5.1°, and the length was (3.61±0.32) mm. A total of 48 ears had branches, including bifurcated type (36 ears), confluence type (4 ears), side branch type (5 ears) and bilateral branch type (3 ears). In the SNC group with single turning point, the diameter of the turning point in the cases without branches was wider than that of cases with branches ( t=2.11, P=0.039). However, there was no significant difference in the diameter of each section between these two subgroups of SNC cases with double turning point type. Conclusions:U-HRCT is able to clearly show the SNC, the imaging features of whom are variable and should be re-understood.
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An essential step for cancer vaccination is to break the immunosuppression and elicit a tumor-specific immunity. A major hurdle against cancer therapeutic vaccination is the insufficient immune stimulation of the cancer vaccines and lack of a safe and efficient adjuvant for human use. We discovered a novel cancer immunostimulant, trichosanthin (TCS), that is a clinically used protein drug in China, and developed a well-adaptable protein-engineering method for making recombinant protein vaccines by fusion of an antigenic peptide, TCS, and a cell-penetrating peptide (CPP), termed an "all-in-one" vaccine, for transcutaneous cancer immunization. The TCS adjuvant effect on antigen presentation was investigated and the antitumor immunity of the vaccines was investigated using the different tumor models. The vaccines were prepared
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Hyperglycemia induces chronic low-grade inflammation (inflammaging), which is a newly identified contributor to diabetes-related tissue lesions, including the inflammatory bone loss in periodontitis. It is also a secondary senescent pattern mediated by an increased burden of senescent cells and senescence-associated secretory phenotype (SASP). Macrophage is a key SASP-spreading cell and may contribute to the maintenance of SASP response in the periodontal microenvironment. Using a transgenic diabetic model (BLKS/J-Lepr
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Animals , Mice , Cellular Senescence , Diabetes Mellitus, Experimental , Glucose Transporter Type 1 , Inflammation , MacrophagesABSTRACT
Objective:To introduce a newly modified surgical approach and explore the clinical efficacy of en bloc kidney transplantation from deceased infant donors to adults.Methods:Four cases of en bloc kidney transplantation from deceased infant donor to adult were performed with a new modified surgical approach in renal transplantation and dialysis center of the Second People's Hospital of Shanxi Province from January 2017 to September 2019. All 4 cases were cardiac death donors. There were 3 males and 1 female donors, aged (54 ± 22.69) d and weighing (5.6 ± 0.79) kg. There were 1 male and 3 female recipients, aged (41.5 ± 5.97) years and weighing (45 ± 3.56) kg. For lowering operative difficulties and preventing hemodynamic disturbances, bilateral kidneys were sutured and fixed during trimming. Then end-to-side anastomosis was performed between donor kidney abdominal aortic valve and recipient external iliac artery and between donor renal inferior vena cava valve and recipient external iliac vein.Results:All operations were successful without vascular or urinary complication. The average duration of donor kidney repair was 20 min and the average duration of transplantation 68.75 min. The functions of transplanted kidney recovered well during a follow-up period of 12 months. The long-term survivals of recipient and transplanted kidney were satisfactory.Conclusions:The newly modified surgical approach of en bloc kidney transplantation from deceased infant donor to adult has optimized operative handling. With a higher success rate, vascular complications are lowered. A wider popularization is recommended.
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Objective:To investigate the effect of apatinib on radiosensitivity of glioma cells U87MG and its potential mechanism.Methods:U87MG cells were divided into control group, apatinib group, radiation group and combination group treated with apatinib and radiation. The effect of different concentrations of apatinib (5, 10, 20, 40, 80 μmol/L) on cell proliferation was detected by CCK8 assay. The effect of apatinib on cell migration and invasion was detected by wound-healing assay and transwell assay, respectively. The effect of apatinib on cell radiosensitivity was detected by plate cloning assay, the cell apoptosis rate was detected by flow cytometry, and the protein expressions of Bax and Bcl-2 were detected by Western blot.Results:Apatinib significantly inhibited the proliferation of U87MG cells in a manner depended on the drug treatment time and radiation. Compared with the radiation group, the cell proliferation, migration and invasion in the combination group were inhibited much significantly ( t=9.857, 18.704, 4.197, P<0.05), so that the value of D0, Dq and SF2 of the combination group was lower, resulting in a radiosensitivity enhancement ratio (SER D0 ) of 1.3. Moreover, compared with the radiation group, the apoptosis rate of the combination group was increased, the expression of Bcl-2 protein was decreased, and the expression of Bax protein was increased ( t=16.187, 8.890, 5.222, P< 0.05). Conclusions:Apatinib inhibits cell proliferation, invasion and migration, induces apoptosis and increases radiosensitivity of glioma cells.
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Objective:To verify the ability of the newly developed ultra-high resolution CT (U-HRCT) for displaying the fine bony anatomy of temporal bone.Methods:The cone-beam CT architecture was used on U-HRCT. The focus size of X-ray generator was 0.27 mm × 0.29 mm, the rated tube voltage was 60-100 kV, and the unit size of flat panel detector was 0.074 8 mm×0.074 8 mm. From October to December 2019, 16 adult head specimens (32 temporal bones, provided by Huanghe University of Science and Technology) were imaged using U-HRCT. The scanning mode was small-field-of-view and high-resolution scanning for unilateral temporal bone. The scanning parameters were: voltage 100 kV, current 3.5 mA, rotation time 40 s, reconstructed field of view 65 mm×65 mm, voxel size 0.1 mm×0.1 mm×0.1 mm, layer number 370, slice thickness 0.1 mm, and slice interval 0.1 mm. The ultimate spatial resolution of the system was detected using a phantom with line pair card, after the scanning with the same parameters. Through multi-planar reconstruction and minimum intensity projection method, a total of 6 anatomical positions of 4 structures (stapes footplate, cochlear axis bottom, vestibular aqueduct internal orifice and isthmus, cochlear aqueduct internal orifice and auditory sac segment) were scored with 1-3 points. The Wilcoxon test was used to compare the difference of bilateral scores of each structure.Results:The phantom test results showed that the ultimate spatial resolution of the system was ≥4.0 lp/mm. The scores of stapes footplate, cochlear axis bottom and vestibular aqueduct internal orifice were ≥2 points, with a display rate of 100%. The display rates of vestibular aqueduct isthmus, cochlear aqueduct internal orifice and auditory sac segment were 87.5% (28/32), 71.9% (23/32) and 53.1% (17/32), respectively. There were no significant differences in left and right scores of all anatomical structures ( P>0.05). Conclusion:The newly developed U-HRCT has good display ability for fine bony anatomy of temporal bone and has great clinical application potential.
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Objective: To evaluate the prevalence and imaging characteristics of persistent petrosquamosal sinus (PSS) in adults based on HRCT. Methods Data of 708 adult patients who underwent thin-slice HRCT without bilateral temporal bone abnormalities were retrospectively analyzed. Based on the standardized reconstructed axial and coronal images with 0.67 mm layer thickness, the presence of PSS and its HRCT signs, including the mean diameter, course, saccular dilation of PSS as well as wall dehiscence and postglenoid foramina were evaluated. The differences of PSS in different genders and age groups were analyzed. Results: HRCT showed that the prevalence of PSS in 708 adult patients (1 416 sides) was 10.59% (150/1 416), with the average diameter of (1.29±0.58)mm. The difference in prevalence of PSS was statistically significant between women (92/728, 12.64%) and men (58/688, 8.43%). No significant difference in the prevalence was shown between sides of each gender (Pmale=0.583, Pfemale=0.372). There was no significant difference in the prevalence of PSS between each two groups among the 18-29 years old group, the 30-39 years old group, the 40-49 years old group, the 50-59 years old group (all P>0.05), while there were significant differences in the prevalence of PSS between the ≥70 years old group and each other groups above, respectively (all P<0.05). In 150 sides PSS, 24.67% (37/150) coursed in the petrosquamosal fissure, 75.33% (113/150) in the outer sulcus of the fissure, while 47.33% (71/150) showed postglenoid foramina formed, including 36.67% (55/150) horizontal ones to the outer subcutaneous tissue and 10.67% (16/150) into the temporomandibular joint; 2.67% (4/150) had dehiscent wall; 4.67% (7/150) had saccular expansion. Conclusion: HRCT can show the characteristics of PSS, which should be carefully evaluated before skull base or ear surgeries to avoid iatrogenic injury.
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Objective To investigate the value of high resolution CT (HRCT) in displaying the anatomic relationship between labyrinth segment of facial canal and cochlea.Methods Totally 110 patients (220 ears) who underwent HRCT were collected.The original images were transferred to workstation for image processing.MPR images were acquired.The anatomic relationship between labyrinth segment of facial canal and cochlea was observed in oblique coronal MPR images.The bony septum between labyrinth segment of facial canal and cochlea was assessed as definite defect (Type Ⅰ),doubtful defect (Type Ⅱ) or complete (Type Ⅲ),respectively.Results There were 71 ears (71/220,32.27％) of Type Ⅰ,diameters of bone fissure ranged from 0.3-1.3 mm (average diameters [0.64±0.26]mm),86 ears (86/220,39.09％) of Type Ⅱ and 63 ears (63/220,28.64％) of Type Ⅲ,with bony septum thickness ranged from 0.3-1.0 mm (average thickness [0.68±0.15]mm).No statistical difference of rates of the above three types was found between different genders,among age groups and between both side of ears (all P＞0.05).Conclusion HRCT is a reliable method to show the anatomic relationship between labyrinth segment of facial canal and cochlea.
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Objective To quantitatively analyze brucellar spondylitis, tuberculous spondylitis and spinal metastatic tumors by dynamic contrast-enhanced (DCE)-MRI, and to evaluate the quantitative DCE-MRI in the differential diagnosis of brucellar spondylitis, tuberculous spondylitis and spinal metastatic tumors. Methods This was a retrospective study including 30 patients with brucellar spondylitis, 30 with tuberculous spondylitis, and 30 with spinal metastatic tumors. The clinical and demographic data were collected. All patients received routine MRI and DCE-MRI examinations. Volume transfer constant(Ktrans), rate constant(Kep), extravascular extracellular volume fraction(Ve) and plasma volume fraction(Vp) of diseased vertebral bodies of the patients with brucellar spondylitis, tuberculous spondylitis and spinal metastatic tumors were measured on perfusion parameter maps. All indexes showed non-normal distribution. Differences of all indexes were compared and analyzed statistically with rank-sum test among the above diseases. Results For brucellosis spondylitis, spinal tuberculosis, and vertebrae metastasis, the values of Ktrans were(0.716 ± 0.017),(0.316 ± 0.004),(0.986 ± 0.012)min-1, the values of Kep were(1.326 ± 0.018), (0.747 ± 0.005),(2.899 ± 0.054)min-1, the values of Ve were 0.541 ± 0.011, 0.427 ± 0.017, 0.338 ± 0.007 and the values of Vp were 0.034 ± 0.003, 0.029 ± 0.003, 0.049 ± 0.007. The differences suggested statistical significance(H=50.24, 52.49, 48.31, 46.54, P<0.01) among the three diseases. Conclusion DCE-MRI quantitative analysis is helpful in the differential diagnosis of brucellar spondylitis, tuberculous spondylitis and spinal metastatic tumors.
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Objective:To forecast Urban Employees' Basic Medical Insurance ( UEBMI) in the next 85 years based on population size, age and gender distribution, and to calculate its sustainability gap. Methods:According to the population policy of Beijing and economic development of the region;based on the data of the sixth census in Bei-jing, the estimation model was constructed, and its parameters were defined and selected. Based on the period of 2010, the future of UEBMI in the next 85 year was predicted based on the population size, age and gender distribu-tion. Results:The population of UEBMI in Beijing will reach the maximum value in 2020, and then the downward trend will increase. The aging rate of the insured population will accelerate year after year and will reach the peak in the middle of this 21st century. The sustainability gap is predicted to reach at least 9541. 35 Billion dollars, and the Beijing municipal government is expected to level an average of at least 44 . 693 billion yuan per year to set aside the financial funds in order to fill the gap, so sustainable development of the fund is ensured. Conclusion:From the point of view of the insured population, there is a huge financial sustainability risk in the future of UEBMI in Beijing.
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Objective To study the mechanisms of levofloxacin,thymopentin combined with decoction of four noble drugs for treatment of patients with severe pulmonary tuberculosis and offer a new therapeutic strategy for treatment of the disease.Methods A total of 100 patients with severe pulmonary tuberculosis admitted to Qinghai Fourth People's Hospital from November 2013 to January 2016 were enrolled,and they were divided into a research group (50 patients) and a control group (50 patients) by random number table.The patients in two groups were treated with 2HRZE/4HR standardized therapy program.The patients in the research group were additionally treated with levofloxacin (0.5 g orally taken,1 times a day),thymopentin (1 mg intravenous injection,once a day) combined with decoction of four noble drugs (ginseng 9 g,poria 9 g,atractylodes 9 g,and licorice 6 g,all the above ingredients were immersed in 400 mL water and boiled to 100 mL,one dose orally taken daily and it was equally divided into 2 parts,one part taken in the morning and the remaining part taken in the evening).Four months after treatment,the changes of indexes of immune functions [total lymphocyte count (LY),CD4+,CD8+,and CD4+/CD8+ ratio],blood coagulation indexes [prothrombin time (PT),activated partial thromboplastin time (APTT),thrombin time (TT),D-dimer,and plasma fibrinogen (Fib)],pulmonary function indexes [forced vital capacity (FVC),peak expiratory flow rate (PEF),forced expiratory maximum volume in 1 second (FEV1),and mean maximum expiratory flow (MMEF)] and blood gas analysis indexes [arterial partial pressure of carbon dioxide (PaCO2),arterial partial pressure of oxygen (PaO2),pulse oxygen saturation (SpO2),and oxygenation index (PaO2/FiO2)] and the therapeutic effects were observed in the two groups.Results After treatment,the CD8+,TT,PT,Fib,D-Dimer and PaCO2 of two groups were decreased significantly than those before treatment (all P ＜ 0.05);while the LY,CD4+,CD4+/CD8+ ratio,FEV1,FVC,PEF,MMEF,APTT,PaO2,SpO2 and PaO2/FiO2 of two groups were all increased significantly than those before treatment (all P ＜ 0.05).The changes of the study group were more obvious than those of the control group [LY (109/L):1.79 ± 0.19 vs.1.45 ± 0.16,CD4+:0.40 ± 0.03 vs.0.33 ± 0.03,CD8+:0.20 ± 0.01 vs.0.23 ± 0.02,CD4+/CD8+ ratio:2.10 ± 0.23 vs.1.67 ± 0.20,FEV1:0.269 ± 0.004 vs.0.198 ± 0.003,FVC:(3.78 ± 0.41)％ vs.(3.14 ± 0.39)％,PEF (L/s):3.68 ± 0.26 vs.3.05 ± 0.23,MMEF (L/s):0.96 ± 0.06 vs.0.74 ± 0.05,PaO2 (mmHg,1 mmHg =0.133 kPa):95.11 ± 7.68 vs.85.23 ± 7.01,PaCO2 (mmHg):31.76± 3.26 vs.46.28±4.36,SpO2:0.96±0.08 vs.0.91 ±0.07,PaO2/FiO2 (mmHg):310.58± 11.12 vs.285.01 ± 10.76,TT (s):15.64± 1.25 vs.18.82 ± 1.54,PT (s):12.69 ± 1.01 vs.14.28 ± 1.21,APTT (s):29.01 ± 2.02 vs.25.21 ± 1.80,Fib (mg/L):233.46 ± 15.61 vs.286.27 ± 18.14,D-Dimer (μg/L):210.88 ± 14.13 vs.256.39 ± 16.47,all P ＜ 0.05].After combined treatment,the sputum negative conversion rate [94％ (47/50) vs.60％ (30/50)],the total efficiency [88％ (44/50) vs.64％ (32/50)] and the focus absorption rate [86％ (43/50) vs.60％ (30/50)] of research group were significantly higher than those of the control group (all P ＜ 0.05).Conclusions The combination of levofloxacin,thymopentin and decoction of four noble drugs on the bases of 2HRZE/4HR standardized therapy for treatment of patients with severe pulmonayr tuberculosis can help to regulate acid-base balance,improve the hypoxia condition and lung function,elevate the immune function and increase the blood circulation in the body to improve clinical efficacy.
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Objective To study the distribution characteristics of intraperitoneal free gas and the location value of the site of gastrointestinal perforation using multi-slice CT (MSCT).Methods 60 cases of gastrointestinal perforation were retrospectively collected.The distribution of the intraperitoneal free gas in CT image was analyzed and observed.The digestive tract were divided to the upper digestive tract and the lower digestive tract by Treitz ligament.The distribution of the intraperitoneal free gas was analyzed using χ2 test.The distribution of the intraperitoneal free gas between each different perforational site was analyzed.Results 38 cases of the site of gastrointestinal perforation located in upper gastrointestinal tract and 22 cases located in lower gastrointestinal tract,there was statistically significant difference between the upper digestive tract and the lower digestive tract about the distribution of the intraperitoneal free gas(χ2=22.33,P0.05).In the cases of lower gastrointestinal tract perforation,11 cases of the site located in bowel and 11 cases located in colon,there was statistically significant difference between bowel and colon(χ2=8.98,P<0.05).Conclusion The MSCT distribution of the intraperitoneal free gas has important value in localization diagnosis of gastrointestinal perforation.
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Objective To explore the value of dynamic contrast-enhanced (DCE).MRI in the early diagnosis of brucellosis spondylitis.Methods Fifty-six patients (24 female and 32 male) with Brucellosis with average age of (49± 3)years were retrospectively analyzed.Inclusion criteria:The patients with clinically diagnosed brinell coli spondylitis,drops of serum agglutination test degree 1:100＞(++),Hu＞red plate agglutination test (+ +),enzyme-linked immunosorbent assay to detect specific antibody IgG/IgM (+).Exclusion criteria:Pregnant and lactating women,patients with MRI examination contraindications and spinal tuberculosis,myeloma or other spinal disease,patients with the cervical,thoracic and lumbar 5 vertebral body involvement.The patients were classified into early lesion group and lesion group.Early lesion group was defined as low back pain less than a month,enzyme-linked immunosorbent assay positive IgM and negative IgG results,and no abnormality in conventional MR imaging,while lesion group was defined as low back pain for longer than 3 months,enzyme-linked immunosorbent assay positive IgG and negative IgM and marked lesion in conventional MR imaging.All the patients conducted with conventional MRI and DCE-MRI scan.The differences of the Ktrans,Kep,Ve and Vp between the vertebral lesions,early lesions of vertebral body and normal tissues were measured and compared.Results The values of Ktrans,Kep,Ve and Vp were significantly different between the vertebral lesions [(0.856±0.539) ml/min,(1.482±0.711) ml/min,0.542±0.267,0.034±0.017] and normal tissues [(0.315±0.298) ml/min,(0.713±0.548) ml/min,0.358±0.259,0.056±0.03](all P＜0.05).The values of Ktrans,Kep and Vp were significantly different between the early lesions of vertebral body and normal tissues (all P＜0.05),while no difference was found for Ve between the two groups (P＞0.05).Conclusion DCE-MRI quantitative analysis plays a role in the early diagnosis of the brucella spondylitis.