Epidemiology and exposure management of rabies in Shanxi Province， 2011‒2022 / 上海预防医学

ObjectiveTo analyze the epidemiological features and influencing factors of rabies in Shanxi Province，and to provide evidence to further promote the elimination of rabies in Shanxi Province. MethodsThe incidence data of rabies in Shanxi from 2011 to 2022 were collected and subjected to descriptive analysis. ResultsFrom 2011 to 2022， a total of 348 rabies cases were reported in Shanxi Province， with an average annual incidence of 0.080 3/105. The incidence of rabies showed a downward trend overall. The highest incidence was in August. The cases were mainly farmers， mostly males， and most cases were reported between 50 and 69 years old. The data of cases showed that dogs were the main animals attacking human （93.96%）. The incubation period of most cases was 1‒3 months （37.37%）.The main exposure site was hand（51.33%）. Only 2.66% cases with grade Ⅲ exposure were injected with passive immune agents. ConclusionThe incidence of rabies in Shanxi Province continues to decrease， but there are still loopholes in prevention and control measures. It is necessary to strengthen the management and immunization of dogs，health education， and standardized procedures after exposure to maintain the achievements in the prevention and control of rabies.

Anxiety and depression in primary and middle school students quarantined in hotels during the COVID-19 epidemic / 中国心理卫生杂志

Objective:To investigate symptoms of anxiety and depression among primary and middle school students quarantined in hotels during the COVID-19 epidemic.Methods:Anxiety and depression symptoms among 726 primary and middle school students quarantined in hotels were investigated with The Screen for Child Anxiety Related Emotional Disorders(SCARED)and Depression Self-rating Scale for Children(DSRSC)from September to October 2022 in Chifeng City,Inner Mongolia Autonomous Region.There were 624 students completed investi-gation with response rate of 86％.The positive score of SCARED was ≥23 and DSRSC was ≥ 15.Results:The detection rates of anxiety and depression were 17.9％and 15.4％respectively.The detection rates of anxiety and depression were higherin middle school students than inprimary school students(Ps＜0.05).The scores of general-ized anxiety and social phobia factors were higher in female students than in male students(Ps＜0.05).The scores of dissociative anxiety factor and depression were higher in middle school students than in primary school students(Ps＜0.05).Conclusion:During the COVID-19 epidemic,middle school students quarantined in hotels are more likely to have anxiety and depression symptoms than primary school students,and female students are more likely to have anxiety symptoms than male students.

The effect of feeding methods on fecal metabolites of infants delivered by cesarean section based on non-targeted metabolomics / 中华实用儿科临床杂志

Objective:To explore the effect of breast feeding versus mixed feeding on fecal metabolites of infants delivered by cesarean section.Methods:This was a cross-sectional study.Fecal samples were collected from 23 healthy 1-month-old infants delivered by cesarean section from autumn 2021 and winter 2022 in two maternal and infant care facilities in the North and South of Xi′an city.The samples were divided into the breast feeding group (11 cases) and mixed feeding group (12 cases). Fecal metabolites were analyzed by the non-targeted metabolomic approach and gas chromatography-mass spectrometry coupling, and differentially expressed fecal metabolites between groups were screened using the non-parametric Mann- Whitney U test.Metabolic pathways enriched in them were further analyzed. Results:A total of 155 metabolites were characterized, including 57 sugars and sugar derivatives, 34 fatty acids, 25 organic acids, 22 amino acids, 8 esters, 4 nucleosides, 3 vitamins and 2 other substances.The relative contents of the differentially expressed fecal metabolites were measured, and it was found that some types of sugars and sugar derivatives were highly expressed in the fecal samples of breast feeding group, while amino acids, organic acids and fatty acids were highly expressed in those of the mixed feeding group.A total of 28 metabolic pathways enriched in differentially expressed fecal metabolites were obtained.Among them, alanine, aspartic acid and glutamic acid metabolism, valine, leucine and isoleucine metabolism, arginine metabolism and the tricarboxylic acid (TCA) cycle influenced infant health.Conclusions:Feeding methods have an effect on the fecal metabolites in infants delivered by cesarean section born infants, and mixed feeding may speed up the process of TCA cycle and amino acid metabolism in the intestine of infants delivered by cesarean section to a certain extent.

The effects of linalool on transient receptor potential vanilloid 1 pathway and its role in alleviating visceral hypersensitivity in rats with irritable bowel syndrome / 中华消化杂志

Objective:To observe the effects of linalool on central and alleviating peripheral nervous system through transient receptor potential vanilloid 1 (TRPV1) pathway and its role in alleviating visceral hypersensitivity in irritable bowel syndrome (IBS).Methods:Thirty-six female newborn Sprague-Dawley (SD) rat pups in specific pothogen free was selected, among which 30 rats were used for behavioral experiments and 6 rats for electrophysiological experiment. In behavioral experiments, 30 newborn SD rats were randomly divided into normal control group (0.2 mL 0.9% sodium chloride solution was injected into the colorectal), neonatal colonic inflammation (NCI) group (0.2 mL 0.5% acetic acid was injected into the colorectal), linalool 20, 50 and 100 mg/kg groups (after NCI model successfully established, the rat were gavaged with linalool 20, 50 or 100 mg/kg at 5 weeks old). At 6 weeks old, abdominal withdrawal reflex (AWR) and pressure value of pain threshold (inflation pressure value at AWR score of 3) was observed by colorectal distention test. One hour after behavioral experiments, the expression of TRPV1 at protein level in colonic mucosa and spinal cord of each group was detected by Western blotting and immunohistochemistry. In electrophysiological experiment, female SD rats aged 6 to 7 weeks were selected to make in vitro transverse sections of the spinal cord. Five to eight neurons were randomly selected from each rat for whole-cell patch-clamp recording. The effects of linalool, tetrodotoxin and anti capsaicinand on the spontaneous excitatory postsynaptic current (sEPSC) of substantiagelatinosa neurons was recorded. Independent sample t test and paired t test were used for statistical analysis. Results:The AWR score of rats in NCI group was higher than those in normal control group, linalool 20 mg/kg group, linalool 50 mg/kg group and linalool 100 mg/kg group at 40 mmHg (1 mmHg=0.133 kPa) pressure (2.5±0.2 vs. 1.0±0.3, 1.5±0.3, 1.5±0.2, and 1.5±0.2, respectively), at 60 mmHg pressure the AWR score was higher than those in normal control group, linalool 50 mg/kg group and linalool 100 mg/kg group (3.8±0.2 vs. 2.3±0.4, 2.3±0.5, and 2.0±0.3, respectively), and the differences were statistically significant ( t=4.39, 2.45, 3.16, 3.16, 3.31, 2.88 and 5.97; P=0.001, 0.034, 0.010, 0.010, 0.008, 0.028, and<0.001). The pain threshold of rats in NCI group was lower than those of normal control group, linalool 20 mg/kg group, linalool 50 mg/kg group and linalool 100 mg/kg group ((35.8±2.0) mmHg vs. (55.8±1.5), (49.2±2.4), (53.3±2.1), and (55.0±1.8) mmHg, respectively), and the differences were statistically significant ( t=-7.91, -4.28, -6.01, and -7.06; P<0.001, =0.002, <0.001, and <0.001). The results of Western blotting showed that the relative expression of TRPV1 at protein level in colorectal tissues of rats in NCI group was higher than those of normal control group, linalool 20 mg/kg group, linalool 50 mg/kg group and linalool 100 mg/kg group (0.86±0.03 vs. 0.32±0.03, 0.68±0.01, 0.45±0.03, and 0.56±0.02, respectively), and the relative expression of TRPV1 at protein level in spinal dorsal horn was higher than those of normal control group, linalool 20 mg/kg group, linalool 50 mg/kg group and linalool 100 mg/kg group (0.91±0.02 vs. 0.34±0.03, 0.72±0.03, 0.51±0.06, and 0.63±0.05), and the differences were statistically significant ( t=12.44, 5.14, 9.68, 7.69, 19.14, 5.13, 6.72, and 5.60; P<0.001, <0.001, <0.001, <0.001, <0.001, <0.001, =0.001, and <0.001). There were no statistically significant differences in the frequency and the outward current of sEPSC in neurons of same glial region among rats with 2 mmol/L linalool gavaged for 4 minutes, 0.5 μmol/L tetrodotoxin and 2 mmol/L linalool gavaged for 4 minutes ( n=5, (23.84±4.81) Hz vs. (20.54±5.71) Hz, (7.60±0.35) pA vs. (7.62±0.75) pA, both P>0.05). The frequency of sEPSC administered with 2 mmol/L linalool gavaged for 4 minutes was higher than that of neurons in the same glial area administered with 10 μmol/L capsazepine and 2 mmol/L linalool gavaged for 4 minutes ( n=5, (20.17±2.55) Hz vs.(14.09±2.98) Hz), and the difference was statistically significant ( t=3.58, P=0.021); however there was no statistically significant difference in the outward current ((7.42±0.78) pA vs. (7.03±1.32) pA, P>0.05). Conclusion:Linalool can relieve visceral hypersensitivity in IBS partially through TRPV1 pathway, which may be related to the hyperpolarization of the membrane potential of neurons in glial region.

Efficacy of theta burst stimulation in treatment of stroke-related insomnia / 中风与神经疾病杂志

@#Objective To investigate the therapeutic effect of continuous theta burst stimulation (cTBS) for stroke-related insomnia. Methods Sixty patients with subacute cerebral infarction were evaluated for sleep disorders using the Pittsburgh Sleep Quality Index (PSQI,global score>7 indicating sleep disturbances). They were divided randomly into drug therapy group and combined treatment group. The drug treatment group was given zolpidem 10 mg orally,and the combined treatment group was given oral zolpidem 5 mg plus cTBS to the right dorsolateral prefrontal lobe and parieto-occipital region. The efficacy of cTBS for stroke-related insomnia was determined by comparing the two groups in terms of time to zolpidem withdrawal,zolpidem withdrawal rate within two weeks,PSQI score reduction rate,and the changes of National Institutes of Health Stroke Scale (NIHSS) score,Hamilton Depression Scale (HAMD) score,and Hamilton Anxiety Scale (HAMA) score. Results Compared with the drug treatment group,the combined treatment group showed a significantly shorter time to zolpidem withdrawal and a significantly higher zolpidem withdrawal rate within two weeks(P<0.05). For both groups,NIHSS,HAMD,and HAMA scores improved with the course of treatment,without significant differences between the two groups at the same follow-up time. However,the interaction P-value was statistically significant,which indicated that HAMD and HAMA scores of the two groups would differ over time. Conclusion cTBS has significant benefits in the treatment of stroke-related insomnia,moderately improving patients'anxiety and depression.

Lung protective effect of driving pressure-guided lung protective ventilation strategy combined with pressure-controlled ventilation in elderly patients undergoing thoracoscopic radical resection of lung cancer / 肿瘤研究与临床

Objective:To investigate the lung protective effect of driving pressure-guided lung protective ventilation strategy (LPVS) combined with pressure-controlled ventilation (PCV) in elderly patients undergoing thoracoscopic radical resection of lung cancer.Methods:One hundred elderly patients scheduled for thoracoscopic radical resection of lung cancer from April 2021 to April 2022 in the Second Hospital of Shanxi Medical University were selected. Patients were aged 60-80 years old and American Society of Anesthesiologists (ASA) classification Ⅰ-Ⅱ. All patients were divided into 4 groups by using the random number table method, with 25 cases in each group. Group A received volume-controlled ventilation (VCV) + 5 cm H 2O (1 cm H 2O = 0.098 kPa) PEEP, group B received PCV+5 cm H 2O PEEP, group C received VCV+driving pressure-guided individualized PEEP, and group D received PCV+driving pressure-guided individualized PEEP. The arterial oxygen partial pressure (PaO 2) was recorded before one-lung ventilation (OLV) (T 0), 30 min after OLV (T 1) and 60 min after OLV (T 2). The serum concentrations of neutrophil elastase (NE) in radial artery blood samples of patients were measured at T 0 and 10 min after the end of OLV (T 3). The occurrence of postoperative pulmonary complications (PPC) within 5 d after surgery was recorded. Results:The PaO 2 of group A and B at T 1 [(135±50), (146±51) mmHg (1 mmHg = 0.133 kPa)] and T 2 [(137±46), (143±47) mmHg] were lower than those of group C and group D at T 1 [(168±27), (190±30) mmHg] and T 2 [(180±30), (183±24) mmHg] (all P < 0.05). The incidence of PPC within 5 d after surgery in group A was higher than that in group D [36% (9/25) vs. 4% (1/25)] ( P = 0.005). The concentration of NE at T 3 in group A [(202.8±9.7) ng/ml] was lower than that in group B, C and D [(182.5±12.0), (180.0±10.3), (160.6±13.0) ng/ml] ( P < 0.05). Conclusions:During OLV, driving pressure-guided LPVS combined with PCV can not only improve oxygenation, but also show obvious advantages in reducing inflammatory response. It is a safe and effective intraoperative ventilation strategy for elderly patients undergoing thoracoscopic radical resection of lung cancer.

OCTN2 gene polymorphisms affect the chemotherapeutic sensitivity of oxaliplatin in colorectal cancer / 中国临床药理学与治疗学

AIM: To explore the effect of OCTN2 gene polymorphism on the expression and function of OCTN2, as well as the sensitivity of SW480 cells to oxaliplatin. METHODS: Four mutations of OCTN2 (F17L, E317K, S467C and P478L) transfected cell lines were constructed. Real-time RT-PCR and Western blot were used to detect the levels of OCTN2 mRNA and protein. The content of oxaliplatin was detected by HPLC. MTS assay was used to detect cell viability. RESULTS: The expression level of all mutant OCTN2 mRNA and protein was not significantly different from that of wild-type OCTN2. Oxaliplatin uptake experiments showed that there was no significant difference in V

Study on the relationship between pre-pregnancy vitamin D level and pregnancy outcome in unexplained recurrent spontaneous abortion / 中国医师杂志

Objective:To investigate the pre-pregnancy vitamin D level and pregnancy outcome in patients with unexplained recurrent spontaneous abortion (URSA).Methods:A prospective study was performed in 4 534 patients with URSA from May 2017 to April 2019 at Shanghai First Maternity and Infant Health Hospital Affiliated to Tongji University. The serum Vitamin D levels was obtained before pregnancy. Pregnancy complications and newborns outcomes were recorded after pregnancy.Results:The serum vitamin D level of patients with URSA before pregnancy was (42.22±16.27)nmol/L, and the proportions of vitamin D deficiency, insufficiency and sufficiency were 72.3%, 24.0 %, and 3.7%, respectively. The Vitamin D level was positively correlated with age ( P<0.05); The age of vitamin D<50 nmol/L group was lower than that of vitamin D≥50 nmol/L group ( P<0.05); patients with vitamin D<50 nmol/L had higher proportion of spontaneous abortions ≥3 times than those with the vitamin D≥50 nmol/L ( P<0.05); The level of vitamin D was negatively correlated with the ratio of CD3 + CD4 + T cells in peripheral blood ( P<0.05); In multivariate logistic regression analysis, the final model adjusted for age, abortion frequency and season. The risk of pregnancy failure was increased in vitamin D <50 nmol/L group [30.6%(76/248) vs 17.9%(12/67), χ 2=3.67, P=0.02], OR=2.02(95% CI: 1.02-3.9); In the group of vitamin D<50 nmol/L before pregnancy, the risk of newborns entering NICU was increased, OR=3.16(95% CI: 1.15-8.65). Conclusions:Vitamin D deficiency is prevalent in URSA patients before pregnancy, which correlates with the times of previous spontaneous abortions and recurrent pregnancy failure. Vitamin D deficiency before pregnancy is one of the high-risk factors for URSA.

The COVID-19 Healthcare Personnel Study (CHPS): Overview, Methods and Preliminary Report

IntroductionThe COVID-19 Healthcare Personnel Study (CHPS) was designed to assess and mitigate adverse short and long-term physical and mental health impacts of the COVID-19 pandemic on New Yorks health care workforce. Here we report selected baseline results. MethodsOnline survey of New York State physicians, nurse practitioners and physician assistants registered with the New York State Department of Health. Survey-weighted descriptive results were analyzed using frequencies, proportions, and means, with 95% confidence intervals. Odds ratios were calculated for association using survey-weighted logistic regression. ResultsApproximately 51.5% (95% CI 49.1, 54.0) of the survey-weighted respondents reported having worked directly or in close physical contact with COVID-19 patients. Of those tested for COVID-19, 27.3% (95% CI 22.5, 32.2) were positive. Having symptoms consistent with COVID-19 was associated with reporting a subsequent positive COVID-19 test (OR=14.0, 95% CI 5.7, 34.7). Over half of the respondents, (57.6%) reported a negative impact of the COVID-19 efforts on their mental health. Respondents who indicated that they were redeployed or required to do different functions than usual in response to COVID-19 were more likely to report negative mental health impacts (OR=1.3, 95% CI 1.1, 1.6). ConclusionsAt the height of the COVID-19 pandemic in New York State in Spring 2020, more than half of physicians, nurse practitioners and physician assistants included in this study responded to the crisis, often at a cost to their physical and mental health and disruption to their lives.

The validity and reliability of the Chinese version of Connor Davidson Resilience Scale in schizophrenia / 中国实用护理杂志

Objective:To test the factor structure and psychometric properties of the Chinese version of the Connor Davidson Resilience Scale (CD-RISC) in schizophrenia patients. In order to provide resilience scale for schizophrenia patients in China.Methods:A convenient sampling method was used to select 503 inpatients with schizophrenia in Chifeng Anding hospital from December 2017 to December 2018. The Chinese version of CD-RISC was used to conduct a questionnaire survey. Data processing was performed using SPSS 23.0 statistical software and AMOS 24.0 software.Results:The item analysis showed that the Chinese version of CD-RISC could discriminate the high-score group from the low-score group ( P<0.01). Pearson correlation analysis and principal component analysis showed that the correlation between item 3 and the total amount was poor, and it was considered to be deleted. A total of 6 common factors were extracted from the revised exploratory factor analysis of the CD-RISC, and the cumulative variance contribution rate was 50.79%. The Cronbach α coefficient was 0.882, and the test-retest reliability was 0.912 after two weeks. Confirmatory factor analysis fitted index: χ2/ df was 1.057, RMSEA was 0.015, GFI was 0.926, CFI was 0.989, and IFI was 0.989. Conclusions:The revision 24-item CD-RISC has good psychometric properties, it could be used to assess resilience in Chinese patients with schizophrenia.

Reasons and endoscopic management for proximally migrated pancreatic stents / 中华消化内镜杂志

Objective:To explore the reasons of the proximal migration of pancreatic stents and the endoscopic management.Methods:From April 2007 to January 2015, of all 967 patients with biliopancreatic diseases implanted with pancreatic duct plastic stents at the First Affiliated Hospital of Nanchang University, proximal migration occurred in 10 cases. Migrated rates and endoscopic retrieval methods of pancreatic straight stents and single pigtail stents were compared.Results:Pancreatic straight stents showed a higher migration rate than those single pigtail ones [3.23% (7/217) VS 0.40% (3/750)]. For 3 migrated single pigtail pancreatic stents: 2 were directly removed with biopsy forceps. Another failed in retrieval, and the same stent then was implanted. There was no discomfort after the operation. For 7 migrated pancreatic straight stents: 2 were pulled out of duodenum papilla incision under wire-guided balloon and basket. Five others were pulled out of papilla under wire-guided balloon, and then the stents were removed by a snare.Conclusion:Pancreatic straight stents are more likely to migrate compared with single pigtail stents. Migrated pancreatic straight stents can be removed with wire-guided balloon or basket and snare, while migrated single pigtail stents can be directly retrieved with biopsy forceps.

Application of endoscopic ultrasonography guided reverse dissection for refractory benign esophageal stricture / 中华消化内镜杂志

Objective:To study the effect and safety of endoscopic ultrasonography guided reverse dissection for refractory benign esophageal stricture.Methods:Seventeen patients with refractory benign esophageal stricture were selected for endoscopic ultrasonography guided reverse dissection in Shunde Hospital, Southern Medical University from January 2016 to December 2019. The clinical data including operation success rate, complications and clinical efficacy were analyzed.Results:All 17 patients were successfully treated with endoscopic ultrasonography guided reverse dissection. The operating time was 38.82±24.27 minutes. No serious complications such as major bleeding, perforation, and infection were found during and after the operation. The follow-up time ranged from 3 to 44 months. Four patients had symptoms of dysphagia again at 3, 12, 18, and 26 months after operation, and re-examination of gastroscopy revealed recurrent esophageal stenosis. The rest of the patients did not re-stenosis until the last time of follow-up.Conclusion:Endoscopic ultrasonography guided reverse dissection is a safe and effective treatment for refractory benign esophageal stricture.

Role of pyroptosis in cardiovascular disease.

Cardiac function is determined by the dynamic equilibrium of various cell types and the extracellular matrix that composes the heart. Cardiovascular diseases (CVDs), especially atherosclerosis and myocardial infarction, are often accompanied by cell death and acute/chronic inflammatory reactions. Caspase-dependent pyroptosis is characterized by the activation of pathways leading to the activation of NOD-like receptors, especially the NLRP3 inflammasome and its downstream effector inflammatory factors interleukin (IL)-1ß and IL-18. Many studies in the past decade have investigated the role of pyroptosis in CVDs. The findings of these studies have led to the development of therapeutic approaches based on the regulation of pyroptosis, and some of these approaches are in clinical trials. This review summarizes the molecular mechanisms, regulation and cellular effects of pyroptosis briefly and then discusses the current pyroptosis studies in CVD research.

Value of three-dimensional multi-slice spiral computed tomography imaging in the diagnosis and activity evaluation of Crohn's disease / 中国医师杂志

Objective To evaluate the diagnostic value of three-dimensional multi-slice spiral computed tomography (CT) imaging in Crohn's disease(CD) of small intestine and its active and remission stages.Methods The clinical and CT data of 34 patients with Crohn's disease confirmed by digestive endoscopy were retrospectively analyzed.According to whether the lesions were active,the patients were divided into active group (25 cases) and remission group (9 cases).The difference of CT signs between the two groups was compared.Chi square test was used to evaluate the diagnostic efficiency of CT three-dimensional imaging for polyps and their activity evaluation of Crohn's disease.Results The incidences of intestinal wall stratification,moderate enhancement,severe enhancement,ulcer,cellulitis,lymph node enlargement and wood comb sign in active group were higher than those in remission group (x2 =20.193,9.018,4.986,3.947,9.551,4.986,6.766,4.986 respectively,P ＜ 0.05).The incidence of intestinal wall monolayer thickening,non-enhancement,mild enhancement and abdominal abscess in remission group was higher than that in active group,with significant difference (x2 =15.092,13.768,25.336,16.996,P ＜0.05).while there were no significant difference between the two groups in the incidence of pneumoperitoneum,intestinal stenosis and enlargement (P ＞ 0.05).Conclusions Spiral CT three-dimensional reconstruction imaging can show the intestinal wall thickening,intestinal lesions and parenteral complications of Crohn's disease comprehensively,carefully and intuitively,and play an important role in guiding clinical treatment by evaluating the active and remission stages of CD.

Estimates of influenza-associated excess mortality by three regression models in Shanxi Province during 2013-2017 / 中华预防医学杂志

Objective@#Using three models too estimate excess mortality associated with influenza of Shanxi Province during 2013-2017.@*Methods@#Mortality data and influenza surveillance data of 11 cities of Shanxi Province from the 2013-2014 through 2016-2017 were used to estimate influenza-associated all cause deaths, circulatory and respiratory deaths and respiratory deaths. Three models were used: (i) Serfling regression, (ii)Poisson regression, (iii)General line model.@*Results@#The total reported death cases of all cause were 157 733, annual death cases of all cause were 39 433, among these cases, male cases 93 831 (59.50%), cases above 65 years old 123 931 (78.57%). Annual influenza-associated excess mortality, for all causes, circulatory and respiratory deaths, respiratory deaths were 8.62 deaths per 100 000, 6.33 deaths per 100 000 and 0.68 deaths per 100 000 estimated by Serfling model, respectively; and 21.30 deaths per 100 000, 16.89 deaths per 100 000 and 2.14 deaths per 100 000 estimated by General line model, respectively; and 21.76 deaths per 100 000, 17.03 deaths per 100 000 and 2.05 deaths per 100 000, estimated by Poisson model, respectively. Influenza-related excess mortality was higher in people over 75 years old; influenza-associated excess mortalityfor all causes, circulatory and respiratory deaths, respiratory deaths were 259.67 deaths per 100 000, 229.90 deaths per 100 000 and 32.63 deaths per 100 000, estimated by GLM model, respectively; and 269.49 deaths per 100 000, 233.69 deaths per 100 000 and 31.27 deaths per 100 000, estimated by Poisson model,respectively.@*Conclusion@#Excess mortality associated with influenza mainly caused by A (H3N2), Influenza caused the most associated death amongold people.

Value of three-dimensional multi-slice spiral computed tomography imaging in the diagnosis and activity evaluation of Crohn's disease / 中国医师杂志

Objective@#To evaluate the diagnostic value of three-dimensional multi-slice spiral computed tomography (CT) imaging in Crohn's disease(CD) of small intestine and its active and remission stages.@*Methods@#The clinical and CT data of 34 patients with Crohn's disease confirmed by digestive endoscopy were retrospectively analyzed. According to whether the lesions were active, the patients were divided into active group (25 cases) and remission group (9 cases). The difference of CT signs between the two groups was compared. Chi square test was used to evaluate the diagnostic efficiency of CT three-dimensional imaging for polyps and their activity evaluation of Crohn's disease.@*Results@#The incidences of intestinal wall stratification, moderate enhancement, severe enhancement, ulcer, cellulitis, lymph node enlargement and wood comb sign in active group were higher than those in remission group (χ2=20.193, 9.018, 4.986, 3.947, 9.551, 4.986, 6.766, 4.986 respectively, P<0.05). The incidence of intestinal wall monolayer thickening, non-enhancement, mild enhancement and abdominal abscess in remission group was higher than that in active group, with significant difference (χ2=15.092, 13.768, 25.336, 16.996, P<0.05). while there were no significant difference between the two groups in the incidence of pneumoperitoneum, intestinal stenosis and enlargement (P>0.05).@*Conclusions@#Spiral CT three-dimensional reconstruction imaging can show the intestinal wall thickening, intestinal lesions and parenteral complications of Crohn's disease comprehensively, carefully and intuitively, and play an important role in guiding clinical treatment by evaluating the active and remission stages of CD.

Research progress of functional magnetic resonance imaging in radiation-induced brain injury after head and neck carcinoma radiotherapy / 中华放射肿瘤学杂志

Radiation?induced brain injury is a common adverse reaction to radiotherapy for head and neck carcinoma, and may develop into radiation?induced brain necrosis in some patients. The disease has a substantial impact on the quality of life and 5?year survival in patients. Early diagnosis and prevention are important for the clinical treatment of radiation?induced brain injury. On the other hand, recurrence and pseudoprogression as complications of malignant tumor radiotherapy are also key problems for clinical diagnosis and identification of radiation?induced brain injury. Magnetic resonance imaging ( MRI) , especially functional MRI, provides an important approach for basic and clinical studies of radiation?induced brain injury.

Evaluation of the value of resting state BOLD-fMRI in radiation-induced brain injury after nasopharyngeal carcinoma radiotherapy / 实用放射学杂志

Objective To analyze the value of resting state BOLD-fMRI in the early diagnosis of brain injury after nasopharyngeal carcinoma radiotherapy.Methods Four groups of nasopharyngeal carcinoma patients,including before radiotherapy group (G0),0-3 months after radiotherapy group (G1), 3-6 months after radiotherapy group (G2) and 6-9 months after radiotherapy group (G3),were underwent a resting state BOLD-fMRI scan, and Matlab software DPARSF tool was used to analyze and postprocess the data based on G1-G0,G2-G0,G3-G0,G2-G1,G3-G2 and G3-G1.Results Compared with the G0 group,the activity of bilateral hippocampus and temporal lobes was decreased in G1 and G2 groups,and the decreased degree in G2 group was smaller than that in G1 group.Compared with G1 group,brain metabolic activity increased in G2 and G3 group,but did not return to the initial level before radiotherapy.Conclusion Abnormal changes of resting state BOLD-fMRI have an important clinical significance in early diagnosis of radiation-induced brain injury after nasopharyngeal carcinoma radiotherapy.

A meta-analysis of diffusion tensor imaging for diagnosis of early radiation-induced brain injury / 中华放射肿瘤学杂志

Objective To analyze the diagnostic value of diffusion tensor imaging (DTI) for early radiation-induced brain injury.Methods We searched CNKI and PubMed and included articles according to the PRISMA statement.FA value, λ||, and λ丄 were pooled, and Forest plot generation, cumulative analysis, sensitivity analysis, and regression analysis were performed.We also used the funnel plot to analyze publication bias.Results A total 11 studies were included for meta-analysis.The results of FA value heterogeneity test were as follows:P=0.000, I2=93.6% in China;P=0.004, I2=82.2% in other countries and regions;P=0.000, I2=91.5% in all regions.The regression analysis of time-dose dependence and study design showed significant and non-significant associations, respectively, with the heterogeneity of these studies (adjusted P=0.026, P=0.005;adjusted P=0.859, P=0.908).The results of λ||and λ丄 heterogeneity tests were as follows:P=0.908, I2=0.0%;P=0.100, I2=56.6%.There was a sign of publication bias by Egger's test (coefficient:-6.26, 95%CI:-9.31 to-3.20, P=0.001) and Begg's test (P=0.004).Conclusions DTI-derived metrics are sensitive and reliable in the diagnosis of early radiation-induced brain injury.

Risk evaluation of endoscopic retrograde cholangiopancreatography for elder patients / 中华消化内镜杂志

Objective To evaluate the safety of endoscopic retrograde cholangiopancreatography (ERCP) for elder patients (age more than or equal to 80 years).Methods Data of 464 patients (age ≥ 80 years) who underwent ERCP procedures from June 2008 to June 2014 in the First Affiliated Hospital of Nanchang University were compared with those of patients less than or equal to 60 years old,randomly chosen at 1∶4,for comorbidity,feature of disease distribution,intraoperative situation and postoperative complications of ERCP.Results The comorbidity rates of coronary heart disease,hypertension,chronic pulmonary disease and type 2 diabetes in observation group were significantly higher than those in the control group(P＜0.05),but there was no significant difference between two groups regarding to the comorbidity rate of arrhythmia(P =0.111).The main feature of disease distribution in two groups was choledocholithiasis,but the rate of malignant tumor in observation group was higher than that in the control group(P＜0.05).The success rate of ERCP showed no significant difference in two groups (98.92％ VS 99.35％,P=0.358).There was no significant difference between the two groups in the complication rates of acute pancreatitis (4.96％ VS 3.18％,P =0.064),infection (0.43％ VS 0.54％,P =1.000) and hemorrhage (1.08％ VS 0.59％,P=0.259).However the rate of perforation in observation group was lower than that in the control group (0.43％ VS 0.05％,P =0.043).Conclusion ERCP is safe and effective for elder patients.