Correlation between diaphragmatic-rapid shallow breathing index and lung ultrasound score in elderly patients with mechanical ventilation and its predictive value for weaning results / 中华危重病急救医学

Objective:To investigate the correlation between diaphragmatic-rapid shallow breathing index (D-RSBI) and lung ultrasound score (LUS) in elderly patients with mechanical ventilation and its predictive value for weaning results.Methods:A retrospective study was conducted. The clinical data of elderly patients (age > 60 years old) with invasive positive pressure ventilation (IPPV) admitted to the department of intensive care unit (ICU) of the First Affiliated Hospital of Jinzhou Medical University from January 2021 to June 2022 were enrolled. According to the outcome of withdrawal, the patients were divided into successful and failed groups. The differences in gender, age, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), D-RSBI and LUS before weaning and extubation were compared between the two groups. Pearson correlation was used to analyze the correlation between D-RSBI and LUS. The predictive value of D-RSBI and LUS on weaning results of elderly patients with IPPV was analyzed by receiver operator characteristic curve (ROC curve).Results:A total of 398 elderly patients with IPPV were enrolled, including 300 successful weaning patients and 98 failed weaning patients. There were no significant differences in gender and age between the failed group and successful group [male: 55.1% (54/98) vs. 59.0% (177/300), age (years old): 67.02±5.03 vs. 66.96±4.99, both P > 0.05]. APACHEⅡ score in the failed group was significantly higher than that in the successful group (17.09±3.30 vs. 16.06±3.81, P < 0.05), and the D-RSBI and LUS score before extubation were significantly higher than those in the successful group [D-RSBI (time·min -1·mm -1): 2.19±0.33 vs. 1.60±0.22, LUS: 17.30±3.04 vs. 11.97±3.20, both P < 0.01]. All patients showed a significant positive correlation between D-RSBI and LUS score ( r = 0.406, P = 0.000). ROC curve analysis showed that the area under the curve (AUC) of D-RSBI for predicting weaning outcomes in elderly IPPV patients was 0.920, with a 95% confidence interval (95% CI) of 0.881-0.958 and P = 0.000. When the cut-off value was 1.85 times·min -1·mm -1, the sensitivity was 88.7% and the specificity was 86.7%. The AUC of LUS score for predicting weaning outcome in elderly IPPV patients was 0.875, with a 95% CI of 0.839-0.912 and P = 0.000. When the cut-off value was 14.50, the sensitivity was 75.7% and the specificity was 84.7%. Conclusion:There is a significant correlation between D-RSBI and LUS score in elderly mechanically ventilated patients, both of them can predict weaning outcome in elderly patients with mechanical ventilation.

The efficacy of artificial(nonbiological)extracorporeal liver support system for primary biliary cholangitis and the effect of this therapy on prognosis / 实用医学杂志

Objective To evaluate the clinical efficacy of plasma exchange(PE)and double plasma molecular absorption system(DPMAS)in the treatment of primary biliary cholangitis(PBC)and the effect of this therapy on prognosis.Methods The clinical data on 526 PBC patients in our hospital from December 2013 to January 2022 were retrospectively analyzed.The patients were divided into different groups according to different therapies and then matched with propensity.The changes in symptoms,laboratory indexes and MELD scores were compared between two groups before and after treatment,and the clinical efficacy of artificial liver treatment for PBC patients was assessed.The effect of this treatment on the survival outcomes in these patients via comparing the cumulative survival rates at 3,6 and 12 months between the two groups.Results The efficiency was better in the group with artificial liver treatment in addition medical therapy than the group with medical treatment alone,the difference was statistically significant(76.7%vs.55.8%,χ2 = 4.214,and P = 0.040).Cox proportional risk regression showed that TBIL was an independent risk factor affecting the 3-,6-,or 12-month survival in PBC patients.Conclusions Artificial liver support system can effectively relieve symptoms,reduce levels of ALT,AST and TBIL,improve blood coagula-tion function,and lower MELD scores in PBC patients.This therapy revealed a trend of improvement in 3-,6-,or 12-month survival outcomes.

Predictive value of diaphragm thickening fraction and intra-abdominal pressure monitoring-oriented risk prediction model for weaning failure in patients with severe acute pancreatitis / 中华危重病急救医学

Objective:To establish a risk prediction model dominated by diaphragm thickening fraction (DTF) and intra-abdominal pressure (IAP) monitoring, and to explore the predictive value of the model for weaning failure in patients with severe acute pancreatitis (SAP).Methods:A prospective research was conducted. Sixty-three patients undergoing invasive mechanical ventilation treatment who diagnosed with SAP admitted to intensive care unit of the First Affiliated Hospital of Jinzhou Medical University from August 2020 to October 2021 were enrolled. The spontaneous breathing trial (SBT) was carried out when the clinical weaning criteria was met. The stable cardiovascular status, good pulmonary function, no chest and abdominal contradictory movement, and adequate oxygenation were defined as successful weaning. Otherwise, it was defined as failure weaning. The clinical indicators such as SBT 30-minure DTF, IAP, tidal volume (VT), respiratory rate (RR), body mass index (BMI), and blood lactic acid (Lac) were compared between the weaning success group and the weaning failure group. The indicators with statistically significant differences in the single-factor analysis were included in the secondary multivariable Logistic regression analysis to establish a risk prediction model. The correlation between the DTF and IAP at 30 minutes of SBT was analyzed. Receiver operator characteristic curve (ROC curve) was drawn to analyze the predictive value of the risk prediction model for SAP patient withdrawal failure at 30 minutes of SBT.Results:Finally, 63 patients with SAP were enrolled. Among the 63 patients, 42 were successfully weaned and 21 failed. There were no significant differences in age, gender, and oxygenation index (PaO 2/FiO 2), sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score at admission between the two groups, indicating that the data in the two groups were comparable. Compared with the weaning success group, IAP, RR, BMI and Lac at 30 minutes of SBT in the weaning failure group were significantly increased [IAP (mmHg, 1 mmHg≈0.133 kPa): 14.05±3.79 vs. 12.12±3.36, RR (times/min): 25.43±8.10 vs. 22.02±5.05, BMI (kg/m 2): 23.71±2.80 vs. 21.74±3.79, Lac (mmol/L): 5.27±1.69 vs. 4.55±1.09, all P < 0.05], while DTF and VT were significantly decreased [DTF: (29.76±3.45)% vs. (31.86±3.67)%, VT (mL): 379.00±98.74 vs. 413.60±33.68, both P < 0.05]. Secondary multivariable Logistic regression analysis showed that DTF [odds ratio ( OR) = 0.758, 95% confidence interval (95% CI) was 0.584-0.983, P = 0.037], IAP ( OR = 1.276, 95% CI was 1.025-1.582, P = 0.029), and RR ( OR = 1.145, 95% CI was 1.014-1.294, P = 0.029) were independent risk factors for SBT withdrawal failure in 30 minutes in SAP patients. The above risk factors were used to establish the risk prediction model of aircraft withdrawal failure at 30 minutes of SBT: Logit P = -0.237-0.277×DTF+0.242×IAP+0.136×RR. Pearson correlation analysis showed that SBT 30-minute DTF was significantly correlated with IAP in SAP patients, and showed a significant positive correlation ( r = 0.313, P = 0.012). The ROC curve analysis results showed that area under the ROC curve (AUC) of the risk prediction model for SAP patient withdrawal failure at 30 minutes of SBT was 0.716, 95% CI was 0.559-0.873, P = 0.003, with the sensitivity of 85.7% and the specificity of 78.6%. Conclusions:DTF, IAP and RR were independent risk factors for SBT withdrawal failure in 30 minutes in SAP patients. The DTF and IAP monitoring-oriented risk prediction model based on the above three variables has a good predictive value for weaning failure in patients with SAP.

Correlation between dead space fraction and pulmonary ultrasound score in patients with acute respiratory distress syndrome and its prognostic value / 中华危重病急救医学

Objective:To investigate the correlation between dead space fraction and lung ultrasound score (LUS) and their prognostic value in patients with acute respiratory distress syndrome (ARDS).Methods:The data of 98 patients with ARDS treated in the intensive care unit (ICU) of the First Affiliated Hospital of Jinzhou Medical University from January to December 2020 were collected and analyzed. The gender, age, acute physiology and chronic health evaluationⅡ(APACHEⅡ), oxygenation index, dead space fraction and LUS score immediately and 24, 48, 72 and 96 hours after ICU admission and 28-day outcomes of all patients were collected. Pearson correlation was used to analyze the correlation between dead space fraction and LUS score. Binary Logistic regression was performed to analyze whether the dead space fraction and LUS score could be the risk factors of the prognosis in patients with ARDS. Receiver operator characteristic curve (ROC) was used to analyze the predictive effect of dead space fraction and LUS score on 28-day mortality in patients with ARDS.Results:A total of 98 patients with ARDS were included, of which 76 cases survived and 22 cases died within 28 days. With the prolongation of ICU stay, the dead space fraction and LUS score in the survival group increased first and then decreased. The dead space fraction and LUS score in the death group continued to increase to 96 hours, and were significantly higher than those in the survival group (dead space fraction: 0.569±0.019 vs. 0.491±0.021, LUS score: 20.09±2.39 vs. 15.13±1.91, both P < 0.05). There was a positive correlation between the dead space fraction and LUS score at 48, 72 and 96 hours in ICU ( r values were 0.200, 0.471 and 0.677, all P < 0.05). Binary Logistic regression analysis showed that dead space fraction and LUS score were independent risk factors affecting the prognosis of patients with ARDS [dead space fraction: odds ratio ( OR) was 69.064, 95% confidence interval (95% CI) was 22.680-123.499, P = 0.008; LUS score: OR was 4.790, 95% CI was 1.609-14.261, P = 0.005]. The results of ROC curve analysis showed that the dead space fraction at 48, 72 and 96 hours after ICU admission could be used to predict the 28-day mortality of patients with ARDS, the sensitivity was 59.1%, 90.9% and 95.5%, and the specificity was 89.5%, 80.3% and 98.7%. The area under the curve (AUC) of dead space fraction predicting 28-day mortality was 0.802, 0.952 and 0.998, all P < 0.01. The LUS score of 72 hours and 96 hours in ICU could be used to predict the 28-day mortality of patients with ARDS, the sensitivity was 77.3%, 77.3% and 100.0%, and the specificity was 68.4%, 88.2% and 80.3%, respectively. The AUC of the LUS score to predict the 28-day mortality of patients were 0.935 and 0.959, both P < 0.01. Conclusion:There was significant correlation between dead space fraction and LUS score, both of which were risk factors of 28-day mortality and be used to evaluate the 28-day prognosis of patients with ARDS.

Role of Kupffer cells in the development and progression of primary biliary cholangitis / 临床肝胆病杂志

The incidence rate of primary biliary cholangitis (PBC) is increasing year by year, but there is still no specific medicine at present and PBC has a complex pathogenesis. Kupffer cells, as the key cells involved in immunoregulation, play an important role in PBC. When hepatocytes are damaged, Kupffer cells will be activated and release a large amount of inflammatory cytokines and chemokines, which participate in the development and progression of PBC. This article briefly reviews the role of Kupffer cells in PBC, so as to provide a theoretical basis for Kupffer cells as a potential target for the treatment of PBC.

Analysis on the Clinical Characteristics of 36 Cases of Novel Coronavirus Pneumonia in Kunming

ObjectiveTo analyze the clinical characteristics of patients with novel coronavirus pneumonia in Kunming City, and to study the correlation between nutritional status and immune function. MethodsClinical data of 36 patients with novel coronavirus pneumonia in isolation area of Kunming Third Peoples Hospital from January 31 to February 15, 2020 were collected, and the basic situation, clinical characteristics, laboratory examination and CT imaging characteristics were analyzed. Serum albumin (ALB), prealbumin (PAB), hypersensitive c-reactive protein (hs-crp), CD3T cells, CD4T cells, CD8T cells and normal control group were analyzed. A simple linear regression analysis of the relationship between proalbumin and T cell subpopulation counts in the blood of patients. Results(1) The patients with new coronavirus pneumonia in Kunming were mainly of common type. (2) 50% of the patients first symptoms were fever and cough; (3) The total number of white blood cells in peripheral blood was normal or decreased in 23 cases (79%), and the lymphocyte count decreased in 5 cases (13.89%), without anemia. Hypersensitive c-reactive protein increased in 19 (52.78%) cases, and procalcitonin increased in 1 case. Albumin decreased in 5 cases (13.89%), proalbumin decreased in 15 cases (41.67%), alanine transaminase increased slightly in 4 cases (11.11%), alanine transaminase increased slightly in 4 cases (11.11%), total bilirubin increased slightly in 11 cases (30.56%), and renal function and blood coagulation were normal. Absolute value of CD3+T cells is with a decrease in 21 cases (58.3%), CD4+T in 28 cases (77.8%), CD8+T in 17 cases (47.2%), and CD4+/ CD8+ inverse in 6 cases (16.7%). (4) The prealbumin, CD3 T cells, CD4 T cells and CD8 T cells in the new coronavirus pneumonia group were significantly lower than those in the normal control group, and the hypersensitive c-reactive protein was higher than that in the normal control group. (5) The levels of PAB in the serum of the patients were linearly correlated with hs-crp, CD3 T cells, CD4 T cells and CD8 T cells, and the correlation coefficients were -0.474, 0.558, 0.467 and 0.613, respectively, showing statistical differences. ConclusionThe clinical characteristics of the novel coronavirus pneumonia in Kunming are different from those in Wuhan. The changes of serum proalbumin and T cell subsets are relatively obvious. Changes in serum proalbumin may contribute to the early warning of novel coronavirus pneumonia. The nutritional status of patients with common and mild pneumonia should be considered.

Expression and clinical significance of the NK cell-activating receptor NKG2D and its ligand in liver tissue of patients with primary biliary cholangitis / 临床肝胆病杂志

ObjectiveTo investigate the association of the expression of the NK cell-activating receptor NKG2D, its ligand major histocompatibility complex class I chain-related gene A (MICA), and related cytokines ［interferon-γ (IFN-γ), interleukin-10 (IL-10), and interleukin-15 (IL-15)］ with intrahepatic inflammation in primary biliary cholangitis (PBC). MethodsLiver biopsy specimens were collected from 30 patients with PBC (PBC group), 15 patients with chronic hepatitis B (CHB group), and 10 patients with nonalcoholic fatty liver disease (NAFLD group), who were hospitalized in The Second Affiliated Hospital of Kunming Medical University from August 2014 to June 2015. The degree of liver inflammation (G) and fibrosis degree (S) of the liver specimens were determined, and immunohistochemistry was used to measure the expression of NKG2D, MICA, IFN-γ, IL-10, and IL-15 in liver tissue (the scores were determined based on the number of cells stained and the degree of staining to evaluate the expression of each marker). A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the t-test was used for comparison between two groups; a Spearman correlation analysis was used to investigate correlation. ResultsIn the PBC group, the expression of NKG2D increased with the degree of inflammation, and the patients with G3-4 inflammation had significantly higher expression than those with G1-2 inflammation (G1 vs G2 vs G3 vs G4: 1.4±0.05 vs 1.56±0.05 vs 1.86±0.11 vs 2.60±0.17, F=150.8, P＜0.05); the expression of NKG2D decreased with fibrosis degree (S3 vs S4: 2.30±0.17 vs 1.56±0.05, t=-1.52, P＜0.05). In the PBC group, there was no significant difference in MICA between G3 and G4 (0.11±0.01 vs 0.20±0.03, t=-2.20, P＞0.05) and between S3 and S4 (0.12±0.02 vs 0.18±0.03, t=-2.64, P＞0.05). In the PBC group, there was a significant difference in the expression of IL-15 between the patients with different degrees of inflammation (G1 vs G2 vs G3 vs G4: 0.70±0.10 vs 1.50±0.10 vs 1.93±0.11 vs 2.60±0.17, F=251.3, P＜0.05), while there was no significant difference between the patients with different fibrosis degrees (S3 vs S4: 2.00±0.05 vs 2.40±0.30, t=-1.62, P＞0.05). In the CHB group, there was a significant difference in the expression of IL-15 between the patients with different degrees of inflammation (G1 vs G2 vs G3: 0.73±0.15 vs 1.96±0.15 vs 2.50±0.17, F=150, P＜0.05) and between the patients with different fibrosis degrees (S1 vs S2 vs S3: 0.70±0.10 vs 21.96±0.15 vs 2.50±0.17, F=158.7, P＜0.05). In the PBC group, the expression of IL-10 was only observed in the patients with G1 inflammation (0.16±0.01), and in the CHB group, the expression of IL-10 was observed in the patients with G1 and G2 inflammation, with no significant difference (G1 vs G2: 0.19±0.01 vs 0.13±0.01, t=-1.522, P＞0.05). In the patients with PBC, the expression of IL-15 in liver tissue was positively correlated with the levels of alkaline phosphatase (ALP) and gamma-glutamyl transpeptidase (GGT) (r=0.241 and 0.407, P=0.014 and 0.045). ConclusionThe NK cell-activating receptor NKG2D affects the degree of intrahepatic inflammation in PBC, and the NKG2D ligand MICA is expressed in the advanced stage of PBC and can downregulate NKG2D. The expression of IL-15 increases with the degree of inflammation in PBC and is positively correlated with the levels of ALP and GGT, suggesting that the activation of NK cells and abnormal secretion of cytokines are involved in the development and progression of PBC and IL-15 may be used as an auxiliary index for the diagnosis of PBC.

Correlation between follicular fluid sRAGE level and ovarian responsiveness in non-PCOS patients undergoing controlled ovarian hyperstimulation / 南方医科大学学报

OBJECTIVE@#To investigate the correlation between soluble receptor for advanced glycation end products (sRAGE) level in the follicular fluid and ovarian responsiveness in non-PCOS patients undergoing controlled ovarian hyperstimulation.@*METHODS@#Ninety non-PCOS patients underwent IVF/ICSI using a short-acting long protocol for ovarian stimulation with a GnRH agonist. For each patient, the level of sRAGE in the follicular fluid was measured by enzyme linked immunosorbent assay (ELISA), and the data including the clinical baseline state, hormone level, number of oocytes obtained and the fertilization rate were collected.@*RESULTS@#Follicular fluid sRAGE level showed significant negative correlations with basal FSH level (=0.0036) and Gn dose ( 15) than in cases with oocytes obtained within the range of the target numbers (7-15) and below the target number (< 7) ( < 0.0001 and =0.0012, respectively).@*CONCLUSIONS@#Follicular fluid sRAGE level can reflect ovarian reserve function in non-PCOS patients, the number of oocytes obtained and the fertilization rate, and can thus predict ovarian responsiveness during controlled hyperstimulation in nonPCOS patients.

Microbial transformation of resveratrol by endophyte Streptomyces sp. A12 isolated from Polygonum cuspidatum.

Resveratrol (1) undergoes microbial transformation when fermented with Streptomyces sp. A12 to yield 3, 5, 4'-trimethoxy-trans-stilbene (2). The structure of the compound 2 was elucidated using the modern spectroscopic techniques. This is the first report of the microbial transformation of resveratrol to compound 2 using the endophyte isolated from Polygonum cuspidatum.

First discrimination of the meanings of the seven words relevant with acupuncture in Huangdi Nei- jing (Yellow Emnerors Internal Classic) / 中国针灸

Huangdi Neijing (Yellow Emperor's Internal Classic) is the earliest medical classic work existing at present in Chinese medical treasures and is the foundation of TCM. It not only contains rich medical words, but also supplements the new meanings of seven words, i. e. Wang, Xiu, Yuan, Fang, Xu, Jiu and Bian for removing needle, retaining needling, reinforcing technique, reducing technique, slow needling, moxibustion and stone-needle puncturing, respectively.

Analysis of etiology and biochemical markers of acute liver failure in children / 临床儿科杂志

ObjectiveTo explore the etiology and biochemical markers of acute liver failure (ALF) in children.Methods The cause and the biochemical markers of ALF in children who were treated in December 2014 to January 2011 were ana-lyzed retrospectively.ResultsA total of 67 children were enrolled, including 31 females and 36 males. According to the cause of the disease, the children were divided into non-genetic metabolic group, genetic metabolic group, and cryptogenic group. In the non-genetic metabolic group (29 cases, 43.28%) there were 12 cases of drug-induced ALF, 5 cases of Reye syndrome, 3 cases of hemophagocytic syndrome, 3 cases of herpes simplex virus infection, 2 cases of autoimmune hepatitis, one of case mushroom poisoning one case of hepatitis A virus infection, one case of cytomegalovirus infection and one case of sepsis respectively. In the genetic metabolic group (14 cases, 20.90%) there were 6 cases of Wilson’s disease, 2 case of glycogen storage disease, 2 of cas-es progressive familial intrahepatic cholestasis, 2 cases of neonatal intrahepatic cholestasis caused by citrin deifciency, one case of very long-chain acyl coenzyme A dehydrogenase deifciency and one case of primary carnitine deifciency. In the cryptogenic group there were 24 cases (35.82%). The serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin, blood glucose level and AST/ALT were statistically signiifcantly different in genetic metabolic group from in non-genetic me-tabolism disease group and cryptogenic group, (P<0.05). The genetic metabolic group had the lowest levels of serum ALT, AST, albumin and glucose while the genetic metabolic group had the highest ratio of AST/ALT.ConclusionsThe etiology of ALF in children are complex. Genetic metabolic disease should be considered when the child with ALF has no signiifcantly elevated ALT, extremely high ratio of AST/ALT, combined with hypoproteinemia and hypoglycemia.

Biomechanical analysis in patients with knee osteoarthritis after Chinese massage combined with functional exercise / 中国组织工程研究

BACKGROUND:There are less reports on the evaluation of plantar pressure distribution in knee osteoarthritis patients using modern gait analysis, and moreover, the database of characteristic plantar pressure has not been established in patients with osteoarthritis. OBJECTIVE: To evaluate the therapeutic effect of Chinese massage and functional exercise on knee osteoarthritis. METHODS:Forty patients with left knee osteoarthritis who were eligible for the inclusive criteria were randomized into two groups, with 20 in each group. Control group was given conventional treatment, and treatment group was given Chinese massage combined with functional exercise. Japanese Orthopaedic Association score and gait parameters were measured and compared between two groups before and at 3 months after treatment. RESULTS AND CONCLUSION:After treatment, the two groups both had evident efficacy in pain relief during walking, and there was no statisticaly difference between the two groups. There was a significant difference in the knee range of motion in the patients in the treatment group when going upstairs and downstairs as wel as during joint flexion before and after treatment, but no changes occurred in the control group. After treatment, the range of motion during joint flexion was better in the treatment group than the control group, but there was no difference in the sweling reduction between the two groups. In addition, the treatment group had a higher Japanese Orthopaedic Association score after treatment than before treatment (P < 0.05), and there was no statistical difference in the control group. Gait analysis showed that there were improvements in the percentage of contact time, parameters during stance phase and peak plantar pressure in the two groups, but there was no significant difference before and after treatment. Foot axis angle in the treatment group was improved significantly, which was significantly better than that in the control group. Al the indexes in the treatment group were improved a lot, but did not reach the normal.

Differentiation of Papillary Thyroid Microcarcinoma and Benign Thyroid Nodules Using CT Diameter Ratio / 中国医学影像学杂志

Purpose Papillary thyroid microcarcinoma (PTMC) is difficult to diagnose its nature before surgery, thus results in misdiagnosis. This paper aims to determine the best diagnostic cutoff value using anteroposterior and transverse diameter ratio (A/L) and longitudinal and transverse diameter ration (L/T) in PTMC. Materials and Methods The CT data of 154 pathology proven benign and malignant thyroid nodules ≤ 1.0 cm in diameter in 78 cases were reviewed, including 75 PTMC in 47 patients and 79 benign nodule in 31 patients. The anteroposterior and transverse diameter ratio (A/T) on axial view, A/L on sagittal view, and L/T on coronal view were measured and calculated. A non-parametric method was used to draw the receiver operating curve of A/T, A/L and L/T. The mean and standard deviation of CT diameters in benign and malignant nodules were calculated. The area under the curve, sensitivity, specificity and diagnostic accuracy, positive predictive value and negative predictive value were determined. CT manifestations of small benign and malignant thyroid nodules were also analyzed. Results The A/T and A/L ratio were significantly larger for PTMC than benign nodules (P<0.01), while L/T diameters were significantly smaller than the benign nodules (P<0.01). The area under ROC was 0.8841, 0.7676 and 0.4052 for A/T, A/L and L/T respectively. The best diagnostic cutoff value of A/T and A/L were 1.05 and 1.0. With A/T ≥ 1.05, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 88.00%, 84.81%, 86.36%, 84.62% and 88.12%, respectively. With A/L ≥ 1.0, the sensitivity, specificity, accuracy, positive predictive value and negative predictive values were 66.67%, 82.28%, 74.68%, 78.13% and 72.22%, respectively. CT characteristics of PTMC included superficial location, oval low density, blurry boundary, microcalcification and progressive enhancement with accuracy of 71.43%, 50.00%, 79.22%, 68.83% and 90.91%, respectively. Conclusion The cutoff values of A/T ≥ 1.05 and A/L ≥ 1.0 can be used to diagnose PTMC with high accuracy.

Construction of Notch1(NICD) Eukaryotic Expression Vector and Its Influence on the Proliferation and Differentiation of Rat Bone Marrow Mesenchymal Stem Cells in vitro / 天津医药

Objective To investigate the effect of construct the Notch1 (NICD) eukaryotic expression vector on the proliferation and differentiation of rat bone marrow mesenchymal stem cells (BMSCs) in vitro. Methods Rat BMSCs were experimented as the object. NICD eukaryotic expression vector was constructed. pEGFP-N1-NICD expressing plasmids were used to transfect BMSCs. The study included control group (CON group), empty vector group (VEC group) and the trans-fection group (TRA group). After 48-hour transfection, BMSCs were observed for general morphology. The protein expres-sions of NSE, GFAP and Notch1 were detected by real-time PCR and Western blotting assay respectively. The apoptosis, cy-cle distribution and cell proliferation were evaluated by flow cytometry and MTT assay. Results The DNA sequencing con-firmed that the pEGFP-N1-NICD recombinant plasmid was successfully constructed, and both VEC group and TRA group expressed green fluorescence after 48-hour transfection. The relative expression levels of Notch1 and GFAP mRNA and pro-tein were significantly higher in TRA group than those in VEC group and CON group (P<0.05), and there was no significant difference between VEC group and CON group. After 48-hour transfection, the ratio of living cells was significantly lower in TRA group than that of CON group and VEC group, and the early apoptotic rate and late apoptotic rate were significantly higher in TRA group than those of CON group and VEC group (P<0.05). The late apoptotic rate was significantly higher in VEC group than that of CON group. The proportion of G1/G0 cells was significantly higher in TRA group than that of CON group and VEC group, but S and G2/M cells were significantly lower (P<0.05). The value of growth curve was gradually de-creased in TRA group than that of CON group and VEC group (P<0.05). Conclusion The high expression of NICD gene might induce apoptosis of BMSCs, inhibit the proliferation in part, and induce into glial-like cell differentiation.

Very long chain acyl-CoA dehydrogenase deficiency：a case report with literature review / 临床儿科杂志

Objective To explore the clinical features of very long chain acyl-CoA dehydrogenase deifciency (VLCADD). Methods The clinical manifestation and the biochemical data of one baby girl with VLCADD were summarized and related literatures were reviewed. Results Female patient, aged 7 months, presented with recurrent vomit, haematemesis, stare, nodal tachycardia, hypoglycemia, abnormal liver function and myocardial enzyme. She died after one month due to frequent relapse together with withdrawing treatment. Conclusion VLCADD as a rare disease that cause sudden unexpected death in infant, the early diagnosis and treatment are important to patients.

A New Class Model Based on Partial Least Square Regression and Its Applications for Identifying Authenticity of Bezoar Samples / 分析化学

SIMCA(self independent modeling of class analogy) is a classical class modeling method for chemical) pattern recognition. Although widely used, SIMCA suffers difficulties in selecting a proper number of principal components and determining the decision region. A new class modeling technique based on partial least squares regression, partial least squares class model(PLSCM) is proposed, where the number of latent variables) and decision region can be readily estimated by the routine methods in multivariate calibration, e.g. Monte Carlo cross validation. PLSCM is successfully applied to identify trueborn bezoar samples from artificial and adulterated bezoar samples based on infrared spectra measured in the range of 4000-9000 cm~(-1). It is demonstrated that PLSCM outperforms SIMCA in terms of both maneuverability and identification accuracy. For the raw spectra, both the training and prediction accuracy of PLSCM are 100%. For the standard normal variate-processed data, the training and prediction accuracy of PLSCM is 99% and 100%, respectively.

Normal reference value of forced vital capacity of Chinese younger women and geographical factors / 药物分析学报

Objective To supply a scientific basis for standardizing the normal reference value of forced vital capacity (FVC) of Chinese younger women. Methods We studied the relationship between the normal reference value of 21767 samples of FVC of younger women and eight geographical factors in 157 areas in China. Results It was found that the correlation between geographical factors and the normal reference value of FVC of younger women was quite significant (F=5.884, P=0.000). By adopting the method of mathematical regression analysis, one regression equation was inferred: =3.146+0.00006919X1+0.01315X4-0.006966X6+0.09524X8±0.254. In the above equation, is the normal reference value of younger women' FVC (L); X1 is the altitude (m); X4 is the annual mean air temperature (℃); X6 is the annual mean relative humidity (%); X8 is the annual mean wind speed (m/s); 0.254 is the value of the residual standard deviation. Conclusion If geographical values are obtained in a certain area, the normal reference value of FVC of younger women in this area can be obtained by using the regression equation. Furthermore, according to the geographical factors, China can be divided into eight regions: Northeast China Region, North China Region, Shanxi-Shaanxi-Inner Mongolia Region, middle and lower reaches of the Yangzte River Region, Southeast China Region, Northwest China Region, Southwest China Region, and Qinghai-Tibet Plateau Region.

Research status of joint reconstruction in hand after bone or joint defects / 中国组织工程研究

BACKGROUND: Hand metacarpophalangeal and interphalangeal joint defects caused by trauma, infection, tumor excision or congenital disease seriously affect hand function and contour. At present, there are many methods for the repair of hand bone or joint damage, but none of them can effectively reconstruct the joint anatomic structure and function to restore the normal activity function of joints. OBJECTIVE: To summarize the domestic and foreign researches on the reconstruction of injured hand bone or joint, and to explore the research status and progress of each method in recent years. RETRIEVAL STRATEGY: A computer-based online search of PubMed was undertaken to identify the English articles dated from January 1980 to August 2007 with the keywords "hand, bone and joint injury". In addition, we searched China Periodical Full-text Database, Wanfang Database, and VIP database for the related articles published in Chinese between January 1997 and August 2007-08 with the keywords "hand, bone and joint damage, treatment" in Chinese. We also manually searched the related books. Finally, 62 articles were collected. After the first trial, only articles closely correlated with treatment of hand joint damage, and published in the near future or in the authoritative journals were selected. Duplicated researches were excluded. LITERATURE EVALUATION: The articles mainly discussed the research progress in joint damage treatment. Of the 30 selected articles, 5 were review articles, and the others were clinical or basic experimental studies. DATA SYNTHESIS: Now, there are many methods for treating hand joint damage such as fusion of joint, arthroplasty, prosthetic replacement, joint transplantation, cartilage transplantation, cell transplantation, and tissue engineering technique. How to integrate the advantages of each therapy to explore more fast, effective, and low damage treatment methods has become the hot spot in present studies. CONCLUSION: Although the joint reconstruction in hand with bone or joint defects has made a great progress, it still needs further improvement in clinic. To explore fast, highly effective, and low damage treatment method is a hot spot in recent researches.

Normal reference value of hemoglobin of middleaged women and altitude.

AIM: In order to supply a scientific basis for uniting the normal reference value standard of hemoglobin of Chinese middlescent women. METHODS: A research is made about the relationship between the normal reference value of 25,917 examples of hemoglobin of middlescent women and altitude in 268 areas in China, the normal reference values of hemoglobin of middlescent women are determined by the hemoglobincyanide method. RESULTS: The correlation between the normal reference value of hemoglobin of middlescent women and altitude is quite significant (r = 0.827). By using the method of univariate linear regression analysis, one regression equation is inferred. CONCLUSION: If the altitude values are obtained in some areas, the normal reference value of hemoglobin of middlescent women of this area can be reckoned by using the regression equation. Furthermore, depending on the altitude, China can be divided into three districts: Qingzang District, Central District, and Eastern District.