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This study summarizes the skills training work of the National College Students' Clinical Skills Competition for 9 consecutive years, and explores a set of teaching methods suitable for the standardized training of residents of anesthesiology. This method is applied to the clinical operation, professional theory, clinical thinking, humanistic care, doctor-patient communication and other aspects of the standardized training of residents. The results show that the teaching effect of all aspects of standardized training of residents is more practical and efficient, and residents can quickly master the basic operation skills of anesthesia in a short time, indicating that the training method of clinical skills competition of college students can be applied in the standardized training of anesthesia residents, which can effectively improve the training effect.
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Objective:To summarize our experience and outcomes of surgical repair of type Ⅱ right-sided aortic arch(RAA) with Kommerell's diverticulum(KD).Methods:From May 2010 to August 2020, a total of 13 patients with type Ⅱ RAA and KD underwent surgery at our center. Mean age was(50.46±10.31) years, 10 were male, and 3 were female. All patients had an aneurysmal KD and aberrant left subclavian artery(ALSA). Preoperative comorbidities included type B aortic dissection in 1 case, aortic arch pseudoaneurysm in 2 cases, and type B intramural hematoma in 2 cases, respectively. Eight(61.5%) patients underwent stented elephant trunk procedures under moderate hypothermic circulatory arrest combined with selective antegrade cerebral perfusion via median sternotomy, and all of them had ALSA reconstruction. Five(38.5%) patients underwent distal arch and descending thoracic aortic replacement through a right posterolateral thoracotomy, the ALSA was reconstructed or ligated in 1 each, and ALSA embolization was performed before surgery in the other 3 cases.Results:No operation deaths occurred. Recurrent laryngeal nerve injury occurred in 2 cases. There was 1(7.69%) in-hospital death. Follow-up was complete in 100 % at mean(5.28±3.84) years. No late death occurred. A persistent anastomotic leak of the proximal arch was detected in a patient who underwent stented elephant trunk procedure, but no aortic dilatation or tracheal and esophageal compression was observed during follow-up. Meanwhile, aortic events, limb ischemia, or symptoms of tracheal and esophageal compression were not observed in the remaining 11 patients.Conclusion:Surgical repair of type Ⅱ RAA with KD can achieve favorable early and midterm outcomes. Surgical strategies should be chosen based on the anatomy of the aorta and whether it is combined with compression symptoms.
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OBJECTIVE@#This study aimed to compare 9 perfluoroalkyl sulfonic acids (PFSA) with carbon chain lengths (C4-C12) to inhibit human placental 3β-hydroxysteroid dehydrogenase 1 (3β-HSD1), aromatase, and rat 3β-HSD4 activities.@*METHODS@#Human and rat placental 3β-HSDs activities were determined by converting pregnenolone to progesterone and progesterone secretion in JEG-3 cells was determined using HPLC/MS-MS, and human aromatase activity was determined by radioimmunoassay.@*RESULTS@#PFSA inhibited human 3β-HSD1 structure-dependently in the order: perfluorooctanesulfonic acid (PFOS, half-maximum inhibitory concentration, IC 50: 9.03 ± 4.83 μmol/L) > perfluorodecanesulfonic acid (PFDS, 42.52 ± 8.99 μmol/L) > perfluoroheptanesulfonic acid (PFHpS, 112.6 ± 29.39 μmol/L) > perfluorobutanesulfonic acid (PFBS) = perfluoropentanesulfonic acid (PFPS) = perfluorohexanesulfonic acid (PFHxS) = perfluorododecanesulfonic acid (PFDoS) (ineffective at 100 μmol/L). 6:2FTS (1H, 1H, 2H, 2H-perfluorooctanesulfonic acid) and 8:2FTS (1H, 1H, 2H, 2H-perfluorodecanesulfonic acid) did not inhibit human 3β-HSD1. PFOS and PFHpS are mixed inhibitors, whereas PFDS is a competitive inhibitor. Moreover, 1-10 μmol/L PFOS and PFDS significantly reduced progesterone biosynthesis in JEG-3 cells. Docking analysis revealed that PFSA binds to the steroid-binding site of human 3β-HSD1 in a carbon chain length-dependent manner. All 100 μmol/L PFSA solutions did not affect rat 3β-HSD4 and human placental aromatase activity.@*CONCLUSION@#Carbon chain length determines inhibitory potency of PFSA on human placental 3β-HSD1 in a V-shaped transition at PFOS (C8), with inhibitory potency of PFOS > PFDS > PFHpS > PFBS = PFPS = PFHxS = PFDoS = 6:2FTS = 8:2FTS.
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Humans , Pregnancy , Female , Rats , Animals , Placenta , Progesterone/pharmacology , Aromatase/pharmacology , Cell Line, Tumor , Fluorocarbons , Alkanesulfonic Acids , Structure-Activity Relationship , Hydroxysteroid Dehydrogenases/pharmacologyABSTRACT
BACKGROUNDHow well mouse models recapitulate the transcriptional profiles seen in humans remains debatable, with both conservation and diversity identified in various settings. The K18-hACE2 mouse model has been widely used for evaluation of new interventions for COVID-19. METHODHerein we use RNA-Seq data and bioinformatics approaches to compare the transcriptional responses in the SARS-CoV-2 infected lungs of K18-hACE2 mice with those seen in humans. RESULTSOverlap in differentially expressed genes was generally poor ({approx}20-30%), even when multiple studies were combined. The overlap was not substantially improved when a second mouse model was examined wherein hACE was expressed from the mouse ACE2 promoter. In contrast, analyses of immune signatures and inflammatory pathways illustrated highly significant concordances between the species. CONCLUSIONAs immunity and immunopathology are the focus of most studies, these hACE2 transgenic mouse models can thus be viewed as representative and relevant models of COVID-19.
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OBJECTIVE@#To detect the expression level of suppressors of cytokine signaling 3 (SOCS3) in acute lymphoblastic leukemia (ALL), and to observe the effect of over-expresson of SOCS3 in Jurkat cells on the cytotoxicity of NK cells.@*METHODS@#The expression levels of SOCS3 mRNA in peripheral blood mononuclear cells of 20 children with ALL and 20 healthy children (normal control group) were detected by RT-PCR. The peripheral blood NK cells from healthy subjects were selected by immunomagnetic technique, and the purity was detected by flow cytometry. SOCS3 was overexpressed in Jurkat cells infected with lentivirus vector, and SOCS3 mRNA expression was detected by RT-PCR after lentivirus infection. The NK cells were co-cultured with the infected Jurkat, and LDH release method was used to detect the cytotoxicity of NK cells on the infected Jurkat cells. The concentrations of TNF-α and IFN-γ were determined by ELISA. The expression of NKG2D ligands MICA and MICB on the surface of Jurkat cells were detected by flow cytometry. Western blot was used to detect the effect of SOCS3 overexpression on STAT3 phosphorylation in Jurkat cells.@*RESULTS@#Compared with the control group, the mRNA expression of SOCS3 in the peripheral blood mononucleated cells of ALL children was significantly decreased. The purity of NK cells isolated by flow cytometry could reach more than 70%. The expression of SOCS3 mRNA in Jurkat cells increased significantly after lentivirus infection. Overexpression of SOCS3 in Jurkat cells significantly promoted the killing ability of NK cells and up-regulated the secretion of TNF-α and IFN-γ from NK cells. The results of flow cytometry showed that the expression of NKG2D ligands MICA and MICB on Jurkat cells increased significantly after SOCS3 overexpression. Western blot results showed that overexpression of SOCS3 significantly reduced the phosphorylation level of STAT3 protein in Jurkat cells.@*CONCLUSION@#SOCS3 mRNA expression was significantly decreased in ALL patients, and overexpression of SOCS3 may up-regulate the expression of MICA and MICB of NKG2D ligands on Jurkat cell surface through negative regulation of JAK/STAT signaling pathway, thereby promoting the cytotoxic function of NK cells.
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Child , Humans , Histocompatibility Antigens Class I/metabolism , Killer Cells, Natural/cytology , Leukocytes, Mononuclear/cytology , Ligands , NK Cell Lectin-Like Receptor Subfamily K/metabolism , Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics , RNA, Messenger/genetics , Suppressor of Cytokine Signaling 3 Protein/metabolism , Tumor Necrosis Factor-alpha/metabolismABSTRACT
Human ACE2 (hACE2) is the key cell attachment and entry receptor for SARS-CoV-2, with the original SARS-CoV-2 isolates unable to use mouse ACE2 (mACE2). Herein we describe a new system for generating mouse-adapted SARS-CoV-2 in vitro by serial passaging virus in co-cultures of cell lines expressing hACE2 and mACE2. Mouse-adapted viruses emerged with up to five amino acid changes in the spike protein, all of which have been seen in human isolates. Mouse-adapted viruses replicated to high titers in C57BL/6J mouse lungs and nasal turbinates, and caused severe lung histopathology. One mouse-adapted virus was also able to replicate efficiently in ACE2-negative cell lines, with ACE2-independent entry by SARS-CoV-2 representing a new biology for SARS-CoV-2 that has potential widespread implications for disease and intervention development.
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Nitrogen and phosphorus are the leading causes of water eutrophication, and it is challenging to remove nitrogen and phosphorus effectively through a single water remediation method. In this study, an aerobic denitrifying bacterium (AD-19) isolated from eutrophic water was used to construct an immobilized biofilm and combined with Phoslock® to remove nitrogen and phosphorus from the water. The phosphorus control efficiency of Phoslock®, nitrogen removal performance of the denitrifying bacteria, and combined remediation performance for the eutrophic water were studied. The results demonstrated that the removal rate of PO43--P in the simulated eutrophic water reached 95% with a dosing ratio of 80 (mass ratio of Phoslock® to PO43--P), and phosphorus release from sediment was effectively inhibited at the same time. Strain AD-19, which was identified as Pseudomonas sp. Using the 16S rDNA method, had a good heterotrophic nitrification and aerobic denitrification ability, and more than 97% of the nitrogen was removed when NH4+-N or NO3--N was used as the nitrogen source. The feasibility of the combined remediation of the eutrophic water was demonstrated using a lake simulation device. Furthermore, this technique was used to restore a eutrophic pond in a park in Wuhan city. After 16 days of treatment, the water quality indices for nitrogen and phosphorus were improved from worse than Grade â ¤ to Grade â ¢ (GB 3838-2002, Ministry of Environmental Protection of China, 2002) and remained stable for more than 270 days, indicating that Phoslock® combined with the immobilized biofilm could quickly and effectively restore eutrophic water as well as maintain the water quality for long periods.
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Phosphorus , Water , Bacteria , China , Denitrification , Nitrification , Nitrogen , Phosphorus/analysisABSTRACT
SARS-CoV-2 uses the human ACE2 (hACE2) receptor for cell attachment and entry, with mouse ACE2 (mACE2) unable to support infection. Herein we describe an ACE2-lentivirus system and illustrate its utility for in vitro and in vivo SARS-CoV-2 infection models. Transduction of non-permissive cell lines with hACE2 imparted replication competence, and transduction with mACE2 containing N30D, N31K, F83Y and H353K substitutions, to match hACE2, rescued SARS-CoV-2 replication. Intranasal hACE2-lentivirus transduction of C57BL/6J mice permitted significant virus replication in lungs. RNA-Seq analyses illustrated that the model involves an acute inflammatory disease followed by resolution and tissue repair, with a transcriptomic profile similar to that seen in COVID-19 patients. Intranasal hACE2-lentivirus transduction of IFNAR-/- and IL-28RA-/- mice lungs was used to illustrate that loss of type I or III interferon responses have no significant effect on virus replication. However, their importance in driving inflammatory responses was illustrated by RNA-Seq analyses. We also demonstrate the utility of the hACE2-lentivirus transduction system for vaccine evaluation in C57BL/6J mice. The ACE2-lentivirus system thus has broad application in SARS-CoV-2 research, providing a tool for both mutagenesis studies and mouse model development. AUTHOR SUMMARYSARS-CoV-2 uses the human ACE2 (hACE2) receptor to infect cells, but cannot infect mice because the virus cannot bind mouse ACE2 (mACE2). We use an ACE2-lentivirus system in vitro to identify four key amino acids in mACE2 that explain why SARS-CoV-2 cannot infect mice. hACE2-lentivirus was used to express hACE2 in mouse lungs in vivo, with the inflammatory responses after SARS-CoV-2 infection similar to those seen in human COVID-19. Genetically modified mice were used to show that type I and III interferon signaling is required for the inflammatory responses. We also show that the hACE2-lentivirus mouse model can be used to test vaccines. Overall this paper demonstrates that our hACE2-lentivirus system has multiple applications in SARS-CoV-2 and COVID-19 research.
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Objective:To enable the low-seniority medical personnel having the ability of disposing of difficult airway properly by mastering the knowledge of basic airway management through Airway Management Simulation Training and using all kinds of airway treatment tools.Methods:The senior medical simulation training tutors were selected, and the Airway Management Simulation Training Project Team was formed to develop the training course. Through combination of video teaching and practice of simulated teaching forms, we taught 219 trainees the airway management training course. And the feasibility and effectiveness of the course were evaluated by KE's evaluation method.Results:The course of "oriental airway simulation training" was successfully developed, and the complete course package was delivered, including bilingual airway management trainee textbook, Airway Management Simulation Training tutor manual, standardized teaching video and so on. After this simulation training, students had a good grasp of airway management skills, and more than 90.86% of the students' skills assessment resulted in more than 80 points. The overall satisfaction of the students was more than 97%, and 99% participants said that the training helped them enhance their confidence in clinical treatment, and 98% participants said that the training should be promoted among medical staff.Conclusion:The course of "oriental airway simulation training" which is made up of the combination of airway technical training, correct clinical decision-making and reality simulation, has significantly improved the airway management skills, enhanced the self-confidence of low-seniority medical staffs and improved patients' safety.
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To observe therapeutic effect of levosimendan on acute heart failure (AHF) and its impact on cardiac function ,levels of brain natriuretic peptide (BNP) ,high sensitive C reactive protein (hsCRP) ,tumor necro‐sis factor (TNF)‐α and interleukin (IL)‐6. Methods :A total of 148 AHF patients treated in our hospital from Jan 2016 to Jan 2018 were randomly and equally divided into dobutamine group and levosimendan group ,both groups re‐ceived corresponding medication based on routine treatment for 21d.Cardiac function ,levels of plasma BNP ,serum hsCRP ,TNF‐α and IL‐6 ,6min walking distance (6MWD) before and after treatment ,total effective rate and inci‐dence of adverse reactions were observed and compared between two groups .Results :Total effective rate of levosi‐mendan group was significantly higher than that of dobutamine group (83. 78% vs.68.92%) , P=0.033. Compared with dobutamine group after treatment , there were significant rise in LVEF [ (49. 98 ± 3. 68 )% vs.(52.17 ± 3.82)%] ,stroke volume [SV ,(67. 52 ± 5. 79) ml vs.(69. 48 ± 5. 83) ml] and 6MWD [ (328.46 ± 31.62) m vs. (396.75 ± 31.89) m] ,and significant reductions in left ventricular end systolic dimension [ (54. 12 ± 8.64) mm vs. (51.31 ± 8.26) mm] ,left ventricular end diastolic dimension [(65.25 ± 8. 86) mm vs.(62.14 ± 8.57) mm] ,levels of plasma BNP [ (572.59 ± 89. 62) mg/ml vs .(351.78 ± 81. 41) mg/ml] ,serum TNF‐α [ (24. 68 ± 5.83) ng/L vs. (21.05 ± 5. 39) ng/L] ,IL‐6 [(21.36 ± 4. 51) ng/L vs.(18.29 ± 4.34) ng/L] and hsCRP [(4. 89 ± 2. 15) ng/L vs. (3. 06 ± 1.47) ng/L] in levosimendan group , P<0. 05 or <0. 01. There was no significant difference in incidence rate of adverse reactions during treatment between two groups , P=0.690. Conclusion :Compared with dobutamine , levosimendan possesses more significant therapeutic effect on AHF .It can more significantly improve cardiac func‐tion ,exercise capacity and reduce cytokine levels in these patients .
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Objective To determine whether thyroid hormone (TH) level could also be an independent and incremental predictor of adverse events in patients with hypertrophic cardiomyopathy (HCM).Methods A total of 982 consecutive patients with HCM at the National Center for Cardiovascular Diseases (China) from October 2009 to December 2013 were included in the present study,and followed up till the end of December 2016.The patients were divided into three groups according to the levels of free triiodothyronine (FT3):the group 1 (FT3≤4.28 pmol/L,n=335),the group 2 (FT3>4.28-<4.79 pmol/L,n=310),and the group 3 (FT34.79-6.30 pmol/L,n=337).Results After a follow-up period of (53.8 ± 14.1) months,39 patients (4.0%) either suffered death with all causes or received a cardiac transplantation (7.8%,2.9% and 1.2% of the patients in the group 1,group 2 and group 3,respectively).A multivariable Cox regression analysis revealed that FT3≤4.28 pmol/L was associated with a significantly higher risk of all-cause mortality or cardiac transplantation (HR 8.83,95% CI 1.115-69.905,P=0.039) in HCM patients.Conclusions Low levels of FT3 is a risk factor of adverse events for patients with HCM,indicting a role of FT3 as a marker for assessing the risk of long-term adverse events in these patients.
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The ischemic mitral regurgitation( IMR) is present in 20% to 30% of patients with old myocardial infarction. In patients with heart failure after myocardial infarction , the incidence of IMR is even as high as 50%.IMR has adverse effects on the prognosis of patients and is positively correlated with the degree of reflux , including increased risk of heart failure and mortality of cardiovascular disease.Patients with severe hemodynamic abnormalities, and in the case of have accepted the best drug treatment is still difficult to alleviate symptoms of heart failure , surgical treatment should be implemented.However, the surgical treatment strategy of IMR is still controversial, that is, for the moderate IMR, only the blood transport reconstruction is sufficient to restore the natural form of the valve, whether the valve operation needs to be performed simultaneously ; In the case of severe IMR, simultaneous valvular surgery has been agreed upon.The controversy is that the mitral valve repair(MVP) and mitral valve replacement(MVR) are both superior and inferior.The purpose of this paper is to review the literature on IMR sur-gery in order to help us understand this important question.
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Objective@#To determine the value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) on predicting the long-term outcome of patients with hypertrophic cardiomyopathy (HCM) .@*Methods@#NT-proBNP was measured in 831 consecutive patients with HCM at Fuwai Hospital from October 2009 to December 2013 and patients were followed up clinically for (53.3±15.4) months. Patients were divided into 3 groups according to NT-proBNP values: NT-proBNP<860 pmol/L (n=276) , 860 pmol/L≤NT-proBNP≤1 905 pmol/L (n=278) , NT-proBNP>1 905 pmol/L (n=277) . The related baseline data, laboratory examination and echocardiographic results were compared among groups. The primary endpoints of this study were all-cause mortality and cardiac transplantation. Cox proportional hazards model was used to estimate hazard ratio (HR) . Kaplan-Meier analysis was used to evaluate the survival status of patients among the 3 groups.@*Results@#During a median follow-up of (53.3±15.4) months, all-cause mortality or cardiac transplantation occurred in 37 patients (4.5%) , event rate was 1.4% (4/276) , 4.0% (11/278) and 7.9% (22/277) in patients with NT-proBNP<860 pmol/L, 860 pmol/L≤NT-proBNP≤1 905 pmol/L and NT-proBNP>1 905 pmol/L, respectively. Multivariable Cox regression analysis identified that age (HR 1.066, 95%CI 1.027-1.107) and NT-proBNP (HR 1.026, 95% CI 1.010-1.042) were independent predictors of all-cause mortality or cardiac transplantation. Among the 3 groups, the survival rate of the NT-proBNP<860 pmol/L group was the highest,and that of the NT-proBNP>1 905 pmol/L group was the lowest (P<0.01) .@*Conclusions@#The level of NT-proBNP provides clinically relevant information for long-term adverse events risk stratification in patients with HCM.
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Objective@#To analyze effects of cooperation between physicians in department of burn surgery and department of intensive care medicine on rescue and treatment of severe mass burn patients involved in August 2nd Kunshan factory aluminum dust explosion accident.@*Methods@#On August 2nd, 2014, 15 extremely severe burn patients involved in August 2nd Kunshan factory aluminum dust explosion accident were admitted to temporary burn treatment center established in Department of Critical Care Medicine of the Second Affiliated Hospital of Soochow University. The 15 patients were equally divided into 3 groups, with 5 patients in each group. Fifteen surgeons and 30 nurses from department of burn surgery and 15 physicians and 30 nurses from department of intensive care medicine from different hospitals in China were divided into 3 groups, with 5 physicians and 10 nurses from department of burn surgery and 5 physicians and 10 nurses from department of intensive care medicine in each group. Each group of physicians and nurses were responsible for treatment of 5 patients. Treatment of patients was leaded by surgeons from department of burn surgery, who were responsible for wound dealing and operation. Physicians from department of intensive care medicine were responsible for systemic treatment and adjustment of relevant equipment's parameters. Volume of fluid infusion and urine output in shock period, severe systemic complication during period of treatment, using time and kind of antibiotics, death in 1 month after admission, length of hospital stay, and survival of patients were monitored.@*Results@#Volume of fluid infusion of 15 extremely severe burn patients within the first 24 hours post injury was 10 360-17 162 (12 998±1 811) mL, including (1.62±0.23) mL·% total body surface area (TBSA)-1·kg-1 electrolyte and colloid and (2 850±232) mL glucose, with electrolyte and colloid ratio of (1.76±0.23)∶1.00. Volume of urine output within the first 24 hours post injury was (2 384±1 242) mL, with (99±52) mL in each hour. Volume of fluid infusion of 15 extremely severe burn patients within the second 24 hours post injury was 8 720-11 616 (9 406±1 277) mL, including (1.04±0.22) mL·%TBSA-1·kg-1 electrolyte and colloid and (2 910±187) mL glucose, with electrolyte and colloid ratio of (1.53±0.31)∶1.00. Volume of urine output within the second 24 hours post injury of patients was (2 299±1 362) mL , with (108±61) mL in each hour. One patient had pulmonary infection, and 7 patients had fungal infection, and no patient had gut microbiota dysbiosis. Patients were treated with combined 2 kinds of antibiotics for 21-85 (50±16) d. No patient died within 1 month after admission. The length of hospital stay was 53-132 (98±44) d. Ten patients survived finally.@*Conclusions@#After being treated by cooperation between physicians in department of burn surgery and department of intensive care medicine, severe mass burn patients involved in August 2nd Kunshan factory aluminum dust explosion accident had hemodynamic stability and could stably experience shock period, with less complication, shorter length of hospital stay, no death within 1 month after admission, more survived patients, which can provide reference for rescue and treatment of severe mass burn patients.
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Objective@#To investigate the clinical features and surgical treatment effect of patients with cardiac cavernous hemangioma.@*Methods@#Clinical data of 9 patients (5 male, aged from 4 to 53 years old) with cardiac cavernous hemangioma, who underwent surgical treatment from November 2002 to March 2015 and the diagnosis of cardiac cavernous hemangioma was confirmed by postoperative histological examination, were retrospectively analyzed. Effects of surgical treatment were analyzed.@*Results@#Four patients were asymptomatic (heart murmur presented in 3 patients during physical examination). Three patients presented with palpitation, chest distress, and short of breath. One patient presented with epigastric discomfort and another patient presented with intermittent fever for more than 10 months. ST and T wave changes of electrocardiogram were found in 2 patients, cardiac mass was detected in the right heart chamber in 5 patients by echocardiography, and no cardiac mass was detected the rest 4 patients. Cardiac masses were resected en bloc, then the adjacent tissues were repaired in 7 patients, and mass was partially resected due to the involvement with adjacent heart structure. No cardiac mass was found during operation in 1 case, impaired mitral valve structure was excised and postoperative pathologically confirmed as cardiac valve cavernous angioma on the excised mitral valve structure. No signs of recurrence or enlargement of cardiac cavernous hemangioma were found during the 11(10, 11)years follow up.@*Conclusions@#There is no specific clinical feature for patients with cardiac cavernous hemangioma. It is difficult to detect the cardiac valve cavernous angioma by echocardiography before surgery. Individualized surgical treatment is associated with good clinical outcome in this patient cohort. However, the clinical features and surgical treatment effect of patients with cardiac cavernous hemangioma still need to investigate in large sample trial.
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Objective To compare the diagnostic value of dual-phase 99Tcm-MIBI scintigraphy and color Doppler ultrasonography for localizing ectopic parathyroid lesions in patients with HPT secondary to chronic renal failure (CRF-HPT).Methods Medical records of 368 CRF-HPT patients (204 males,164 females,age range:12-76 years) from January 2011 to April 2015 were retrospectively analyzed.Pathological results was used as the gold standard for the diagnosis of HPT.The sensitivity and specificity of dualphase 99Tcm-MIBI scintigraphy and color Doppler ultrasonography for the diagnosis and localization of ectopic parathyroid lesions were studied and compared by x2 test.Results A total of 1 398 positive lesions were found in 356 patients by dual-phase 99Tcm-MIBI scintigraphy,and 54 ectopic lesions occupying 3.9%(54/1 398) of positive lesions were detected by delayed planar imaging or SPECT/CT fusion imaging in 45 patients.Most of them (n =53) were confirmed by pathology.While only 966 positive lesions were found in 254 patients and no ectopic lesions were identified by color Doppler ultrasonography.The diagnostic sensitivity and specificity of dual-phase 99Tcm-MIBI scintigraphy for CRF-HPT lesions were 97.2%(1 375/1 415) and 53.1%(26/49),respectively.The corresponding parameters of color Doppler ultrasonography were 66.4% (940/1 415) and 46.9% (23/49),respectively.The specificity of ectopic lesion localization by radionuclide imaging was 98.1% (53/54).The accuracy of dual-phase 99Tcm-MIBI scintigraphy was significantly higher than that of color Doppler ultrasound in lesion localization (x2 =20.8,P < 0.05).Conclusion Compared to color Doppler ultrasonography,99Tcm-MIBI scintigraphy is more sensitive in identifying the positive lesions and more specific in localizing the ectopic parathyroid lesions in patients with CRF-HPT.
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BACKGROUND: Cardiovascular disease (CVD) is a common problem of middle-aged and older adults. Increased arterial stiffness is a CVD risk factor. Whole-body vibration (WBV) is a simple and convenient exercise for middle-aged and older adults; however, there have been few studies investigating the effect of WBV on arterial stiffness. This study mainly investigated the effect of WBV on arterial stiffness in middle-aged and older adults. METHODS: A total of 38 (21 women and 17 men) middle-aged and elderly subjects (average age, 61.9 years) were randomly divided into the WBV group and the control group for a 3-month trial. The WBV group received an intervention of 30 Hz and 3.2 g WBV in a natural full standing posture at a sports center. The brachial-ankle pulse wave velocity (baPWV), a marker of systemic arterial stiffness, and blood pressure and heart rate were measured before and after the intervention. RESULTS: After 3 months, there were no significant changes in blood pressure or heart rate in both groups. However, the bilateral baPWV was significantly reduced in the WBV group (decreased by 0.65 m/second [P=0.014]; 0.63 m/second [P=0.041] in either side), but not in the control group. The comparison between the two groups was not statistically significant. CONCLUSION: This study found that 3 months of WBV had a positive effect on arterial stiffness in middle-aged and older adults and could therefore be regarded as a supplementary exercise. Larger-scale studies are needed to confirm the effects of WBV in the future.
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Vascular Stiffness , Vibration/therapeutic use , Blood Pressure , Female , Heart Rate , Humans , Male , Middle Aged , Vascular Stiffness/physiologyABSTRACT
OBJECTIVES: To examine the screening methods for mycobacteria recommended by the China Anti-tuberculosis Association, in order to increase laboratory diagnostic accuracy for mycobacterial screening. METHODS: Using P-nitrobenzoic acid (PNB 0.5 g/L) as the control group, and hydroxylamine hydrochloride (HA, in 125, 150 and 175 mg/L concentrations) as the study group, laboratory preserved strains of H37Rv M.tuberculosis, and standard and clinically isolated strains of M.nontuberculosis (NTM) from Guangzhou Chest Hospital were tested for both PNB and HA sensitivity. Differences between groups were analyzed by χ(2) test. RESULTS: Among the 2529 MTB strains, the resistance rate to PNB was 3.0% (76/2529), to HA was 12.2% (308/2529), 4.8% (121/2529), and 0.9% (23/2529), respectively, corresponding to the aforementioned 3 different concentrations of HA. Among the 1766 NTM strains, the sensitive rate to PNB was 8.3% (147/1766), to HA was 0.1% (2/1766), 0.5% (9/1766), and 0.9% (16/1766), respectively, corresponding to the aforementioned 3 different concentrations of HA. There was significant difference (χ(2) = 5.44-83.50, P < 0.05). CONCLUSION: HA at 175 mg/L concentration was the optimal condition for laboratory tuberculosis preliminary screening.
Subject(s)
Hydroxylamine/pharmacology , Mycobacterium/isolation & purification , Nitrobenzoates/pharmacology , Culture Media , Drug Resistance, Bacterial , Humans , Microbial Sensitivity Tests , Mycobacterium/classification , Mycobacterium/drug effects , Mycobacterium tuberculosis/classification , Mycobacterium tuberculosis/drug effects , Mycobacterium tuberculosis/isolation & purification , Nontuberculous Mycobacteria/classification , Nontuberculous Mycobacteria/drug effects , Nontuberculous Mycobacteria/isolation & purificationABSTRACT
Objective Explore the safe nursing method of the plasma infusion for patients with extraordinarily severe burn in shock stage,ensure patients inputing plasma safely and timely,tide over shockstage smoothly.Method 68 patients with severe burn shock stage were randomly divided into experimental group and control group,both with 34 cases?The experimental group input plasma take regular blood transfusion methods and special nursing care,control group take usual care only.Result to take special nursing care for patients with severe burn in shockstage inputing plasma can reduce the incidence of adverse transfusion reactions,tide over shockstage smoothly,improve cure rates and reduce mortality?
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This study was aimed to explore the correlation of mean platelet volume (MPV), fibrinogen (FIB) and blood rheology with the youth patients with cerebral infarction, so as to provide the basis for the clinical early diagnosis and treatment. The 109 patients with cerebral infarction aged between 18 - 45 were divided into three group: the large (> 10 cm(3)), middle (4 - 10 cm(3)) and small (< 4 cm(3)) area infarction; 30 healthy persons were served as control group. All the four groups were subjected to 16 examinations, such as MPV, FIB, and rheology (Lηb, Mηb, Hηb, ηp, Lηr, Mηr, Hηr, KVE, EAI, ERI, EDI, EEI, HCT, ESR). The results showed that all the MPV, FIB and rheology indexes of the different infarction groups were higher than those of healthy control group (P < 0.05). The MPV, FIB and rheology indexes in the large area infarction group were all higher than those in the small area infarction group (P < 0.05). The indexes of MPV, FIB and rheology in the various cerebral infarction area groups obviously decreased, but those did not reach to the level in the healthy control group (P < 0.05). The MPV, FIB content and rheology level correlated with infarction areas (r = 0.36, 0.29 and 0.48, respectively). It is concluded that the serious intensity of youth patients with cerebral infarction positively correlated with the levels of MPV, FIB and rheology indexes. Regular examination of above mentioned index may be useful to prevent youth patients from cerebral infraction.