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Objective:To compare the results of operative versus interventional treatments in patients presenting with sentinel hemorrhage after hepatobiliary and pancreatic surgery.Methods:The clinical data of patients presenting with sentinel hemorrhage after hepatobiliary and pancreatic surgery at the Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Guangzhou Medical University from August 2017 to July 2022 were retrospectively analyzed. Of 82 patients who were enrolled in this study, there were 50 males and 32 females, aged (59.0±7.7) years. The patients were divided into the interventional group ( n=42) and the surgical group ( n=40) based on the treatment they received for sentinel hemorrhage. The vascular injury rate, the first operation time for sentinel bleeding, the rate of successful hemostasis in a single operation, the number of deaths and other indicators were compared between groups. Results:In both the two groups of patients who underwent percutaneous transhepatic cholangial drainage, hepatectomy, endoscopic retrograde cholangiopancreatography, hilar cholangiocarcinoma resection and cholecystectomy were mainly performed hepatic artery injury, pancreaticoduodenectomy with gastroduodenal artery injury, and splenectomy with splenic artery injury. In the intervention group, 36 patients (85.7%) were successfully hemostasis after single treatment, and 32 patients (80.0%) in the operation group, and there was no significant difference between the two groups (χ 2=0.47, P=0.492). The first operation time for the intervention group was (40.5±8.5) min and the mortality rate was 2.4% (1/42), which were significantly better than that of the operation group (90.6±20.8) min and 15.0% (6/40) (all P<0.05). Conclusion:Interventional therapy can be used as the first-line diagnosis and treatment for sentinel bleeding after hepatobiliary and pancreatic surgery. It has the advantages of a lower mortality rate in treating these patients.
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Objective:To investigate the effects of continuous renal replacement therapy (CRRT) on plasma concentration, clinical efficacy and safety of colistin sulfate.Methods:Clinical data of patients received with colistin sulfate were retrospectively analyzed from our group's previous clinical registration study, which was a prospective, multicenter observation study on the efficacy and pharmacokinetic characteristics of colistin sulfate in patients with severe infection in intensive care unit (ICU). According to whether patients received blood purification treatment, they were divided into CRRT group and non-CRRT group. Baseline data (gender, age, whether complicated with diabetes, chronic nervous system disease, etc), general data (infection of pathogens and sites, steady-state trough concentration, steady-state peak concentration, clinical efficacy, 28-day all-cause mortality, etc) and adverse event (renal injury, nervous system, skin pigmentation, etc) were collected from the two groups.Results:A total of 90 patients were enrolled, including 22 patients in the CRRT group and 68 patients in the non-CRRT group. ① There was no significant difference in gender, age, basic diseases, liver function, infection of pathogens and sites, colistin sulfate dose between the two groups. Compared with the non-CRRT group, the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and sequential organ failure assessment (SOFA) were higher in the CRRT group [APACHE Ⅱ: 21.77±8.26 vs. 18.01±6.34, P < 0.05; SOFA: 8.5 (7.8, 11.0) vs. 6.0 (4.0, 9.0), P < 0.01], serum creatinine level was higher [μmol/L: 162.0 (119.5, 210.5) vs. 72.0 (52.0, 117.0), P < 0.01]. ② Plasma concentration: there was no significant difference in steady-state trough concentration between CRRT group and non-CRRT group (mg/L: 0.58±0.30 vs. 0.64±0.25, P = 0.328), nor was there significant difference in steady-state peak concentration (mg/L: 1.02±0.37 vs. 1.18±0.45, P = 0.133). ③ Clinical efficacy: there was no significant difference in clinical response rate between CRRT group and non-CRRT group [68.2% (15/22) vs. 80.9% (55/68), P = 0.213]. ④ Safety: acute kidney injury occurred in 2 patients (2.9%) in the non-CRRT group. No obvious neurological symptoms and skin pigmentation were found in the two groups. Conclusions:CRRT had little effect on the elimination of colistin sulfate. Routine blood concentration monitoring (TDM) is warranted in patients received with CRRT.
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Objective:To investigate the effects of low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with music biofeedback on insomnia.Methods:Sixty patients with insomnia who received treatment in Outpatient Department of Seventh People's Hospital of Dongyang from January to August 2021 were included in this study. They were randomly divided into an observation group ( n = 30) and a control group ( n = 30) using the random number table. The control group was given music biofeedback therapy and conventional drug treatment, and the observation group was treated with rTMS based on music biofeedback therapy. The changes in polysomnography sleep structure and Pittsburgh Sleep Quality Index score after 1 month of treatment relative to before treatment were determined in each group. Results:After 1 month of treatment, the total sleep time, sleep efficiency, rapid eye movement (REM) sleep, non-REM sleep phase II (N2%) and non-REM sleep phase III (N3%) in the observation group were (419.87 ± 42.63) minutes, (83.69 ± 13.39)%, (25.27 ± 3.26)%, (53.75 ± 11.36)% and (16.27 ± 2.25)%, respectively, and they were (388.74 ± 40.39) minutes, (76.38 ± 13.17)%, (23.16 ± 2.68)%, (51.62 ± 12.27)%, and (14.36 ± 2.21)%, respectively. There were significant differences in these indices between the two groups ( t = -2.90, -2.13, -2.22, -2.26, -3.31, P = 0.005, 0.037, 0.030, 0.027, 0.002). The sleep latency, actual wake time, numbet of awakenings, non-REM sleep phase I (N1%), and total score of Pittsburgh Sleep Quality Index in the observation group were (24.16 ± 7.82) minutes, (23.18 ± 6.95) minutes, (1.76 ± 0.28) times, (9.74 ± 2.12)%, (9.17 ± 1.56) minutes, respectively. They were (28.35 ± 7.74) minutes, (28.36 ± 7.21) minutes, (2.25 ± 0.79) times, (11.12 ± 1.17)%, and (10.26 ± 1.42) minutes, respectively in the control group. There were significant differences in these indices between the two groups ( t = 2.09, 2.83, 3.20, 3.12, 2.83, P = 0.041, 0.006, 0.002, 0.003, 0.038). Conclusion:rTMS combined with music biofeedback for the treatment of insomnia can effectively improve sleep quality in patients with insomnia.
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ObjectiveTo explore the effect of low frequency or high frequency repetitive transcranial magnetic stimulation (rTMS) on right Broca's homologue in stroke patients with nonfluent aphasia. MethodsFrom January, 2019 to August, 2022, 80 inpatients in Beijing Bo'ai Hospital were randomly divided into control group (n = 20), sham stimulation group (n = 20), low-frequency (1 Hz) rTMS (LF-rTMS) group (n = 20) and high-frequency (10 Hz) rTMS (HF-rTMS) group (n = 20). All the patients received routine language therapy. LF-rTMS group and HF-rTMS group received ten days of rTMS (1 Hz or 10 Hz), and the sham group received ten days of sham rTMS. The Western Aphasia Battery (WAB) was used to evaluate the language function before, after treatment, and two months after treatment. ResultsBefore treatment, there was no significant difference in the scores of WAB among four groups (P > 0.05). All the scores improved in the four groups immediately after treatment and two months after treatment (P < 0.05). Compared with immediately after treatment, all the scores of WAB improved in LF-rTMS group (P < 0.05), and the scores of recall, name and aphasia quotient (AQ) improved in HF-rTMS group (P < 0.05) two months after treatment. Immediately after treatment, the scores of content and fluency, auditory comprehension and AQ were higher in LF-rTMS group than in HF-rTMS group (P < 0.05). Two months after treatment, the scores of content and fluency were higher in LF-rTMS group than in HF-rTMS group (P < 0.05). ConclusionBoth 1 Hz and 10 Hz rTMS could improve the language function of stroke patients with nonfluent aphasia, especially 1 Hz.
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Objective:To evaluate the effect of controlled low central venous pressure with milrinone on laparoscopic hepatectomy in the patients.Methods:Fifty American Society of Anesthesiologists physical statusⅠ-Ⅲ patients of both sexes, aged 18-64 yr, with body mass index of 18-30 kg/m 2, of Child-Pugh grade A or B, undergoing elective laparoscopic hepatectomy, were divided into 2 groups ( n=25 each) using a random number table method: milrinone group (group M) and nitroglycerin group (group NG). After the start of surgery, milrinone 0.5 μg·kg -1·min -1 was continuously infused in group M, and nitroglycerin was continuously infused with the initial dose of 0.5 μg·kg -1·min -1 to maintain central venous pressure (CVP)≤5 mmHg in group NG.Mean arterial pressure and heart rate were recorded on admission to the operation room (T 0), at skin incision (T 1), at the beginning of liver resection (T 2), at completion of liver resection (T 3), at the end of operation (T 4), and CVP, cardiac index and stroke volume variation were recorded at T 1-4.Internal jugular vein blood samples were collected to determine the concentrations of hemogloblin, blood lactate at T 1 and T 4, and serum alanine aminotransferase, aspartate aminotransferase and creatinine concentrations at 1, 3 and 7 days after surgery.The score of blood oozing in hepatic surgical field, amount of norepinephrine used, blood loss, postoperative recovery and occurrence of complications within 7 days after operation were recorded. Results:Compared with group NG, cardiac index was significantly increased at T 2, 3, the CVP was decreased at T 2, the blood oozing score, blood loss, consumption of norepinephrine, and concentrations of blood lactate were decreased, and the postoperative drainage indwelling time was shortened in group M ( P<0.05). There was no significant difference in the serum alanine aminotransferase, aspartate aminotransferase and creatinine concentrations and incidence of postoperative complications at 1, 3 and 7 days after operation between the two groups ( P>0.05). Conclusions:Milrinone is better than nitroglycerin in decreasing central venous pressure, reducing blood loss, maintaining stable circulatory function and tissue perfusion in laparoscopic hepatectomy.
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Objective To analyze the epidemiological characteristics and its trends of other infectious diarrhea diseases in infants in Inner Mongolia Autonomous Region.Methods Statistical analysis was conducted on other infectious diarrhea cases of infants in Inner Mongolia Autonomous Region from China Information System for Disease Prevention and Control from 2005 to 2016.The main methods were descriptive epidemiology for population,area and time distribution of these registered cases in Inner Mongolia Autonomous Region.The trends were analyzed by the ratio of fixed base and ring base.Area map method was used for regional differences.Results From 2005 to 2016,17 760 other infectious diarrhea diseases of infants were reported in Inner Mongolia Autonomous Region,accounting for 58％of the total reposed cases.The cases number and incidence showed an overall upward trend.After 2011,the growth rate of case reports and incidences slowed down relatively.The peak of the incidence was in July and August(4 739 cases),accounting for27％of cases of the whole year.Seventy-three point forty-four percent of the cases were located in Hulunbeier City(5 161 cases,29.06％),Hohhot City(4 465 cases,25.14％)and Baotou City(3 417 cases,19.24％).Except for Wuhai City.the remaining 11 cities showed increased incidence of other infectious diarrhea diseases in infants.The ratio of male to female was 1.55∶1,and the incidence in males was higher than that in females every year.Twelve-month-old(5 800 cases,33％)had the greatest proportion.Clinical diagnosis(56.26％)and confirmed diagnosis(43.51％)were the main categories,but the rate of pathogen labeling was only 7.60％.Conclusions After 2011,the incidence of other infectious diarrhea diseases of infants in Inner Mongolia Autonomous Region have slowed down relatively.However,the incidence has significant time,region and population aggregation.
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Objective@#To analyze the epidemiological characteristics and its trends of other infectious diarrhea diseases in infants in Inner Mongolia Autonomous Region.@*Methods@#Statistical analysis was conducted on other infectious diarrhea cases of infants in Inner Mongolia Autonomous Region from China Information System for Disease Prevention and Control from 2005 to 2016. The main methods were descriptive epidemiology for population, area and time distribution of these registered cases in Inner Mongolia Autonomous Region. The trends were analyzed by the ratio of fixed base and ring base. Area map method was used for regional differences.@*Results@#From 2005 to 2016, 17 760 other infectious diarrhea diseases of infants were reported in Inner Mongolia Autonomous Region, accounting for 58% of the total reported cases. The cases number and incidence showed an overall upward trend. After 2011, the growth rate of case reports and incidences slowed down relatively. The peak of the incidence was in July and August (4 739 cases), accounting for 27% of cases of the whole year. Seventy-three point forty-four percent of the cases were located in Hulunbeier City (5 161 cases, 29.06%), Hohhot City (4 465 cases, 25.14%) and Baotou City (3 417 cases, 19.24%) . Except for Wuhai City, the remaining 11 cities showed increased incidence of other infectious diarrhea diseases in infants. The ratio of male to female was 1.55∶1, and the incidence in males was higher than that in females every year. Twelve-month-old (5 800 cases, 33%) had the greatest proportion. Clinical diagnosis (56.26%) and confirmed diagnosis (43.51%) were the main categories, but the rate of pathogen labeling was only 7.60%.@*Conclusions@#After 2011, the incidence of other infectious diarrhea diseases of infants in Inner Mongolia Autonomous Region have slowed down relatively. However, the incidence has significant time, region and population aggregation.
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Objective To investigate the imaging features of peripheral schwannoma and analyze the relevant pathological basis to improve the preoperative diagnosis.Methods Fifty-one cases with schwannoma confirmed by pathological were analyzed retrospectively,and the CT and MRI findings were studied in correlation with pathological results.Results There were 24 cases in the neck,11 in the chest wall and 16 in the abdominal and pelvis.On the CT plain scan,12 cases showed slightly low and equal density,21 cases showed iso-density,5 cases showed low density.Most of the lesions showed mild to moderate homogenous enhancement and some lesions showed significantly heterogeneous enhancement on contrast-enhanced CT.On T1 WI,4 cases showed hypointense and isointense signal,and 1 case showed mixed signal.All cases showed hyperintense signal or mixed signal on T2 WI and heterogeneous marked enhancement on contrast-enhanced MRI.Conclusion Schwannomas in neck,chest wall,abdominal and pelvic have similar findings on CT and MRI. However,there are characteristic signs in different part.CT and MRI can accurately show the tumor shape,location,internal structure and relationship with adjacent structures,which has important value to diagnosis and differential diagnosis of peripheral schwannoma.
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OBJECTIVE@#To determine the expression profile of microRNA (miRNA) in peripheral blood mononuclear cells (PBMC) and immune factors in pregnant women with hepatitis B virus (HBV) infection.@*METHODS@#A total of 182 pregnant women infected with HBV were randomly selected, with 40 healthy pregnant women and 35 non-pregnant women as controls. High-throughput sequencing was used to detect RNA in the PBMC of all subjects. Indirect ELISA method was used to determine the changes of cytokines in peripheral blood samples.@*RESULTS@#Compared with the control group, 18 differentially expressed miRNA were identified in those with HBV infection (P< 0.01). Among these, miR-3607-3p, miR-20a, miR-1296, miR-153-1 and miR-X4 may directly regulate the transcriptional level of target genes including IL-10, IL-18, IL-16, MCP-1, NUP50 and CCR1. Meanwhile, peripheral blood cytokines IL-10, IL-18, IL-16 and MCP-1 were significantly increased in those with HBV infection (P<0.01), with the expression level of IL-16 and MCP-1 being strongly correlated with the viral load.@*CONCLUSION@#The expression profiles of miRNA in PBMC and cytokines in peripheral blood can change significantly during pregnancy, both may be involved in the immune response to HBV infection.
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Femenino , Humanos , Embarazo , Citocinas , Sangre , ADN Viral , Hepatitis B , Sangre , Virus de la Hepatitis B , Leucocitos Mononucleares , Metabolismo , MicroARNs , SangreRESUMEN
The occurrence of endoplasmic reticulum stress (ERS) is involved in the development of various diseases in human body.Accurate and effective intervention and regulation of ERS has become a hot spot in recent years.Amino acids are the nutrients that make up the proteins that people need, and they are also important signal transduction molecules in the human body.Intervention and regulation of ERS stress by amino acids is likely to be an important and unexplored area, and it is expected to become a potential target for new prevention strategies such as malignant tumors and cardiovascular diseases.Therefore, in this article, we will briefly review the research progress of the effects of amino acids on cellular ERS stress in recent years.
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Positron emission tomography (PET) imaging of functional metabolism has been widely used to investigate functional recovery and to evaluate therapeutic efficacy after stroke. The voxel intensity of a PET image is the most important indicator of cellular activity, but is affected by other factors such as the basal metabolic ratio of each subject. In order to locate dysfunctional regions accurately, intensity normalization by a scale factor is a prerequisite in the data analysis, for which the global mean value is most widely used. However, this is unsuitable for stroke studies. Alternatively, a specified scale factor calculated from a reference region is also used, comprising neither hyper- nor hypo-metabolic voxels. But there is no such recognized reference region for stroke studies. Therefore, we proposed a totally data-driven automatic method for unbiased scale factor generation. This factor was generated iteratively until the residual deviation of two adjacent scale factors was reduced by < 5%. Moreover, both simulated and real stroke data were used for evaluation, and these suggested that our proposed unbiased scale factor has better sensitivity and accuracy for stroke studies.
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Animales , Femenino , Masculino , Ratas , Simulación por Computador , Modelos Animales de Enfermedad , Fluorodesoxiglucosa F18 , Procesamiento de Imagen Asistido por Computador , Métodos , Infarto de la Arteria Cerebral Media , Diagnóstico por Imagen , Tomografía de Emisión de Positrones , Métodos , Ratas Sprague-Dawley , Accidente Cerebrovascular , Diagnóstico por ImagenRESUMEN
Stroke at the acute stage is a major cause of disability in adults, and is associated with dysfunction of brain networks. However, the mechanisms underlying changes in brain connectivity in stroke are far from fully elucidated. In the present study, we investigated brain metabolism and metabolic connectivity in a rat ischemic stroke model of middle cerebral artery occlusion (MCAO) at the acute stage using F-fluorodeoxyglucose positron emission tomography. Voxel-wise analysis showed decreased metabolism mainly in the ipsilesional hemisphere, and increased metabolism mainly in the contralesional cerebellum. We used further metabolic connectivity analysis to explore the brain metabolic network in MCAO. Compared to sham controls, rats with MCAO showed most significantly reduced nodal and local efficiency in the ipsilesional striatum. In addition, the MCAO group showed decreased metabolic central connection of the ipsilesional striatum with the ipsilesional cerebellum, ipsilesional hippocampus, and bilateral hypothalamus. Taken together, the present study demonstrated abnormal metabolic connectivity in rats at the acute stage of ischemic stroke, which might provide insight into clinical research.
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Animales , Masculino , Enfermedad Aguda , Encéfalo , Diagnóstico por Imagen , Metabolismo , Mapeo Encefálico , Modelos Animales de Enfermedad , Fluorodesoxiglucosa F18 , Glucosa , Metabolismo , Infarto de la Arteria Cerebral Media , Diagnóstico por Imagen , Metabolismo , Vías Nerviosas , Diagnóstico por Imagen , Metabolismo , Tomografía de Emisión de Positrones , Radiofármacos , Distribución Aleatoria , Ratas Sprague-DawleyRESUMEN
Objective To investigate the clinical effects of therapeutic hypothermia on the mortality and neurological function recovery in patients with acute large hemispheric infarction (LHI).Methods Seventy-three acute LHI patients (within 24 hours of symptom onset) admitted to our hospital from February 2015 to July 2016 were randomized to the hypothermia group (37 patients)and the control group (36 patients).Patients in the hypothermia group were given standard medical treatment and the surface cooling with a target temperature between 32-35 ℃ lasting for 5-7 days.Patients in the control group were given standard medical treatment and maintained a target temperature of normothermia.All patients were observed the primary end points including mortality and the modified Rankin Scale (mRS) score at 3 months.Results At three months,nine patients of survivors in the hypothermia group had good outcome (mRS score 0-3),whereas only five patients of survivors in the control group,though there was no significant difference (9/17 vs 5/19,x2 =2.676,P＞ 0.05)between the two groups.Twenty patients (54.1％)died in the hypothermia group,while 17 patients(47.2％) in the control group(x2 =0.341,P ＞0.05).Conclusion Therapeutic hypothermia is safe and feasible to patients with acute LHI,but may neither reduce mortality nor improve the neurological outcome in survivors.
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Purpose Meta-analysis of diagnostic value of prostate cancer (PCa) based on multi-parameter magnetic resonance imaging (mp-MRI). Materials and Methods Computer-based search of PubMed, Ebsco, Embase, Ovid, CBM, VPCS, Wanfang, and CNKI databases for related literatures on PCa diagnosed via mp-MRI from January 1, 2013 to September 31, 2017. Two researchers independently screened out literatures, extracted data based on inclusion and exclusion criteria, applied QUADAS-2 to evaluate the quality of methodologies included for the study, calculated combined sensitivity (Sen), specificity (Spe), positive likelihood ratio (+LR), negative likelihood ratio (-LR), and diagnostic odds ratio (DOR), drew Summerized receiver operating characteristic (SROC) curve and calculated the area under the curve (AUC). Results Eventually 20 articles of literatures were included, totally 3334 lesions. Meta-analysis results showed that Senmergeof PCa diagnosed via mp-MRI was 0.89(95% CI 0.87-0.92),Spemerge0.76(95% CI 0.67-0.84),+LRmerge3.8(95% CI 2.7-5.4),-LRmerge=0.14(95% CI 0.11-0.17),DORmerge=27(95% CI 17-44),AUCmerge=0.92(95% CI 0.89-0.94).Conclusion mp-MRI has a high diagnostic value for PCa and can be used as an important method for PCa diagnosis.
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Purpose To synthetically evaluate MR diffusion kurtosis imaging (DKI) using Meta-analysis to differentiate diagnostic value of benign and malignant breast lesions and quantitatively analyze mean kurtosis (MK) values of benign and malignant breast lesions in an attempt to provide evidence-based facts for clinical decision making. Materials and Methods Computer-based retrieval of Chinese and English literatures concerning differential diagnosis of benign and malignant breast lesions with application of DKI publicly published at home and abroad in PubMed, Ebsco, Embase, CNKI, Cochrane Library, CBM, VIP Data database from January. 1, 2006 to September. 30, 2017. Two valuators independently screened and extracted data according to inclusion and exclusion criteria, and drew on QUADAS for quality assessment, Stata 12.0 and Meta-Disc 1.4 software for Meta analysis and extraction of relevant parameters. Results Totally 8 up-to-standard literatures were included, including 3 in English and 5 in Chinese. The total number of focus was 689. Corresponding effect model analysis revealed that MK value in malignant breast lesion group was higher than that in benign lesion group, the difference of which was statistically significant. The optimal diagnostic threshold was determined by the maximum Youden index, which was approximately 0.71 in size,with combined sensitivity of 0.907(95% CI 0.860-0.939),specificity of 0.910(95% CI 0.856-0.945),positive likelihood ratio of 10.053(95% CI 6.293-16.059),negative likelihood ratio of 0.102(95% CI 0.068-0.154),and diagnostic test odds ratio of 98.203(95% CI 55.014-175.296).The area under receiver operating characteristic curve was 0.96.MK value suggested 94% posterior malignant rate of malignant breast lesions, and 13% malignant rate of benign breast lesions. Conclusion MK value has high diagnostic value for benign and malignant breast lesions with good sensitivity and specificity.
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Objective To evaluate the value of dynamic contrast-enhanced MRI (DCE-MRI)in diagnosing benign and malignant solitary pulmonary nodule (SPN)with Meta-analysis.Methods The databases including PubMed,EBSCO,Cochrane Library,Ovid, CBM,VIP,Wan Fang Database and CNKI were searched to select the literatures about the diagnosis of SPN with DCE-MRI.Inclusion criteria were established,according to the validity criteria for diagnostic research published by the Cochrane Methods Group on Screening and Diagnostic Tests .Methodological quality was assessed by using the quality assessment of diagnostic studies (QUADAS-2)instrument.Meta-analysis was performed by Stata 12.0 and Meta-Disc 1.4.According to the results of heterogeneity of the included articles,proper effect model was selected to calculate the pooled sensitivity,specificity,positive likelihood ration,negative likelihood ration,and diagnostic odds ratio.Summary receiver operating characteristic (SROC)curve was drawed and the area under the curve (AUC)was calculated.Results A total of 17 studies involving 1255 lesions were included.The results of Meta-analysis showed the pooled sensitivity,specificity,positive likelihood ration,negative likelihood ration,and diagnostic odds ratio were 0.95,0.81,4.9,0.06 and 85,respectively.The AUC of SROC was 0.97.Conclusion DCE-MRI has relatively high sensitivity and specificity in the differential diagnosis of benign and malignant SPN.
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Objective To evaluate the value of dynamic contrast-enhanced MRI (DCE-MRI)in diagnosing benign and malignant solitary pulmonary nodule (SPN)with Meta-analysis.Methods The databases including PubMed,EBSCO,Cochrane Library,Ovid, CBM,VIP,Wan Fang Database and CNKI were searched to select the literatures about the diagnosis of SPN with DCE-MRI.Inclusion criteria were established,according to the validity criteria for diagnostic research published by the Cochrane Methods Group on Screening and Diagnostic Tests .Methodological quality was assessed by using the quality assessment of diagnostic studies (QUADAS-2)instrument.Meta-analysis was performed by Stata 12.0 and Meta-Disc 1.4.According to the results of heterogeneity of the included articles,proper effect model was selected to calculate the pooled sensitivity,specificity,positive likelihood ration,negative likelihood ration,and diagnostic odds ratio.Summary receiver operating characteristic (SROC)curve was drawed and the area under the curve (AUC)was calculated.Results A total of 17 studies involving 1255 lesions were included.The results of Meta-analysis showed the pooled sensitivity,specificity,positive likelihood ration,negative likelihood ration,and diagnostic odds ratio were 0.95,0.81,4.9,0.06 and 85,respectively.The AUC of SROC was 0.97.Conclusion DCE-MRI has relatively high sensitivity and specificity in the differential diagnosis of benign and malignant SPN.
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Objective To analyze the distribution characteristics of Pseudomonas aeruginosa and Acinetobacter baumannii ,and to investigate the changing pattern of antimicrobial resistance of these strains isolated during 2012 - 2014 .Methods Strains of Pseud‐omonas aeruginosa and Acinetobacter baumannii isolated from January 2012 to December 2014 were collected .Antimicrobial suscep‐tibility of clinical isolates was tested by Kirby‐Bauer method .Results In the past three years ,214 strains of Pseudomonas aerugino‐sa and 347 strains of Acinetobacter baumannii were isolated .The nosocomial infection rate of Pseudomonas aeruginosa decreased year by year ,while the Acinetobacter baumannii ′s increased .Most strains were isolated from sputum ,wound secretion and urine . The strains of Pseudomonas aeruginosa and Acinetobacter baumannii were distributed in various departments of the hospital .The detection rates of these strains were the highest in ICU ,respectively 27 .6% and 34 .9% .Both the resistance rates of Pseudomonas aeruginosa to ceftazidime ,imipenem ,Amikacin and Acinetobacter baumannii to Piperacillin/Tazobactam and imipenem had in‐creased ,while the resistance rates of Acinetobacter baumannii to polymyxin B had decreased with each passing year .Conclusion Pseudomonas aeruginosa and Acinetobacter baumannii causes severe nosocomial infections and the antimicrobial resistance rates in‐creased ,especially the resistance rates to carbapenem are becoming more higher in recent years .Acinetobacter baumannii shows strong antibacterial activity in vitro to Polymyxin B .Therefore ,antimicrobial resistance surveillance should be strengthened to direct rational use of antibiotics .
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@#Aphasia is common after stroke, and seriously influences the family and social communication of the patients. As a safe and noninvasive therapy, repetitive transcranial magnetic stimulation (rTMS) is used to induce or enhance neural plasticity, including promoting the recovery of aphasia after stroke. This paper reviewed mechanism of speech recovery and the application of rTMS for aphasia after stroke.
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Aphasia is common after stroke, and seriously influences the family and social communication of the patients. As a safe and noninvasive therapy, repetitive transcranial magnetic stimulation (rTMS) is used to induce or enhance neural plasticity, including promoting the recovery of aphasia after stroke. This paper reviewed mechanism of speech recovery and the application of rTMS for aphasia after stroke.