Construction of containing CT imaging features Nomograms model of postoperative intraluminal thromus formation in patients with aortic dissective aneurysm / 中国医师进修杂志

Objective:To investigate the construction of containing CT imaging features Nomograms model of postoperative intraluminal thromus (ILT) formation in patients with aortic dissective aneurysm (ADA).Methods:One hundred and twenty patients with Stanford type B ADA treated with overlapping stent endoluminal repair and multilayer spiral CT (MSCT) examination in Affiliated Hospital of Jining Medical College from May 2020 to February 2022 were selected. The patients were divided into the modeling population (84 patients) and the validation population (36 patients) according to a 7∶3 ratio. The factors influencing postoperative ILT formation in ADA patients were analyzed by univariate and Logistic multifactor regression models, and the prediction model of postoperative ILT formation was constructed based on the influencing factors.Results:In the modeled population, the rate of ILT formation within 1 month after luminal repair with overlapping stents was 27.38%(23/84), including 5 cases in the aortic arch and 18 cases in the abdominal aorta. In the modeled population, the results of univariate analysis showed that the sex, age, body mass index(BMI), smoking, drinking, hypertension, hyperlipidemia, rupture diameter, rupture distance from left subclavicular artery, involvement of important branches, uneven thickening of aneurysm wall, low density on plain scan and operation timing between the ILT formation group and non-ILT formation group had no statistically significant ( P>0.05). The diabetes mellitus, irregular inner wall, calcified plaque, postoperative anticoagulant therapy, B-type brain natriuretic peptide (BNP), fibrinogen (Fib), D-dimer (D-D) and C-reactive protein (CRP) between the two groups had statistical differences: 43.48%(10/23) vs. 11.48%(7/61), 86.96%(20/23) vs. 57.38%(35/61), 91.30%(21/23) vs. 62.30%(38/61), 21.74%(5/23) vs. 57.38%(35/61), (523.60 ± 128.74) ng/L vs.(271.83 ± 109.65) ng/L, (3.82 ± 0.96) g/L vs. (2.85 ± 0.83) g/L, (601.37 ± 75.62) μg/L vs. (389.20 ± 68.79)μg/L, (0.63 ± 0.19) mg/L vs. (0.48 ± 0.15) mg/L, P<0.05. The results of Logistic multifactor regression analysis showed that diabetes mellitus, irregular inner wall, calcified plaque, postoperative anticoagulant therapy and BNP, Fib, D-D CRP levels were influential factors for postoperative ILT formation in Stanford type B ADA patients ( P<0.05). The C-index of the model was 0.903 and 0.894 for the modeled and validated populations, respectively, which had good discrimination and was good at predicting ILT formation after operation in Stanford type B ADA patients. The model had good clinical utility in predicting postoperative ILT formation in Stanford B ADA patients. Conclusions:The Nomograms model can help to screen and identify patients with high risk of ILT formation at an early clinical stage.

The relation between positive fluid balance and the prognosis in severe sepsis patients with acute kidney injury / 中华急诊医学杂志

Objective To investigate the relation between positive fluid balance and the prognosis in severe sepsis patients with acute kidney injury (AKI).Methods A retrospective analysis of clinical data of 90 patients in our department was carried out.According to the final outcome,patients were divided into survival group (n =26) and non-survival group (n =64),in which the relation between patients' positive fluid balance and the prognosis was evaluated.Results (1) There was no statistically significant difference in the age and severity between survival group and non-survival group of patients with severe sepsis and consequent AKI,but the patients in non-survival group had greater volume overload.Compared with the survival group,higher mean fluid balance [(1 112.12±546.85) mLvs.(644.69±474.93) mL,P=0.00],and less urine output [(1 224.07 ± 708.79) mL vs.(2 032.36 ± 723.53) mL,P =0.00) in non-survival group.(2) There was no significant difference in mortality between early and late continuous renal replacement therapy (CRRT) during ICU care.However,the average daily fluid load in late CRRT patients was significantly greater than that in early CRRT patients [(1178.81 ±397.03) mLvs.(287.22 ± ± 433.53) mL,P =0.00] and the lung oxygenation index in late CRRT patients was significantly worse thanthat in early CRRT patients [(211.22±42.56) vs.(169.46±57.40),P=0.04] (3) The relevant variables to 28-day mortality in AKI patients with severe sepsis included CRRT treatment,oxygenation index and the average daily fluid balance ＞ 500 mL.Among them,fluid balance ＞ 500mL was an independent risk factor for AKI patients with severe sepsis.Their prognosis was worse if they had greater positive fluid balance.CRRT was the protective factor which could affect the prognosis of patients with severe sepsis complicated by AKI.Conclusions Patients with severe sepsis complicated by AKI has a high mortality.Persistent fluid overload can lead to increased mortality in patients with severe sepsis complicated by AKI.Early CRRT can reduce fluid retention in patients with renal failure and improve oxygenation index.

The clinical application of Mycoplasma pneumoniae antibody in children′s respiratory tract infection / 国际检验医学杂志

Objective To detect mycoplasma pneumoniae antibody in children having the upper respiratory tract infection.And then investigate mycoplasma pneumoniae infection status of different season different age children.Methods In 5 403 cases of suspected pneumonia mycoplasma infection of 0 to 14 years old children using the method of passive particle agglutination determination of mycoplasma pneumoniae antibody,and analysis of the statistical results.Results The positive rate was 67.8％ in the groups of children.The rates of infection was biggest during 2 to 3 years old children and 3-4 years old children,14.9％ and 18.4％,respectively.In addition,we found that the highest rate of mycoplasma pneumoniae infection arised from October to January every year of the following year.Conclusion The infection of mycoplasma pneumoniae is on the rise,and children aged 0 to 6 years old are the main population.

Hepatitis C patients serum HCV-RNA copy number and AFP-L3 percentage correlation analysis / 国际检验医学杂志

Objective To investigate the HCV patients with HCV‐RNA and AFP different plastid percentage (AFP‐L3/AFP) correlation ,analysis of liver cirrhosis to liver cancer caused by hepatitis c in the process of the development of HCV‐RNA and AFP‐L3/AFP change characteristics .Methods Collected clinical confirmed simple HCV patients 80 cases ,including 44 patients with cir‐rhosis of the liver and 36 cases of HCV liver cancer group and liver cirrhosis group were followed up at 3 ,6 months ,follow‐up re‐sults are divided into transfer of liver cancer group and treatment group ,in addition to choose 60 cases of healthy people as control group .Using case‐control study .Between different groups of HCV‐RNA and AFP‐L3/AFP compared by t test .Results The liver cirrhosis group average HCV‐RNA ,AFP‐L3/AFP for 7 .15 × 103 copy/mL ,44 .3% ,compared with the control group 400 copy/mL ,1 .1% ,the difference was statistically significant(P< 0 .05) .Liver cirrhosis group average HCV‐RNA ,AFP‐L3/AFP for 8 .33 × 109 copy/mL ,3 .35% ,and HCV liver cancer group (5 .71 × 107 copy/mL ,94 .33% ) ,the difference was statistically signifi‐cant(P<0 .05) .3 months follow‐up of patients with liver cirrhosis have 4 cases for the development of liver cancer ,8 cases after 6 months for the development of liver cancer .Conclusion The patients with cirrhosis caused by hepatitis c virus (HCV) should be combined ,dynamic detection of HCV RNA and AFP‐L3/AFP ,in order to early discover the liver cancer .

Analysis of the correlation between the expression level of TNF-α,IL-10 and CD4+ cells in patients with HIV infection / 国际检验医学杂志

Objective To investigate the correlation between interleukin 10(IL‐10) ,tumor necrosis factor (TNF‐α) and serum CD4+ T‐lymphocytes cell in people who infected HIV .Methods The HIV antibody screening test ,IL‐10 and TNF‐αmeasurement adopted enzyme‐linked immune‐sorbent assay(ELISA) .The HIV antibody confirm test adopted western blot(WB) and CD4+ cell count determination used flow cytometry .Results Compared with the normal control group(NC group) ,the concentration of TNF‐αand IL‐10 in patients group have statistically significant difference(P<0 .05) .Moreover ,the extent of the increase in group A(pa‐tients with the CD4+ T cell count less than 3 .5 × 105 cells/mL) was higher than that in group B(patients with the CD4+ T cell count no less than 3 .5 × 105 cells/mL) .Conclusion Due to the defect of the immune system ,the serum concentration of TNF‐αand IL‐10 in people infected with HIV would increased ,and the increase of the concentration could be more significant in patients whose CD4+cell count obviously decrease .This study have shown that dynamic measurement of TNF‐α and IL‐10 concentration would provide data to konw the patients′immune status and illness development .

Corelationship between proton pump inhibitors and hospital-acquired pneumonia in abdominal surgical patients / 实用医学杂志

Objective To investigate the corelationship between proton pump inhibitors (PPI) and the incidence of hospital-acquired pneumonia (HAP) in abdominal surgical patients. Methods A total of 283 cases admitted from 2010 to 2014 were divided into PPI group (n = 326) and HRA group (n = 92). In PPI group, patients were divided into omeprazole subgroup (subgroup A, n = 146), lansoprazole subgroup (subgroup B, n = 102) and pantoprazole subgroup (subgroup C, n = 78) by the types of PPI. In HRA group, patients were divided into famotidine subgroup (subgroup D, n = 58) and ranitidine subgroup (subgroup E, n=34) by the types of histamine-2 receptor antagonist (H2RA). The incidence of stress ulcer bleeding (SUB) and HAP were calculated, while mechanical ventilation period (MV), ICU stay and 28-day-mortality were compared. Results There were lower incidences of SUB and HAP, shorter MV and ICU stay and lower 28-day-mortality in PPI group than those in HRA group (P < 0.05). In three subgroups of PPI group, there were no significant difference on incidence rate of SUB and HAP, as well as MV, ICU stay and 28-day-mortality. Conclusion The incidence rates of SUB and HAP are lower by using PPI than H2RA in abdominal surgical patients, as well as MV, ICU stay and 28-day-mortality. Different types of PPI have no effect on the incidence rate of HAP in abdominal surgical patients.

Research in the role of extravascular lung water in patients with sepsis-induced ALI/ARDS / 中华急诊医学杂志

Objective To investigate and compare the change of extravascular lung water (EVLW) and levels of cytokines in septic patients without clinical acute lung injury (ALI) /acute respiratory distress syndrome (ARDS) with those in spetic patients with sepsis-induced ALI/ARDS in order to determine the role of EVLW involved in the pathogenesis of lung injury in the patients by quantifying the relationship between EVLW and biomarkers of lung injury in patients with sepsis.Methods A total of 40 septic patients complicated either with or without clinical ALI/ARDS after sepsis. In each patient,transpulmonary thermodilution (PiCCO) was used to measure cardiovascular hemodynamics and EVLWI for 7 days via an arterial cannula indwelled within 72 hours after diagnosis of severe sepsis was made, and serial bronchoalveolar lavages (BAL) were carried out.Other examinations including blood gas analysis,ventilator parameters,chest X-ray and the levels of pro-inflammatory cytokines such as tumor necrosis factor (TNF-oα),interleukin-1 in the BAL were recorded.In-hospital and ICU mortalities were also observed.Results Of total 40 patients,29 were complicated with clinically defined septic ALI/ARDS ( ARDS n =15,and ALI n =14).The septic patients complicated with ALL/ARDS had significantly higher amount of EVLWI and higher levels of TNF-α and interleukin-1 in the BAL than patients without ALI/ARDS ( P ＜ 0.05).The arterial oxygen tension/fractional inspired oxygen ratio,lung injury score,and the levels of TNF-α,IL-1 in the BAL correlated with EVLWI.Moreover,in-hospital mortality,ICU mortality and the length of ICU stay of the patients with high amount of EVLWI were markedly increased than those of patients with low amount of EVLWI. Conclusions In septic patients complicated with ALI/ARDS, the extravascular lung water index correlates with oxygenation,lung injury severity and inflammatory cytokines in lung.Determination of EVLWI may be useful for evaluation of severity of lung injury and prognosis of septic patients.

The effect of direct hemoperfusion with neutral resin on patients with septic shock caused by gram-negative bacteria infection / 中华急诊医学杂志

Objective To evaluate clinical effect and safety of direct hemoperfusion with neutral resin (NS-DHP) on patients with septic shock caused by Gram-negative bacteria infection.Methods A total of 42 patients were enrolled in the study and randomly ( random number) divided into two groups.Patients of control group ( n =24) received sepsis bundle therapy,and patients of group D ( n =18 ) were treated with NS-DHP in addition to sepsis bundle therapy.HA330 hemoperfusion device were used in each patient of group D.The procedure of hemoparfusion lasted 2.5 hours and carried out trice a 24 hours.Clinical data including APCHE Ⅱ score,PO2/FiO2 (OI),mean arterial pressure (MAP),dopamine usage (DA),plasma level of endotoxin (ET),C-reactive protein (CRP),TNF-α,IL-6 and IL-10 were recorded during the treatment.Results Patients well tolerated NS-DHP without any complication in group D.All patients in both two groups did not receive long-term renal replacement therapy.At 24 h,48 h and 72 h after the initiation of treatment,APACHE Ⅱ score,O1,MAP,DA,ET,CRP,TNF-α and IL-6 improved obviously both groups (P ＜0.05),but there was no significant ditterence in serum levels of IL-10 in both groups.In the group D,APCHE Ⅱ score,OI,MAP,DA,CRP,TNF-α and IL-6 were improved more obviously than those in the group C (P ＜0.05) ).There was no significant difference in plasma levels of ET in both groups during the treatment.Conclusions NS-DHP can improve APACHE Ⅱ score,PO2/FiO2 and MAP in patients with septic shock caused by gram-negative bacteria infection and reduce the levels of CRP,TNF-α and IL-6,but has no effect on the levels of ET and IL-10 as well as on 28-day mortality and ICU stay.

Analysis of allergic sieving detection results and clinical significance in children with allergic disease / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the clinical use of sieving detection among the childhood with allergic disease.@*METHOD@#The sieving detection about allergen inhalant allergens, Fx5 in the CAP anaphylactogen detection system, and serum specific IgE were detected in three hundred and thirty-one cases of children (aged from 1 year to 14 years old) with allergic disease. Patients were divided into group 1, group 2 and group 3 according to the age from 0 to 3, 3 to 6, and 6 to 14 years old. All datas were statistical analysed among different age groups.@*RESULT@#Among the 331 patients, the positive rate of allergic sieving detection was 67.98%, the elevation rate of IgE was 53.78%. Inhalant allergen positive rate was 60.42%, while the food allergen positive rate was 28.10%. Inhalant allergen positive rate of the group 3 (aged from 6 to 14 years old) was significant higher than the other two age groups (68.45%). And the food allergen positive rate of the age group 1 (aged from 0 to 3 years old) was significant higher than the other two age groups (62.50%). Positive rate for simply inhalant allergen was 39.88%, while positive rate for simply food allergen was 7.55% and mixed allergen was 20.54%.@*CONCLUSION@#Inhalant allergen was the main allergen of the children with allergic disease aged over 3 years old, while food allergen was the main allergen of the children with allergic disease aged below 3 years old. It was safe, sensible and effective to use Uni CAP anaphylactogen detection system for rapid assay of specific allergens.

Investigation and analysis of the common inhaled allergens in allergic diseases in Jingmen area of Hubei Province / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#In order provide important evidences for epidemiologic survey, clinical diagnosis, treatment and preservation of allergic diseases in this area, we investigate the distribution of the common allergens in allergic rhinitis and allergic asthma in Jingmen area and the sensitization condition of the major allergen house dust mite.@*METHOD@#Four hundred and twenty-five patients with suspected allergic rhinitis and asthma in our area accepted skin prick tests of 10 standard allergen agents and specificity IgE detection. The different positivity ratios of allergens in different age groups were compared and the correlation between the two different technique methods testing the dust mite allergen was analyzed.@*RESULT@#Among 425 patients with suspected allergic rhinitis and asthma in our area, 298 patients were positive and 89 patients suffered a combined allergic asthma. House dust mite (292 cases) and dermatophagoides farinae (289 cases) were the commonest allergens. The other common allergens were mugwort (45), ragweed (31), fungus I (19), fungus II (15), spring-pollen II (14), poly-animal hair (14), spring-pollen I (9), poly-feather (3). There was a correlation between skin test and sIgE test for house dust mite, dermatophagoides farinae in children group, and the positivity ratios were significantly higher than the adults group.@*CONCLUSION@#Dust mite is the most important allergen in allergic rhinitis and asthma in Jingmen.

Analyzing of the inhaled allergens profiles of allergic rhinitis patients in district of Jingmen / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the profiles of inhaled allergens in allergic rhinitis patients in district of Jingmen, and to provide basic epidemiologic information for the prevention and treatment of allergic rhinitis in this area.@*METHOD@#Retrospectively analyze 10 allergens skin prick test results of 1800 allergic rhinitis patients recruited.@*RESULT@#The most common inhaled allergens in allergic rhinitis patients in our area were house dust mite (76.83%), dermatophagoides farinae (75.50%), mugwort (10.50%), ragweed (7. 39%), fungus II (6.28%), fungus I (5.83%), spring-pollen I (4.44%), spring pollen II (3.72%), poly-animal hair (3.56%), poly-feather (1.89%). Moreover, the positivity frequencies of house dust mite and dermatophagoides farinae were decreased with age increasing.@*CONCLUSION@#House dust mite and dermatophagoides farinae were the most common allergens in allergic rhinitis patients in Jingmen area.

Ultimate cold preservation time in Ringer's solution for murine cardiac graft / 中国病理生理杂志

AIM: To determine the ultimate preservation time of murine cardiac grafts in 4℃ Ringer's solution. METHODS: Murine cardiac grafts were implanted to the abdominal vessels heterotopically 2, 4, 6, 8 and 10 hours after cold preservation. Graft survival rate and histological morphological changes, as well as the neutrilphil, T cell, macrophage infiltration, ICAM expression were determined by immunohistochemistry. RESULTS: The cardiac function-recovery rate and 1-week graft survival rate were 100% and 83.3% in 6-hour preservation group. Compared with non-preservation control group, no more apparent histological damages, cell infiltration and ICAM expression were found. CONCLUSION: The ultimate preservation time of murine cardiac graft in 4℃ Ringer's solution was 6 hours. [

In vitro perfusion method during cardiac graft preservation and its application in adenovirus mediated gene transfection / 中国病理生理杂志

AIM: To establish a method of in vitro donor heart perfusion in murine cardiac transplantation during preservation and apply it in adenovirus mediated gene transfection for donor heart. METHODS: Donor heart was transfected with recombinant adenovirus and stored for 2 hours after harvest, then it was transplanted heterotopically in abdomen. The grafts were appraisal by palpitation. Marked gene products were determined by X-Gal staining, aod T cell infiltration was determined by immunohistochemistry. The activation markers of recipients' lymphocytes were examed by cytometry. RESULTS: The grafts survival rate is 100% after perfusion and cold storage. The LacZ staining became strong 1 week after transplantation. The grafts remained an intact structure and no apparent T cell infiltration. The activation status of recipients' lymphocytes were not enhanced by transfected cardiac graft. CONCLUSION: In vitro perfusion during graft cold preservation is feasible for adenovirus mediated gene transfection. [

Investigation on Phthalates in Drinking Water of Nantong City / 环境与健康杂志

Objective To know phthalates(PAEs) pollution in drinking water of Nantong City. Methods With solid phase extraction and gas chromatography-mass spectroscope(GC-MS),main phthalates in drinking water were determined. Results Phthalates could be detected in all the source water, product water and tap water samples, mainly were di-n-butyl phthalate(DBP) and di(2-ethylhexyl) phthalate(DEHP),ranged from 1.25 to 4.59 ?g/L and from 0.97 to 3.57 ?g/L respectively. PAEs levels in product water were less than those in source water. The highest removal rate of DBP was 50%. PAEs levels in tap water were higher than those in product water,sometimes even higher than those in source water. Conclusion PAEs can not be effectively removed from source water after general water treatment process.