Objective The study the formative causes of low dense area in lung on CT images during expiration.Methods This group included 15 young volunteers,mean age was 22 years.Thin sections of spiral CT at right middle hilum were scanned at suspended deep inspiration and deep expiration on both supine and prone positions.The density and area of lobes on matching structural images in the middle hilum at deep inhalation and exhalation were measured on the supine and prone.The increasing rate in area and absolute increasing value in attenuation as full inhalation comparing to full exhalation were calculated.Results Changes of distention and density in the same section of the right lower lobe on dependent position were greater than that on nondependent one.Correlation between distention and density of the lobes was high(P

Objective To know the microbial pollution in the indoor air of classrooms and dormitories in a university and analyze the possible impact factors.Methods In April and May,2007,the indoor air sampling was conducted and the total count of air microbe in indoors was determined in eight classrooms and twenty dormitories by the impacting method.Results According to the related national hygienic standard of China, the total count of air microbe in all classrooms was qualified, the total count of air microbe in the dormitories was all qualified, but it was higher in male's dormitories compared with female's.Conclusion In general, there was not obviously indoor microbial pollution in the investigated university.

Objective To analyze the clinical features of melioidosis spleen abscess.Methods A retrospective analysis of 26 cases with melioidosis spleen abscess at Hainan People′s Hospital between October 2002 and March 2015 was performed.Data with general conditions, clinical characteristics, imaging features, treatment and outcome were all extracted and analyzed.Results High fever (100.0%) and splenomegaly (73.1%) were the main clinical symptoms and signs.Laboratory examinations showed that white blood cell and neutrophil percentage increased, with a mean value of 12.6×10.9/L and 0.86, respectively.88.5% cases had diabetes mellitus which was the main underlying disease.Apart from spleen abscess, pulmonary infection (73.1%) and liver abscess (38.5%) were the majority.Imaging showed multiple small abscess (92.3%).All patients had at least one positive blood culture of Burkholderia pseudomalleiand were treated with imipenem, ceftazidime and sulfamethoxazole alone or in combination.Hospitalization days ranged between 8 to 65 days with the mean of 29.5 days.Twenty-three cases (88.5%) were cured, the remaining 3 cases (11.5%) abandoned treatment and were all lost for follow-up.Conclusions Melioidosis should be suspected in patients from epidemic areas, who have diabetes and imaging shows spleen abscess and other organ infections including pulmonary infection and liver abscess.Microbiological culture is needed immediately.

Objective To assess the feasibility and efficacy of transarterial lidocaine lipiodol emulsion administration for controlling abdominal pain and preventing the arterial spasm resulting from TACE, and to evaluate the optimal amount of lidocaine administration. Methods In a prospective trial of 120 consecutive patients with malignant tumor who underwent TACE were divided into three groups, those who received lidocaine lipiodol emulsion administration (group A, n =40), those who received lidocaine bolus intraarterial infusion immediately before TACE (group B, n =40) and those who received no lidocaine injection before TACE, (group C, n =40). The degree of post procedure pain was evaluated by a subjective method (using visual analogue scales from 0 to 10), and an objective method (amount of post procedure analgesics). Incidence and degree of arterial spasm were assessed by DSA. Results The correlative pain incidences between the three groups showed significant difference ( P 0.05). Mean dose of intramuscular analgesics for controlling intolerable pain in group A and B was significantly lower than that of group C ( P

Objective To investigate the feasibility and efficacy of iliofemoral endovascular therapy for the treatment of chronic ischemia of lower extremities due to arterial atherosclerosis. Methods During the period of September 2005-January 2009 percutaneous endovascular angioplasty and stent implantation were performed in 15 consecutive patients with CTA-proved chronic occlusive iliofemoral artery disease. The patients included 11 males and 4 females with a mean age of (72.1 ± 5.9) years (ranged from 61 to 82 years). Before the procedure, all patients underwent clinical and imaging assessments, including Fontaine classification, ankle-brachial pressure index (ABI), and lower limb computed tomography angiography (CTA). According to the length, morphology and location of the occlusive segment, different types of stents were employed together with pereutaneous transluminal angioplasty (PTA) to treat the occluded lilac or superficial femoral artery. At the end of the procedure, distal angiogram was performed to assess the success of the procedure and to exclude thromboembolism or dissection complications. After PTA, the residual stenosis < 30% and/or pressure gradient < 10 mmHg were defined as technical success. Clinical success was identified when patient's clinical symptoms were improved by one or more grade according to Fontaine classification. Results Technical success was totally achieved in all patients with no occurrence of complication. Recanalization of the occluded artery was performed preferably by retrograde ipsilateral femoral artery approach in 5 patients and by contralateral access using the crossover aorta technique in 10 patients. PTA was performed in all patients after stent release to open the occluded vessel to its normal diameter. The mean length of the lilac arterial segment covered with 8 stents was (7.6 ± 1.4) cm (ranged from 6 cm to 10 cm). The mean diameter ± SD of the iliac stents was 9.5 mm ± 1.4 mm (ranged from 8 mm to 12 mm). The mean length of 5 superficial artery implanted stents was (4.5 ± 1.1) cm (ranged from 4 cm to 6 cm). The mean ABI before treatment and six months after treatment was 0.64 (range 0.41 to 0.89) and 0.76 (range 0.50 to 0.95), respectively. The difference in ABI between pre-interventional and post-interventional procedure was statistically significant (t = -4.64, P < 0.01). Clinical improvements according to Fontaine classification were obtained in all patients, in whom technical success was achieved (100%). Conclusion Endovascular interventional procedure is a safe and effective treatment for iliofemoral arterial occlusive disease due to arterial atherosclerosis. PTA combined with subsequent stent implantation can well improve the patient's quality of life as well as the hemodynamics of lower extremities, which is very important for preserving the diseased limb for a long period of time.

AIM: To investigate the effect of losartan on the mRNA expression of type 2 angiotensin II receptor and cytokines in diabetic rat kidney.METHODS: SD rats were randomly divided by following groups: control rats(group C),diabetic rats(group D) and diabetic rats treated with losartan (30(mg?kg~(-1)?d~(-1)),by gavage,group DT).At the end of 8-weeks study,mRNA expressions of the type 2 angiotensin II receptor(AT_2),transforming growth factor-?_1(TGF-?_1),platelet-derived growth factor-B(PDGF-B),tumor necrosis factor-?(TNF-?) and collagen Ⅳ in rats renal cortex were measured by RT-PCR,respectively.In addition,angiotensin Ⅱ level in renal cortex was determined by the radioimmunoassay.RESULTS: In group D,urine protein excretion(P

Objective To evaluate the image quality and radiation dose of prospective electrocardiography-triggered coronary 320-slice volume CT angiography with different kV, and the feasibility of coronary scan with ＜ 1 mSv radiation dose.Methods Eighty consecutive patients were randomly divided into two groups equally.The tube voltage according to paradigm was 100 kV in group A and 120 kV in group B.All raw data in group A was reconstructed by the software AIDR in CT system to create a new group named as A1. Such parameters as the mean intraluminal attenuation (SI),noise (SD),signal-to-noise ratio (SNR),contrast-to-noise ratio (CNR),effective radiation dose(E) and image quality score measured in group A were compared with those in group B.The values such as SI,SD,SNR,CNR,image quality scores were compared between group A and group A1.The significance of group B and group A1 was compared in SI,SD,SNR,CNR,image quality scores as well.Results E in group A was significantly lower than that in group B[ E =(0.67 ± 0.18) mSv in group A vs.E =(3.08 ± 1.04) mSv in group B].The value of E in group A was decreased by 78％ compared to group B(t =- 14.30,P＜0.05 ).There was no significant difference in mean image quality scores between two groups(4.57 ± 0.57in groupA vs.4.59 ± 0.59 in group B,t=-1.17,P＞0.05).The values of SI,SD,SNR,CNR in group A were (570.8 ±131.5)HU,25.1 ±6.9,24.5 ±9.1,19.8 ±6.1.And the values of SI,SD,SNR,CNR in group B were (460.6 ± 14.3) HU,15.1 ±3.6,31.7 ±7.7,29.3 ±6.8.The values of SI and SD in group A were significantly higher than those in group B(t =4.49,8.18,P ＜0.05). The values of SNR and CNR in group A were lower than those in group B (t =-4.24,-6.19,P＜0.05).The valuesofS1,SD,SNR,CNR,image quality scores in group Al were (557.9 ±24.5) HU,21.1 ±6.0,27.7±10.0,23.4±7.8,4.60 ± 0.56.There was no difference in the SI and the image quality scores between group A and group A1 ( t =1.09,- 1.90,P ＞ 0.05).Conclusions 320-slice volume CT with 100 kV tube voltage and prospective ECG-triggered technique can reduce the radiation dose to less than 1 mSv and obtain optimal images in diagnosis of coronary arterial diseases.

Objective To evaluate the cost-effectiveness of budesonide/formoterol powder inhalation(BF)versus salmeterol/fluticasone powder inhalation(SF)for the treatment of persistent asthma in adolescents,and to provide economic evidence and reference for clinical medication and decision-making.Methods From perspective of Chinese healthcare,a Markov model was established based on a prospective cohort study conducted by Shanghai Fudan University Affiliated Minhang Hospital.The cycle length was 7 days,and the time horizon was 6 years.A discount rate of 5％per year was applied.Clinical parameters including asthma acute exacerbation,treatment costs,and health utility values were obtained from relevant literature.The primary outcomes were direct medical costs,quality-adjusted life-years(QALYs),and incremental cost-utility ratio(ICUR).Cost-utility analysis was performed using TreeAge Pro 2022.The one-way sensitivity analysis and probabilistic sensitivity analysis were conducted to validate the robustness of the basic analysis results.Results Compared with SF group,BF group contributed to an incremental QALYs of 0.002 5 and reduced the cost by 7 043.93 yuan,which implied that BF group was a dominating treatment.Results of one-way sensitivity analysis showed that SF price,BF price and Hazard ratio of asthma acute exacerbation(BF vs.SF)were the main sensitivity factors of model.Probabilistic sensitivity analysis demonstrated the probability of BF being cost-effective was about 80％within the willingness to pay threshold of 257 100 yuan/QALY.Conclusions It was found out in this study that BF was a more cost-effective option for the adolescents with persistent asthma compared with SF.

Objective:To observe any effect of dry needling of myofascial trigger points on substance P and synaptophysin expression in the spinal dorsal horn.Methods:Sixty-four Sprague-Dawley rats were randomly divided into a control group ( n=16) and a model group ( n=48). Myofascial trigger points were induced in the model group by a blunt strike and eccentric running. That group was then randomly divided into a no-treatment group ( n=15), a massage group ( n=16), and a dry needling group (16 rats). The rats in the two treatment groups received 4 weeks of dry needling or Chinese massage. Pressure pain thresholds were recorded before the experiment and after the 4 weeks. The content of substance P and synaptophysin in the spinal dorsal horn were measured using immunoblotting and immunohistochemistry. Results:After the treatment 14 rats (93%) in the model group had trigger points, significantly higher than the 8 rats (50%) in the massage group and the 7 rats (44%) in the dry needling group. After treatment, the average pressure pain thresholds of the no-treatment and massage groups was significantly lower than the control group′s average, while the difference between the dry needling group and the control group was not significant. The average pressure pain threshold had improved significantly in the no-treatment group, the massage group and the dry needling group, and the averages of the massage group and the dry needling group were significantly higher than that of the no-treatment group. The level of substance P was significantly higher in the no-treatment group than in the other three groups and the ratio of substance P to Glyceraldehyde 3-phosphate dehydrogenase (GAPDH)was significantly higher. The substance P: GAPDH ratio of the massage group was significantly higher than that of the control group.Conclusions:Dry needling and massage are effective in relieving myofascial pain, at least in rats. Both can reduce the content of substance P in the spinal dorsal horn.