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PURPOSE: To investigate the findings of plain spectral computed tomography (CT) with multiparameter of early cerebral ischemia. PATIENTS AND METHODS: Thirty-three patients with suspected early cerebral ischemia who received a one-stop CT examination (plain scan with spectral CT imaging mode, CTP and CTA) of the brain were enrolled in this study. No clear lesion was observed in any patient on the plain CT. However, the CTA displayed evidence of vascular stenosis and the CTP displayed a corresponding low perfusion area consistent with early cerebral ischemia. Regions of interest were placed in the abnormal perfusion regions and the contralateral symmetric regions on plain CT. Then, the CT value of the monochromatic images (70âkV), the slope of the spectral HU curve, blood (iodine), iodine (water), and water (iodine) concentrations were measured. A paired t-test was performed for data comparison. The receiver operating characteristic curve was used to evaluate diagnostic performance. RESULTS: The CT values of the ischemic regions at 70âkeV, the spectral HU curve, water, and blood values of the ischemic measurements were slightly lower than those of the contralateral symmetric regions (Pâ<â.05). Monochromatic images at 70âkeV had the highest area under the curve value, and the sensitivity and specificity were 90.0% and 63.0%, respectively. CONCLUSION: The difference of monochromatic CT values, spectral HU curve, and basic material concentrations between the early cerebral ischemia region and the contralateral symmetric region on spectral CT imaging may provide a reference with the diagnosis of early cerebral ischemia.
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Isquemia Encefálica/diagnóstico por imagem , Infarto Cerebral/diagnóstico por imagem , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Tomografia Computadorizada por Raios XRESUMO
PURPOSE: The purpose of this study was to analyze the imaging findings and clinical features of intracal lymphoplasmacyte-rich meningioma. PATIENTS AND METHODS: The clinical, radiographic, and pathological data of 9 patients of lymphoplasmacyte-rich meningioma were analyzed retrospectively. RESULTS: All cases were solitary; 8 patients with headache, dizziness, and vomiting; 2 patients with vision loss and one with progressive hearing loss; and 4 cases of secondary anemia, 3 of them with secondary hyperplasia of polyclonal immunoglobulin. In the plain CT scan of 6 cases, all masses showed higher density and without clear boundary, and 5 masses accompany obvious peritumoral edema. In plain MRI scan, all of the tumors appeared with irregular shape and unclear boundaries, 8 of the masses with obvious peritumoral edema. Enhanced scan showed all cases were significantly enhanced and the meninges in 7 cases thicken irregularly and extensively. The pathology showed that the tumors were irregularly shaped with grayish red or grayish white cut surfaces. Histological examination showed that the tumors consisted of abundant and diverse cells and different numbers of spindle tumor cells, and meningeal epithelial cells in the background of abundant inflammatory cells could be seen. The 9 cases all had surgery; only 1 case of recurrence in the first year after the operation was noted in the follow-up over 1 to 4 years, and no recurrence could be found after the second surgery. CONCLUSION: Lymphoplasmacyte-rich meningioma is a seldom-seen subtype meningioma of WHO grade I, often accompanying anemia or polyclonal immunoglobulin hyperplasia, which can recover to normal state after removing the masses. The masses showed higher density and without clear boundary in plain CT scan, and most of the tumors appear with irregular shape, obvious edema, and significant enhancement in the MRI scan. The prognosis is favorable after surgical resection and the recurrence rate is low.
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Neoplasias Meníngeas/diagnóstico , Meningioma/diagnóstico , Adolescente , Adulto , Anemia/diagnóstico , Criança , Tontura/diagnóstico , Edema/diagnóstico , Feminino , Seguimentos , Cefaleia/diagnóstico , Humanos , Linfócitos/patologia , Imageamento por Ressonância Magnética/métodos , Masculino , Neoplasias Meníngeas/patologia , Neoplasias Meníngeas/cirurgia , Meningioma/patologia , Meningioma/cirurgia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Plasmócitos/patologia , Reoperação , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Vômito/diagnóstico , Adulto JovemRESUMO
ObjectiveTo analyze the equity of medical and health resource allocation in 12 cities of Inner Mongolia Autonomous Region and to provide policy suggestions for further optimizing the allocation of medical and health resources. MethodsBased on two dimensions of geography and population, a comprehensive evaluation of the equity of medical and health resource allocation was conducted using location entropy, health resource density index (HRDI), entropy-weighted TOPSIS method, and GIS spatial analysis. ResultsLocation entropy showed that the allocation of medical resources in each league city exceeded or approached 1 in the population dimension, but less than 1 in the geography dimension. HRDI revealed that the number of health institutions in Tongliao City was 8.3 times that of Alxa League; the number of beds, health technical personnel, practicing (assistant) physicians, and registered nurses in Wuhai City was 20.3 times, 18.2 times, 15.2 times, and 22.7 times that of Alxa League. The entropy-weighted TOPSIS method showed that the top three weighted indicators were registered nurses (24.14%), health technical personnel (22.63%), and practicing (assistant) physicians (21.13%). Allocation of medical resources in Hulunbuir City, Xilinguole League, and Alashan League was significantly inequitable; GIS spatial analysis showed that the equity of medical resource allocation exhibited a decreasing distribution pattern from the central region to the western and eastern regions. ConclusionThere is a significant disparity in the equity of medical and health resource allocation among various leagues and cities, with resource allocation in the population dimension being better than in the geographical dimension. Allocation of medical and health human resources should be strengthened.
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Objective The pathogenesis of acute mountain sickness(AMS)is still unclear.This study intends to continuously record the changes of physiological parameters of the Han population in the plain after high altitude exposure,and screen out the difference between AMS and high altitude acclimatization.Methods A total of 46 healthy Han people in the plain were recruited to establish a study cohort.The basic physiological and hematological parameters were measured at the time of in the plain(500 m above sea level,CQ),on the second day(LS1),the 23rd day(LS2),the 44th day(LS3)and the 65th day(LS4)after reaching the plateau.According to the 2018 version of the Louise Lake Acute Mountain Sickness Scoring System(LLS)scale score at LS2,they were divided into the AMS group and the non-AMS group,and the differences and continuous changes of parameters between groups were analyzed.Results At any time point,there was no significant difference in basic physiological and hematological parameters such as oxygen saturation,heart rate(HR),blood pressure(BP),red blood cell count(BRC),hemoglobin(Hb),and hematocrit(HCT)between the two groups(P>0.05).Among the blood biochemical parameters,only albumin(ALB)was statistically significant at the time of LS2 and LS3 between the AMS group and the non-AMS group(P<0.05),and the in-crease of ALB was significantly correlated with the decrease of AMS incidence(OR=0.676,95%CI:0.511-0.894,P=0.006).Conclusion Blood oxygen saturation,BRC,hemoglobin level Hb,Hb may have no predictive value for AMS,while ALB may be a good predictor for AMS,and its changes may play an important role in a-voiding AMS and promoting high altitude acclimatization.
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Objective To evaluate the implementation effect of the teaching of high-altitude military medical geography , and to provide guidance for the teaching reform of this curriculum . Methods A questionnaire survey was conducted on the curriculum of high-altitude military medical geography among 108 undergraduate students majoring in high-altitude medicine in 2011 class (5 years). The contents of the investigation included learning motivation, learning interest, learning outcome, curriculum contents, and practical teaching. SPSS 18.0 was used for the treatment of investigation results. Results Among the 103 students who participated in the questionnaire survey, 69 (67.0%) were interested in the curriculum itself and 77 (74.8%) were interested in the knowledge of high-altitude human geography. There was a lack of understanding of the importance of the curriculum and its impact on future work. The examination results showed that most students mastered the contents of this curriculum and the overall teaching goal was reached, with an excellent and good rate of 63.0%(68 students). Conclusion The curriculum construction should be combined with the requirements for the first job after graduation. The curriculum system should be further perfected and its contents should be optimized to give full play to its interdisciplinary characteristics. The contents of human geography can be added to stimulate students' learning enthusiasm.
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Objective To study the plasma biochemical indexes among the hypertension in Xining area.Methods According to diagnosis standard of hypertension,104 males who emigrated to Xining area were divided into hypertension group and control group,height,weight,blood routine,renal function,blood lipid of the two groups were measured.Results Among the 104 subjects, 17 cases were hypertensive patients,and other 87 cases were served as control group.The body weight,blood uric acid levels in hy-pertension group were significantly higher than those in the control group(P <0.05),the other indexes had no significant difference between two groups.Conclusion The uric acid may be a risk factor for hypertension people living in plateau area,and the mecha-nism need to be further studied.
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Objective To explore the MRI features of germ cell tumors in sellar regions for better developing clinical treatment plans.Methods The imaging and pathologic findings of 44 sellar germ cell tumors were retrospectively analyzed.Results There were 1 9 germinoma,most of which had clear boundaries,different extents of cystic necrosis and mild peritumoral edema.Lesions were significantly enhanced in contrast-enhanced MRI (CE-MRI).There were 8 cases with mature teratoma,most showed cystic-solid changes,presenting mixed-intensities on T1-weighted images and T2-weighted images.There were 1 1 malignant teratoma(im-mature teratoma and teratoma malformation ),however,there were more parenchymatous tissue in malignant teratoma than mature teratoma.Two yolk sac tumors showed uniform signals on T1-weighted images and T2-weighted images,significant enhancement on CE-MRI,and visibly higher AFP in serum.Two embryonal carcinomas had clear boundary,inhomogeneous intensities,visibly cyst-ic necrosis,median to servere peritumoral edema,the parenchyma showed significant enhancement in CE-MRI.The signals of two mixed germ cell tumors were not typical,which depended on the components within tumors.Conclusion The MRI features of germ cell tumors in sellar region are characteristic.
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There were a lot of differences between the American and Chinese medical education.Students in American should obtain bachelor's degree of humanities or science before reciveing medical doctor's degree at graduation.High altitude militray medicine is a characteristic discipline of the third military medical university,aming at training general doctors for the plateau.During the designing of high altitude militray medicine curriculum and its teaching process,we actively learned from the advanced experiences of American based on the reality,optimizd currulum,improved teaching methods,greatly cultivated the students' protential in order to increase the qualify of high altitude militray medicine personnel.
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OBJECTIVES: Nail has been a substitute DNA source for genotyping. To investigate the integrity and consistency of nail DNA amplification for biomarker study, nail clippings from 12 subjects were collected at monthly intervals. The possibility of longer amplification and existence of GAPDH RNA/protein, were also investigated with three nail samples. METHODS: Three primer sets were designed for quantitative amplification of nuclear and mitochondrial genes and analysis of their consistency. The mean threshold cycles in amplification of the target genes were compared to test the consistency of polymerase chain reaction (PCR) performance among individual factors including age groups, sex, family, the nail source, and by the size of the amplification segments. RESULTS: The amplification of the target genes from nail DNA showed similar integrity and consistency between the nail sources, and among the serial collections. However, nail DNA from those in their forties showed earlier threshold cycles in amplification than those in their teens or seventies. Mitochondrial DNA (mtDNA) showed better DNA integrity and consistency in amplification of all three targets than did nuclear DNA (nucDNA). Over 9 kb of mtDNA was successfully amplified, and nested quantitative PCR showed reliable copy numbers (%) between the two loci. Reverse transcription PCR for mRNA and immunoblotting for GAPDH protein successfully reflected their corresponding amounts. Regarding the existence of RNA and protein in nails, more effective extraction and detection methods need to be set up to validate the feasibility in biomarker study. CONCLUSIONS: Nail DNA might be a feasible intra-individual monitoring biomarker. Considering integrity and consistency in target amplification, mtDNA would be a better target for biomarker research than nucDNA.
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Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Etários , Biomarcadores/análise , DNA/análise , Primers do DNA , DNA Mitocondrial/análise , Estudos de Viabilidade , Amplificação de Genes , Unhas/química , Projetos PilotoRESUMO
AIM: To study the protective effects of HIF-1α gene transfection on hypoxic injury in human HepG2 cells. METHODS: After gene transfection, HepG2 cells were randomly divided into 4 groups: normoxia with Ad-GFP transfected group, normoxia with Ad-HIF-1 transfected group, hypoxia with Ad-GFP transfected group and hypoxia with Ad-HIF-1 transfected group. LDH leaking rate, cell viability, contents of NO and ROS, the iNOS activity were measured. RESULTS: High levels of HIF-1α mRNA and protein were detected in Ad-HIF transfected HepG2 cells. Cell viability was significantly lower in Ad-GFP transfected-hypoxia group than that in Ad-GFP transfected-normoxia group (P<0.05). No marked difference of cell viability was found between Ad-HIF transfected-hypoxia group and Ad-HIF transfected-normoxia group. ROS was significantly higher in Ad-GFP transfected-hypoxia group than that in Ad-GFP transfected-normoxia group (P<0.05), while no marked difference was found either between Ad-HIF transfected-hypoxia group and Ad-HIF transfected-normoxia group or between Ad-HIF transfected-hypoxia group and Ad-GFP transfected-hypoxia group. The content of NO and iNOS activity were significantly higher in Ad-HIF transfected-normoxia group and Ad-GFP transfected-hypoxia group than those in Ad-GFP transfected-normoxia group (P<0.05), no marked difference was found either between Ad-HIF transfected-hypoxia group and Ad-GFP transfected-hypoxia group or between Ad-HIF transfected-hypoxia group and Ad-HIF transfected-normoxia group. CONCLUSION: Higher HIF-1α expression is contributed to protective effects against hypoxic injury in HepG2 cells, the mechanisms of which may be correlated with promoting expression of gene regulated by HIF-1 and restraining over-expression of injure factors.
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Objective To observe the pituitary tumor transforming gene (PTTG), estradiol-stimulated protein 1 (ESP1) expressions in S, G 2/M phases in A549, SPC-A-1 cell lines. Methods The mammalian cells for cell cycle was synchronizated by thymidine, the total RNA in the S, G 2/M phases was collected, and the total RNA was observed by Real-time PCR. Results PTTG expression in A549 and SPC-A-1 cell lines was higher in S phase than that in G 2/M phase while no PTTG expression in MRC-5 cells in S, G 2/M phases. ESP1 expression in A549, SPC-A-1, MRC-5 cell lines was lower in S phase than that in G 2/M phase. Conclusion That no PTTG in S and G 2/M phases in the normal cell line and PTTG expression in the lung cancer cell line higher in S phase than that in G 2/M phase suggested that the aneuploidy may be caused by the overexpression of PTTG. ESP1 expression was lower in S phase than G 2/M phase in all of the three cell lines, suggesting that sister chromatids separation depend on the active ESP1.
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Objective To investigate effect of sodium cyanide(NaCN)at different concentrations on the mitochondrial respiratory oxygen consumption,the mitochondrial membrane potential(MMP)and activity of the complex Ⅳ of mitochondrial breath train in in vitro liver mitochondria from the rats exposed to simulated high altitude hypoxia,and to explore the characteristics of energy metabolism in the mitochondria from the rats subjected to cyanide poisoning during acute hypoxia exposure.Methods Adult Sprague-Dawley(SD)rats were set randomly into control and acute hypoxia groups(n=8 in each group).The acute hypoxic rats were exposed to simulate 5 000 m high altitude in a hypobaric chamber 23 h/d for 3 d.Rats in the control group were bred in the normoxia condition at the same time.The liver mitochondria were isolated by centrifugation.Mitochondrial oxidative respiratory consumption and activity of the complex Ⅳ was measured by Clark electrode after the treatment of NaCN at 0,0.01,0.1 and 0.25 mmol/L respectively,so as to calculate mitochondrial state 3 respiration(ST3),state 4 respiration(ST4),respiratory control rate(RCR),the rate of oxidative phosphorylation(OPR),and oxygen consumption rate of the complex Ⅳ.MMP was detected by Rhodamine 123 method at the above-mentioned concentrations of NaCN.Results NaCNat0.01,0.1and0.25mmol/Linhibited the mito-chondrial oxidative respiratory function,and decreased MMP significantly.The inhibitory effects of NaCN onenergy metabolism in mitochondria was in a dose-dependent manner.Compared with the treatment of NaCN atthe corresponding concentration in the control group,mitochondrial function in the acute hypoxia group was in-hibited more seriously.Conclusion Acute hypoxia exacerbates the inhibitory effects of sodium cyanide on en-ergy metabolism in rat liver mitochondria.Its mechanism might be relevant to the decoupling of oxidative phos-phorylation,functional down-regulation of complexⅣin respiratory chain and changes of the mitochondrialmembrane potential in liver mitochondria from rats exposed to acute hypoxia.