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Objective:To investigate the value of gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced MRI in predicting the pathological grade and early recurrence rate of hepatocellular carcinoma.Methods:The imaging data, pathological data, and follow-up data of 90 patients with hepatocellular carcinoma who underwent Gd-EOB-DTPA-enhanced MRI examination and surgical treatment in People's Hospital of Baise from January 2016 to October 2017 were retrospectively analyzed. The correlation between the signal intensity of contrast-enhanced MRI and postoperative pathological grade was analyzed. Kaplan-Meier survival analysis was performed to investigate the effects of the signal characteristics of hepatobiliary lesions on the early recurrence rate of hepatocellular carcinoma.Results:A total of 59 (65.56%) patients showed low-intensity signals and 31 (34.44%) patients showed mixed-intensity signals. High-intensity signal was not found in any patients. The signal intensity of the hepatobiliary phase was significantly correlated with the pathological grade of the tumor ( χ2 = 2.26, P = 0.040) and tumor size ( t = 3.10, P = 0.033). The early recurrence rate of hepatocellular carcinoma was significantly higher in patients exhibiting mixed-intensity signals than that in patients exhibiting low-intensity signals ( χ2 = 2.25, P = 0.041). Conclusion:Gd-EOB-DTPA-enhanced MRI in the hepatobiliary phase with different signal intensities has the potential to predict the pathological grade and early recurrence rate of hepatocellular carcinoma.
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Objective:To study the main blood parameters of Leishmania-infected dogs with different clinical symptoms in the high incidence area of visceral leishmaniasis in Gansu Province, and to provide scientific basis for early diagnosis and monitoring of canine leishmaniasis. Methods:In May 2019, Wenxian County of Longnan City and Diebu County of Gannan Tibetan Autonomous Prefecture, the historical endemic areas of visceral leishmaniasis in Gansu Province, were selected as the investigation sites, and 40 dogs with positive Leishmania DNA were investigated. According to their clinical symptoms, they were divided into three groups: asymptomatic ( n = 17), minimally symptomatic ( n = 12) and symptomatic ( n = 11). At the same time, 10 healthy dogs were selected as controls. Major blood indexes were detected by an automatic animal blood five-classification cell analyzer. Results:Compared with the control group, the number of red blood cells, hemoglobin content, hematocrit, and the number of lymphocytes, monocytes and eosinophils in the asymptomatic, minimally symptomatic and symptomatic groups were decreased ( P < 0.05), while the number of white blood cells and neutrophils in minimally symptomatic and symptomatic groups were decreased ( P < 0.05). The above blood indexes were lower in the symptomatic group than those in the asymptomatic group. The number of red blood cells (control group vs symptomatic group) decreased from (6.82 ± 0.05) × 10 12/L to (4.19 ± 0.08) × 10 12/L, hemoglobin content decreased from (15.84 ± 0.74) g/L to (9.65 ± 0.18) g/L, hematocrit decreased from (46.41 ± 0.95)% to (27.86 ± 0.42)%, the number of white blood cells decreased from (14.90 ± 0.22) × 10 9/L to (10.23 ± 0.24) × 10 9/L, the number of neutrophils decreased from (7.25 ± 0.18) × 10 9/L to (6.18 ± 0.11) × 10 9/L, the number of lymphocytes decreased from (2.80 ± 0.07) × 10 9/L to (1.64 ± 0.06) × 10 9/L, the number of monocytes decreased from (1.13 ± 0.01) × 10 9/L to (0.53 ± 0.02) × 10 9/L, and the number of eosinophils decreased from (1.70 ± 0.06) × 10 9/L to (0.71 ± 0.03) × 10 9/L. Conclusion:Different clinical symptoms of Leishmania-infected dogs have different blood test results.
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Objective:To learn about the diagnosis of Kala-azar in Gansu Province, and to provide a basis for formulating corresponding prevention and control measures.Methods:The data (age, gender, onset time, diagnosis time, diagnosis unit, etc.) of Kala-azar cases in Gansu Province from January to December 2018 were collected from the China Disease Prevention and Control Information System. At the same time, a case report questionnaire was designed to collect information such as the initial diagnosis unit and initial diagnosis results; a diagnosis and treatment questionnaire of medical institutions was designed to investigate the knowledge of diagnosis and treatment of Kala-azar (main epidemic areas, main symptoms, common detection methods, main therapeutic drugs and drug use methods) among doctors in county and township hospitals, and the pass rate and awareness rate were calculated.Results:A total of 47 Kala-azar cases were included, with an average age of 17 years. Among them, men accounted for 57.45% (27/47) and women accounted for 42.55% (20/47). Among the initial diagnosis hospitals, the proportions of provincial, municipal, county and township hospitals were 2.13% (1/47), 12.77% (6/47), 42.55% (20/47) and 42.55% (20/47), respectively; among the hospitals with confirmed cases, provincial, municipal, county and township hospitals accounted for 48.94% (23/47), 31.91% (15/47), 19.15% (9/47) and 0 (0/47), respectively. The shortest time from initial diagnosis to diagnosis of the 47 cases was 1 day; the longest was 124 days, with an average of 27 days. A total of 96 valid questionnaires were collected from doctors in county and township hospitals, of which 30 scored 60 points or above, and the pass rate was 31.25% (30/96). Among the five surveys on diagnosis and treatment knowledge of Kala-azar, doctors in county and township hospitals had the highest awareness rate of "main therapeutic drugs", which was 77.08% (74/96), and there was significant difference (χ 2 = 9.86, P = 0.002) between doctors in the two-level hospitals [90.00% (45/50), 63.04% (29/46)]. The awareness rate of "main symptoms" was the lowest, which was 25.00% (24/96), and there was significant difference (χ 2 = 4.51, P = 0.034) between doctors in the two-level hospitals [34.00% (17/50), 15.22% (7/46)]. Conclusions:The awareness rate of diagnosis and treatment knowledge of Kala-azar among doctors in county and township hospitals in Gansu Province is low, and their diagnostic ability is weak. It is recommended to strengthen the training of clinicians, improve the timeliness of diagnosis, and achieve early diagnosis, early report and early treatment of Kala-azar.
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Objective:To investigate the species types and phylogenetic relationship of canine Leishmania in Diebu County, Gansu Province, so as to provide a basis for exploring new methods of prevention and control of canine visceral leishmaniasis. Methods:DNA was extracted from blood samples of eight asymptomatic Leishmania-infected dogs in Luoda administrative village in Diebu County, Gansu Province. Ribosomal internal transcribed spacer 1 (ITS-1) gene fragments were amplified and isolated by PCR, and then the amplified target fragments were sequenced. The MEGA 7.0 software was used for multiple sequence alignment, and a phylogenetic tree was constructed by neighbor-joining method to analyze the phylogenetic relationship of canine Leishmania in Diebu County, Gansu Province. Results:Fragments of about 320 bp corresponding in size to the target sequence ITS-1 were isolated from all of the eight asymptomatic Leishmania-infected dogs blood samples. ITS-1 sequence alignment showed that the sequence homology between 8 samples and Leishmania infantum MG969403, MN648755 strains was 99.1% - 100.0%; phylogenetic tree showed that all 8 samples were clustered into one branch with Leishmania infantum. Conclusion:Leishmania infantum is identified from all of the eight asymptomatic Leishmania-infected dogs blood samples in Diebu County, Gansu Province.
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Objective:To investigate the Leishmania infection status in dogs in canine-derived visceral leishmaniasis endemic areas in Wenxian County and Diebu County of Gansu Province, to provide basis for formulating effective prevention and treatment measures for visceral leishmaniasis. Methods:In 2019, household survey method was used to collect dog basic information (such as gender and age) in villages with higher incidence of previous cases in Wenxian County and Diebu County of Gansu Province; and venous blood of dog was collected, PCR method was used to detect microloop DNA of Leishmania. Results:A total of 537 dogs were investigated, the positive rate of Leishmania detected by PCR was 41.15% (221/537); the positive rates of PCR detection were 64.63% (95/147) and 32.31% (126/390) in Wenxian County and Diebu County, respectively, and the positive rate in Wenxian County was higher than that in Diebu County (χ 2=46.044, P < 0.05). In 35 dogs with clinical symptoms of visceral leishmaniasis, the positive rate of PCR detection was 74.29% (26/35); the positive rates of PCR detection in symptomatically infected dogs were 84.62% (22/26) and 4/9 in Wenxian County and Diebu County, respectively, the positive rate in Wenxian County was higher than that in Diebu County ( P < 0.05). The positive rate of PCR detection was 38.84% (195/502) in 502 asymptomatic dogs; the positive rates of PCR detection were 60.33% (73/121) and 32.02% (122/381) in Wenxian County and Diebu County, respectively, the positive rate in Wenxian County was higher than that in Diebu County (χ 2=39.982, P < 0.05). Conclusions:The infection rates of Leishmania in dogs are high in Wenxian County and Diebu County of Gansu Province, the positive rate of PCR detection in asymptomatic dogs infected with Leishmania is high. This indicates that local residents and dogs are at high risk of infection with Leishmania. It is recommended that relevant departments should enhance residents' awareness of active protection and strengthen efforts to control the Leishmania infection of dogs.
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Objective:To analyze the spatial distribution characteristics of dogs infected with Leishmania in Wenxian and Diebu counties of Gansu Province, and provide a scientific basis for implementation of precise prevention and control measures. Methods:In 2019, blood samples were collected from all dogs in visceral leishmaniasis endemic areas Xinglong Village, Wenxian County and Luoda Village, Diebu County, Gansu Province, by cluster sampling method. The primer RV1-RV2 which was commonly used to diagnose visceral leishmaniasis, was used for PCR amplification of dog blood samples. SaTScan V9.5 software was used to analyze the spatial clustering of dogs infected with Leishmania. Results:A total of 537 dogs were investigated, and the number of positive infection was 221, with a positive rate of 41.2%. Among them, the positive rates of dogs infected with Leishmania in Wenxian and Diebu counties were 64.6% (95/147) and 32.3% (126/390), respectively. The results of SaTScan analysis showed that the spatial clustering of dogs infected with Leishmania in Wenxian and Diebu counties were not statistically significant ( P > 0.05). Conclusions:There are no spatial clustering of dogs infected with Leishmania in Wenxian and Diebu counties, but the positive rate of dogs infected with Leishmania is higher, and there is a higher risk of epidemic. It is recommended to strengthen health education in local area, strictly drive out lacewings, detect and kill diseased dogs, and reduce the risk of visceral leishmaniasis transmission.
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Objective@#To explore the correlation between quantitative parameters of dynamic enhanced magnetic resonance imaging (DCE-MRI) and Dukes stage, lymph node metastasis, tumor differentiation degree and molecular biological indicators [Ki67 and human epidermal growth factor receptor 2 (CerbB-2)] of rectal cancer.@*Methods@#This study was a prospective study. From October 2014 to October 2017, 168 cases of rectal cancer patients were selected as the research objects. DCE-MRI was performed preoperatively to obtain the quantitative parameter values of region of interest (ROI) [apparent diffusion coefficient (ADC)mean, Ktrans, Ve, and Kep] in tumor site. The expression of Ki67 and CerbB-2 were detected by immunohistochemical. Correlations of DCE-MRI quantitative parameter values and rectal cancer Dukes staging, lymph node metastasis, tumor differentiation degree to Ki67 and CerbB-2 expression level were analysised.@*Results@#With the increase of tumor differentiation, ADCmean was increasing, while Ktrans and Ve showed a downward trend, with significant difference (P<0.05). Among them, Ktrans and Ve in the high-differentiation group and the medium-differentiation group were significantly lower than those in the low-differentiation group (P<0.05), while there was no statistical significance between the high-differentiation group and the medium-differentiation group (P>0.05). The ADCmean was statistically significant between different groups (P<0.05), while Kep was not statistically significant (P>0.05). The ADCmean of lymph node metastasis group was significantly lower than that of no lymph node metastasis group (P<0.001), while Ktrans, Ve and Kep were significantly higher than that of no lymph node metastasis group (P<0.001). With the increase of Dukes staging in rectal cancer, ADCmean was decreasing and Ktrans was increasing, with statistically significant difference (P<0.001); among which the ADCmean of Dukes A and B was significantly higher than that of Dukes C and D (P<0.05), and Ktrans was significantly lower than that of Dukes C and D (P<0.05). Ktrans and Kep were increased with the increased expression levels of Ki67 and CerbB-2, and the difference between Ktrans and Kep was statistically significant (P<0.05). The ADCmean decreased with the increase of Ki67 and CerbB-2 expression level, and the difference was statistically significant (P<0.05).@*Conclusions@#DCE-MRI quantitatively participates can reflect the biological behavior of rectal cancer, and can be used to evaluate the prognosis of tumors and guide the clinical selection of more appropriate treatment options.
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Objective To explore the correlation between quantitative parameters of dynamic enhanced magnetic resonance imaging (DCE-MRI) and Dukes stage,lymph node metastasis,tumor differentiation degree and molecular biological indicators [Ki67 and human epidermal growth factor receptor 2 (CerbB-2)] of rectal cancer.Methods This study was a prospective study.From October 2014 to October 2017,168 cases of rectal cancer patients were selected as the research objects.DCE-MRI was performed preoperatively to obtain the quantitative parameter values of region of interest (ROI) [apparent diffusion coefficient (ADC) Ktrans,Ve,and Kep] in tumor site.The expression of Ki67 and CerbB-2 were detected by immunohistochemical.Correlations of DCE-MRI quantitative parameter values and rectal cancer Dukes staging,lymph node metastasis,tumor differentiation degree to Ki67 and CerbB-2 expression level were analysised.Results With the increase of tumor differentiation,ADCmean was increasing,while Ktrans and Ve showed a downward trend,with significant difference (P ＜ 0.05).Among them,Ktrans and Ve in the high-differentiation group and the medium-differentiation group were significantly lower than those in the low-differentiation group (P ＜ 0.05),while there was no statistical significance between the high-differentiation group and the medium-differentiation group (P ＞ 0.05).The ADC was statistically significant between different groups (P ＜ 0.05),while Kep was not statistically significant (P ＞ 0.05).The ADCmean of lymph node metastasis group was significantly lower than that of no lymph node metastasis group (P ＜0.001),while Ktrans,Ve and Kep were significantly higher than that of no lymph node metastasis group (P ＜0.001).With the increase of Dukes staging in rectal cancer,ADCmean was decreasing and Ktrans was increasing,with statistically significant difference (P ＜0.001);among which the ADCmean of Dukes A and B was significantly higher than that of Dukes C and D (P ＜ 0.05),and Ktrans was significantly lower than that of Dukes C and D (P ＜ 0.05).Ktrans and Kep were increased with the increased expression levels of Ki67 and CerbB-2,and the difference between Ktrans and Kep was statistically significant (P ＜ 0.05).The ADCmean decreased with the increase of Ki67 and CerbB-2 expression level,and the difference was statistically significant (P ＜ 0.05).Conclusions DCE-MRI quantitatively participates can reflect the biological behavior of rectal cancer,and can be used to evaluate the prognosis of tumors and guide the clinical selection of more appropriate treatment options.
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Objective: To evaluate the risk factors for contrast-induced nephropathy (CIN) in patients of acute coronary syndrome (ACS) with normal or slightly impaired renal function after percutaneous coronary intervention (PCI). Methods: A total of 254 consecutive ACS patients with normal or slightly impaired renal function received PCI in the Second Artillery General Hospital from 2013-06 to 2015-06 were retrospectively studied. All patients had eGRF≥60 ml (min?1.73 m2) and they were divided into 2 groups:CIN group, the patients with serum creatinine increased by 0.5mg/dl (44.2μmol/L) or elevated to 25%higher than the baseline, n=23;Non-CIN group, n=231. The basic condition with laboratory tests, operative indexes were recorded and eGRF value were calculated in all patients. Results: There were 9%(23/254) patients suffered from CIN after PCI. Multivariate regression analysis indicated that emergent PCI (OR=0.370, 95%CI 0.060-2.297), increased plasma level of NT-proBNP (OR=4.209, 95%CI 1.202-14.742) and without pre-operative aspirin administration (OR=7.950, 95%CI 1.108-57.034) were the clinical risk factors for post-operative CIN occurrence. Conclusion: Emergent PCI, higher plasma level of NT-proBNP and no pre-operative aspirin administration were the risk factors for CIN occurrence in ACS patients with normal or slightly impaired renal function after PCI.
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Objective:To compare the immediate therapeutic effect and safety between esmolol and lanatoside in con-trolling ventricular rate for patients with rapid atrial fibrillation.Methods:A total of 72 patients with rapid atrial fi-brillation (ventricular rate ≥120 beats/min)were randomly and equally divided into esmolol group and lanatoside group.Esmolol group received first dosage of 0.5 mg/kg intravenously for 1 min,then were observed for 5 min,if ventricular rate still >100 beats/min or decreased 100 beats/min or decreased0.05)between two groups.Conclusion:Intravenous using esmolol is efficient and safe,and it can be regarded as pre-ferred therapy to control ventricular rate in patients with rapid atrial fibrillation.
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Objective:To investigate the relation between the angiotensinⅡ(AngⅡ)levels in thoracic aorta and plasma and atherosclerosis(AS).Methods:Totally40healthy male Wistar rats were randomly divided into4groups(n=10).Four different feeding methods,including normal diet,high lipid,high lipid+vitamin D overload,and high lipid+vitamin D over-load+endothelium injury,were used for inducing AS in rats.The thickness of intima was taken as the index of AS severity, radio-immunity analysis was used to assay AngⅡin each group in thoracic aorta and plasma.Results:Only rats in high lipid diet group did not develop AS plaque;high lipid+vitamin D only resulted in AS fibrous plaque with VSMC proliferation;high lipid+vitamin D+endothelium injury formed ripe AS plaque.The thickness of intima and AngⅡof thoracic aorta in-creased gradually compared with control group(P