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Objective:To investigate the diagnostic value of multi-slice spiral CT(MSCT)perfusion imaging parameters in the differential diagnosis of benign and malignant solitary pulmonary nodules(SPN).Methods:A total of 80 patients with SPN admitted to our hospital from Oct 2021 to Oct 2022 were selected.All patients underwent MSCT perfusion imaging and pathological examination after admission.According to the histopathological examination results,the patients were divided into benign nodule group and malignant nodule group.MSCT perfusion imaging parameters(blood volume,mean transit time,blood flow,surface permeability coefficient)of the two groups were compared.Receiver operating characteristic(ROC)curve was used to analyze the value of MSCT perfusion imaging parameters in the differential diagnosis of benign and malignant SPN.Results:Among the 80 patients with SPN,47 were diagnosed as malignant nodules and 33 as benign nodules by pathological examination.There was no significant difference in mean transit time between 2 groups(P＞0.05).The blood volume,blood flow and surface permeability coefficient in malignant nodule group were higher than those of benign nodule group(P＜0.05).The results of ROC curve showed that the area under the curve(AUC)of blood volume,blood flow and surface permeability coefficient separately and in combination were 0.823(95% CI:0.721-0.926),0.855(95% CI:0.761-0.949),0.850(95% CI:0.752-0.948)and 0.963(95% CI:0.924-1.000)for the diagnosis of benign and malignant SPN,all of which had certain diagnostic value.When blood volume,blood flow and surface permeability coefficient were 4.405 ml/100 g,51.325 ml/(min·100 g)and 21.115 ml/(min·100 g),respectively,the best diagnostic efficiency could be obtained,and the combined diagnosis value was higher.Conclusion:The combination of blood volume,blood flow and surface permeability coefficient of MSCT perfusion imaging parameters have high value in the differential diagnosis of benign and malignant SPN,which can provide effective basis for the early diagnosis and treatment of benign and malignant SPN.
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Objective:To investigate the epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with maintenance hemodialysis (MHD) in Jiangsu province during SARS-CoV-2 pandemic in China from December 7, 2022 to January 27, 2023, and to analyze the influencing factors of all-cause death.Methods:It was a multi-center cross-sectional investigation. Structured questionnaire was used to collect patient information by medical staff of each hemodialysis center (room) as investigators. Part of the demography data and laboratory examination data came from the Jiangsu Province Hemodialysis Data Information System. MHD patients from hemodialysis centers (rooms) at all levels of medical institutions and independent hemodialysis institutions in Jiangsu province during the outbreak of SARS-CoV-2 infection were included, and the clinical characteristics and all-cause mortality of confirmed and suspected cases of SARS-CoV-2 infection were analyzed.Results:Questionnaire surveys and data analysis on 57 278 patients in 407 hemodialysis centers (rooms) were completed, accounting for 90.41% of the total number of MHD patients (63 357 cases) in Jiangsu province during the same period. There were 24 038 cases (41.97%) of SARS-CoV-2 infection and 14 805 cases (25.85%) of suspected infection, which were widely distributed in all dialysis centers in Jiangsu province. After clinical classification of 38 843 confirmed and suspected SARS-CoV-2 infection cases, 3 662 cases were severe and critical cases, accounting for 9.43% of the infected and suspected cases. Among the patients who had completed the questionnaires, there were 1 812 all-cause deaths, with an all-cause mortality rate of 3.16%. Multivariate logistic regression analysis showed that elderly (taking ≤50 years as a reference, 51-59 years: OR=1.583, 95% CI 1.279-1.933, P=0.001; 60-69 years: OR=3.972, 95% CI 3.271-4.858, P<0.001; 70-79 years: OR=7.236, 95% CI 5.917-8.698, P<0.001; ≥80 years: OR=11.738, 95% CI 9.459-14.663, P<0.001), male ( OR=1.371, 95% CI 1.229-1.529, P<0.001), and co-infection with hepatitis B virus (HBV) (positive serum HBV surface antigen, OR=0.629, 95% CI 0.484-0.817, P<0.001) were independent influencing factors for all cause mortality. Receiver-operating characteristic curve analysis showed that the area under the curve for male, age and current HBV infection prediction of all-cause death was 0.529 ( P<0.001), 0.724 ( P<0.001) and 0.514 ( P=0.042), respectively, and the cut-off value for age prediction of all-cause death was 65.5 years old. Compared with patients without HBV infection, MHD patients with HBV infection significantly reduced the proportion of severe and critically ill patients, all-cause hospitalizations and all cause deaths when infected with SARS-CoV-2 (4.99% vs. 6.41%, χ2=6.136, P=0.013; 8.90% vs. 11.44%, χ2=11.662, P<0.001; 2.01% vs. 3.37%, χ2=10.713, P=0.001, respectively). Conclusion:The MHD patients in Jiangsu province are susceptible to SARS-CoV-2. Elderly age and male gender are independent risk factors for death in MHD patients during the epidemic, while the HBV infection may be a protective factor for death of MHD patients infected with SARS-CoV-2.
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Objective Toexploretheapplicationvalueofmulti-parametermagneticresonanceimaging(MP-MRI)inthediagnosis ofprostatecancer(PCa).Methods Theclinicaldataof50patientssuspectedasPCaandadmittedbetweenJanuary2017andJanuary 2018wereretrospectivelyanalyzed.Thepathologicalexaminationwasusedasthegoldstandard,andallpatientsunderwentMP-MRI. Theapplicationvalues(sensitivity,specificity,accuracy,positivepredictivevalue,andnegativepredictivevalue)ofMP-MRIwereevaluatedin thediagnosisofPCa.Results Amongsingleexaminationofeachsequence,thesensitivity,accuracyandnegativepredictivevalueof DWIwerehigher,whilethespecificityandpositivepredictivevalueofT2WIwerehigher.ThesensitivityofMP-MRIcombinationwas assameasthatofDWI,butthespecificity,accuracy,positivepredictivevalueandnegativepredictivevaluewerehigherthanthoseof anysingleexamination.PI-RADSscoresofthePCawerehigherthanthoseofthebenignprostatichyperplasiainT2WI,DWI,DCE-MRI and MP-MRIcombination(P＜0.05).TheADCvalueofthePCawaslowerthanthatofthebenignprostatichyperplasia(P＜0.05). Conclusion MP-MRIcombinationcanobtain moreeffectiveinformationforprostatediseases,andhashigherspecificity,accuracy, positivepredictivevalueandnegativepredictivevalueindiagnosingPCa.
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Objective To investigate the correlation between serum hepcidin level and iron, mineral metabolism in maintenance hemodialysis (MHD) patients. Methods Seventy-five MHD patients were selected. The serum hepcidin, serum iron and mineral metabolism indexes were detected by enzyme-linked immunosorbent double antibody sandwich method, and their correlation was analyzed. Results The level of serum hepcidin in 75 MHD patients was 87- 264 μg/L. The patients were divided into 3 groups according to serum hepcidin level. In group A, the serum hepcidin level of 26 cases was＜120 μg/L; in group B, the serum hepcidin level of 24 cases was 120- 200 μg/L; in group C, the serum hepcidin level of 25 cases was>200 μg/L. There were no significant differences in age, gender, albumin and serum calcium among 3 groups (P > 0.05). The levels of ferritin, transferrin saturation (TS), serum phosphorus and parathyroid hormone (PTH) increased in the 3 groups as the hepcidin level increased, while hemoglobin, serum iron, total iron binding capacity (TIBC), and 25 hydroxy vitamin D decreased significantly, and there were statistical differences (P＜0.05). The Pearson correlation analysis result showed that serum hepcidin was positively correlated with ferritin, PTH, serum phosphorus (r = 0.862, 0.536 and 0.320; P＜0.01); and serum hepcidin was negative correlation with serum iron, TIBC, hemoglobin, 25 hydroxy vitamin D (r=-0.358,-0.270,-0.284 and-0.614; P＜0.01); but there was no correlation between serum hepcidin and albumin and serum calcium (r=0.018 and-0.005, P＞0.05). Conclusions The serum hepcidin level in MHD patients is closely related to iron and mineral metabolism.
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The incidence of chronic kidney disease (CKD) gradually increased.With the decline of renal function,CKD patients gradually appear intractable hypertension,anemia,malnutrition,calcium and phosphorus metabolic disorders,micro-inflammatory State and other complications which can seriously affect the survival and prognosis.Among them,calcium and phosphorus metabolism disorders are more common complications,and can lead to high incidence of cardiovascular disease and increased mortality.Recent studies have shown that Klotho protein has anti-inflammatory,anti-oxidative stress,anti-apoptosis and antifibrosis effects.It can inhibit renal fibrosis and regulate calcium and phosphorus metabolism disorders in patients with CKD.This article reviews the regulatory role of Klotho protein in calcium and phosphorus metabolism.
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was nominated after the collection of the bamboo slips of medicine unearthed from the tomb of the Han Dynasty in Tiahui county, Chengdu of Sichuan Province. It is the special chapter on the therapeuticmethods of acupuncture, providing the valuable new historical evidences for the study on the inheritance and evolution of acupuncture in TCM. In the paper, using the cross-proof method among the unearthed literature, the inherited literatures and the unearthed relics, the ancient acupuncture techniques at the early Western Han Dynasty were explored. It was discovered that the manipulations of the different needling techniques, such as pulse needling and intermuscular needling, as well as the forms of the needling tools provided the evidences to the Nine Needles recorded in () and the archaeological discovery. There were many acupuncture prescriptions, reflecting the needling methods recorded in () and () as well as needling chart, the stone portrait of the Han Dynasty. The close combination between the acupuncture needling techniques and the pulse diagnosis indicates the theoretic essence of the meridian medicine at the ancient time.
Subject(s)
Acupuncture , History , Acupuncture Therapy , History, Ancient , Medicine, Chinese Traditional , Meridians , Records摘要
Objective To explore the impact of total parathyroidectomy(tPTX)on carotid-femoral pulse wave velocity(cfPWV)in hemodialysis patients. Methods A total of 35 patients undergoing hemodialysis with refractory secondary hyperparathyroidism and treated with tPTX were studied. Before tPTX and 1 year after the oper-ation,cfPWVwas measured and hepatic and renal function,serum calcium,serum phosphorus,intact parathyroid hormone and hemoglobin were measured. The impact of tPTX on cfPWV in hemodialysis patients was analyzed. Results Serum calcium,serum phosphorus and intact parathyroid hormone decreased(P < 0.01),while hemo-globin and serum albumin increased(P < 0.01)and cfPWV decreased 1 year after the operation,which showed statistical significance(P<0.01). The cfPWV of the patients with tPTX was still higher than that of healthy indi-viduals(P<0.01). Conclusion tPTX can effectively reduce cfPWV in hemodialysis patients with refractory sec-ondary hyperparathyroidism.
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Traditional knowledge digital Library (TKDL) is a mature database for protection of traditional knowledge from illicit aggression, and also used for searching and examining the novelty and inventive step of applied inventions. TKDL has the role of defensive protection on Indian traditional medicine through promoting legislation initiatively, signing TKDL access agreement with international intellectual property authorities, and establishing close cooperation with WIPO. TKDL is a typical and successful case. Based on the publication and promotion ways of traditional knowledge digital library and the actual national condition in China, this paper proposes several applicable ways for publication and promotion of traditional knowledge protection directory of traditional Chinese medicine database.
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To investigate the CT findings of thoracic sarcoidosis and improve the understanding and diagnostic level of the disease. Retrospective analysis of the pathology or clinical treatment were observed in 20 patients with thoracic sarcoidosis accorded with the diagnostic standard of CT performance. There were 15 cases confirmed by pathology and 5 cases verified after clinical treatment. There were hilar or mediastinal lymph nodes in 90% cas-es, pulmonary mainly nodules in 60% case, pulmonary fibrosis in 20% cases, bronchovascular bundle thickening in 15%cases, pleural effusion in 10% cases, interlobular septal thickening in 15% cases, ground-glass opacity in 10% cases and pulmonary consolidation in 5% cases. CT findings of thoracic sarcoidosis may help improve the rate of its diagnosis.
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The normative research on safeguarding intangible cultural heritage of traditional Chinese medicine is the important measure after building list and filing work of Convention of the protection of intangible cultural heritage of UNESCO, and also a strategy in accordance with the principle of the protection of traditional knowledge of traditional Chinese medicine.This article discussed the arrangement and standardization in the academic level of folk medicine technology teaching orally from generation to generation, to provide protection for the living inheritance of intangible cultural heritage of traditional Chinese medicine, and a pilot measure for the construction of intangible cultural heritage protection system.
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Objective To survey the current living situation, protection condition, suggestions and demands of protective items and inheritors of TCM intangible cultural heritage;To analyze existing problems and solutions of protection;To lay the foundation for further protection. Methods Survey was carried out through table investigation and meeting and convention from the aspects of item overview, situation of inheriting community, protection status, and demands and suggestions. Results TCM intangible cultural heritage is inherited through traditional teaching and learning between masters and apprentices, and family inheriting. Some inheriting communities are too small, and some inheritors are too old, which make the inheriting prospect quite gloomy. Protective levels of items of TCM intangible cultural heritage vary. Most items are protected by protective institutions, protective personnel, and learning-teaching sites. Some items are supported by protective fund;archive data about the items are filing;researches and work about propaganda and education are also carried out. Conclusion Protection of TCM intangible cultural heritage has made certain achievements. However, some problems about funds, inheriting, filing, training, and propagandizing should be solved.
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Objective To further explore the relationship of CEA in gastric cancer tissue expression and serum levels,and seek after the prediction effect of serum CEA in the peritoneal metastasis.Methods Retrospective analysis of 38 gastric cancer patients with peritoneal metastasis (group A) and 60 gastric cancer patients without peritoneal mnetastasis (group B),and analyze the first time in two groups of patients with preoperative serum CEA levels.The expression levels of CEA was examined by Immunohistochemistry method in primary tumors、negative margin and peritoneal metastases foci from group A and in primary tumors from group A,and the detection result of the statistical was analyzed.Results The expression of the first preoperative CEA serum levels in group A and group B was 73.68％ and 41.67％ respectively (x2 =9.604,P =0.002),and the two groups of patients with the first preoperative CEA serum levels was (74.00 + 6.00) ng/mL,(46.06 + 9.03) ng/mL,The two groups was statistically significant (t =4.715,P ＜0.01).In group A,the expression of CEA of primary tumors was higher than that of negative margins (x2 =29.587,P =0.000);the difference expression of CEA positive degree in gastric cancer primary tumors and negative margins was statistically significant(Z =-5.348,P =0.000).In peritoneal metastases foci the expression of CEA was 92.11％,that was 64.82％ in primary tumor(x2 =6.728,P =0.009);the difference expression of CEA positive degree in peritoneal metastases foci and primary tumors was statistically significant (Z =-5.397,P =0.017).In primary tumors,the expression of CEA in group A and group B was 68.42％ and 42.67％ respectively (x2 =4.450,P =0.035),the two groups of patients with the difference expression of CEA positive degree was statistically significant,the two groups was statistically significant(Z =-2.227,P =0.026).Conclusion Over expression of CEA might have a critical role in peritoneal metastases of gastric carcinoma.The differences of the expression of CEA in gastric cancer in different tissues may indicate the risk of gastric cancer peritoneal metastasis.
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Large number of TCM ancient books, the literature, has a long history and complicated contents, including the principles, methods, prescriptions, medicines and other various aspects. How to obtain and make use of knowledge in ancient books, we must establish a set of relatively precise knowledge and semantic relation networks. Knowledge yun performing reasonable rebuilding of TCM literature, containing much TCM knowledge and information, will be an important way for knowledge findings.
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Objective: To observe an abnormal expression of humoral immune response induced by memory B cells in tonsils and peripheral blood of patients with IgA nephropathy ( IgAN) , the variation of memory B cells after tonsillectomy , and to discover the role of tonsillectomy in IgAN .Methods: In the study , 28 patients were diagnosed as IgAN via renal biopsy , and 27 patients suffering from chronic ton-sillitis without nephritis and 10 normal human beings were selected as controls .The expression of memory B cells in the tonsils and peripheral blood was tested by flow cytometry , and the same method was used to test the variation of the expression of memory B cells in peripheral blood of patients with IgAN after tonsil -lectomy.Results:In this study , higher percentages of memory B cells were observed in tonsil and pe-ripheral blood of IgAN patients, which were 5.72%±5.26%, 4.92%±5.10%.After tonsillectomy, the percentage of memory B cells was 1 .10%±0 .65%, lower than that before tonsillectomy ( P <0.05).Meanwhile, in tonsils and peripheral blood , the percentage of memory B cells varied with the variation of the urinary findings of the IgAN patients .Conclusion:The percentage of memory B cell in tonsils and peripheral blood could predict disease progression of IgAN to a certain extent .
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Chinese medical thesaurus was constructed setting knowledge element as the core and knowledge classification as the basis. In making the full use of our previous traditional knowledge classification research on traditional knowledge protection of TCM, the ancient literature of TCM knowledge classification system was constructed. The construction of TCM ancient books thesaurus plays a vital role in ancient Chinese medicine resource description, intelligent retrieval and knowledge discovery. This article disscussed the necessity of constructing Chinese medical thesaurus and the problems need to pay attention to in the process of building from three points of the Chinese medical thesaurus construction idea, plan, and the relevant system construction.
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BACKGROUND:In total hip replacements, aseptic loosening of uncemented femoral hip prosthesis is the main reason for the failure of artificial hip replacement, the prerequisite of reducing aseptic loosening of prosthesis is to increase fil ing area of femoral prosthesis in femoral cavity. OBJECTIVE:To obtain the fil ing rate of customized femoral prosthesis in femoral cavity and verify the validity of the methods of CAD/CAM/Robotic integration and the robot grind. METHODIn this paper, the CT data of femur were used to reconstruct three-dimensional model of femoral cavity. According to this model, a custom uncemented femoral hip prosthesis was designed, then the model of this custom prosthesis was imported into the CAD/CAM/Robotic software to generate cut path. After the cut path was imported into the robotic control er, the custom prosthesis can be fabricated, then this custom prosthesis was inserted into the femoral cavity, and the fil ing result of the custom prosthesis in femoral cavity was analyzed. RESULTS AND CONCLUSION:The experiment results showed that the customized prosthesis in femoral cavity achieved good fil ing result, the structure of femoral cavity resisted the rotation of the customized prosthesis in femoral cavity, and the customized prosthesis obtained stable fixation in the femoral cavity.
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To study the initiatives and progress of African nations in promoting the development of traditional medicine to determine if these measures can be applied to the protection of traditional Chinese medicine knowledge. Information research methods were used to collect and analyze relevant literature. The development of African traditional medicine has been effectively promoted through various measures taken by African organizations and governments. In recent years, Africa has achieved remarkable results in promoting the development of traditional medicine. Many other countries will benefit from studying their examples and adopting similar measures.
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Objective To investigate the value of three-dimensional visualization system in the treatment of hilar cholangiocarcinoma.Methods The clinical data of 10 patients with hilar cholangiocarcinoma who were admitted to Chenggong Hospital of Xiamen University from January 2012 to September 2012 were retrospectively analyzed.The two-dimensional computed tomography images were converted to three-dimensional images with the three-dimensional visualization system,and then the volume of liver and tumor size,volume of liver to be resected,remnant liver volume were measured.Surgical procedure was planned based on the three-dimensional images,and the difference between the actual and planned surgical procedures was analyzed.The correlation between actual liver resection volume and predicted liver resection volume was analyzed by calculating the Pearson correlation coefficient.Results The mean liver volume,tumor size,predicted liver resection volume and remnant liver volume of the 10 patients detected by the three-dimensional visualization system were (1496 ± 162) ml,(67 ± 18) ml,(335 ± 241)ml and (1140 ± 197)ml,respectively.The average error rate of predicted liver resection volume was 6.4％.Surgical plan was made in accordance with the principle of curative hepatectomy,including 4 cases of left semihepatectomy,2 cases of right semihepatectomy,3 cases of partial liver resection and 1 case of palliative liver resection.The coincidence rate between the planned and actual surgical procedures was 9/10.R0 resection was performed on 7 patients,R1 resection on 1 patient and palliative resection on 2 patients.One patient received restrictive portal vein arterialization.Preoperative evaluation of the anatomy of blood vessels,bile ducts and tumors based on three-dimensional images was confirmed with operative findings.The accuracy of tumor typing by the three-dimensional visualization system was 8/10.The actual liver resection volume was (325 ± 258) ml,which was positively correlated with the predicted liver resection volume (r =0.902,P ＜ 0.05).Conclusion The three-dimensional visualization system is helpful in the treatment of hilar cholangiocarcinoma.
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Objective To determine the CT and MR findings of Madelung syndrome. MethodsFive cases of Madelung syndrome were collected in our hospital from February 2006 to June 2009, including 3 cases of typeⅠMadelung syndrome and 2 cases of typeⅡ Madelung syndrome. The 5 cases were all examined by CT, meanwhile 1 case by CT enhancement scanning and 2 cases by MR. The clinical characteristics and imaging manifestations were analyzed. Results CT and MR images in 3 patients of typeⅠMadelung syndrome displayed fat accumulation within the subcutaneous tissue of the upper trunk and deep layer tissue of neck. The diffuse masses were located around the neck, upper chest and shoulders, which were called horse collarandbuffalo humps. The other 2 cases of type Ⅱ Madelung syndrome displayed fat thickening within the subcutaneous tissue of the proximal extremities, anterior chest wall, showing special appearance of vigorous sailor. All the 5 patients showed fat deposit within the subcutaneous tissue of the anterior rectus abdominis, inguina and fat accumulation within the scrotum. CT showed proliferated fat at the subcutaneous tissue of the involved regions. The CT value of proliferated fat were between -30 and -70 HU. The proliferated fat tissue all could be displayed on MR T1WI,T2WI and T2WI fat suppression sequence, with typical hypointensity on T1WI and hyperintensity on T2WI, hypointensity on fat-suppression sequence and fibrous septation presenting among fat tissue. Conclusion Combination with the history of long-term alcohol abuse, the Madelung syndrome could be diagnosed by CT and MR, which had great value in the surgical planning for identifying the extent of disease.
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By reviewing the selection principle and evaluation criterion on the periodicals in the well-known evaluation and index system of China and abroad, the article provides both the related information for researchers to get a general idea of this system and the criterion for periodicals to join the system.