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Objective To summarize the epidemiological and clinical features of infectious diseases of the central nervous system(CNS)by a single-center analysis.Methods A retrospective analysis was conducted on the data of 1247 cases of CNS infectious diseases diagnosed and treated in the First Medical Center of PLA General Hospital from 2001 to 2020.Results The data for this group of CNS infectious diseases by disease type in descending order of number of cases were viruses 743(59.6%),Mycobacterium tuberculosis 249(20.0%),other bacteria 150(12.0%),fungi 68(5.5%),parasites 18(1.4%),Treponema pallidum 18(1.4%)and rickettsia 1(0.1%).The number of cases increased by 177 cases(33.1%)in the latter 10 years compared to the previous 10 years(P<0.05).No significant difference in seasonal distribution pattern of data between disease types(P>0.05).Male to female ratio is 1.87︰1,mostly under 60 years of age.Viruses are more likely to infect students,most often at university/college level and above,farmers are overrepresented among bacteria and Mycobacterium tuberculosis,and more infections of Treponema pallidum in workers.CNS infectious diseases are characterized by fever,headache and signs of meningeal irritation,with the adductor nerve being the more commonly involved cranial nerve.Matagenomic next-generation sequencing improves clinical diagnostic capabilities.The median hospital days for CNS infectious diseases are 18.00(11.00,27.00)and median hospital costs are ¥29,500(¥16,000,¥59,200).The mortality rate from CNS infectious diseases is 1.6%.Conclusions The incidence of CNS infectious diseases is increasing last ten years,with complex clinical presentation,severe symptoms and poor prognosis.Early and accurate diagnosis and standardized clinical treatment can significantly reduce the morbidity and mortality rate and ease the burden of disease.
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BACKGROUND:As a leading technique in the treatment of primary stenosis by posterior spinal endoscopy through unilateral approach and bilateral decompression using single channel endoscopy,the long-term efficacy needs to be further observed.There are few reports on the scope of intraoperative resection and few relevant studies on biomechanics and finite element analysis. OBJECTIVE:A three-dimensional finite element model was established to evaluate the effects of bilateral lumbar canal decompression under a one-hole split endoscope on lumbar range of motion and intradiscal pressure,to provide suggestions for clinical operation and theoretical basis for further clinical research. METHODS:A complete L3-L5 vertebral body model was reconstructed by CT images of nine healthy volunteers,which was used as the preoperative model M1.The simulated surgical resection range of L4-L5 was performed,and 1/4,1/3 and 1/2 of bilateral facet joints were removed respectively to obtain models M2,M3 and M4.The range of motion and the maximum Von Mises stress of the four models were compared in the six directions of forward bending,backward extension,left and right bending,and left and right rotation. RESULTS AND CONCLUSION:(1)The L3-L5 finite element model established in this study was effective,and the range of motion was within the range of previous solid studies under six motion states.(2)Compared with the M1 model,the L4-L5 lumbar spine range of motion increased with the increase of resection range in M2 with M3 and M4 models under forward bending,left and right bending and left and right rotation loading,and the difference was significant(P<0.05).Under posterior extension loading,there was no significant difference in lumbar range of motion between M1 and M2(P>0.05),but there was a significant difference of M1,M3 and M4(P<0.05).(3)The range of motion of the L3-L4 lumbar spine had no significant change with the increase of bilateral facet arthrotomy(P>0.05).(4)There was a significant difference in the maximum value of L4-L5 Von Mises between M1 and M2(P<0.05),and there was a significant difference in the maximum value of L4-L5 Von Mises between M1 and M3,M4(P<0.01),and the maximum value of L4-L5 lumbar von Mises increased with the increasing range of bilateral facet joint resection.Resection of more than 1/3 was particularly obvious.(5)The maximum value of Von Mises in the L3-L4 lumbar spine was increased with the increase of the resection range under forward bending,left and right bending and left and right rotation loading and the difference was significant(P<0.05).(6)The results exhibited that the L4-L5 lumbar motion and intervertebral disc pressure increased with the increase of the excision range.Intervertebral disc pressure at L3-L4 increased with the increased extent of excision,but the lumbar range of motion was not significantly affected.In conclusion,the stability of the operative segment may be affected by the increase in the scope of facet joint resection.Although the immediate stability of adjacent segments is not affected,it may accelerate disc degeneration.
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Lung cancer is one of the most common cancers worldwide, and its mortality rate remains high. In addition to conventional surgery, radiotherapy, and chemotherapy, immunotherapy methods have been developed and used in recent years for the treatment of non-small cell lung cancer (NSCLC). However, only a small number of patients with NSCLC can benefit from immunotherapy strategies, and some patients even have hyperprogression after receiving immunotherapy. Therefore, precision immunotherapy requires effective biomarkers to guide it. In this paper, tissue samples, blood samples, intestinal microbiota, and other biomarkers are reviewed according to different sample sources. Blood samples, including TCR immune repertoire, Tregs cells, cytokines, lactate dehydrogenase, and other markers, are summarized and analyzed to provide reference for clinicians' diagnosis and treatment decisions.
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Objective: To examine the association of greenness exposure with waist circumference (WC) and central obesity in older adults in China. Methods: Based on the cross-sectional data from the Chinese Longitudinal Healthy Longevity Survey in 2017-2018, 14 056 participants aged 65 years and over were included. Demographic characteristics, lifestyle, WC, and other information were collected through a questionnaire and physical examination. Based on the satellite monitoring data of moderate-resolution imaging spectroradiometer (MODIS) provided by NASA, the annual mean of normalized difference vegetation index (NDVI) within a radius of 1 000 meters was obtained as the measurement value of greenness exposure. Multivariate linear regression model, multivariate logistic regression model, and restricted cubic splines (RCS) model were used to analyze the association and dose-response relationship between greenness exposure and WC and central obesity in older adults in China. Results: A total of 14 056 participants were enrolled with a median age of 84.0 years [IQR: 75.0-94.0 years]. About 45.0% (6 330) of them were male and 48.6% (5 853) were illiterate. There were 10 964 (78.0%) participants from rural. The mean of WC was (84.4±10.8) cm. Central obesity accounted for 60.2% (8 465), and the NDVI range was (-0.06, 0.78). After adjusting for confounding factors, the multivariate linear regression model showed that the change value of WC in the urban group [β (95%CI):-0.49 (-0.93, -0.06)] was smaller than that in the rural [-0.78 (-0.98, -0.58)] for every 0.1 unit increase in NDVI (Pinteraction=0.022). Compared with the Q1 group in NDVI, WC of Q2 and Q3 groups in rural decreased, and the β (95%CI) values were-1.74 (-2.5, -0.98) and-2.78 (-3.55, -2.00), respectively. The multivariate logistic regression model showed that after adjusting for confounding factors, the risk of central obesity decreased for urban and rural older adults with an increase of 0.1 unit in NDVI, and the OR (95%CI) values were 0.87 (0.80, 0.95) and 0.86 (0.82, 0.89), respectively (Pinteraction=0.284). Compared with the Q1 group in NDVI, the risk of central obesity in the Q2 and Q3 groups in rural was lower, and the OR (95%CI) values were 0.68 (0.58, 0.80) and 0.57 (0.49, 0.68), respectively. The results of the multivariate regression model with RCS showed that there was a non-linear association of NDVI with WC (Pnonlinear=0.006) and central obesity (Pnonlinear=0.025). Conclusion: Greenness exposure is negatively associated with WC and central obesity in older adults in China.
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The scrap management of the level Ⅱ biosafety cabinet in some institution from 2019 to 2021 was introduced.The level l[biosafety cabinet was analyzed in terms of the causes for the failures,service length and the correlation between them.Some suggestions were put forward including standardizing the utilization,maintenance and scrap management of the biosafety cabinet.References were provided for ensuring the biosafety and operation of the laboratory.[Chinese Medical Equipment Journal,2023,44(10):91-94]
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Objective:The nasal swell body(NSB) consists of the nasal septal cartilage, nasal bone, and swollen soft tissue, all of which are visible during endoscopic and imaging examinations. Although the function of the NSB remains uncertain, there is evidence to suggest that it plays a vital role in regulating nasal airflow and filtering inhaled air. Based on anatomical and histological evidence, it is hypothesized that the NSB is indispensable in these processes. This study aims to investigate the impact of NSB on nasal aerodynamics and the deposition of allergen particles under physiological conditions. Methods:The three-dimensional (3D) nasal models were reconstructed from computed tomography (CT) scans of the paranasal sinus and nasal cavity in 30 healthy adult volunteers from Northwest China, providing basis for the construction of models without NSB following virtual NSB-removal surgery. To analyze the distribution of airflow in the nasal cavity, nasal resistance, heating and humidification efficiency, and pollen particle deposition rate at various anatomical sites, we employed the computed fluid dynamics(CFD) method for numerical simulation and quantitative analysis. In addition, we created fully transparent segmented nasal cavity models through 3D printing, which were used to conduct bionic experiments to measure nasal resistance and allergen particle deposition. Results:①The average width and length of the NSB in healthy adults in Northwest China were (12.85±1.74) mm and (28.30±1.92) mm, respectively. ②After NSB removal, there was no significant change in total nasal resistance, and cross-sectional airflow velocity remained essentially unaltered except for a decrease in topical airflow velocity in the NSB plane. ③There was no discernible difference in the nasal heating and humidification function following the removal of the NSB; ④After NSB removal, the deposition fraction(DF) of Artemisia pollen in the nasal septum decreased, and the DFs post-and pre-NSB removal were(22.79±6.61)% vs (30.70±12.27)%, respectively; the DF in the lower airway increased, and the DFs post-and pre-NSB removal were(24.12±6.59)% vs (17.00±5.57)%, respectively. Conclusion:This study is the first to explore the effects of NSB on nasal airflow, heating and humidification, and allergen particle deposition in a healthy population. After NSB removal from the healthy nasal cavities: ①nasal airflow distribution was mildly altered while nasal resistance showed no significantly changed; ②nasal heating and humidification were not significantly changed; ③the nasal septum's ability to filter out Artemisia pollen was diminished, which could lead to increased deposition of Artemisia pollen in the lower airway.
الموضوعات
Adult , Humans , Cross-Sectional Studies , Nasal Cavity/surgery , Allergens , Pollen , Artemisia , Hydrodynamicsالملخص
Objective:To explore the marking method for magnetically controlled capsule gastroscopy (MCCG) pictures with artificial intelligence (AI), so as to improve the work efficiency of endoscopist and to reduce the blind area of AI image reading.Methods:According to the consensus of MCCG, 24 parts of stomach in 14 775 pictures of MCCG from 35 subjects in Shenzhen Zifu Medical Technology Co., Ltd received MCCG from March to August, 2020 were marked by ten gastroenterologists and one developer of MCCG with medical background, the marking shape included rectangles and polygons. Among the ten gastroenterologists, three were senior endoscopist (the total number of gastroenteroscopy operations over 80 000, chief physician or associate chief physician), four were medium seniority endoscopist (the total number of gastroenteroscopy operations between 10 000 and 80 000, associate chief physician), and three were junior endoscopist (the total number of gastroenteroscopy operations less than 10 000, attending physician). The pictures of the same subject were pre-marked by two selected senior endoscopists with blind method, and the standard of marking with most appropriate coincidence rate was determined. The qualified marked pictures were automatically learn with AI deep learning method, and the learning results were fed back. Chi square test was used for statistical analysis.Results:According to the pre-marked results, the standard of coincidence rate for rectangular marking area was set as 50.0% and that for polygon marking area was 70.0%. The first correction for qualified rate was 39.0% (5 762/14 775). A total of 9 013 pictures were corrected. After repeated training and correction for one to five times, all pictures were qualified marked. The marking qualified rate of senior endoscopist partners was higher than that of partners of different qualifications (48.7%, 1 200/2 466 vs. 19.0%, 825/4 337), and the difference was statistically significant ( χ2=659.20, P<0.001). There was no statistically significant difference in the marking qualified rate between the senior endoscopist partners and partners of senior endoscopist and capsule developer (48.7%, 1 200/2 466 vs. 49.6%, 1 496/3 019; P>0.05). Conclusions:Establishment of AI marking method for MCCG can provide technical support for AI non-blind area reading, and AI non-blind area monitoring during the operation of MCCG.
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OBJECTIVE@#To study the binding target of photosensitizer and bacteria in antimicrobial photodynamic therapy with computer-simulated target prediction and molecular docking research methods and to calculate the binding energy.@*METHODS@#The protein names of Porphyromonas gingivalis (Pg) were obtained and summarized in Uniprot database and RCSB PDB database; the structure diagrams of methy-lene blue were screened in SciFinder database, PubChem database, ChemSpider database, and Chemical Book, and ChemBioDraw software was used to draw and confirm the three-dimensional structure for target prediction and Cytoscape software was used to build a visual network diagram; a protein interaction network was searched and built between the methylene blue target and the common target of Pg in the String database; then we selected FimA, Mfa4, RgpB, and Kgp K1 proteins, used AutoDock software to calculate the docking energy of methylene blue and the above-mentioned proteins and performed molecular docking.@*RESULTS@#The target prediction results showed that there were 19 common targets between the 268 potential targets of methylene blue and 1 865 Pg proteins. The 19 targets were: groS, radA, rplA, dps, fabH, pyrG, thyA, panC, RHO, frdA, ileS, bioA, def, ddl, TPR, murA, lepB, cobT, and gyrB. The results of the molecular docking showed that methylene blue could bind to 9 sites of FimA protein, with a binding energy of -6.26 kcal/mol; with 4 sites of Mfa4 protein and hydrogen bond formation site GLU47, and the binding energy of -5.91 kcal/mol, the binding energy of LYS80, the hydrogen bond forming site of RgpB protein, was -5.14 kcal/mol, and the binding energy of 6 sites of Kgp K1 protein and the hydrogen bond forming site GLY1114 of -5.07 kcal/mol.@*CONCLUSION@#Computer simulation of target prediction and molecular docking technology can initially reveal the binding, degree of binding and binding sites of methylene blue and Pg proteins. This method provides a reference for future research on the screening of binding sites of photosensitizers to cells and bacteria.
الموضوعات
Computer Simulation , Methylene Blue , Molecular Docking Simulation , Photosensitizing Agents , Porphyromonas gingivalisالملخص
Objective:To investigate the effect of inferior epigastric artery perforator flap transplantation in repairing traumatic soft tissue defects of lower limbs.Methods:A retrospective case series study was conducted to analyze the clinical data of 34 patients with traumatic soft tissue defects of lower limbs admitted to Chongqing Great Wall Hospital from January 2019 to May 2021, including 31 males and 3 females; aged 12-65 years [(38.5±5.6)years]. There were 8 patients with defects on the calf and 26 on the ankle. All wounds were found with exposed tendons, muscles and/or bones. The area of soft tissue defects ranged from 10 cm×6 cm to 40 cm×11 cm. All patients were repaired with inferior epigastric artery perforator flap. The wound healing, flap survival and recovery were observed. The visual analogue scale (VAS) and American Orthopedic Foot and ankle Society (AOFAS) ankle-hindfoot score were used to evaluate pain and ankle function before operation and at 3 days, 7 days, 14 days, 1 month, 3 months, 6 months and 12 months after operation. The complications were observed.Results:All patients were followed up for 12-36 months [(19.5±5.3)months]. All wounds were healed by stage I, showing the healing time of 14-24 days [(17.6±2.8)days]. All flaps survived with good color, soft texture and satisfactory appearance, with no obvious swelling. All flaps produced protective sensation. The VAS was (4.3±0.8)points, (3.3±0.7)points, (1.4±0.5)points, (1.2±0.3)points, (0.8±0.2)points and (0.4±0.1)points at 7 days, 14 days, 1 month, 3 months, 6 months and 12 months after operation, decreased gradually from preoperative (7.4±1.3)points (all P<0.05). The AOFAS ankle-hindfoot score was (35.6±3.1)points, (42.6±3.6)points, (50.3±4.3)points, (56.2±5.6)points, (60.3±6.8)points and (65.3±9.0)points at 7 days, 14 days, 1 month, 3 months, 6 months and 12 months after operation, increased from preoperative (22.4±2.5)points (all P<0.05). The ankle function was excellent in 25 patients, good in 5 and fair in 4 at 12 months after operation, with an excellent and good rate of 88.2%. Venous crisis occurred in 3 patients after operation, and the flaps survived completely after venous reanastomosis or venous bridging. Conclusion:For traumatic soft tissue defects of lower limbs, inferior epigastric artery perforator flap transplantation has advantages of enhanced survival of flaps, satisfactory appearance, attenuated pain, good functional recovery and few complications.
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Objective To establish a nomogram for predicting the distant metastasis risk of pancreatic neuroendocrine tumors (pNETs) in elderly patients. Methods We extracted data of patients with diagnosis of pNETs at age ≥65 years old between 1973 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database. All eligible patients were divided randomly into a training cohort and validation cohort. Uni- and multivariate logistic regression analyses were performed on the training cohort to identify independent factors for distant metastasis. A nomogram was developed based on the independent risk factors using rms packages of R software, and was validated internally by the training cohort and externally by the validation cohort using C-index and calibration curves. Results A total of 411 elderly patients were identified, of which 260 were assigned to training cohort and 151 to validation cohort. Univariate and multivariate logistic regression analyses indicated the tumor site (body/tail of pancreas: odds ratio [
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Aged , Humans , Neoplasm Staging , Nomograms , Pancreatic Neoplasms , Prognosis , Risk Factorsالملخص
Objective To investigate the impact of prior non-pancreatic cancer on the survival outcomes of patients with localized pancreatic neuroendocrine tumors (PanNETs). Methods We reviewed the Surveillance, Epidemiology, and End Results database and selected patients with localized PanNETs diagnosed between 1973 and 2015. We divided the patients into two groups according to the presence or absence of prior non-pancreatic malignancy. Before and after propensity score matching, we compared the clinicopathological characteristics and studied the overall survival and cancer-specific survival. Results A total of 357 (12.9%) of 2778 patients with localized PanNETs had prior cancer. A total of 1211 cases with only a localized PanNET and 133 cases with a localized PanNET and prior cancer had complete data and met the inclusion criteria of the current study. Patients with prior cancer were associated with advanced age (>65 years, 57.9% prior cancer
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Aged , Female , Humans , Male , Multivariate Analysis , Neoplasms, Second Primary , Neuroendocrine Tumors/epidemiology , Pancreatic Neoplasms/epidemiology , Propensity Scoreالملخص
Objective@#: A role of diffusion-weighted imaging (DWI) in the diagnosis of cerebral venous thrombosis (CVT) is not wellunderstood. This study evaluates the effectiveness of DWI in the diagnosis of CVT. @*Methods@#: Literature search was conducted in electronic databases for the identification of studies which reported the outcomes of patients subjected to DWI for CVT diagnosis. Random-effects meta-analyses were performed to achieve overall estimates of important diagnostic efficiency indices including hyperintense signal rate, the sensitivity and specificity of DWI in diagnosing CVT, and the apparent diffusion coefficient (ADC) of DWI signal areas and surrounding tissue. @*Results@#: Nineteen studies (443 patients with 856 CVTs; age 40 years [95% confidence interval (CI), 33 to 43]; 28% males [95% CI, 18 to 38]; symptom onset to DWI time 4.6 days [95% CI, 2.3 to 6.9]) were included. Hyperintense signals on DWI were detected in 40% (95% CI, 26 to 55) of the cases. The sensitivity of DWI for detecting CVT was 22% (95% CI, 11 to 34) but specificity was 98% (95% CI, 95 to 100). ADC values were quite heterogenous in DWI signal areas. However, generally the ADC values were lower in DWI signal areas than in surrounding normal areas (mean difference−0.33×10-3 mm2/s [95% CI, −0.44 to −0.23]; p<0.00001). @*Conclusion@#: DWI has a low sensitivity in detecting CVT and thus has a high risk of missing many CVT cases. However, because of its high specificity, it may have supporting and exploratory roles in CVT diagnosis.
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BACKGROUND@#Mastectomy techniques have been extended to nipple-sparing mastectomy (NSM). This study aimed to assess the actual application of NSM in China and identify the factors influencing postoperative complications.@*METHODS@#The clinical data of 615 patients (641 surgeries) undergoing NSM from January 1st, 2018 to December 31st, 2018 at 28 centers nationwide were retrospectively analyzed to obtain the rate of NSM and investigate factors related to NSM surgery.@*RESULTS@#The proportion of NSM surgery performed in this study was 2.67% (17/641). Malignant breast tumors accounted for the majority of NSM surgery (559/641, 87.2%). A total of 475 (77.3%) patients underwent NSM combined with reconstructive surgery. The rate of reconstruction decreased with age in our study, and implants were the most common option (344/641, 53.7%) in reconstruction. Radial incision was the most selected method regardless of reconstruction. However, for those who underwent reconstruction surgery, 18.4% (85/462) of cases also chose curvilinear incision, while in the simple NSM surgery group, more patients chose circumareolar incision (26/136, 19.1%). The tumor-to-nipple distance (TND) influenced postoperative complications (P = 0.004). There were no relationships between postoperative complications and tumor size, tumor location, histologic grade, molecular subtype, nipple discharge, and axillary lymph nodes.@*CONCLUSIONS@#NSM surgery is feasible and only TND influenced postoperative complications of NSM surgery. But the proportion of NSM surgery performed is still low in nationwide centers of China. The selection criteria for appropriate surgical methods are important for NSM in clinical practice. To optimize clinical applications of NSM, further multicenter prospective randomized controlled studies are needed.@*TRIAL REGISTRATION@#ChiCTR.org.cn, ChiCTR1900027423; http://www.chictr.org.cn/showprojen.aspx?proj=38739.
الموضوعات
Humans , Breast Neoplasms/surgery , China , Mammaplasty , Mastectomy , Nipples/surgery , Prospective Studies , Retrospective Studiesالملخص
OBJECTIVE: Vacuum-sealing drainage has the effect of promoting wound healing and preventing infection. At present, a large number of studies have confirmed the significant efficacy of vacuum-sealing drainage combined with antibiotic bone cement in the treatment of chronic osteomyelitis, but the corresponding evidence is still lacking. A meta-analysis was performed on the effect of treatment of chronic osteomyelitis by vacuum-sealing drainage combined with antibiotic bone cement. METHODS: CNKI, VIP, Wanfang, PubMed, Cochrane Library and EMbase were searched to find randomized controlled trials of vacuum-sealing drainage combined with antibiotic bone cement for the treatment of chronic osteomyelitis. The retrieval time was from inception to February 2020. The quality of the included literature was strictly evaluated, and the RevMan 5.3 software was used for meta-analysis of the included research. RESULTS: Ten randomized controlled trials involving 637 patients with chronic osteomyelitis were included, with the treatment group of 313 cases and control group of 324 cases. Due to the special wound therapy, it was difficult to implement blind method clinically, so there was partial implementation bias. (2) Metaanalysis results showed that the recurrence rate of chronic osteomyelitis treated with vacuum-sealing drainage with antibiotic bone cement was lower than that in the control group (OR=0.20, 95%CI:0.11-0.37, P < 0.000 01). In the healing rate (OR=3.44, 95%CI:2.01-5.92, P < 0.000 01), healing time (MD=-11.05, 95%CI:-18.59 to-3.52, P=0.004), duration of antibiotic use (MD=-12.36, 95%CI:-13.27 to-11.44, P < 0.000 01), visual analogue scale score (MD=-1.94, 95%CI:-2.80 to-1.08, P < 0.000 01), times of dressing change (MD=-5.78, 95%CI:-6 .64 to-5.12, P < 0.000 01), bone absorption time (MD=-0.81, 95%CI:-0.98 to-0.64, P < 0.000 01), and bone healing time (MD=-1.62, 95%CI:-2.22 to-1.03, P < 0.000 01) were all better in the vacuum-sealing drainage with antibiotic bone cement group than those in the control group. CONCLUSION: The combination of vacuum-sealing drainage and antibiotic bone cement in the treatment of chronic osteomyelitis has a significant advantage over the traditional treatment, which is worthy of clinical promotion. Limited by the quantity and quality of the included studies, the above conclusions need to be verified by more high-quality clinical studies.
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Objective@#: A role of diffusion-weighted imaging (DWI) in the diagnosis of cerebral venous thrombosis (CVT) is not wellunderstood. This study evaluates the effectiveness of DWI in the diagnosis of CVT. @*Methods@#: Literature search was conducted in electronic databases for the identification of studies which reported the outcomes of patients subjected to DWI for CVT diagnosis. Random-effects meta-analyses were performed to achieve overall estimates of important diagnostic efficiency indices including hyperintense signal rate, the sensitivity and specificity of DWI in diagnosing CVT, and the apparent diffusion coefficient (ADC) of DWI signal areas and surrounding tissue. @*Results@#: Nineteen studies (443 patients with 856 CVTs; age 40 years [95% confidence interval (CI), 33 to 43]; 28% males [95% CI, 18 to 38]; symptom onset to DWI time 4.6 days [95% CI, 2.3 to 6.9]) were included. Hyperintense signals on DWI were detected in 40% (95% CI, 26 to 55) of the cases. The sensitivity of DWI for detecting CVT was 22% (95% CI, 11 to 34) but specificity was 98% (95% CI, 95 to 100). ADC values were quite heterogenous in DWI signal areas. However, generally the ADC values were lower in DWI signal areas than in surrounding normal areas (mean difference−0.33×10-3 mm2/s [95% CI, −0.44 to −0.23]; p<0.00001). @*Conclusion@#: DWI has a low sensitivity in detecting CVT and thus has a high risk of missing many CVT cases. However, because of its high specificity, it may have supporting and exploratory roles in CVT diagnosis.
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Schizophrenia and obsessive-compulsive disorder are common disorders in clinical psychiatry, accompanied by varying degrees of painful experience and social functioning impairment, and a high prevalence rate of co-morbidities. In this paper, a review of comparative study of structural and functional magnetic resonance imaging of the two diseases is presented, so as to explore the similar and specific biological markers of them and to provide a forceful imaging basis for subsequent studies.
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Objective: To evaluate the effectiveness of the nose ring drain (NRD) in treatment of severe diabetic foot infection. Methods: The clinical data of 35 patients with severe diabetic foot infection who were treated with NRD between June 2017 and June 2019 were analyzed retrospectively. There were 24 males and 11 females with an average age of 54.5 years (range, 28-82 years). All of them were type 2 diabetic patients. The diabetes duration was 3-20 years, with an average of 9.4 years. The diabetic foot duration was 4 months to 2 years, with an average of 1.16 years. There were 16 cases of left foot and 19 cases of right foot. According to Wagner's grading, there were 11 cases of grade 2, 20 cases of grade 3, and 4 cases of grade 4, all of which were moderate and severe infection of diabetic foot wound. Postoperative wounds were treated with "nibble-like" debridement until the patient's epidermis regenerated and healed. During the treatment process, the indexes of bacterial culture type of wound secretions, duration of antibiotic therapy, wound healing method, healing time, amputation rate, and other indicators were analyzed and summarized. Results: All 35 patients were followed up 3-6 months, with an average of 4.5 months. Postoperative bacterial culture of wounds showed that 5 cases of Staphylococcus aureus, 4 cases of Pseudomonas aeruginosa, 5 cases of Escherichia coli, 3 cases of Enterobacter cloacae, 3 cases of coagulase-negative Staphylococcus, and 15 cases of other types were detected. The duration of antibiotic therapy ranged from 3 to 15 days, with an average of 9.1 days. The wound was autolytically healed without skin grafting, and the healing time was 62-82 days, with an average of 72.3 days. During the follow-up, 3 cases (8.6%) had amputation due to the patient's poor blood glucose control, which led to a large spread of infection. In addition, among the other patients with wound healing, there was no recurrence of wound infection or new ulcer on the original surface. Conclusion: The NRD is a simple operation for treatment of severe diabetic foot infection, which can effectively control wound infections and promote wound healing and regeneration without skin grafting.
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Dao-di herbs are the Chinese herbs which have high quality and best clinic effects. Sichuan is one of the proviences most rich in Chinese herb resources,which has 7 290 species of Chinese herbs, such as Curcumae Longae Rhizoma, Chuanxiong Rhizoma, Aconiti Lateralis Radix Praeparata, Ophiopogonis Radix, Coptidis Rhizoma, Gentianae Radix, Rhei Radix et Rhizoma, Curcumae Rhizoma, Gardeniae Fructus, ect. After textual research on materia medica of the 7 290 Chinese herbs, we find there are 86 Dao-di herbs in Sichuan, such as Chuanxiong Rhizoma from Dujiangyan, Aconiti Lateralis Radix Praeparata from Jiangyou, Fritillariae Radix, Notoptergii Rhizoma et Radix, Angelicae Dahuricae Radix from Suining, Ophiopogonis Radix from Santai, Salviae Miltiorrhizae Radix et Rhizoma from Zhongjiang, Magnoliae Officinalis Cortex from Pingwu. In China more attention is paid to the production of Dao-di herbs. In 2018, the State Administration of Traditional Chinese Medicine launched the "Construction Plan of national production base of genuine medicinal materials". Developing genuine medicinal materials in genuine production areas is one of the effective ways to ensure the quality of medicinal materials. Based on the study of geographical environment and ecological factors(altitude, climate, soil) in Sichuan province. The Dao-di herbs of Sichuan province are divided into 4 districts, including, Sichuan basin medicinal materials production area, mountain and the basin edge medicinal materials production area, Panxi medicinal materials production area, Plateau Mountain Canyon medicinal materials production area. The suitable regions and best suitable regions of the 86 Dao-di herbs in Sichuan are determined by remote sensing and GIS spatial analysis of the suitable environmental indicators of these Dao-di herbs. Our study is beneficial to the rational distribution of the production and to improvement of the quality of traditional Chinese medicine in Sichuan province.
الموضوعات
China , Drugs, Chinese Herbal , Medicine, Chinese Traditional , Plants, Medicinal/classificationالملخص
OBJECTIVE@#To evaluate the possible association between radon exposure and kidney cancer.@*METHODS@#We performed a systematic review and a meta-analysis based on random effect models to provide a pooled association measure.@*RESULTS@#We subjected 8 studies (overall relative risks and 95% confidence intervals: 1.01, 0.72 to 1.43, I2 = 64.4%) to meta-analysis. Subgroup analysis revealed a marginally significant association between radon exposure and kidney cancer in studies conducted in Europe. Two population-based studies provided no evidence for the increased risk of kidney cancer in the general population.@*CONCLUSION@#The association between radon and kidney cancer remains unclear but cannot be excluded because of its biological plausibility and the limited number and quality of existing studies. Additional data from the general population and well-designed miner cohort studies are needed to reveal the real relationship between radon exposure and kidney cancer.
الموضوعات
Humans , Cohort Studies , Environmental Exposure , Kidney Neoplasms , Radon , Toxicityالملخص
Objective To investigate the expression and clinicopathological significance of Twist1 gene in esophageal squamous cell carcinoma(ESCC),and its effect on migration and invasion of ESCC.Methods The ESCC tissues and adjacent normal tissues of 30 ESCC patients having underwent surgery were selected. The expression levels of Twist1 mRNA and protein were detected by real time fluorescence quantitative polymerase chain reaction (RT- qPCR) and Western blot methods. The expression level of Twist1 mRNA in adjacent normal tissues was used as control,the relative expression levels of Twist1 mRNA in 3 ESCC cell lines K70,K140 and EC109 were detected,and the relationship between the expression level and clinicopathological features was analyzed. ESCC cell line EC109 was selected for cell scratch test and Transwell chamber invasion assay respectively.Twist1 small interfering RNA and control double stranded nonsense RNA were transfected respectively, and the changes were compared.Results The expression level of Twist1 mRNA in ESCC tissue was significantly higher than that in adjacent normal tissue(1.91 ± 0.93 vs.0.54 ± 0.26),and there was statistical difference(P<0.01). The relative expression levels of Twist1 mRNA in 3 ESCC cell lines K70, K140 and EC109 were significantly higher than those in adjacent normal tissue (2.30 ± 0.34, 1.78 ± 0.28 and 4.37 ± 0.25 vs. 1.00 ± 0.48), and there were statistical differences (P<0.05). The expression level of Twist1 protein in ESCC tissue was significantly higher than that in adjacent normal tissue (1.35 ± 0.66 vs. 0.25 ± 0.05), and there was statistical difference (P<0.05). The relative expression level of Twist1 mRNA in ESCC tissue had correlation with lymph node metastasis and invasion degree(P<0.05).The expression levels of Twist1 mRNA in ESCC cell lines EC109 after transfected Twist1 small interfering RNA and double stranded nonsense RNA were 0.45 ± 0.16 and 1.00 ± 0.20, the express levels of Twist1 protein were 0.24 ± 0.09 and 0.58 ± 0.10,and there were statistical differences(P<0.05).The cell scratch test result showed that the migration rates of 36 and 72 h of ESCC cell line EC109 were significantly lower than those of the control double stranded nonsense RNA,after Twist1 expression was down regulated by RNA interference:(32.6 ± 4.7)% vs.(16.2 ± 6.0)% and(71.9 ± 4.7)% vs.(53.2 ± 6.6)%,there were statistical differences(P<0.05).The Transwell chamber invasion assay result showed that the total number of cells in the bottom of Twist1 through the small interfering RNA of EC109 was lower than that of the transfected control double stranded nonsense RNA (92.5 ± 8.1 vs. 32.7 ± 7.5), and there was statistical difference (P<0.05). Conclusions Twist1 gene may be highly abnormally expressed in ESCC, which has some correlation with invasion and lymph node metastasis,and may have some influences on the migration and invasion of ESCC.