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Objective:To realize the bacterial distribution and antibiotic resistance in children with severe pneumonia in this region.Methods:A total of 203 children with severe pneumonia diagnosed in Gansu Provincial People′s Hospital from April 2018 to March 2020 were divided into 0-1, 1-3, 3-7 and 7-14 years old groups.Bronchoalveolar lavage fluid was collected for bacterial culture and identification, and antibiotic susceptibility tests were performed.Results:The positive rate of pathogens was 69.5% (141/203), including 72.3% (102 strains) of Gram-negative bacteria and 30.5%(43 strains)of Gram-positive bacteria.The infection rates were highest in 0-1 years old group and the lowest in 7-14 years old group, which were 45.2%(19/42) and 16.9%(10/59), respectively.The infection rates of Haemophilus influenzae, Escherichia coli and Branhamella catarrhalis in the 1-3 years old group were 30.30%(10/33), 33.33% (11/33), and 21.21% (7/33), respectively, which showed significant differences compared with other groups( P<0.05). The infection rate of Streptococcus pneumoniae in the 0-1 years old group was 42.9%(18/42), which was significantly different compared with other groups ( P<0.001). The resistance rate of Haemophilus influenzae to trimethoprim/sulfamethoxazole was 89.5%(34/38), and the Streptococcus pneumoniae to trimethoprim/sulfamethoxazole and tetracycline were both 82.4%(28/34). The highest antibiotic resistance rate of Escherichia coli was 34.6%(9/26), and the Branhamella catarrhalis to clindamycin was 56.3%(9/16). Conclusion:The dominant bacteria for severe pneumonia in children are Haemophilus influenzae, Streptococcus pneumoniae, Escherichia coli and Branhamella catarrhalis.The bacterial infection rate is highest within 1 year old, but gradually decreases with the increase of age.Haemophilus influenzae and Streptococcus pneumoniae have severe resistance to several antibiotics.
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Objective:To investigate the changes of T lymphocyte subsets and cytokines in children with he-patitis B virus(HBV)-associated glomerulonephritis (HBV-GN), and their relationship with HBV-DNA load.Methods:Forty-one children who was the first diagnosed with HBV-GN in Department of Pediatrics, the People′s Hospital of Gansu Province and Institute of Infectious Diseases, the First Hospital of Lanzhou University from September 2012 to September 2016 were collected as the objects(HBV-GN group). At the same time, the 40 patients with HBV infection (chronic HBV infection, normal liver and kidney function, normal 24-hour proteinuria quantitation, no hematuria under the microscope, no recent symptoms of cold and fever, etc.) were enrolled as the control group.The levels of T lymphocyte subset, tumor necrosis factor α(TNF-α), interferon-γ (IFN-γ), interleukin (IL)-2, IL-4, IL-6, IL-8 and IL-10 in the HBV-GN group and the control group were compared, and the relationship between HBV-DNA and cell factors was farther analyzed.Results:Compared with the control group, the proportions of CD3 + T, CD4 + T lymphocyte and CD4 + /CD8 + ratio decreased in the HBV-GN group(0.632±0.052 vs.0.692±0.047, 0.204±0.050 vs.0.466±0.038, 0.006±0.002 vs.0.017±0.003, t=1.025, 3.342, 5.234, all P<0.05), and the proportions of CD8 + T lymphocyte was significantly higher than that in the control group (0.411±0.023 vs.0.220±0.043, t=4.452, P<0.01). Besides, IL-2 and IFN-γ levels in the HBV-GN group were significantly lower than those in the control group[(23.36±2.55) ng/L vs.(36.33±1.24) ng/L, (19.20±2.18) ng/L vs.(61.25±2.08) ng/L, all P<0.05], and the serum levels of TNF-α, IL-4, IL-6, IL-8, and IL-10 were significantly higher than those in the control group[(19.60±1.46) ng/L vs.( 6.68±2.32) ng/L, (13.65±3.34) ng/L vs.(1.35±1.52) ng/L, (5.57±1.02) ng/L vs.(1.43±0.57) ng/L, (26.32±3.45) ng/L vs.(9.68±2.55) ng/L, (19.82±2.78) ng/L vs.(1.02±0.56) ng/L, all P<0.01]. Moreover, in HBV-GN patients, there was negative correlation between HBV-DNA load and IFN-γ, IL-2( r=-0.985, -0.943, all P<0.05), and positive relationship in HBV-DNA load with TNF-α, IL-4, IL-6, IL-8 and IL -10 levels( r=0.942, 0.966, 0.953, 0.944, 0.963, all P<0.05). Conclusions:There is an CD4 + /CD8 + imbalance and an abnormal level of cell factors in HBV-GN progression.In further HBV-GN treatment, HBV-DNA and the cell factors should be detected simultaneously to dynamically eva-luate the illness change and the clinical curative effect.
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Objective: To analyze the effects of serum hepatitis B virus covalently closed circular DNA (HBV-cccDNA) level on the liver and kidney functions, detection of HBV antigens in kidney tissue, pathological grading and staging of liver tissue in the children with hepatitis B virus associated glomerulonephritis (HBV-GN), and to evaluate the clinical value of HBV-cccDNA level detection in the diagnosis of the children with HBV-GN. Methods: A total of 39 HBV-GN children (observation group) were selected and all of them underwent the liver and kidney biopsy. A total of 40 HBV-carried children with normal liver function were selected as control group. The levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) of the children were detected. Molecular beacons PCR method was used to detect the serum HBV-cccDNA level of the children. The morphology of liver and kidney tissues of the children was detected with HE staining. The detection rates of HBsAg, HBeAg and HBcAg in kidney tissue of the children were detected by immunofluorescence. Receiver operating characteristic (ROC) curve and area under the ROC curve (AUC) were used to evaluate the value of HBV-cccDNA level detection in the diagnosis of HBV-GN. The Ax fluorescence value of HBV-cccDNA > 21 was determined as positive, and the Ax fluorescence value of HBV-cc cDNA 0. 05). Membranous nephropathy (MN) was the main pathological type of kidney biopsy in the HBV-GN. HBeAg and HBcAg were the main components of HBV antigens. The detection rates of HBeAg and HBcAg of the children in HBV-cccDNA positive group were significantly higher than those in HBV-cccDNA negative group (χ2 =5. 652, P = 0. 027; =12. 523, P=0. 001). The ROC curve analysis results showed that the HBV-cccDNA level detection could effectively distinguish the HBV-GN children in observation group from those in control group, AUC=0. 804 (95% Cl 0. 709-0. 883). The levels of HBV-cccDNA of 10 cases of HBV-GN children underwent standardized treatment with complete follow-up treatment data were decreased significantly at the 2nd week after treatment. At the 12th week after treatment, in 7 cases the HBeAg turned negative, without proteinuria and hematuria symptoms, and the AST and ALT levels were normal. The HBV-cccDNA levels of 3 cases with ineffective treatment were higher than that those of the remaining 7 cases. Conclusion; The high expression of HBV-cccDNA is closely related to the liver function, proteinuria and HBV antigen detection in kindney tissue of the HBV-GN children. The detection of HBV-cccDNA level has potential clinical value for the auxiliaty diagnosis and evaluation on the curative effect of the HBV-GN.
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Objective To explore the clinical value of Z score in assessing coronary artery lesions (CAL) of children with Kawasaki disease. Methods The clinical records of 102 children with Kawasaki disease from January 2012 to December 2016 in Gansu Provincial Hospital were retrospectively analyzed. The internal diameter of left main coronary artery (LMCA) and right coronary artery ( RCA) was measured by echocardiography (ECHO),and the incidence of CAL was preliminarily judged. The Z scores of LMCA and RCA were calculated on the basis of the coronary artery diameter,the age of the children and the body surface area,and the incidence of CAL was judged again. Results A total of 22 cases(21. 6%) of CAL were found in 102 cases by ECHO examination,of which 18 cases(17. 6%) of LMCA lesions,and 22 cases(21. 6%) of RCA lesions. A total of 33 cases(32. 4%) of CAL were found by calculating the Z score of coronary artery, of which 29 cases(28. 4%) of LMCA lesions and 33 cases(32. 4%) of RCA lesions. There was significant difference between two methods for determining LMCA lesions (χ2=3. 35,P＜0. 05),and there was no sig-nificant difference between two methods for determining RCA lesions (χ2=3. 01,P＞0. 05). Z score of coro-nary artery was more accurate to detect the CAL in Kawasaki disease,especially LMCA lesions. A large coro-nary artery aneurysm was found in the patients with the largest Z score by selective coronary angiography. Conclusion The Z score can be more conductive to assess the CAL in children with Kawasaki disease,and the higher the Z score,the more serious the CAL is.
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Objective To study the effects of the different phases of breast dynamic contrast enhanced MR with 3D MIP in reconstruction of breast vascular.To explore the reconstruction parameters of breast vascular in benign and malignant breast lesions.Methods All of 132 female patients with pathologically confirmed breast disease were enrolled,including 50 cases of benign lesions and 82 malignant cases.All of them underwent high temporal resolution dynamic enhanced MR scanning,with each phase of 20 s.All of the images were reconstructed by 3D MIP and analyzed.Results In both of benign and malignant lesions,the display rate of the internal thoracic artery was higher than that of the lateral thoracic artery and intercostal artery.The display rate of grade Ⅱ vessels of internal thoracic artery and intercostal artery were higher in malignant lesion(P=0.035,0.000).The grade Ⅰ and Ⅱ vessels of the internal thoracic artery and the lateral thoracic artery increased gradually with time delay.The vascular branches were showed in malignant lesions earlier than those in benign lesions,in the 20th seconds in which grade Ⅰ vessels could be displayed,and in the 60th seconds,internal thoracic artery in malignant lesions(96.3%)can be clearly displayed.For benign lesions,grade Ⅰ branch of the internal thoracic artery in patients(80%)could be displayed in the 120th seconds.Conclusion Breast dynamic contrast enhanced MR with 3D MIP can be used to display the blood vessels of the breast,which is of great value in the diagnosis of breast diseases.To achieve the best display effect,different enhanced phases should be selected to reconstruct the blood vessels based on the different enhancement patterns in benign and malignant lesions.
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Objective To evaluate the value of MRI in the diagnosis of secondary dysmenorrhea.Methods 96 cases of secondary dysmenorrhea confirmed by clinic were analyzed retrospectively.Organic diseases contributed to secondary dysmenorrhea were classified and the characteristics of MRI were analyzed.Results There were 53 cases of endometriosis(EM),22 cases of adenomyosis (AM),14 cases of genital malformations,5 cases of chronic pelvic inflammation and 2 cases of uterine leiomyoma.Conclusion MRI can search the etiology of secondary dysmenorrhea,which can be used as effective means of inspection for secondary dysmenorrhe.
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Objective To study the value of the application of 320-row detector dynamic volume CT in diagnosis of complicated congenital heart diseases(CCHD).Methods Datas of 43 cases with CCHD,who examined by ECC-gated 320-row CT angiography (CTA)as preoperative examinations were collected.All the CT data were processed by combined application of multi-imaging post-processing technique to show the anatomic malformation based on segmental analysis,and were compared with the transthoracic ech-ocardiography (TTE )and surgical results .Results 1 97 various malformations were found in 43 cases and proved by operation, among which there were 87 intracardiac malformations,the diagnostic accuracy with CTA and TTE were 86.2%,89.7%,and there was no obvious difference between them(P >0.05 ).1 10 extracardiac malformations (including connection malformations between heart and vessels,extracardiovascular malformation,bronchial or other nonvascular structure malformation)were found ,the accura-cy with CTA and TTE were 91.8% and 76.4%,the former was superior to latter (P <0.05)Conclusion 320-row detector dynamic volume CT in diagnosis of CCHD has very important meaning and practical application value,should be used as the significant choice for clinical diagnosis of CCHD.
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Objective To investigate the positive ratio of urine and gender difference of chronic kidney disease(CKD) with children in Lanzhou,a heavy pollution and underdeveloped city in northwest of China.Methods Through the Multistix 10 SG,the morning urine of the children were detected,which aged from 12 to 13 years old.Results The positive ratio of urine was 14.9％ in subjects,18.2％ in girls and 12.8 ％ in boys respectively.Furthermore,the positive ratio in girls showed statistically significant higher than boy's.(x2 =21.77,P ＜ 0.01).Espcially,the ratios of hematuria and pyuria significantly increased in girls (x2 =17.52,P ＜ 0.01;x2=7.95,P ＜ 0.01).Conclusion The gender difference of the positive rate of urine was existed in our large samples.And there is a higher prositive rate of hematuria and pyuria in the girls.This investigation will enrich the epidemiological data of CKD in children(12 ～ 13 years old)in Lanzhou city.
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Objective This study was designed to investigate the correlation between the apparent diffusion coefficient(ADC)value and pathological change of the non-injured side brain tissue of traumatic brain injury(TBI)of rat.Methods Sixty healthy adult Wist-ar rats were randomly divided into two groups:the control or TBI groups.The TBI group was divided into five sub-groups according to the different time intervals:1,3,6,12,24 h(n = 10).The animal brain of each group was scanned with MR-DWI,and the ADC value of damaged areas and contralateral non-damaged areas were measured.After that the brains were taken out at different time points after TBI.The cerebral edema and blood-brain barrier(BBB)changes in structure were examined with an optical micros-copy and transmission electron microscopy,and the IgG content in the same tissues were determined by means of immunohistochem-istry.The data was analyzed with SPSS 13.0 statistical software.Results There was no signal abnormality on MR-DWI and tissue structure in control group,and the IgG stain was negative.In the contralateral non-damaged areas of TBI group,pathological obser-vation revealed no variation at 1 h after TBI,and the IgG stain was also negative.Cellular edema was shown at 3 h and the IgG stain was slight positive.The cellular edema aggravated with time and angioedema appeared at 6 h.IgG stain was shown significantly posi-tive.At 12~24 h,cellular edema kept increasing more severe,however angioedema had a trend to mitigated along with time,IgG stain became slight and the proliferation of glial cells could observed.Compared with control group,the ADC values of the contralat-eral non-damaged areas in each group showed no significant difference (P >0.05).However,in the damaged areas of each group, angioedema appeared at 1 h and gradually aggravated,cellular edema occurred at 3 h,Both of them were aggravated with time. ADC values increased at 1 h,and then decreased until 6 h,then followed a climbing up to 24 h,showed as a “V”-shaped.Con-clusion When contused on one side brain,the contralateral non-inj ured side tissue also has pathological changes that occurs later than those on the inj ured side.Cellular edema of the tissues ap-peares first and is followed by angioedema,which lessens over time..There is no significant difference of ADC values between con-tralateral side of TBI groups and control group(P >0.05),which reveals a “pseudo-normal”phenomenon.
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Objective To evaluate the efficacy of 10-day compound allantoin containing quadruple regimen in the treatment of chronic gastritis with Helicobacter pylori (H.pylori) infection,and to compare with the bismuth-containing quadruple therapy.Methods Altogether 173 patients with H.pylori positive chronic gastritis confirmed by gastric endoscope were divided into 10-day compound allantoin containing quadruple regimen group (n =43),24-day compound allantoin containing quadruple regimen group (n =46),10-day bismuth-containing quadruple regimen group (n =42) and 24-day bismuth-containing quadruple regimen group (n =42).After the treatment,the eradication rate of H.pylori,the rate of gastrointestinal symptoms (epigastric pain,bloating and belching) relief and the adverse effects of each group were observed.Intention-to-treat (ITT),per-protocol (PP) statistical analysis and chi-square analysis were performed for statistical analysis.Results H.pylori eradication rates of 10-day compound allantoin containing quadruple regimen group,24-day compound allantoin containing quadruple regimen group,10-day bismuth-containing quadruple regimen group and 24-day bismuth-containing quadruple regimen group analyzed by ITT were 90.7％ (39/43),91.3％ (42/46),90.5％ (38/42) and 88.1％ (37/42),respectively; while analyzed by PP were 90.7％ (39/43),93.3％ (42/45),90.5％ (38/42) and 90.2％ (37/41),respectively.And there were no statistical differences between groups (all P＞0.05).Ten days after the treatment,the rates of epigastric pain relief of 24-day compound allantoin containing quadruple regimen group and 24-day bismuth-containing quadruple regimen group were 81.1％ (30/37) and 78.8％ (26/33),respectively,the rates of bloating relief were 82.4％ (28/34) and 71.0％ (22/31),respectively,and the rates of belching relief were 76.9％ (20/26) and 75.0％ (21/28),respectively.There were no statistical differences between the two groups (all P＞ 0.05).However after 24-day treatment,the rates of epigastric pain relief of 24-day compound allantoin containing quadruple regimen group and 24-day bismuth-containing quadruple regimen group were 91.9 ％ (34/37) and 87.9％ (29/33),respectively,the rates of bloating relief were 94.1％ (32/34) and 87.1％ (27/31),respectively,and the rates of belching relief were 96.2％ (25/26) and 85.7％ (24/28),respectively.There were no statistical differences between the two groups (all P＞0.05).And the rates of epigastric pain and bloating relief increased after 24-day treatment compared with those of 10-day treatment,however the differences were not statistically significant between the two groups (all P＞ 0.05).In 24-day compound allantoin containing quadruple regimen group,the rate of belching relief was higher after 24-day treatment compared with that of 10-day treatment,and the difference was statistically significant (x2=4.127,P=0.042).No severe adverse effects were observed in each group,and there were no adverse effects such as oral metal odor,tongue black and melena in compound allantoin containing quadruple therapy.Conclusions Ten-day compound allantoin containing quadruple therapy as first-line approach in the treatment of chronic gastritis with H.pylori infection can get better H.pylori eradication and the efficacy is similar to bismuth quadruple therapy.Meanwhile the symptom relief rate is high and no obvious adverse effects were found.
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Objective To investigate the prevalence of urine abnormalities for school children in Lanzhou and evaluate the signiifcance of urine screening. Methods During 2012-2013, urine from 10795 students were collected, and screened by urine reagent paper. Two weeks later, repeated screening was conducted in those who had abnormal result in the ifrst screening. Children with both results being abnormal were submitted to urine routine tests in local hospitals. Results In the ifrst screening of school children, 1653 (15.31%) children were urinary occult blood positive, 516 (4.78%) had urinary protein, 112 (1.04%) had occult blood with proteinuri and 743 (6.88%) had white cells in urine. In the second urine screening, the positive rate of occult blood was 7.55%(815 ), urinary protein was 2.13%(230), occult blood with proteinuria was 0.69%(74) and white cells in urine was 2.51%(271). Four hundred and iffty-ifve students in 1359 were submitted to urine routine tests. Thirty-two children had pyuria, 147 had hematuria, 23 had proteinuria and 13 had occult blood with proteinuria. Thirteen cases of chronic kidney disease were found in the follow-up. The incidence of urine abnormalities was signiifcantly higher in junior middle school than in primary school. Conclusions Urine screening is an effective way to ifnd asymptomatic kidney disease and urinary tract infection. Follow-up should be strengthened.
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Objective To investigate the pathological changes of brain tissues from contused and contralateral non-contused sides and their significance.Methods A total of 100 healthy adult Wistar rats were assigned to brain contusion group and sham operation group according to the random number table.Ten rats in each group were sacrificed at 1,3,6,12,and 24 hours respectively.Brain samples were collected to perform pathophysiological analysis of brain tissues and test blood brain barrier (BBB)permeability by semiquantitative immunohistochemical staining of IgG.Results There was no damage to the bilateral brain tissues in sham operation group and IgG stain was negative.In brain contusion group,angioedema characterized by the breakdown of BBB was seen in the contused side at 1 hour followed by cellular edema at 3 hours,with aggravation of both over time.Moreover,tissue necrosis,inflammatory cell infiltration,and microglia proliferation emerged at 12 hours.Besides,IgG-positive staining was seen at 1 hour,was strongest at 6 hours,and remained a high level at 24 hours.With respect to the non-injured side in brain contusion group,no pathological abnormalities and negatively stained IgG were observed at 1 hour; cellular edema and weakly positive-stained IgG were found at 3 hours; aggravated cellular edema,emergence of angioedema,and IgG strongly positive staining were noted at 6 hours;cellular edema continued aggravation,but angioedema tended to be attenuated,IgG staining weakened,and microglia proliferation were observed at 12-24 hours.Conclusion Pathological changes of brain tissues from the contused and contralateral non-contused sides are differed,which provides a basis in determining treatment choices.
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Objective To investigate the expression of aquaporins 4 (AQP4) and histopathological changes in early phase of traumatic brain edema and the correlation between AQP4 expression and structural damage to blood-brain barrier (BBB).Methods A total of 120 healthy adult Wistar rats were divided into sham operation group and brain trauma group (which was subgrouped at hours 1,3,6,12 and 24 postinjury) according to random number table,with 20 rats per group.At each time point,brain water content was measured; brain edema and BBB structural changes were observed pathologically;IgG and AQP4 expressions in traumatic brain tissues were detected with immunohistochemical method and Western-blotting.Results In sham operation group,negatively stained IgG was observed and there were no abnormalities in brain tissue structure,brain water content as well as AQP4 expression.In brain trauma group,cerebral water content presented notable increase at 6 hours postinjury and peaked at 24hours; IgG expression showed significant increase at 1 hour postinjury,peaked at 6 hours postinjury and remained a high level at 24 hours.Pathologic observation revealed damage to BBB,blood red cells leaking out of the blood vessels,and tissue gap widening at 1 hour postinjury,which manifested as vasogenic brain edema.Further,those phenomena were gradually aggravated over time and became obvious at 6 hours postinjury.Intracellular edema occurred at 3 hours postinjury,with the presence of increased glial cell body,cytoplasm light staining or vacuolar degeneration,as well as mitochondria swelling and was also aggravated with time,particularly at 6 hours postinjury.Except that the previously mentioned two forms of edema coexisted at 12 hours postinjury,tissue necrosis,inflammatory cell infiltration and microglia proliferation were emerged and aggravated at 24 hours postinjury.AQP4 level decreased at 1 hour,minimized at 6 hours and regained at 12 hours,showing a V-shape curve.Conclusions Vasogenic edema characterized by BBB disruption is the primary histopathological change in early-phase of brain trauma,followed by the coexistence with intracellular edema and aggravation of the two forms of edema over time.AQP4 expression is down-regulated in the vasogenic edema phase but highly expressed at phase of the intracellular edema.
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Objective To study the relationship between serum hepatitis B virus covalently closed circle DNA (HBV cccDNA) as well as liver function and liver tissue pathological changes in children with chronic hepatitis B.Methods One hundred and twenty-four HBV-DNA positive children with hepatitis B were enrolled.Among 124 patients,65 cases were HBV carriers,59 cases were chronic hepatitis (mild in 31 cases,moderate in 18 cases and severe in 10 cases).HBV cccDNA in serum and liver function were detected,46 of which underwent liver biopsy and liver tissue inflammation and fibrosis grading classification was made.Results In moderate and severe cases,positive rates of serum HBV cccDNA (77.8％,100％) were higher than those of the HBV carriers and mild cases (32.3％,54.8％) (x2 =25.429,P ＜ 0.01),indicating more severe illness in children,detection rate of serum HBV cccDNA was higher.ALT,AST,and TBIL were higher in serum HBV cccDNA positive group than those of negative group[(95.6 ± 18.2) U/L vs (52.5 ± 17.7) U/L,(88.8 ±20.3) U/L vs (48.4 ±21.4) U/L,(68.4 ±24.6) μmol/L vs (28.3 ± 23.9) μmol/L](t =15.572,10.750,17.067,P ＜ 0.01).Serum HBV cccDNA and liver inflammatory activity and fibrosis showed no significant correlationship.Conclusion Serum HBV cccDNA is a sensitive indicator of viral replication,the more severe the disease situation,the peripheral HBV cccDNA detection rate is higher.But it is not entirely consistent with liver inflammation and fibrosis,so it can not completely reflect the degree of liver damage.
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Influenza A(H1N1)virus is a re-mixed strains of human influenza virus genes,avian influenza virus gene and swine influenza virus gene.Influenza A(H1N1)pandemic influenza has spread around the world,which has drawn worldwide attention.In order to early discovery,early diagnosis,early treatment and effective prevention of Influenza A(H1N1),we describe the characteristics of linfluenza A(H1N1)virus,epidemiology,pathogenesis,clinical manifestations,laboratory examination and effective treatment and preventive measures.
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Objective To evaluate the value of 64-slice spiral computed tomography angiography(CTA) in diagnosis of acute severe chest pain caused by vascular diseases.Methods 34 cases with acute severe chest pain caused by vascular lesions confirmed clinically underwent CTA examinations.The images were processed with multi-planar reconstruction,maximal intensity projection,curved planar reconstruction and volume rendering,then the imaging features were analysed.Results CTA showed acute aortic dissection in 13 cases,acute pulmonary embolism in 9 cases and acute coronary syndrome in 12 cases,all cases were confirmed by clinic.Conclusion 64-slice CTA has very important practical value in diagnosis of acute severe chest pain.
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Objective To study the relationship between Tei index and the myocardial enzymes in newborns with myocardial damage due to asphyxia. Methods Forty-four newborns with mild asphyxia,27 newborns with severe asphyxia and 20 healthy newborns hospitalized in our hospital from January 2005 to December 2008 were enrolled in this study.The peak E and peak A and E/A ratio at mitral valve,the ejection fraction,isovolumetric contraction time,isovolumetric relaxation time and Tei index were measured by conventional echocardiography,and aspartate aminotransferase,creatine kinase,lactate dehydrogenase,hydroxybutyrate dehydrogenase and creatine phosphate kinase isoenzyme,and cardiac troponin T were tested also.One-way ANOVA was used to analyze the difference between groups. Results Tei index,isovolumetric contraction time and isovolumetric relaxation time in the severe asphyxia newborns were 0.62±0.13,(47±7)ms and(52±8)ms,higher than those in the mild asphyxia newborns[0.51±0.14,(41±6)ms and(43±6)ms],those in the mild asphyxia newborns were higher than in the healthy newborns[0.39±0.12,(34±6)ms and (37±6)ms] (all P<0.01).Aspartate aminotransferase,lactate dehydrogenase,hydroxybutyrate dehydrogenase,creatine kinase and its isoenzymes and cardiac troponin T in the severe asphyxia newborns were higher than in the mild asphyxia newborns and healthy group(P<0.01).Tei index,isovolumetric contraction time and isovolumetric relaxation time were positively related to the myocardial enzymes.The positive relationships were more statistically significant in Tel index,creatine kinase,its isoenzymes and cardiac troponin T(r=0.762,0.821,0.778,P<0.01).Conclusions Combination of Tei index and myocardial enzymes can not only be applied to assess the cardiac function in newborns with myocardial damage due to asphyxia,but also to evaluate the degree of cardiac dysfunction accurately and dynamically.
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Objective To explore the changes of renal blood flow and renal injury in neonates with birth asphyxia. Methods Seventy-one patients were tested for Ultrasonic Doppler renal blood flow and renal function. Results The blood perfusion resistance was increased and the blood flow perfusion was decreased, Even in light asphyxia. Conclusion The hemodynamic disturbance is the main reason for renal injury and dysfunction in infants with birth asphyxia, and detecting hemodynamic disturbance and urinary enzyme may be an early diagnostic method to evaluate the renal injury.
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Objective To analyze the MR features of atypical meningiomas,so that to improve the diagnostic accuracy of this tumor pre-surgery.Methods There were 12 cases of atypical meningiomas proved by surgery and pathology.All of these patients underwent plain and contrast-enhanced MR examinations.Results Totally 12 cases,included 2 cases of multiple meningiomas,2 cases of lateral ventriclar meningiomas,2 cases of completely calcific meningiomas,3 cases of cystic meningiomas and 3 cases of malignant meningiomas.Conclusion The external cerebral signs of the tumors are the important basis for the localizing diagnosis of atypical meningiomas.Atypical MR signs of meningiomas are of complimentary value in qualitative diagnosis.
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Objective To investigate the accuracy and applied value of measurement of pulmonary flow velocity with phase-contrast MRI(PC-MRI).Methods ①42 healthy volunteers were divided into 2 groups randomly,one group was examined by PC-MRI,another was examined by doppler ultrasound.The inner diameter,maximum velocity and mean velocity of main pulmonary artery(MPA) were measured;②The flow volume of MPA in a cardiac cycle was calculated with formulation.Results ①The inner diameters of MPA measured with PC-MRI and doppler ultrasound were(24.4?3.41) mm and(21.5?2.55) mm respectively;②The maximum velocity and mean velocity of MPA measured by PC MRI were(79.9?24.0) cm/s and(50.3?7.71) cm/s respectively;③The maximum velocity and mean velocity of MPA gained by doppler ultrasound was(88.8?8.33) cm/s and(53.7? 5.04) cm/s resepectively;④The flow volume of MPA in a cardiac cycle measured by PC MRI and doppler ultrasound was(73.5?6.60) ml and(69.0?10.6) ml respectively.The results were analyzed by group sample t-test,and the level of test was 0.05.Conclusion The blood flow velocity and volume of pulmonary artery can be measured accurately by PC-MRI,it is of certain applied value in assessing the pulmonary blood flow dynamics changes.