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ObjectiveTo investigate the characteristics of polysomnography (PSG) in depression patients complicating moderate-to-severe obstructive sleep apnea hypopnea syndrome (OSAHS). MethodsA retrospective analysis was conducted on the outpatients, inpatients and physical examination population who completed overnight PSG monitoring in the sleep medicine center of Suzhou Guangji Hospital from December 2017 to October 2019. Four groups of subjects were finally enrolled, including depression patients with moderate-to-severe OSAHS (n=31), depression patients without OSAHS (n=79), moderate-to-severe OSAHS patients (n=96) and normal control group (n=32). The sleep process related indicators (total sleep time, sleep latency, number of awakenings), sleep structure related indicators (N1, N2, N3, percentage of REM sleep, REM latency, REM sleep duration), sleep-related respiratory variables (oxygen reduction index) and other polysomnographic parameters of the four groups were compared. ResultsIn terms of sleep process, the total sleep time, sleep latency and number of awakenings yielded significant differences among the four groups (F=2.874, 3.959, 12.291, P<0.05 or 0.01). In terms of sleep structure, the percentage of total sleep time in N2 and N3 stages demonstrated significant differences among the four groups (F=13.885, 48.013, P<0.01). The REM latency, REM sleep duration and percentage of REM sleep manifested significant differences among the four groups (F=41.492, 11.827, 10.552, P<0.01). In terms of sleep-related respiratory variables, the oxygen reduction index exhibited significant differences among the four groups (F=170.585, P<0.05). ConclusionDepression patients complicating moderate-to-severe OSAHS suffer from severe sleep process and structural disturbances, accompanied by quite frequent and severe sleep-related respiratory events.
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PurposeTo identify differences in CT imaging and clinical features between COVID-19 and influenza pneumonia in the early stage, and to identify the most valuable features in the differential diagnosis. Materials and MethodA consecutive cohort of 73 COVID-19 and 48 influenza pneumonia patients were retrospectively recruited from five independent institutions. The courses of both diseases were confirmed to be in the early stages (2.66 {+/-} 2.62 days for COVID-19 and 2.19 {+/-} 2.10 days for influenza pneumonia after onset). The chi-square test, students t-test, and Kruskal-Wallis H-test were performed to compare CT imaging and clinical features between the two groups. Spearman or Kendall correlation tests between feature metrics and diagnosis outcomes were also assessed. The diagnostic performance of each feature in differentiating COVID-19 from influenza pneumonia was evaluated with univariate analysis. The corresponding area under the curve (AUC), accuracy, specificity, sensitivity and threshold were reported. ResultsThe ground-glass opacification (GGO) was the most common imaging feature in COVID-19, including pure-GGO (75.3%) and mixed-GGO (78.1%), mainly in peripheral distribution. For clinical features, most COVID-19 patients presented normal white blood cell (WBC) count (89.04%) and neutrophil count (84.93%). Twenty imaging features and 6 clinical features were identified to be significantly different between the two diseases. The diagnosis outcomes correlated significantly with the WBC count (r=-0.526, P<0.001) and neutrophil count (r=-0.500, P<0.001). Four CT imaging features had absolute correlations coefficients higher than 0.300 (P<0.001), including crazy-paving pattern, mixed-GGO in peripheral area, pleural effusions, and consolidation. ConclusionsAmong a total of 1537 lesions and 62 imaging and clinical features, 26 features were demonstrated to be significantly different between COVID-19 and influenza pneumonia. The crazy-paving pattern was recognized as the most powerful imaging feature for the differential diagnosis in the early stage, while WBC count yielded the highest diagnostic efficacy in clinical manifestations.
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Objective To explore causes and clinical factors associated with bronchopulmonary dyspla-sia( BPD) in very low birth weight infant ( VLBWI) and extremely low birth weight infant( ELBWI) . Methods A retrospective analysis was performed on the clinical data of VLBWI and ELBWI,whose birth weight less than1200g and diagnosed BPD in NICU of Shengjing Hospital between Jan. 1st 2010 and Dec. 31st 2014. No-BPD infants with the same birth weight and during the same period were selected as the control group. Results One handred and twenty-eight cases met the criteria of BPD,whose mean gestational age(GA) was (28. 6 ± 1. 8)weeks. Other 121cases were no-BPD,and mean GA was (30. 8 ± 1. 8)weeks. Maternal hypertension during pregnancy,gestational age,birth weight,small for age infant were lower in BPD group than those in no-BPD group. Prenatal infection,premature rupture of membrances≥18h,cesarean delivery,male,Apgar 1min≤3,intra-partum recovery,alveolar surface active substances,mechanical ventilation and the time,oxygen time were higher in BPD group than those in no-BPD group. Logistic regression analysis indicated that low gestational age( OR=1. 014,P<0. 05),male(OR=2. 771,P<0. 05),duration of invasive mechanical ventilation(OR=1. 014,P<0. 05),duration of CPAP(OR=1. 008,P<0. 05)lead to BPD. Multiple logistic regression model showed that Apgar 1min≤3(95%CI:1. 274~14. 017,χ2 = 5. 550,P=0. 018,OR=4. 226),duration of invasive mechanical ventilation(95%CI:1. 001 ~1. 004,χ2 =10. 410,P =0. 001,OR =1. 003),PDA surgery(95%CI:1. 345 ~129. 693,χ2 =4. 904,P=0. 027,OR=13. 210) were the independent risk factors for the moderate-severe BPD. Conclusion Our study showed that low GA,male,long duration of mechanical ventilation were risk factors of the development of BPD. Apgar 1min≤3,duration of mechanical ventilation,PDA surgery were related with moderate-severe BPD.
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Objective@#To explore the characteristic indexes of patients with schizophrenia trees drawing projection through the extraction and quantitative analysis of the projection index of the tree-drawing painted by schizophrenic patients and provide the basis for the diagnosis of schizophrenia.@*Methods@#A tree-drawing test was performed on 69 schizophrenic patients and 59 healthy subjects without psychotic symptoms using the control study design.Computer image recognition and data acquisition was used to quantitatively research on tree projection drawing, and the data were analyzed between the two groups.@*Results@#There were 6 tree-drawing test quantitative indexes had statistical significance between schizophrenia patients and healthy subjects: crown height ((7.4380±3.7939)cm vs (8.9587±3.6632)cm, t=-2.386, P=0.018), crown width ((9.3441±4.7054)cm vs (12.1024±4.7836)cm, t=-3.281, P<0.01), trunk width ((2.3391±2.3857)cm vs (3.7313±2.2822), t=-3.357, P=0.001), crown area ((65.1007±56.2188)cm2 vs (90.8369±61.9536)cm2, t=-2.463, P=c.015), trunk area ((12.8060±17.3851)cm2 vs (19.3813±15.3874)cm2, t=-2.248, P=0.026), the total area ((82.3225±71.7906)cm2 vs (114.5269±73.8087)cm2, t=-2.497, P=0.014), meanwhile 7 quantitative indexes were not statistically significant: the total height of trees ((13.9728±5.8815)cm vs (15.8957±5.4399)cm, t=-1.908, P=0.059), trunk height ((6.4989±5.8861)cm vs (6.4311±3.0242)cm, t=0.080, P=0.936), root height ((0.7321±1.2916)cm vs (0.4780±1.0912)cm, t=1.191, P=0.236), root width ((1.7597±3.5406)cm vs (2.2041±4.8122)cm, t=-0.600, P=0.549), root area ((4.3920±10.8128)cm2 vs (4.3774±12.4586)cm2, t=0.007, P= 0.994), trunk and crown height ratio ((9.0236±15.1846) vs (5.1478±9.0970, t=-0.526, P=0.600), trunk crown width ratio (9.0236±15.1846 vs 5.1478±9.0970, t=1.489, P=0.14).@*Conclusion@#There are significant traits in the area of crown, trunk and tree in the tree drawing projection test between schizophrenics and healthy subjects.After future large sample follow-up study, it can provide quantitative assistance for clinical diagnosis.
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Objective To investigate the values of combined detection of serum pancreas autoantibodies (PAB),anti-saccharomyces cerevisiae antibodies(ASCA),goblet cell autoantibodies(GAB) and antineutrophil cytoplasmic antibodies(PANCA) and fecal calprotectin(FC) in the diagnosis and differential diagnosis of inflammatory bowel diseases(IBD).Methods The serum and feces samples from IBD patients,including 107 with definite Crohn's disease(CD) and 98 with definite ulcerative colitis(UC),and 79 non-IBD patients as the control were collected.Serum PANCA,ASCA,GAB and PAB were detected by an indirect immunofluorescence assay,and FC concentration by double-antibody sandwich ELISA.The results from different patients were compared and analyzed.Results The positive rates of serum PANCA,GAB,PAB and ASCA in 205 IBD patients were 36.1%,29.8%,38.0% and 4.9%,respectively.The FC concentrations in IBD,CD and UC patients were significantly higher than that in the control(P < 0.01),while there was no statistical difference between CD and UC patients (P > 0.05).The positive rates of PANCA in CD and UC patients were 8.4% and 66.3%,respectively,while those of PAB in CD and UC patients were 65.4% and 8.2%,respectively.The sensitivity and specificity of PAB,PANCA,GAB,ASCA,FC and their combination in the differential diagnosis of IBD and non-IBD were 38.0%,36.1%,29.8%,4.9%,54.1%,63.4% and 98.7%,96.2%,94.9%,100%,68.4%,93.7%,respectively.The area under the ROC of the combination of 5 markers was 0.819 in differentially diagnosing IBD and non-IBD.The area under the ROC of PANCA for the differential diagnosis of UC was 0.816,while that of PAB for the differential diagnosis of CD was 0.823.Conclusion GAB is an autoantibody associated with IBD,which may be helpful for the auxiliary diagnosis of IBD.PAB and PANCA are the important serological markers for the diagnosis of CD and UC,respectively.The combination of FC with PAB,PANCA,GAB and ASCA may be used for the differential diagnosis of IBD and non-IBD,but has little value in distinguishing CD and UC.
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Objective To understand the pathogenic epidemiological status quo among populations with respiratory tract infectious in Nanjing area.Methods The IgM antibody detection reagent kit against 9 kinds of respiratory tract pathogen was used to conduct the IgM antibody detection in 25 057 patients with respiratory tract infection in the Affiliated Nanjing Hospital of Nanjing Medical University,Affiliated Children's Hospital of Nanjing Medical University and Nanjing General Hospital of Nanjing Military Region from May 2013 to April 2015.Results A total of 8 575 cases(34.22%) of pathogen positive were detected out,in which Pneumonia mycoplasma (MP) antibody had the highest positive rate (23.77%);followed by respiratory syncytial virus (RSV,5.19 %),adenovirus (ADV,4.56 %),Parainfluenza virus type 1,2 and 3 (PIVS,4.02 %) and influenza B virus (INFB,2.28%).The seasonal distribution of RSV,ADV and PIVS was significant and had high onset in winter and spring,but low onset in summer and autumn.Infants and young children had maximal positive cases in preschool period,which were 5 274 cases;as a whole,MP IgM antibody positive rate was gradually decreased with the age increase.Conclusion MP is the main pathogen causing respiratory tract infections in Nanjing area,followed by RSV.The pathogenic infection has a correlation with the age group,moreover which demonstrates the seasonal epidemic trend.
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Objective To understand the pathogenic epidemiological status quo among populations with respiratory tract infectious in Nanjing area.Methods The IgM antibody detection reagent kit against 9 kinds of respiratory tract pathogen was used to conduct the IgM antibody detection in 25 057 patients with respiratory tract infection in the Affiliated Nanjing Hospital of Nanjing Medical University,Affiliated Children's Hospital of Nanjing Medical University and Nanjing General Hospital of Nanjing Military Region from May 2013 to April 2015.Results A total of 8 575 cases(34.22%) of pathogen positive were detected out,in which Pneumonia mycoplasma (MP) antibody had the highest positive rate (23.77%);followed by respiratory syncytial virus (RSV,5.19 %),adenovirus (ADV,4.56 %),Parainfluenza virus type 1,2 and 3 (PIVS,4.02 %) and influenza B virus (INFB,2.28%).The seasonal distribution of RSV,ADV and PIVS was significant and had high onset in winter and spring,but low onset in summer and autumn.Infants and young children had maximal positive cases in preschool period,which were 5 274 cases;as a whole,MP IgM antibody positive rate was gradually decreased with the age increase.Conclusion MP is the main pathogen causing respiratory tract infections in Nanjing area,followed by RSV.The pathogenic infection has a correlation with the age group,moreover which demonstrates the seasonal epidemic trend.
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Objective To observe the preventive and therapeutic effects of the new process extracts ofTangwang Mingmu Granule on rats with diabetic retinopathy.Methods The best preparation process technology of drug extraction was improved and selected based on the traditional water decoction of Chinese medicine. The active ingredient of two processes were detected and compared by HPLC. In vitro and in vivo pharmacodynamic evaluation models were used to evaluate the drug effects and analyze its mechanism. MTT assay was used to analyze the inhibitory effects of extracts in the two processes on EA.hy 926 cell proliferation in vitro. The effects of two extracts on STZ induced rat diabetic microvascular disease and its related factors were observed by retinal slice staining and ELISA.Results Compared with the traditional process, the active ingredients of the extracts were improved by the new technology ofTangwang Mingmu Granule. The preparation process ofTangwang Mingmu Granule could significantly improve the diabetic rat retinal microvascular pathological state, and reduce the protein expression levels of angiogenesis related factors.Conclusion The new preparation process could effectively improve the active ingredients in the herbal extract. The extract of new technology showed a significantly effect on the diabetic rats in retinal microvascular pathology state. The mechanism may be related to the regulation of vascular cell adhesion molecules and inflammatory factors.
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Objective To study X-ray and clinical diagnosis of multiple myeloma(M M).Methods X-ray findings in 16 cases with M M were retrospectively analyzed.Results The main manifestations on X-ray were:normal in 3;osteoporosis in 8;osteolytic destrucion in 12;osteosclerosis in 1 and mass of soft tissue in 6.Conclusion The diagnosis of M M is mainly depended on clinical and X-ray findings,puncture of bone marrow is of diagnostic value,the differential diagnosis is still necessary.
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Objective To discuss drug application and nursing experience during CT contrast enhancement in infants.Methods CT contrast enhancement with Ultravist,one of the non-ionic contrast media,was performed on 202 infants.Before examination,all the infants were calmed with Diazepam or Chloral Hydrate(10% in concentration).The doses of the drugs were determined by the weight of these infants.Results Non-ionic contrast media was not absolutely safe and a few infants had side effects.Only 7 infants had positive allergic tests.The results of CT contrast enhancement on 202 infants were satisfied.Conclusion During CT enhancement,appropriate use of contrast media and sedatives as well as proper nursing according to the infants’ age will get a better result.