Clinical Efficacy of Modified Zengyetang Against Slow Transit Constipation Due to Qi-Yin Deficiency and Its Effect on Gastrointestinal Function / 中国实验方剂学杂志

Objective:To observe the clinical effect of modified Zengyetang in treating slow transit constipation （STC） due to Qi-Yin deficiency and its effect on gastrointestinal function. Method:One hundred and thirty eligible patients were randomly divided into a control group （<italic>n</italic>=65， 6 cases dropped out or were lost to follow-up and 59 completed the trial） and a treatment group （<italic>n</italic>=65， 3 cases dropped out or were lost to follow-up and 62 completed the trial）. Patients in the control group received oral mosapride citrate dispersible tablets， 5 mg per time， three times per day， while those in the treatment group were treated with modified Zengye Tang， one bag per day， for four successive weeks. The main symptom constipation， the Patient Assessment of Constipation Symptoms （PAC-SYM）， and traditional Chinese medicine （TCM） syndrome scores， colonic transit， as well as motilin （MTL）， vasoactive intestinal peptide （VIP）， and substance P （SP） levels before and after treatment were recorded， together with the frequency of spontaneous complete bowel movements （SCBMs） per week and STC recurrence during treatment. Result:The clinical efficacy （95.16%） of the treatment group was higher than that （81.36%） of the control group （<italic>χ</italic>²=5.631 4， <italic>P</italic><0.05）， whereas the recurrence rate （30.65%） of the treatment group was significantly lower than that （57.63%） of the control group （<italic>χ</italic>²=8.941 1， <italic>P</italic><0.01）. After treatment， the main symptom constipation， three sub-scale and total PAC-SYM， and TCM syndrome scores in the treatment group were obviously decreased as compared with those in the control group （<italic>P</italic><0.01）. The proportions of residual markers at 24， 48， and 72 h in the treatment group declined in contrast to those in the control group （<italic>P</italic><0.01）. The frequency of SCBMs per week in the 2^nd， 3^rd， and 4^th weeks of the treatment group was higher than that in the control group （<italic>P</italic><0.01）. Compared with the control group after treatment， the treatment group exhibited significantly elevated MTL and SP but lowered VIP （<italic>P</italic><0.01）. Conclusion:Modified Zengyetang relieves the clinical symptoms， regulates gastrointestinal hormone secretion， increases the frequency of SCBMs， enhances colonic transit， and decreases the recurrence of patients with STC due to Qi-Yin deficiency.

CT-based Rapid Triage of COVID-19 Patients: Risk Prediction and Progression Estimation of ICU Admission, Mechanical Ventilation, and Death of Hospitalized Patients

The wave of COVID-19 continues to overwhelm the medical resources, especially the stressed intensive care unit (ICU) capacity and the shortage of mechanical ventilation (MV). Here we performed CT-based analysis combined with electronic health records and clinical laboratory results on Cohort 1 (n = 1662 from 17 hospitals) with prognostic estimation for the rapid stratification of PCR confirmed COVID-19 patients. These models, validated on Cohort 2 (n = 700) and Cohort 3 (n = 662) constructed from 9 external hospitals, achieved satisfying performance for predicting ICU, MV and death of COVID-19 patients (AUROC 0.916, 0.919 and 0.853), even on events happened two days later after admission (AUROC 0.919, 0.943 and 0.856). Both clinical and image features showed complementary roles in events prediction and provided accurate estimates to the time of progression (p<.001). Our findings are valuable for delivering timely treatment and optimizing the use of medical resources in the pandemic of COVID-19.

Psychological morbidities and fatigue in patients with confirmed COVID-19 during disease outbreak: prevalence and associated biopsychosocial risk factors

ObjectiveThe coronavirus disease 2019 (COVID-19) - a novel and highly infectious pneumonia - has now spread across China and beyond for over four months. However, its psychological impact on patients is unclear. We aim to examine the prevalence and associated risk factors for psychological morbidities and fatigue in patients with confirmed COVID-19 infection. MethodsAmidst the disease outbreak, 41 out of 105 COVID-19 patients in a local designated hospital in China were successfully assessed using a constellation of psychometric questionnaires to determine their psychological morbidities and fatigue. Several potential biopsychosocial risk factors (including pre-existing disabilities, CT severity score of pneumonia, social support, coping strategies) were assessed through multivariable logistic regression analyses to clarify their association with mental health in patients. Results43.9% of 41 patients presented with impaired general mental health, 12.2% had post-traumatic stress disorder (PTSD) symptoms, 26.8% had anxiety and/or depression symptoms, and 53.6% had fatigue. We did not find any association between pneumonia severity and psychological morbidities or fatigue in COVID-19 patients. However, high perceived stigmatization was associated with an increased risk of impaired general mental health and high perceived social support was associated with decreased risk. Besides, negative coping inclination was associated with an increased risk of PTSD symptoms; high perceived social support was associated with a decreased risk of anxiety and/or depression symptoms. ConclusionsPsychological morbidities and chronic fatigue are common among COVID-19 patients. Negative coping inclination and being stigmatized are primary risk factors while perceived social support is the main protective factor.

Current Status of Etiology, Epidemiology, Clinical Manifestations and Imagings for COVID-19

Coronavirus disease 2019 (COVID-19) is a transmissible respiratory disease that was initially reported in Wuhan, China in December 2019. With the alarming levels of COVID-19 spread worldwide, the World Health Organization characterized COVID-19 as a pandemic. Over the past several months, chest CT has played a vital role in early identification, disease severity assessment, and dynamic disease course monitoring of COVID-19. The published data has enriched our knowledge on the etiology, epidemiology, clinical manifestations, and pathologic findings of COVID-19. Additionally, as the imaging spectrum of the disease continues to be defined, extrapulmonary infections or other complications will require further attention. This review aims to provide an updated framework and essential knowledge with which radiologists can better understand COVID-19.

Infection Control and Management Strategy for COVID-19 in the Radiology Department: Focusing on Experiences from China

Coronavirus disease 2019 (COVID-19) is a new infectious disease rapidly spreading around the world, raising global public health concerns. Radiological examinations play a crucial role in the early diagnosis and follow-up of COVID-19. Cross infection among patients and radiographers can occur in radiology departments due to the close and frequent contact of radiographers with confirmed or potentially infected patients in a relatively confined room during radiological workflow. This article outlines our experience in the emergency management procedure and infection control of the radiology department during the COVID-19 outbreak.

Tube Voltage, DNA Double-Strand Breaks, and Image Quality in Coronary CT Angiography

Objective@#To evaluate the effects of tube voltage on image quality in coronary CT angiography (CCTA), the estimated radiationdose, and DNA double-strand breaks (DSBs) in peripheral blood lymphocytes to optimize the use of CCTA in the era of lowradiation doses. @*Materials and Methods@#This study included 240 patients who were divided into 2 groups according to the DNA DSB analysismethods, i.e., immunofluorescence microscopy and flow cytometry. Each group was subdivided into 4 subgroups: thosereceiving CCTA only with different tube voltages of 120, 100, 80, or 70 kVp. Objective and subjective image quality wasevaluated by analysis of variance. Radiation dosages were also recorded and compared. @*Results@#There was no significant difference in demographic characteristics between the 2 groups and 4 subgroups in eachgroup (all p > 0.05). As tube voltage decreased, both image quality and radiation dose decreased gradually and significantly.After CCTA, γ-H2AX foci and mean fluorescence intensity in the 120-, 100-, 80-, and 70-kVp groups increased by 0.14, 0.09,0.07, and 0.06 foci per cell and 21.26, 9.13, 8.10, and 7.13 (all p 0.05). @*Conclusion@#The 100-kVp tube voltage may be optimal for CCTA when weighing DNA DSBs against the estimated radiationdose and image quality, with further reductions in tube voltage being unnecessary for CCTA.

Coronary Computed Tomography Angiography-Derived Fractional Flow Reserve in Patients with Anomalous Origin of the Right Coronary Artery from the Left Coronary Sinus

Progress of residual inflammatory cardiovascular risk / 医学研究生学报

Coronary artery disease (CAD) remains a leading cause of morbidity and mortality in the world. Although the comprehensive control of cardiovascular disease risk factors has achieved remarkable progress in recent years, the incidence of cardiovascular events is still high after the control of traditional risk factors such as low density lipoprotein cholesterol, blood pressure and blood glucose, collectively referred to as cardiovascular residual risk. Inflammation is a central driver of atherosclerosis and the ultimate rupture of plaque, as well as an important cause of residual cardiovascular risk. Therefore, this article reviews the formation, assessment and treatment of residual inflammatory cardiovascular risk.

Chest CT--The gatekeeper to COVID-19 / 医学研究生学报

In December 2019, an outbreak of pneumonia associated with a novel coronavirus (SARS-CoV-2）emerged in Wuhan and spread rapidly throughout China and beyond. As the first-line imaging modality, thin-section chest CT is easy to perform, fast, available. Combined with epidemiological history and clinical manifestations, positive CT findings can highly suggest the early diagnosis of Coronavirus Disease 2019 (COVID-19) with high sensitivity, so that timely isolation and intervention can be implemented for suspected and confirmed patients. CT can also help assess the disease severity, and surveil disease course, so as to guide clinical decision and provide prognostic information. This paper outlines the CT imaging features of COVID-19 and highlights the value of chest CT in its diagnosis and treatment with the reference to the official documents and latest researches.

Multiparametric Functional Magnetic Resonance Imaging for Evaluating Renal Allograft Injury

Kidney transplantation is the treatment of choice for patients with end-stage renal disease, as it extends survival and increases quality of life in these patients. However, chronic allograft injury continues to be a major problem, and leads to eventual graft loss. Early detection of allograft injury is essential for guiding appropriate intervention to delay or prevent irreversible damage. Several advanced MRI techniques can offer some important information regarding functional changes such as perfusion, diffusion, structural complexity, as well as oxygenation and fibrosis. This review highlights the potential of multiparametric MRI for noninvasive and comprehensive assessment of renal allograft injury.

Cardiac magnetic resonance for assessment of cardiac structure and function after renal transplantation in patients with end-stage renal disease / 医学研究生学报

Objective Few clinical studies have been reported on the reversibility of uremic cardiomyopathy (UC) after renal transplantation. This article aimed to investigate the cardiac structure and function of end-stage renal disease (ESRD) patients undergoing renal transplantation using cardiac magnetic resonance (CMR). Methods This study included 38 ESRD patients undergoing renal transplantation in the National Clinical Research Center for Kidney Diseases, General Hospital of Eastern Theater Command, from September 2015 to February 2017. All the patients received initial CMR examination at 1－2 days before renal transplantation and during the postoperative follow-up. At the median follow-up time of 3.5 (3.4-3.7), 7.0 (3.7-9.5) and 8.4 (7.1-12.7) months, we recorded the CMR parameters, including the left ventricular end-diastolic volume (LVEDV), end-systolic volume (LVESV), end-diastolic mass (LVEDM), end-systolic mass (LVESM), ejection fraction (LVEF), and native myocardial T1 relaxation time, and compared the parameters obtained before and after surgery. Results Twenty-five of the patients completed the postoperative follow-up, who averaged 27.5 years of age, with no history of diabetes mellitus or ischemic heart disease, and treated by dialysis for 1.7 (1.5-2.2) years. At 7.0 months after renal transplantation, as compared with the baseline, the patients showed significant decreases in the LVEDV ([96.7 ± 22.8] vs [83.4 ± 17.4] mL/m², P < 0.05), LVESV ([44.3 ± 14.8] vs [33.0 ± 10.9] mL/m², P < 0.05) and LVEDM ([67.1 ± 24.2] vs [59.0 ± 17.0] mL/m², P < 0.05), but an increase in the LVEF ([54.1 ± 10.6] % vs [60.9 ± 9.6] %, P < 0.01). The LVEDV and LVESV were also remarkably lower at 3.5 and 8.4 months than the baseline (P < 0.001), and so were the left ventricular at basal, mid, apical and global native T1 relaxation times at 3.5, 7.0 and 8.4 months (P < 0.05). Conclusion For young ESRD patients with no history of diabetes mellitus or ischemic heart disease and on short-term dialysis, left ventricular dilatation, systolic dysfunction and diffuse myocardial fibrosis are reversible after renal transplantation. Native T1 relaxation time can be used as a sensitive indicator to evaluate the degree of diffuse myocardial fibrosis in ESRD patients.

The new era of coronary CT angiography: From anatomy to function / 医学研究生学报

Coronary computed tomography (CCTA) has become an important modality in the evaluation of coronary artery disease (CAD). CCTA is able to evaluate beyond the lumen in characterizing and quantifying atherosclerotic plaques, including features of calcification and fat around lesions. Although CCTA has high negative predictive value to exclude obstructive CAD, it has low specificity in the diagnosis of ischemia-inducing lesions. Recent advances in CT technology have resulted in the development of multiple functional CT techniques to provide hemodynamic information, such as coronary transluminal attenuation gradient (TAG), CT-derived fractional flow reserve (CT-FFR), computational fluid dynamics (CFD) and CT perfusion (CTP). In this article, we provide a perspective on these cardiac CT techniques in the evaluation of CAD.

Functional Evaluation of Transplanted Kidneys with Reduced Field-of-View Diffusion-Weighted Imaging at 3T

OBJECTIVE: To determine the feasibility of reduced field-of-view diffusion-weighted imaging (rFOV DWI) with multi-b values to detect functional variability in transplanted kidneys. MATERIALS AND METHODS: Using a 3T MRI scanner, multi-b rFOV DWI of transplanted kidney or native kidney was performed in 40 renal transplantation recipients and 18 healthy volunteers. The patients were stratified, according to an estimated glomerular filtration rate (eGFR): Group 1, eGFR ≥ 60 mL/min/1.73 m2; Group 2, eGFR ≥ 30 mL/min/1.73 m2 and < 60 mL/min/1.73 m2; Group 3, eGFR < 30 mL/min/1.73 m2. Total apparent diffusion coefficient (ADCT), perfusion-free ADC (ADCD) and perfusion fraction (FP) of kidneys were calculated and compared among the four groups. Correlations between the imaging results and eGFR were assessed. RESULTS: All volunteers had eGFR ≥ 60 mL/min/1.73 m2, while 16, 16, and 8 patients were included in Groups 1, 2, and 3, respectively. In the renal cortex, ADCT was higher in Group 1 ([1.65 ± 0.13] × 10−3 mm2/s) than Group 3 ([1.44 ± 0.11] × 10−3 mm2/s) (p < 0.05), and the inter-group differences of FP values were significant (all p < 0.05) (0.330 ± 0.024, 0.309 ± 0.019, 0.278 ± 0.033, and 0.250 ± 0.028 for control group, Groups 1, 2, and 3, respectively). Renal cortical ADCT, ADCD, FP, and renal medullary ADCT and FP correlated positively with eGFR (r = 0.596, 0.403, 0.711, 0.341, and 0.323, respectively; all p < 0.05). When using 0.278 as the cutoff value, renal cortical FP had a sensitivity of 97.1% and a specificity of 66.7% for predicting decreased renal function. CONCLUSION: Multi-b rFOV DWI presents transplanted kidneys with high resolution, which is a promising functional tool for non-invasively monitoring function of transplanted kidneys.

Effects of gonadotropin-releasing hormone analog treatment on glucose and lipid metabolism in girls with idiopathic central precocious puberty / 中华实用儿科临床杂志

Objective To assess the effects of gonadotropin-releasing hormone analog on glucose and lipid metabolism in girls with idiopathic central precocious puberty(ICPP).Methods A total of 26 girls (aged 6-8 years,breast stage B2) with ICPP were followed up in Department of Endocrinology,Shenzhen Children's Hospital from Jan.2008 to Jun.2011.Those girls received triptorelin therapy for 12 months.Before and the end of the 6th month,the 12th month of the treatment,body mass index(BMI) was calculated,fasting plasma glucose(FPG),fasting plasma insulin(FPI),total cholesterol,triacylglycerols,high density lipoprotein cholesterol,low density lipoprotein cholesterol,apolipoprotein A,apolipoprotein B and estradiol(E2) were measured.Insulin sensitivity was estimated by homeostasis model assessment of insulin resistance(HOMA-IR).Twenty age-matched prepuberty girls were set as controls.Results 1.Before treatment,BMI,FPG,FPI and HOMA-IR in ICPP girls had no significant difference compared with the controls.2.After 6 months treatment of triptrolin,serum E2 concentration in ICPP girls declined from(30.5 ± 9.8) ng/L at the beginning of treatment to (11.2 ± 4.6) ng/L at the end of 6th month (P ＜ 0.01) ; The end of 12 th month of the treatment,FPG and FPI had no significant difference compared with that before of the treatment,but BMI increased from(16.46 ± 1.10) kg/m2 to(18.35 ± 1.30) kg/m2,the difference was significant(P ＜0.05),HOMA-IR increased from 1.24 ±0.30 to 2.08 ±0.40,the difference was significant(P ＜0.05).3.Lipid metabolism parameters remained unchangeable after 12 months of triptrolin treatment.Conclusion Triptorelin may lead to raise of BMI and HOMA-IR in girls with ICPP at 12 months after treatment.

Clinical value of multi-detector computed tomography source image on detecting extracoronary abnormalities / 中华心血管病杂志

<p><b>OBJECTIVE</b>To assess the clinical value of multi-detector computed tomography (MDCT) source image on detecting extracoronary abnormalities in a large cohort of patients with suspected coronary artery disease (CAD).</p><p><b>METHOD</b>MDCT source images from 3240 consecutive patients (mean 64.5 years) with suspected CAD were reviewed retrospectively by 2 readers.Extra-coronary findings were classified according to involved organ and level of clinical significance.Following organs were examined:lungs, upper abdomen, spine, chest wall, mediastinum and vascularatures. Clinical relevance of extracoronary findings was considered as either "significant" or "non-significant"."Significant" findings were subclassified as score 1:findings necessitating immediate therapeutic actions, or score 2:findings with uncertain clinical or prognostic relevance, requiring clinical awareness, follow-up or further investigations (non-urgent)."Non-significant" findings were assigned to score 3:findings without clinical implication. The irrelevant incidental findings (e.g. spinal degenerative changes, aortic calcification) were not analyzed.</p><p><b>RESULTS</b>Extracoronary findings was evidenced in 330 patients with 424 abnormalities, 20.3% (67/330) patients had multiple lesions, 16.5% lesions were located in the lungs, 13.2% lesions found in the upper abdomen, 56.8% (241/424) lesions evidenced in the mediastinum,0.9% (4/424) lesions seen in the spine and chest wall, 13.9% (53/424) lesions were related to other vascular disease. Pleural effusion accounts for 5.5% of the mediastinum lesions.Incidence of heart cavity enlargement, heart valve disease, pericardial effusion/calcification, atrial/ventricular perfusion defects, myocardial disease, congenital heart disease, ventricular aneurysm was 14.7% (56/380), 15.5% (59/380), 10.8% (41/380), 3.9% (15/380), 0.8% (3/380), 1.6% (6/380), and 1.8% (7/380) respectively. The clinical significance score 1-3 was 8.5% (36/424) , 81.1% (344/424) , and 10.4% (44/424) respectively.Incidence of detected extracoronary findings was the highest by bone window and the lowest by lung window.Incidence of extracoronary findings was not related to CAD (χ2 = 81.76, C = 0.155, P > 0.05).Inter-reader agreement on extracoronary findings was excellent (Kappa = 0.934, P > 0.05).</p><p><b>CONCLUSION</b>Our data show that it is of clinical value to observe and report extracoronary findings with source image of cardiac MDCT.</p>

Effect of Oleic Acid on Differentiation of SW872 Preadipocytes / 实用儿科临床杂志

Objective To study the effect of oleic acid on the differentiation of SW872 preadipocytes.Methods SW872 prea-(dipocytes) were cultured and induced to differentiate by 0.6 mmol/L oleic acid in vitro.After 24 h,48 h and 72 h of differentiation,the morphological changes of SW872 preadipocytes were observed and the differentiation rate was assayed by oil-red O staining.In addition,triglyceride(TG) mass was detected by chemical colorimetry methods.During the differentiation of SW872 preadipocytes,transcription factors including peroxisome proliferator activated receptor-?_2(PPAR-?_2) and CAAT/enhancer binding protein-?(C/EBP-?)(mRNA) were also measured by reverse transcription-polymerase chain reaction(RT-PCR).Results 1.SW872 preadipocytes were fibroblastic and had no obvious fat droplet in cytoplasm.However,when stimulated for 72 hby 0.6 mmol/L oleic acid,SW872 preadipocytes became more bigger and rounder and differentiated into mature adipocytes with lots of fat droplets in the cells.2.Compared with that of predifferentiation,the concentration of TG mass increased by 14 folds after 72-hour differentiation(P

Gene Expression of Adiponectin Receptors during Diffe rentiation of SW872 Preadipocytes / 实用儿科临床杂志

Objective To explore genes expression of adiponectin receptors during differentiation of SW872 preadipocytes. Met-(hods) SW872 preadipocytes were cultured in vitro and induced to differentiate by 0.6 mmol/L oleic acid. During the progress of diffe-(rentiation), the morphological changes of SW872 cells were observed and the differentiation rate was assayed by oil-red O staining. Adiponectin receptors mRNA was measured by reverse transcription-polymerase chain reaction during differentiation of SW872 preadipocytes. Results 1.After stimulated by 0.6 mmol/L oleic acid for 72 hours, almost all SW872 cells were differentiated,and there were lots of fat droplets in the cells.2.There were adiponectin receptors genes expressions in SW872 preadipocytes.After 72 hours,and the levels of adiponectin receptor(AdipoR) 1 mRNA and AdipoR 2 mRNA were markedly increased up to 2.54 and 4.09 times,respectively. Conclusion There are AdipoR1 and AdipoR2 genes expressions in fat cells and the expressions are differentiation-dependent.

Recombinant human interleukin-6 inhibits mRNA expressions of adiponectin,its receptor 1 and adiponectin secretion in SW872 adipocytes / 中华内分泌代谢杂志

SW872 preadipocytes were cultured and induced to differentiate by oleic acid in vitro.The levels of adiponectin and its receptors (AdipoR1 and AdipoR2) mRNA were measured by semiquantitative RT- PCR.The concentration of adiponectin in the culture medium was assayed by ELISA.The results showed that rhIL- 6 could inhibit adiponectin,AdipoR1 mRNA expressions and adiponectin secretion in SW872 adipocytes in a time- and dose-dependent manner,but did not influence adipoR2 mRNA expression.

Gastrointestinal stromal tumors:imaging features with intraoperative and clinicopathological correlation / 中华放射学杂志

Objective To analyze imaging of gastrointestinal stromal tumors(GIST),and to compare their imaging features with operational and pathological findings.Methods Clinical,imaging,and pathological data of 20 patients with GIST were collected.Results Imaging findings were endophytic or exophytic tumors with heterogeneous density or signal intensity,corresponding to hemorrhage,necrosis,and cystic changes.Imaging was correct for the location of the lesion in 11 of 16 primary GIST and 4 cases of relapsed tumors.Preoperational CT did not detect mesenteric,peritoneal,and omental metastasis in 5 cases. Hepatic metastases detected at CT (3 cases )were identified by operational findings.Conclusions GIST has some imaging features.CT is a useful tool in detecting and characterizating of lesions rather than detecting mesenteric,peritoneal,and omental metastasis.

Effect of recombinant human interleukin-6 on the secretion of acylation-stimulating protein in SW872 adipocytes / 中华内分泌代谢杂志

SW872 cells were cultured in vitro with oleic acid and differentiated into mature adipocytes. The role of interleukin-6(IL-6)in the secretion of acylation-stimulating protein(ASP)in mature SW872 adipocytes was observed.The results suggested that IL-6 significantly inhibited ASP secretion into the media in a dose-and time-dependent manner in mature SW872 adipocytes.