Virulence traits of avian pathogenic (APEC) and fecal (AFEC) E. coli isolated from broiler chickens in Algeria.

Avian pathogenic E. coli (APEC) is the etiologic agent of avian colibacillosis, the most common disease responsible for chicken morbidity in the world. Although multiple virulence-associated factors were identified, their prevalence in Algeria is still poorly known. In the present research, 92 avian pathogenic E. coli (APEC) isolates were recovered from broilers with clinical signs and lesions of colibacillosis. In addition, 32 E. coli isolates collected from feces of healthy birds (AFEC) were included for comparison. All isolates were investigated by PCR for the presence of a total of 11 virulence-associated genes described for avian pathogenic (iroN, ompT, hlyF, iss, iutA, and fimC) and diarrheagenic E. coli (eae, stx, elt/est, ipaH, and aggR). The sensitivity of 39 APEC isolates to 16 antibiotics was also determined using antimicrobial pretreated microplates. Here, we report that 98% of the examined isolates host at least one of the tested virulence factors. The most prevalent genes in APEC were iutA (90.6%), ompT (86.9%), and iss (85.8%); whereas, iutA (78.1%), fimC (78.1%), and iroN (68.7%) were the highest prevalent genes in AFEC. Our data showed that none of the AFEC isolates harbor any of the tested diarrheagenic genes. Moreover, only elt/est (5.4%), stx (2.1%), and ipaH (2.1%) genes were carried by APEC isolates. We further established that ceftazodime, ceftiofur, mequindox, amoxicillin/clavulanic acid, and meropenem were the most efficient antibiotics against the analyzed APEC isolates. Overall, our findings provide more insights about APEC and AFEC virulence potential in Algeria which could participate in the fight against colibacillosis.

Dual-energy computed tomography angiography-based quantification of lesion net water uptake to identify stroke onset time.

Objectives: To explore whether dual-energy computed tomography (DECT) angiography can provide reliable quantitative information on net water uptake (NWU) of ischemic brain to identify stroke patients within 4.5 h. Methods: We retrospectively reviewed 142 patients with stroke occurrence and who underwent DECT angiography between August 2016 and May 2022. DECT angiography manual drawn the ischemic area by referring to the normal area of the contralateral hemisphere and follow-up images. The NWU in the ischemic area was determined using virtual non-contrast and monoenergetic (VNC &VM) images acquired from DECT angiography. The NWU values in the ischemic area were compared between stroke patients within and beyond 4.5 h. The diagnostic performance of the NWU values derived from the VNC and VM images was assessed through receiver operating characteristic curve analysis. Additionally, Furthermore, we examined the correlation between the NWU values and the stroke onset time. Results: Seventy-eight (54.93 %) stroke patients underwent DECT angiography and within 4.5 h. These patients with lower median National Institute of Health stroke scale (NIHSS) scores on admission than those beyond 4.5 h (p < 0.05). Furthermore, the group within 4.5 h had lower NWU values than did the group beyond 4.5 h on all VNC and VM images (p < 0.001). The analysis revealed that the NWU values determined using the VM (60 keV) images had the highest predictive efficiency (AUC, 0.95; sensitivity, 100 %; and specificity, 89.06 %) and showed the strongest positive correlation with stroke onset time (r-value = 0.58, p < 0.001). Conclusions: Our findings showed that DECT angiography-based quantification of NWU helps identify the stroke patients within 4.5 h with high predictive efficiency. Thus, NWU values determined using VM (60 keV) images could serve as a significant biomarker for stroke onset time.

CT images texture analysis versus clinical scores in predicting hemorrhagic transformation of acute ischemic stroke / 介入放射学杂志

Objective To assess the value of CT image texture features in predicting the occurrence of hemorrhagic transformation(HT)in ischemic stroke,and to compare it with the traditional clinical prediction scores.Methods A total of 73 patients with acute anterior circulation ischemic stroke were enrolled in this study.All patients received reperfusion treatment.The region of interesting(ROI)of the infarction area was outlined according to the diffusion restricted area displayed on the follow-up ADC images,which were matched to the corresponding ischemic region on computed tomographic angiography(CTA)and on plain CT scan(non-contrast CT,NCCT).Five patients with HT and 5 patients with non-HT were randomly selected and used as the test set,and the remaining patients were assigned to the train set.The 6 texture features that had the most predictive value were separately selected from the CTA sets and NCCT train set,then the training of classifiers was earried out by using the 5-fold cross-validation method.Finally,the test set was evaluated according to the trained classifier.Besides,the determination of four clinical scores(HAT,SEDAN,HIAT2,THRIVE-c)was performed for all patients in the train set.Results The trained classifiers model performed well in not only CTA but also NCCT.In the CTA prediction model,linear SVM was chosen as the final classifier with 0.816 validation accuracy and 0.890 AUC value;and with 0.800 test accuracy,0.600 sensitivity,and 1.000 specificity in external test set Logistic regression(LR)was the best-performing classifier in NCCT.The predicted performance of HT was slightly worse than that of CTA,which had 0.697 validation accuracy and 0.763 AUC value.The test set of NCCT achieved 0.700 accuracy with 0.600 sensitivity and 0.800 specificity.Compared to the texture analysis models,all the four clinical scores showed a modest prediction efficiency in HT and AUC values,which were no more than 0.700.Conclusion Texture analysis of cerebral ischemic area based on CT images(CTA and NCCT)has the ability to predict HT after reperfusion treatment in AIS patients,and it is superior to traditional clinical scoring methods.(J Intervent Radiol,2024,33:230-235)

Diffusion Kurtosis as an in vivo Imaging Marker of Early Radiation-Induced Changes in Radiation-Induced Temporal Lobe Necrosis in Nasopharyngeal Carcinoma Patients.

PURPOSE: Diffusion kurtosis imaging (DKI), an extension of the popular diffusion tensor imaging (DTI) model, has been applied in clinical studies of brain tissue changes. We explored the value of DKI for the early detection of radiation-induced changes in temporal lobe necrosis (TLN) after radiotherapy (RT) for nasopharyngeal carcinoma (NPC). METHODS: A total of 400 patients with NPC were retrospectively enrolled; all participants underwent MRI scans 0-7 days before RT, at 4 weeks during RT, and 1 month after completing RT. DKI-derived kurtosis parameters (mean kurtosis [MK], axial kurtosis [Ka], radial kurtosis [Kr]), and DKI-derived diffusion parameters (fractional anisotropy [FA], mean diffusivity [MD], axial diffusivity [λa], radial diffusivity [λr]) were assessed in temporal lobe white matter. RESULTS: Analysis was performed for 20 patients with temporal lobe necrosis following long-term follow-up. No brain abnormalities were visible on conventional MRI in any patient at 4 weeks during RT and 1 month after RT. Of all DKI-derived parameters, MK was significantly lower at 1 month after RT than before RT (P < 0.05). CONCLUSION: This study indicates DKI can detect the early presence of relatively subtle RT-induced brain abnormalities before TLN in patients with NPC and may provide a sensitive imaging technique for temporal white matter microstructural abnormalities that are silent on conventional modalities but precede TLN after RT.

Baseline characteristics of the Chinese health quantitative CT big data program in 2018—2019 / 中华健康管理学杂志

Objective:To describe the baseline characteristics of the subjects enrolled in the China Quantitative CT (QCT) big data program in 2018—2019.Methods:Based on baseline data from the Chinese health big data project from January 2018 to December 2019 from the eligible enrolled population, measurements of bone mineral density (BMD) and visceral adipose tissue (VAT) were performed using Mindways′ QCT Pro Model 4 system. The baseline data of age, gender, regional distribution, height, weight, abdominal circumference, blood pressure, blood routine and blood biochemical tests were analyzed. And the single factor analysis of variance (ANOVA) was used to check the age related trend of BMD and VAT in both genders.Results:After screening the inclusion exclusion criteria and outliers of the main indicators, 86 113 people were enrolled in the project. The enrollment rate was 92.47%, including 35 431 (41.1%) women and 50 682 (58.9%) men, and the ratio of men to women was 1.43. The mean age was (50.3±12.7) years in all the subjects, and it was (50.2±12.8) years and (50.4±12.5) years in men and women, respectively, and there was no statistical difference between the two genders ( P>0.05). Total of 43 833 people were enrolled in east China, it was the largest group by region (50.90%), it was followed by central China (16 434 people, 19.08%), and the number of people enrolled in Northeast China was the lowest (2 914 people, 3.38%). The rate of completing of health information indicators related to the main outcome of the study were all above 70%, and there were significant differences between men and women (all P<0.05). The mean BMD was (139.33±46.76) mg/cm 3 in women, (135.90±36.48) mg/cm 3 in men, which showed a decreasing trend with age in both gender (both P<0.001); the mean intra-abdominal fat area was (116.39±56.23) cm 2 in women, (191.67±77.07) cm 2 in men, and there was an increasing trend with age in both men and women (both P<0.001). Conclusions:There are gender differences in BMD and VAT measured by QCT with different age tendency, and there are gender differences in health information index. Regional factors should also be taken into account for regional differences in the inclusion of data.

Correlation analysis of bone mineral density, hemoglobin and serum albumin in healthy population / 中华健康管理学杂志

Objective:To use quantitative computed tomography (QCT) technology to measure the bone mineral density of the spine of the Chinese healthy population, and to explore its correlation with hemoglobin and serum albumin.Methods:The data in this study came from the China Health Quantitative CT Big Data Project (China Biobank). The spine bone density was measured by using QCT Pro Image Analysis System and all cooperating centers used the European spine phantom (NO.145) for quality control. Total of 50 053 healthy persons who met the criteria for entry were selected as the research subjects. The subjects were divided into 7 groups according to age. The general data, spine bone density, serum albumin, hemoglobin of the subjects were collected. The single-factor analysis of variance, Pearson correlation analysis and multi-classification logistic regression model were applied to analyze the correlation between bone density and hemoglobin and serum albumin.Results:The bone mineral density of healthy people decreased with age ( P<0.05), and there were significant differences in hemoglobin, serum albumin and body mass index (BMI) among different age groups (all P<0.05). Linear correlation analysis showed that there were positive correlation between bone mineral density and hemoglobin in healthy males in different age groups ( r=0.086, 0.101, 0.076, 0.090, 0.072, 0.123, 0.100, all P<0.01). There were negative correlation between bone mineral density and hemoglobin in certain age groups in women (40-49 years group: r=-0.027; 70-79 yearsgroup: r=-0.077; both P<0.05). And corelation were found between bone mineral density and serum levels of albumin in certain age groups of healthy subjects (among men, 30-39 years group: r=-0.048; 40-49 years group, r=-0.027; 70-79 years group, r=-0.051; among women, 30-39 years group: r=-0.044; 40-49 years group, r=-0.042; 50-59 years group, r=-0.086; 70-79 years group, r=-0.070; all P<0.05). After adjusting for age and BMI, the multi-category logistic regression analysis showed that the hemoglobin level was protective factor of normal bone density ( OR=1.022, 95% CI:1.017-1.027) and decreased bone density ( OR=1.012, 95% CI:1.007-1.016) in healthy males, and the serum albumin was risk factor for normal bone density ( OR=0.926, 95% CI:0.905-0.948) and decreased bone density ( OR=1.006, 95% CI:0.951-1.011) in healthy women. Conclusion:There is a correlation between bone mineral density and hemoglobin and serum albumin in Chinese healthy population. Hemoglobin is a protective factor for bone mineral density in men, and serum albumin is a risk factor for bone mineral densityin women.

Normal reference and regional variation of spinal bone mineral density under the quantitative CT in Chinese male population / 中华健康管理学杂志

Objective:To investigate the normal reference values of spinal bone mineral density measured by quantitative computed tomography (QCT) and the differences of bone mineral density (BMD) in different regions of in Chinese adult males.Methods:Men who underwent low-dose CT lung scan for cancer screening in regions of Northeast, North, East, South, Central and Southwest of China from January 2018 to December 2019 were selected. And the lumbar vertebrae BMD values in the male subjects were measured by the QCT system (Mindways Software, Inc.). The mean BMD values and their decline rates were calculated at an age interval of 10 years, and the prevalence of osteoporosis was calculated according to the American College of Radiology spine QCT osteoporosis diagnostic criteria.Results:A total of 50 682 males with a mean age of (50.22±12.79) years (ranged 20 to 98 years) were included in this study. The peak BMD of (173.11±28.56) mg/cm 3 in the healthy Chinese adult male population appeared in the age group of 20 to 29 years and then declined with age. Before the age of 70 years, the BMD was relatively higher in males in South China, and it was lower in Central China and Southwest China, and it was intermediate in Northeast, North and East of China, with statistically significant differences. There was no significant differences in BMD in the males in the two age groups of 70 to 79 years and 80 and older among the regions in China. The overall decline rate of spinal BMD in Chinese males under QCT was about 46.92% over the lifetime, and it declined obviouslyin the 40-49 age group. The overall prevalence of osteoporosis in Chinese male population aged 50 years and above was approximately 11.42%, with the highest prevalence in Southwest China and Central China (14.72% and 13.87%, respectively) and the lowest in North China and South China (8.53% and 7.71%, respectively). Conclusions:A reference of lumbar spine BMD values for healthy males in China based on QCT is established. BMD values were highest in South China and Lowest in Central China.

Reference value of lumbar spine bone mineral density and regional differences based on quantitative CT examination in healthy adult female in China / 中华健康管理学杂志

Objective:To establish the normal reference value of lumbar bone mineral density (BMD) under quantitative CT (QCT) in Chinese healthy adult females and to explore the regional differences.Methods:Total of 35 431 healthy women who met the inclusion criteria of Chinese health quantitative CT big data program were selected in this study. The BMD of the central plane of L 1 and L 2 vertebrae was measured by Mindways′s QCT system, and the mean value was taken. One-way analysis of variance was used to compare the BMD differences of lumbar vertebrae in women of different ages and regions. The subjects were grouped by an age interval of 10 years, and the level of BMD in different regions of the same age group were compaired. Results:The peak BMD of Chinese healthy adult women appeared in the age group of 20-29 years (Northeast China(183.01±24.58) mg/cm 3, North China (188.93±24.80) mg/cm 3, East China (187.54±27.71) mg/cm 3, South China (186.22±33.72) mg/cm 3, Central China (176.33±24.91) mg/cm 3, Southwest China(182.25±28.00) mg/cm 3), and then it decreased with age. The level of BMD in different regions decreased with the age. Before the age of 70 years, BMD in Central and Southwest China was always at a low level((176.23±24.91) to (90.38±28.12) mg/cm 3, 182.25±28.00 to (88.55±25.68) mg/cm 3), lower than those in Northeast China ((183.01±24.58) to (99.69±27.85) mg/cm 3), North China ((188.93±24.80) to (95.89±26.12) mg/cm 3), East China ((187.54±27.71) to (95.65±27.86) mg/cm 3). After 70 years of age, BMD tended to be the same in different regions ( P>0.05). The BMD values in Central China and Southwest China were similar in the age group of 40-60 years ( P>0.05). The BMD values in the health adult femles in the age group of 60 years in different regions of Chinawere all lower than those of bone mass abnormality (all P<0.05). The detection rate of osteoporosis in females over 50 years was the highest in Southwest China (25.65%) and it was the lowest in North China (17.30%). Conclusions:This study establishes reference values of BMD under QCT in healthy Chinese women, which can be used as a reference basis for identifying women with low BMD who are at risk of osteoporosis. The BMD value is the lowest in Southwest China and the highest in South China.

Progress in computer-assisted Alberta stroke program early computer tomography score of acute ischemic stroke based on different modal images / 生物医学工程学杂志

Clinically, non-contrastive computed tomography (NCCT) is used to quickly diagnose the type and area of ​​stroke, and the Alberta stroke program early computer tomography score (ASPECTS) is used to guide the next treatment. However, in the early stage of acute ischemic stroke (AIS), it's difficult to distinguish the mild cerebral infarction on NCCT with the naked eye, and there is no obvious boundary between brain regions, which makes clinical ASPECTS difficult to conduct. The method based on machine learning and deep learning can help physicians quickly and accurately identify cerebral infarction areas, segment brain areas, and operate ASPECTS quantitative scoring, which is of great significance for improving the inconsistency in clinical ASPECTS. This article describes current challenges in the field of AIS ASPECTS, and then summarizes the application of computer-aided technology in ASPECTS from two aspects including machine learning and deep learning. Finally, this article summarizes and prospects the research direction of AIS-assisted assessment, and proposes that the computer-aided system based on multi-modal images is of great value to improve the comprehensiveness and accuracy of AIS assessment, which has the potential to open up a new research field for AIS-assisted assessment.

Prevalence of pulmonary tuberculosis in western China in 2010-11: a population-based, cross-sectional survey.

BACKGROUND: Progress in tuberculosis control in China has been the slowest in western areas, which have the highest prevalence. We assessed the prevalence of pulmonary tuberculosis in the Xinjiang province, China, 10 years after introduction of a control programme based on directly observed treatment, short course. METHODS: In this population-based, cross-sectional survey, we used a multistage stratified random cluster sample design to estimate the prevalence of smear-positive and bacteriologically confirmed (either smear positive or culture positive, or both) pulmonary tuberculosis among adults (aged ≥15 years) in Xinjiang who had been resident in their household for the last 6 months. The screening strategy and diagnosis followed WHO guidelines. We estimated prevalence by combining inverse probability weighting and multiple imputation of missing data. We compared our prevalence survey estimates with the ones from the 2010 China national pulmonary tuberculosis survey and the ones from a provincial pulmonary survey done in Xinjiang in 2000. The new smear-positive pulmonary tuberculosis notification rate in 2011 in Xinjiang was obtained to allow the calculation of patient diagnosis rate (PDR). FINDINGS: Between Sept 1, 2010, and July 31, 2011, 31 081 individuals were eligible, of whom 29 835 (96·0%) participated in the survey. We identified 50 (0·2%) smear-positive and 101 (0·3%) bacteriologically confirmed pulmonary tuberculosis cases. The weighted prevalence of smear-positive pulmonary tuberculosis was 170 (95% CI 103-233) per 100 000 people and of bacteriologically confirmed pulmonary tuberculosis was 430 (249-611) per 100 000 people. Compared with 2000 Xinjiang survey estimates, the prevalence of smear-positive pulmonary tuberculosis has decreased by 26·4% (from 231 [95% CI 148-314] per 100 000 people), whereas the prevalence of bacteriologically confirmed pulmonary tuberculosis has increased by 17·8% (from 365 [237-493] per 100 000 people). In each age group and sex, the pulmonary tuberculosis prevalence was higher in the 2010-11 Xinjiang survey than in the 2010 national survey. The PDR in 2011 was 0·34 (95% CI 0·25-0·44). INTERPRETATION: Despite progress in other parts of China, the prevalence of pulmonary tuberculosis in Xinjiang remains high. The very low PDR suggests poor access to diagnosis and care. Further studies are needed to understand the barriers to diagnosis and care of this population, and efforts are urgently needed to enhance tuberculosis screening in this area. FUNDING: Xinjiang Uyghur Autonomous Region Health Bureau.

Quantitative computed tomography-derived abdominal visceral adipose tissue and cardiometabolic risk in a large-scale population / 中华健康管理学杂志

Objective:To investigate the relationship between abdominal visceral adipose tissue (VAT) and cardiometabolic risk (CMR) through quantitative computed tomography (QCT).Methods:The present study included 76226 participants. Abdominal fat areas were measured using the QCT Pro Model 4 system. Cardiometabolic indices were collected, including systolic and diastolic blood pressures, fasting plasma glucose, total cholesterol, triglyceride, and low-density and high-density lipoprotein cholesterols CMR score was the sum of abnormal blood pressure, fasting glucose, triglyceride, and high-density lipoprotein cholesterol. Restricted cubic spline and ordered logistic regression models were applied.Results:The mean age was 50±13 years and the percentage of men was 58.8%. The level of VAT area was higher in men than in women (191.7±77.1 cm 2 vs 116.4±56.2 cm 2, P<0.0001 for all). After adjustment for age, the cardiometabolic indices except high-density lipoprotein cholesterol increased with increasing VAT area. When VAT area was 300 cm 2, age-adjusted odds ratios and 95% confidence intervals of a CMR score ≥ 1 were 14.61 (13.31, 16.04) for men and 5.46 (4.06, 7.36) for women, and the age-adjusted probability of a CMR score ≥ 3 was 31.7% for men and 31.3% for women. Conclusions:QCT-derived VAT is closely related to CMR. The findings suggest that measurement of visceral fat is recommended for the management of abdominal obesity in subjects who agree to undergo lung cancer screening via low-dose CT without additional radiation exposure.

Correction to: EGFR signaling augments TLR4 cell surface expression and function in macrophages via regulation of Rab5a activation

In the original publication the bands in Fig. 1J and Fig. 2B were not visible. The correct versions of Fig. 1J and Fig. 2B are provided in this correction.

Correction to: EGFR signaling augments TLR4 cell surface expression and function in macrophages via regulation of Rab5a activation

In the original publication the bands in Fig. 1J and Fig. 2B were not visible. The correct versions of Fig. 1J and Fig. 2B are provided in this correction.

Research Development of MR Diffusion Tensor Imaging and Track Density Imaging in Central Nervous System / 中国医疗器械杂志

Diffusion tensor imaging (DTI) is being used more and more widely in the diagnosis of central nervous system. Based on DTI, track density imaging (TDI) is an emerging technique applied to clinical use. This article introduced the principle and clinical application, analyzed pros and cons, and made conclusion and prospect of these two techniques.

Prevalence of Decreased Myocardial Blood Flow in Symptomatic Patients with Patent Coronary Stents: Insights from Low-Dose Dynamic CT Myocardial Perfusion Imaging

OBJECTIVE: To study the prevalence and clinical characteristics of decreased myocardial blood flow (MBF) quantified by dynamic computed tomography (CT) myocardial perfusion imaging (MPI) in symptomatic patients without in-stent restenosis. MATERIALS AND METHODS: Thirty-seven (mean age, 71.3 ± 10 years; age range, 48–88 years; 31 males, 6 females) consecutive symptomatic patients with patent coronary stents and without obstructive de novo lesions were prospectively enrolled to undergo dynamic CT-MPI using a third-generation dual-source CT scanner. The shuttle-mode acquisition technique was used to image the complete left ventricle. A bolus of contrast media (50 mL; iopromide, 370 mg iodine/mL) was injected into the antecubital vein at a rate of 6 mL/s, followed by a 40-mL saline flush. The mean MBF value and other quantitative parameters were measured for each segment of both stented-vessel territories and reference territories. The MBFratio was defined as the ratio of the mean MBF value of the whole stent-vessel territory to that of the whole reference territory. An MBFratio of 0.85 was used as the cut-off value to distinguish hypoperfused from non-hypoperfused segments. RESULTS: A total of 629 segments of 37 patients were ultimately included for analysis. The mean effective dose of dynamic CT-MPI was 3.1 ± 1.2 mSv (range, 1.7–6.3 mSv). The mean MBF of stent-vessel territories was decreased in 19 lesions and 81 segments. Compared to stent-vessel territories without hypoperfusion, the mean MBF and myocardial blood volume were markedly lower in hypoperfused stent-vessel territories (77.5 ± 16.6 mL/100 mL/min vs. 140.4 ± 24.1 mL/100 mL/min [p < 0.001] and 6.4 ± 3.7 mL/100 mL vs. 11.5 ± 4 mL/100 mL [p < 0.001, respectively]). Myocardial hypoperfusion in stent-vessel territories was present in 48.6% (18/37) of patients. None of clinical parameters differed statistically significantly between hypoperfusion and non-hypoperfusion subgroups. CONCLUSION: Decreased MBF is commonly present in patients who are symptomatic after percutaneous coronary intervention, despite patent stents and can be detected by dynamic CT-MPI using a low radiation dose.

Effect of tuberculosis prevention and control in Wuhan in 2016 - 2021 / 公共卫生与预防医学

Objective To analyze and evaluate the implementation effect of tuberculosis prevention and control program in Wuhan, and to provide reference for scientific formulation of tuberculosis prevention and control measures. Methods Using the National Tuberculosis Information Management System, descriptive statistical analysis was carried out on the medical record information of pulmonary tuberculosis patients registered in Wuhan , 2016 - 2021. Results A total of 34 937 cases of pulmonary tuberculosis were registered in Wuhan , with an average annual incidence rate of 49.85/100 000. The incidence rate showed a downward trend year by year, with a statistically significant difference in 2016—2021 (χ2trend = 708.387, P2=355.541, P2=1 354.830, P2=1 080.252, P2= 933.655, P<0.001). The sputum examination rate of newly diagnosed patients in each year reached over 90%, and the overall completion rate reached over 95%. The proportion of positive pathogens showed an increasing trend year by year. Conclusion The overall epidemic situation of tuberculosis in Wuhan is declining year by year, and tuberculosis prevention and control work has achieved remarkable results. Active screening in key areas and populations should be strengthened, and prevention and control strategies should be formulated by emphasizing the key and difficult points.

Delay on care-seeking and related influencing factors among tuberculosis patients in Wuhan, 2008-2017 / 中华流行病学杂志

Objective@#To analyze the epidemiological characteristics, trend and related factors of tuberculosis patients that delayed for care, in Wuhan from 2008 to 2017.@*Methods@#Data regarding tuberculosis (TB) patients was collected from the tuberculosis management information system (TMIS), a part of the China information system for disease control and prevention from 2008 to 2017. A total of 64 208 tuberculosis patients, aged 0 to 95 years were included for the analysis. Unconditional logistic regression method was used to estimate those factors that associated with this study.@*Results@#Days of delay among TB patients appeared as M=10 (P25-P75: 3-28) day, in Wuhan, 2008-2017. The prevalence of the delay was 52.5% (33 703/64 208), presenting a downward trend from 2008 to 2017 (trend χ2=10.64, P<0.001), but the proportions of women and ≥65 year-olds were gradually increasing. Results from the multivariate logistic regression analysis showed that factors as: patients living far away from the city vs. near the city (OR=1.29, 95%CI: 1.25-1.35), and age above 45 years vs. younger than 25 years (the age 45-64 years group vs. aged less than 25 years group, OR=1.22, 95%CI: 1.15-1.29; the age 65 or above group vs. aged less than 25 years group, the OR=1.30, 95%CI: 1.22-1.39) were under higher risk on the delay of seeking care. Occupation, way of case-finding and classification of tuberculosis patients also appeared as influencing factors on this issue.@*Conclusions@#Prevalence on the delay of care was 52.5% among tuberculosis patients in Wuhan, 2008-2017, but with an annual decrease. Attention should be paid to female, wrinkly or elderly tuberculosis patients regarding the delay of care on TB, in Wuhan.

Clinical study of traditional Chinese medicine anti-inflammatory mixture for the microcirculation disturbance in patients with sepsis targetting at vascular endothelium / 国际中医中药杂志

Objective To observe the clinical effect of traditional Chinese medicine inflammatory mixture on vascular endothelial cell injury, mcrocirculation disorder and organ dysfunction in sepsis. Methods 73 patients with sepsis were randomly divided into two groups: Anti-inflammatory mixture-treated group (40 cases) and control group (33 cases). Routine medicine therapy was given in both groups.Additionally, in the Anti-inflammatory mixture-treated group, 100 ml Anti-inflammatory mixture was given By oral or nasal feeding, every 12 hours for consecutive 7 days. Vascular endothelial injury index (Soluble thrombomodulin,Vascular endothelial growth factor-2, endothelial specific molecule-1), mcrocirculation disorder index (arterial blood lactate, central venous oxygen saturation, total vessel density, perfused vessel density, proportion of perfused vessels, microcirculatory flow index) of two group patients before and after therapy were observed and the sequential organ failure score (SOFA) was recorded before and after treatment. Results After treatment, the indexes of vascular endothelial injury sTM (12.37 ± 5.08 μg/L vs. 18.77 ± 6.88 μg/L, t=3.448), VEGF-2 [45.6 ng/L (14.3, 112.5) vs. 52.4 ng/L (17.2, 123.6), Z=4.009], ESM-1 (15.54 ± 4.09 ng/ml vs. 17.64 ± 6.79 ng/ml, t=-1.551), Lac (2.6 ± 1.2 mmol/L vs. 3.7 ± 1.8 mmol/L, t=4.115) and SOFA (4.1 ± 1.7 vs. 6.1 ± 3.2, t=-2.118) in anti-inflammatory mixture group decreased significantly than those in the control group. but the ScvO2(0.719 ± 0.243 vs. 0.603 ± 0.201, t=-2.773), PVD (14.8 ± 5.8 mm/mm2 vs. 13.1±5.1 mm/mm2, t=-5.114), PPV (59.1% ± 22.5% vs. 53.9% ± 20.6%, t=1.779), MFI (9.4 ± 4.6 vs. 7.2 ± 2.2, t=4.339) in the anti-inflammatory mixture group were significantly higher than those in the control group. Correlation analysis showed that the sTM and PPV were significantly negatively correlated (r=-0.875, P＜0.01), ESM-1 was significantly negatively correlated with PVD, PPV and MFI (r=-0.877, P＜0.01; r=-0.799, P＜0.01; r=-0.821, P＜0.01) and ESM-1 and SOFA were significantly positively correlated (r=0.840, P＜0.01). Conclusions Anti-inflammatory mixture of Chinese medicine has a certain therapeutic effect on sepsis by protecting vascular endothelial cell function.

Natural History of Untreated Coronary Total Occlusions Revealed with Follow-Up Semi-Automated Quantitative Coronary CT Angiography: The Morphological Characteristics of Initial CT Predict Occlusion Shortening

OBJECTIVE: To investigate the morphological changes of coronary chronic total occlusion (CTO) as determined by coronary computed tomography angiography (CCTA) follow-up using semi-automated quantitative analysis. MATERIALS AND METHODS: Thirty patients with 31 CTO lesions confirmed by invasive coronary angiography and baseline/follow-up CCTA were retrospectively included. CTOs were quantitatively analyzed by a semi-automated coronary plaque analysis software (Coronary Plaque Analysis, version 2.0, Siemens) after manually determining the lesion border. Recanalized lumen was defined as the linear-like enhanced opacity traversing the non-opacified occluded segment. Other parameters, such as total occlusion length, total occlusion volume, volume with low attenuation component (< 30 Hounsfield unit [HU]), volume with middle to high attenuation component (30–190 HU) as well as the calcification volume, were also recorded. RESULTS: Recanalized lumen was found within 48.4% (15/31) occlusions on the follow-up CCTA, compared to 45.2% (14/31) occlusions on the baseline CCTA. Eleven of 14 lesions (78.6%) with CT-visible recanalized lumen within CTOs had a shorter occlusion length on follow-up compared to only 3 of 17 lesions (17.6%) without CT-visible recanalized lumen (odds ratio, 17.1, p < 0.001). The percentage of low attenuation component of occlusions was smaller on follow-up CCTA compared to baseline value (18.1 ± 20.1% vs. 22.6 ± 19.6%, p = 0.033). CONCLUSION: Coronary computed tomography angiography enables non-invasive characterization of natural progression of untreated CTO lesions. Recanalized lumen within CTOs observed at baseline CCTA was associated with shortening of occlusion length on follow-up. Compared to their earlier stage, occlusions of later stage were presented with higher density of non-calcified components.

A magnetic resonance spectroscopy study in the anterior cingulate cortex ofperimenopausal women with depression / 实用放射学杂志

Objective To investigate the changes of gamma-aminobutyric acid (GABA) in the anterior cingulate cortex of perimenopausal women with depression.Methods Forty perimenopausal women as the experimental group and ten healthy women as the control group were recruited and followed up for 18 to 24 months.The proton magnetic resonance spectroscopy (1H-MRS) was used to acquire the concentrations of GABA in the anterior cingulate cortex.The experimental group was examined before and after menopause.The control group was examined before into the group and after out of the group.The experimental group after menopause was further divided into the anxiety group and the depression group according to the Classification and Diagnostic Criteria of Mental Disorders in China-Third Edition (CCMD-3), 14-item Hamilton Anxiety Scale (HAMA-14) and 17-item Hamilton Depression Scale (HAMD-17).The data of three groups were compared respectively.Results The results showed that the concentrations of GABA after menopause in both of the anxiety group and depression group were significantly lower (P<0.05) than those before menopause, and were also significantly lower (P<0.05) than those in the control group.The concentrations of GABA after menopause in the depression group were significantly lower(P<0.05) than those in the anxiety group.Conclusion The changes of GABA in the anterior cingulate cortex are related with the pathophysiology mechanism of perimenopausal depression and the symptoms of perimenopausal depression.