Tuberculosis (TB) is endemic in China with high prevalence of multiple-drug resistant tuberculous bacilli (MDRTB). The incidence of new cases of TB reaches 1,300 thousand annually. Among them, 5.7 percent are MDR-TB. Staining for acidfast bacilli in sputum and clinicoradiological examination have been the main diagnostic tools for TB, particularly pulmonary TB. However, the positive rate of sputum Ziehl-Neelsen stain for sputum is disappointedly low, merely 28% in newly-diagnosed TB. Moreover, the radiological manifestations of the patients suspected of TB are often non-specific. All these facts call for a simple, accurate and rapid diagnostic method to overcome this bottleneck, which hinders the success of satisfactory TB control in China. Employing both hemi-nested RT-PCR and beacon technology with fluorescent probes, the MTB/RIF diagnostic assay specifically amplifies, thus helps detect the rpoB gene, which is unique to Mycobacterium tuberculosis and also a biomolecularmarker of rifampin resistance. As a semi-quantitative analysis, the quantity of Mycobacterium tuberculosis in samples is reflected by the threshold of PCR cycles during MTB/RIF assay. With Mycobacterium tuberculosis culture as the standard reference, for sputum samples from patients suspected of suffering from pulmonary TB, overall diagnostic sensitivity of MTB/RIF assay is 73.1%-90.0% with a specificity of 99.0%-99.5%. For detection of rpoB gene mutations responsible for rifampin-resistance, the sensitivity is 97.2% and specificity is 98.3%. Following sample loading, the system can automatically complete the diagnostic process and report the results within 2 hours. Targeting the rpoB gene specifically, there is no cross-reaction with non-tuberculosis mycobacteria or other common respiratory pathogens. In addition to sputum samples, the system can be used to detect Mycobacterium tuberculosis in various body fluids (including pleural effusion, urine, cerebrospinal fluid and even bronchoalveolar lavage fluid) and lung tissue biopsy samples. As for sensitivity, the assay is comparable to Mycobacterium tuberculosis culture (for the latter, mean interval between loading and result-reporting is 16 or 30 days (depending upon the culture medium used), and it is 100 times longer than Ziehl-Neelsen stains. Compared with conventional laboratory diagnostic approaches, this assay is much simpler and biohazardous aerosol-free.

Radiofrequency ablation therapy not only causes the necrosis of localized tumor cells,but also produces immunogenic tumor associated antigens and a large number of inflammatory cytokines and a variety of immunogenic mediums,which promotes the local infiltration and activation of immune cells and stimulates the immune system to produce certain anti-tumor effect.But the intensity of anti-tumor effect is feeble and is insufficient to inhibit the growth of tumor cells.Radiofrequency ablation therapy combined with special immunotherapies,such as immune stimulants,adoptive immunity cells therapy,dendritic cell vaccines,monoclonal antibodies and so on,can maximize the clinical benefit,which is a good pattern about tumor comprehensive treatment containing immunotherapy.

The implantable axial blood pump, driven by external electromagnet, is studied recently. It oscillats when it is running because of the elastic implanted environment and driving force disequilibrium, etc. In this paper, a model of single erythrocyte in vibrated flow field was built to simulate the deformation and force of the erythrocyte. By using the mechanical injury principle of blood in blood pump, we studied the injury of a single erythrocyte resulted from oscillating boundary flow field. The research results indicated that the shape of the erythrocyte, force and velocity field nearby, which are affected by oscillating boundary flow field, all cause injury to the erythrocyte. All the researches shown in the present paper are expected to provide theoretical foundation for lightening hemolysis by the blood pump.
Assisted Circulation ; Erythrocytes ; cytology ; Hemolysis ; Humans ; Models, Cardiovascular ; Oscillometry ; Prostheses and Implants

Objecfive To investigate the association between bacteriology of airway secretions in acute onset chronic respiratory failure (ACRF) and its clinical prognosis.Methods The bacterial flora and antibiotic resistance in the airway secretions from 44 patients with 49 cases of ACRF were studied,the associations between bacteriology,antibiotic resistance and annual ACRF hospital admission frequency (ACRF≥2 or ACRF<2),its mortality were also explored.Results Positive rate of culture in airway secretions was 63.3%.Untraditional pathogens such as Pseudomonas Aeruginosa accounted for 80.7%.The bacterial yield of patients with ACRF≥2 was twice as that with ACRF<2 (P<0.01).Of the identified bacteria,61.3% displayed antibioticresistance,and there was signifi-cant prolongation of ventilation and hospitalization and increase of mortality in patients with antibiotic resistance(P<0.05).Conclusion There is a predominance of untraditional pathogens such as Pseudomonas Aeruginosa in bacteria from airway secretions of ACRF patients,positive yield and percentage of untraditional pathogens increased with the severity of chronic respiratory failure,infections caused by antibiotic-resistant strains led to higher mortality in ACRF.

Tuberculosis (TB) is endemic in China with high prevalence of multiple-drug resistant tuberculous bacilli (MDRTB). The incidence of new cases of TB reaches 1,300 thousand annually. Among them, 5.7 percent are MDR-TB. Staining for acidfast bacilli in sputum and clinicoradiological examination have been the main diagnostic tools for TB, particularly pulmonary TB. However, the positive rate of sputum Ziehl-Neelsen stain for sputum is disappointedly low, merely 28% in newly-diagnosed TB. Moreover, the radiological manifestations of the patients suspected of TB are often non-specific. All these facts call for a simple, accurate and rapid diagnostic method to overcome this bottleneck, which hinders the success of satisfactory TB control in China. Employing both hemi-nested RT-PCR and beacon technology with fluorescent probes, the MTB/RIF diagnostic assay specifically amplifies, thus helps detect the rpoB gene, which is unique to Mycobacterium tuberculosis and also a biomolecularmarker of rifampin resistance. As a semi-quantitative analysis, the quantity of Mycobacterium tuberculosis in samples is reflected by the threshold of PCR cycles during MTB/RIF assay. With Mycobacterium tuberculosis culture as the standard reference, for sputum samples from patients suspected of suffering from pulmonary TB, overall diagnostic sensitivity of MTB/RIF assay is 73.1%-90.0% with a specificity of 99.0%-99.5%. For detection of rpoB gene mutations responsible for rifampin-resistance, the sensitivity is 97.2% and specificity is 98.3%. Following sample loading, the system can automatically complete the diagnostic process and report the results within 2 hours. Targeting the rpoB gene specifically, there is no cross-reaction with non-tuberculosis mycobacteria or other common respiratory pathogens. In addition to sputum samples, the system can be used to detect Mycobacterium tuberculosis in various body fluids (including pleural effusion, urine, cerebrospinal fluid and even bronchoalveolar lavage fluid) and lung tissue biopsy samples. As for sensitivity, the assay is comparable to Mycobacterium tuberculosis culture (for the latter, mean interval between loading and result-reporting is 16 or 30 days (depending upon the culture medium used), and it is 100 times longer than Ziehl-Neelsen stains. Compared with conventional laboratory diagnostic approaches, this assay is much simpler and biohazardous aerosol-free.

Measurements of the magnetic properties and total contents of Cu, Cd, Pb and Fe in 30 automobile emission particulate samples indicated the presence of magnetic particles in them. The values of frequency dependent susceptibility (chi(fd)) showed the absence of superparamagnetic (SP) grains in the samples. The IRM(20 mT) (isothermal remanent magnetization at 20 mT) being linearly proportional to SIRM (saturation isothermal remanent magnetization) (R(2)=0.901), suggested that ferrimagnetic minerals were responsible for the magnetic properties of automobile emission particulates. The average contents of Cu, Cd, Pb and Fe in automobile emission particulates were 95.83, 22.14, 30.58 and 34727.31 mg/kg, respectively. Significant positive correlations exist between the magnetic parameters and the contents of Pb, Cu and Fe. The magnetic parameters of automobile emission particulates reflecting concentration of magnetic particles increased linearly with increase of Pb and Cu content, showed that the magnetic measurement could be used as a preliminary index for detection of Pb and Cu pollution.
Algorithms ; Environmental Monitoring ; methods ; Feasibility Studies ; Magnetics ; Metals, Heavy ; analysis ; chemistry ; Statistics as Topic ; Vehicle Emissions ; analysis

Objective To investigate the clinical value of enhanced recovery after surgery (ERAS) in patients undergoing postoperative early enteral nutrition (EEN) with radical resection for hilar cholangiocarcinoma.Methods The clinical data of 48 patients with hilar cholangiocarcinoma who were admitted to the Drum Tower Clinical Medical College of Nanjing Medical University from July 2006 to September 2014 were retrospectively analyzed.All the 48 patients underwent radical resection for hilar cholangiocarcinoma,including 24 patients receiving postoperative EEN (EEN group) and 24 patients receiving total parenteral nutrition (TPN group).The serologic indices and liver function were detected regularly after operation.Ten percent of albumin (Alb) 10 g was administered by intravenous infusion when Alb ＜ 30 g/L.The indexes of all the 48 patients were compared in the 2 groups at postoperative day 3 and 7,including the serologic indices and liver function,the exhaust time,the volume of Alb infusion,the complications (incisional infection,abdominal infection,pleural effusion,peritoneal effusion and bile leakage) and the duration of hospital stay.The patients were followed up by outpatient examination and telephone interview till September 2014.The measurement data with normal distribution were presented as x ± s,comparison between groups and count data were analyzed using the t test and chi-squared test,respectively.Results Patients in the 2 groups were cured successfully and discharged,and no patient died perioperatively.Patients in the EEN group had a good tolerance for EEN and no occurrence of EEN-related complications was detected.The level of the GGT was (108 ± 73) U/L in the EEN group,which was significantly lower than (225 ± 121) U/L in the TPN group at postoperative day 3 (t =4.041,P ＜ 0.05).The level of the GGT was (142 ± 86) U/L in the EEN group,which was no significantly different from (183 ± 107)U/L in the TPN group at postoperative day 7 (t =1.477,P ＞ 0.05).The postoperative time to anal exsufflation and the duration of hospital stay were (73 ± 18) hours and (15 ± 4) days in the EEN group,which were significantly different from (97 ± 21) hours and (18 ± 4) days in the TPN group,and the volume of Alb infusion was (44 ± 29)g in the EEN group,which was significantly lower than (101 ± 92) g in the TPN group (t =4.295,2.615,2.916,P ＜ 0.05).All the 48 patients were followed up for 1 to 71 months (mediantime,10 months),no patients received reoperation or re-admitted to the hospital due to complications.Conclusion The application of postoperative EEN in enhanced recovery of patients undergoing radical resection for hilar cholangiocarcinoma is safe and effective,it could accelerate the recovery of enteral function,shorten the postoperative duration of hospital stay and reduce the supplement of extrinsic Alb,which is helpful for the fast recovery of patients.

OBJECTIVETo compare the efficacy of different points combination in the treatment of menopausal insomnia.

METHODSNinety-six cases of menopausal insomnia were randomized into 3 groups, Xinshu (BL 15), Shenshu (BL 23), Sishencong (EX-HN 1), Shenmen (HT 7), Sanyinjiao (SP 6) were chosen in the restore interaction between the heart and the kidney group (group A, 32 cases); Zhaohai (KI 6), Jiaoxin (KI 8), Shenmai (BL 62), Pucan (BL 61) were chosen in the acupuncturing qiao mai group (group B, 32 cases); auricular Shenmen (TF4) and sensitive spot at the distribution area of auricular vagus nervus were chosen in the ear acupuncture group (group C, 32 cases). Six days made one session and the treatments were finished after 4 courses. The polysomnography (PSG) and Pittsburgh sleep quality index (PSQI) were employed before and after treatment to evaluate the alleviation of insomnia.

RESULTSThe parameters of the sleep latency (SL), rapid wave sleep latency (RL) and sleep efficiency (SE) were significantly improved in the three groups, and the differences were statistically significant (P < 0.05, P < 0.01). The SL and awaking time (AT) in group C [SL (401.08 +/- 16.54) min and AT (4.87 +/- 2.64) times] were significantly superior to those in the other two groups [SL (50.36 +/- 18.47) min, (54.87 +/- 20.92) min, AT (5.98 +/- 2.11) times, (6.13 +/- 3.04) times, all P < 0.05]. The S(3+4) (%) in group C was also significantly higher than those in the other two groups (both P < 0.05). It was indicated by PSQI that the sleep quality of group C (0.78 +/- 0.12) was significantly superior to that in group B (1.32 +/- 0.29), the total score and cured and markedly effective rate in group C [(4.34 +/- 1.43), 68.8% (22/32)] were superior to those in group A [(7.48 +/- 3.09), 53.1% (17/32), both P < 0.05].

CONCLUSIONEar acupuncture has a better curative effect than the restore interaction between the heart and the kidney group and acupuncturing qiao mai group, it is worth of being promoted.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Menopause ; psychology ; Middle Aged ; Sleep ; Sleep Initiation and Maintenance Disorders ; therapy ; Treatment Outcome

OBJECTIVETo observe changes in tongue and hyoid position, and pharyngeal airway in patients with skeletal class III malocclusion after the combined orthodontic and orthognathic treatment.

METHODSTwenty patients were involved in this study. Cone beam CT (CBCT) was performed on patients one week before and six months after treatment. Raw data were reconstructed into three-dimensional model. To set up a three-dimensional reference frame, which was based by point "S", the sagittal and transversal measurements, cross sectional areas, partial and total volumes were computed. The three-dimensional position changes of chin, hyoid bone and tongue were measured in order to analyze the amount of mandibular setback relationship with the changes of pharyngeal airway, hyoid bone and tongue positions.

RESULTSAfter treatment, the pharyngeal airway was constricted significantly. The hyoid significantly moved inferoposteriorly by 5.72 mm (backward) and 2.76 mm (downward) and the tongue moved posteriorly by 4.04 mm after surgery (P < 0.05). Among the 19 correlated indexes between the amount of mandibular setback and other measurements, 14 of which were significantly correlated (P < 0.05). The strongest correlation was found between the amount of mandibular setback and total volumes of pharyngeal airway (r = 0.834, P < 0.01).

CONCLUSIONFollowing combination therapy, the pharyngeal airway space decreased, the hyoid moved inferoposteriorly and tongue moved posteriorly. There were great correlations between the amount of mandibular setback and the changes.

Adult ; Cephalometry ; Cone-Beam Computed Tomography ; Humans ; Hyoid Bone ; Male ; Malocclusion, Angle Class III ; Mandible ; Pharynx ; Prognathism ; Tongue

Objective To explore the clinical features, treatment and outcome of puerperium pulmonary thromboembolism (PTE). Methods To count the cases of spontaneous labor and cesarean section, as well as the incidence of PTE, treated in the First Affiliated Hospital of Guangzhou Medical University from Jan. 2006 to Nov. 2011, and retrospectively analyze the data of hospitalized parturients with PTE. Results A total of 5052 cases of spontaneous delivery were collected at the obstetric ward, of which 2910 cases (57.6%) were cesarean sections and 2142 cases (42.4%) were vaginal delivery. On the duration of hospital stay, 13 cases (0.26%) were diagnosed as puerperal PTE by CT pulmonary angiography, of which 11 cases occurred within 3 days after delivery. The incidence of puerperal PTE was significantly higher in cases with cesarean section than in those with vaginal delivery (0.38% vs 0.09%, P=0.043). The most common symptoms of puerperal PTE were breathless (76.9%), cough (53.8%), pleuritic chest pain (23.1%) and fever (30.8%). The clinical symptoms were improved by anticoagulation therapy (11 cases) or thrombolysis (2 cases) with zero mortality. Conclusions The incidence of puerperal PTE in the hospital the authors served is 0.26%. Puerperal PTE should be considered especially to those parturients with sudden dyspnea, chest tightness or pleuritic chest pain within 3 days after cesarean section.