Objective To investigate the clinical efficacy and safety of lyophilized recombinant human brain natriuretic peptide(rhBNP) in the treatment of patients with congestive heart failure (CHF).Methods 120 CHF patients were randomly divided into two groups.58 cases in the observation group were given lyophilized rhBNP,and 62 patients in the control group were given sodium nitroprusside.The clinical effect,changes of echocardiographic indicators and hemodynamic parameters,adverse reactions were observed.Results After treatment,the total effective rate of the observation group was 91.37％,which was significantly higher than that of the control group(x2 =4.23,P ＜ 0.05).The LVEF and NT-proBNP levels in observation group were (59.0 ± 8.2)％ and (535.4 ± 123.8)ng/L,which had higher improvement than control group (P ＜ 0.05).The incidence rate of adverse reactions between the two groups had no significant difference (P＞ 0.05).Conclusion Lyophilized rhBNP in the treatment of CHF has significant effect,and it is worthy of clinical application and promotion.

PurposeTo explore the left ventricle flow propagation process in patients with chronic heart failure (CHF) using velocity flow mapping. Materials and Methods Patients with CHF (n=25) were selected as CHF group. Healthy subjects (n=28) were chosen as the control group. Flow reversal interval (FRI), flow reversal rate (FRR), corrected flow reversal rate (CFRI) and flow rate in peak ejection (FRPE) were measured. Parameters related to the vortex in CHF group were compared with that in the control group. Results Compared with the control group, FRI was longer [(71±13) msvs. (113±30) ms, P<0.05], FRR and FRPE were lower [(46.85±21.35) cm2/svs. (27.90±16.77) cm2/s;(74.54±9.10) cm2/svs. (41.12±17.25) cm2/s,P<0.05] in CHF group. FRI and CFRI were positively correlated with the Tei index (r=0.812 and 0.849,P<0.01). FRI was negatively correlated with LVEF, FS, SV, CO, CI (r=-0.646--0.515,P<0.05 orP<0.01). CFRI was negatively correlated with LVEF, FS, SV, CO and CI (r=-0.685--0.456,P<0.05 orP<0.01); FRR was negatively correlated with Tei index (r=-0.604,P<0.05), and was positively correlated with LVEF, FS, SV, CO and CI (r=0.503-0.812,P<0.05 orP<0.01);FRPE was negatively correlated with Tei index (r=-0.734,P<0.01), and were positively correlated with LVEF, FS, SV, CO and CI (r=0.557-0.776,P<0.05 orP<0.01).Conclusion Velocity flow mapping can demonstratecardiac hydromechanics in patients with chronic heart failure. The heart blood flow direction reversal efficiency may be a new method for diagnosis and treatment evaluation.

Objective:To evaluate the changes of neurocognitive function in early stage in patients with first-episode schizophrenia.Methods:In this study,73 cases of patients with first-episode schizophrenia (research group) and 75 cases of health person (control group) were selected from January 2015 to January 2016 in our hospital.The neurocognitive function was evaluated by neuro-psychological testing tool and the data between two group were compared.Results:Scores of delayed recall,total recall,3 trial,2 trial and 1 trial of research group were lower than those of control group in BVMT-R test,and the difference was statistically significant (P＜0.05).In HVLT-R test,the scores of total delay,3 trial and 2 trial of research group were significantly lower than those of control group (P＜0.05).The consuming time of dominant hands and subdominant hands in pegboard tasks were significantly higher in research group than in control group (P＜0.05).Conpletion time of connection test A,color connection 1 and 2 in connection test of research group were significantly higher than those of control group (P＜0.05).Attempt number and correct number in research group in PASAT test were significantly lower than in control group (P＜0.05).Number of search errors in research group was higher than in control group,while number of search correct,search total score and digital sign score were significantly lower than in control group (P＜0.05).Total number of words,color and color / word count in research group were lower than in control group in Stroop color word test,and the difference was statistically significant (P＜0.05).WMS-Ⅲ test results between two group had no significant difference (P＞0.05).Conclusion:The neurocognitive function in early stage in patients with first-episode schizophrenia has been extensively damaged.

Objective To explore the prevalence of subthreshold body dysmorphic disorder in an undergraduates sample and investigate the mediating role of self-esteem on big five personality and body image disturbance.Methods A sample of 1 166 undergraduates coming from four different colleges were recruited to complete questionnaire survey.Results The prevalence of subthreshold body dysmorphic disorder in undergraduates was 6.2％.Body image disturbance(35.2± 18.4) was negatively correlated with self-esteem ((29.0±4.3),r=-0.41,P＜0.01),positively correlated with neuroticism ((32.9±8.1),r=0.52,P＜0.01) while negatively correlated with extraversion (39.6 ± 6.8),openness (39.8 ± 6.4),agreeableness (41.7±4.7) and conscientiousness ((40.1±6.4),r=-0.18,-0.14,-0.14,-0.25;all P＜0.01).The mediating role of self-esteem was 19.7％.Conclusion The prevalence of subthreshold body dysmorphic disorder in undergraduates is rather high.Big five personality can directly predict body image disturbance and indirectly predict body image disturbance through the mediating role of self-esteem.

Objective To report 9 HIV-negative patients with talaromycosis marueffei (TSM)complicated by Sweet syndrome,and to analyze the relationship of the anti-interferon-γ (anti-IFN-γ)autoantibody with TSM complicated by Sweet syndrome.Methods HIV-negative patients with TSM complicated by Sweet syndrome were collected from the First Affiliated Hospital of Guangxi Medical University between 2013 and 2018.Their clinical and laboratory data were analyzed retrospectively.Meanwhile,19 HIV-positive patients with TSM and 107 health checkup examinees served as controls.Anti-IFN-γ autoantibody was detected in peripheral blood samples of the patients and controls.Results A total of 9 HIV-negative patients with TSM (5 males and 4 females) were included in this study,and the age of onset ranged from 38 to 60 years.The 9 patients all presented with disseminated infections,manifesting as long-term irregular fever,multiple lymph node enlargement,cough,emaciation and anemia.All of the 9 patients met the diagnostic criteria for classical Sweet syndrome,and microbiological examination of Sweet syndrome lesions was negative.Besides Talaromyces marneffei,6 patients also were infected with nontuberculous mycobacteria,4 with varicella-zoster virus,and 2 with Salmonella.All the 9 HIV-negative patients with TSM were positive for anti-IFN-γ autoantibody,while the 107 healthy controls and 19 HIV-positive patients with TSM were negative for anti-IFN-γ autoantibody.Conclusion Anti-IFN-γ autoantibody may be associated with HIV-negative TSM complicated by Sweet syndrome.

Objective To investigate antimicrobial resistance and pathogen in hebei antibacterial resistance investigation net in 2012.Methods Antimicrobial susceptibility test was detected by Kirby-Bauer method or broth dilution test.Results were analyzed according to CLSI 2010 breakpoints.WHONET 5.5 software was used to analyze the data.Results A total of 10 504 clinical isolates were collected in 2012,of which gram negative bacilli and gram positive cocci accounted for 76.2%, 23.8%,respectively.The most common pathogen in gram-negative rod was E.coli,K.pneumoniae,P.aeruginosa, A.baumanii and E.cloacae respectively.The most common pathogen in gram-positive cocci was S.aureus,E.facium,E-.faecalis,S.pneumoniae and S.epidermidis.ESBL rate of E.coli and K.pneumoniae was 66.5 and 46.7%.The resistant rate of E.coli,K.pneumoniae,E.cloacae to imipenem was 0.1%,0.5%,8.9% and to meropenem was 0.1%,0.6%,4.2%, respectively.P.aeruginosa was resistant to imipenem and meropenem were 38.9% and 32.3%.A.baumanii was resistant to imipenem and meropenem were 5 6.5% and 5 9.7%.Methicillin-resistant strains accounted for an average of 5 7.5% in S.aureus and 87.3% in coagulase negative staphylococcus.Staphylococcus was still susceptible to minocycline and chloram-phenicol.No staphylococcal strains were found resistant to vancomycin,linezolid.But a few coagulase negative staphylococcal strains were resistant to teicoplanin.Conclusion Surveillance of antimicrobial agents played an important role in controlling hospital infection.

Pancreatic metastasis of small cell lung cancer is very rare in clinic. The purpose of this article is to improve the knowledge of clinical and radiologists about this disease by reporting one case.

Immunotherapy combined with targeted therapy can benefit the survival of patients with unresectable hepatocellular carcinoma. Atezolizumab combined with bevacizumab has achieved remarkable efficacy in patients with advanced hepatocellular carcinoma, but the efficacy of conversion therapy in patients with unresectable hepatocellular carcinoma still needs more evidences. The authors report the clinical efficacy of a case of unresectable hepatocellular carcinoma with hepatitis B virus related liver cirrhosis who was treated with immunotherapy plus targeted therapy combined with local treatment. Results show a good effect in patient without tumor recurrence after postoperative 9 months.

Objective:To explore the value of triple fusion positron emission tomography (PET)/MRI in location of epileptogenic focus in patients with focal cortical dysplasia (FCD).Methods:Three patients with refractory partial epilepsy, admitted to our hospital from December 2016 to June 2017, were chosen in our study. The raw MRI and PET images of these patients were processed using Freesurfer and FSL image processing softwares. After extraction and coregistration, precise PET/MRI fusion images were obtained; and the grey-white matter dividing line was highlighted on this fusion image to form triple-fusion images to observe the hypometabolic area and clarify the location.Results:Triple-fusion images of these 3 patients were acquired. In patient 1, a marked decrease in metabolism was noted in the gyrus region delineated by the gray-white matter boundary in the right cingulate gyrus. In patient 2, the area with slightly increased local signal in the right superior frontal gyrus (MRI FLAIR sequence) was the area with reduced metabolism. In patient 3, an area of local decreased metabolism was noted in the right cingulate gyrus. The preoperative evaluation of all 3 patients showed that the above areas were epileptic foci; the patients were followed up for 2 years after surgical resection, no clinical seizures occurred in all patients, and antiepileptic drugs were gradually stopped. All 3 patients were diagnosed as having FCD by postoperative pathology.Conclusion:Triple fusion PET/MRI is a powerful way to assist FCD diagnosis, especially for those FCD cases which are difficult to be diagnosed by other imaging methods, and has a potential clinical application value in epilepsy patients.

In recent years, immune checkpoint inhibitors (ICIs) have greatly improved the survival rate of non-small cell lung cancer (NSCLC) patients without driver mutation. Compared with wild-type tumors, tumors with epidermal growth factor receptor (EGFR) mutations have greater heterogeneity in immune microenvironment characteristics such as programmed cell death ligand 1 (PD-L1) and tumor mutational burden (TMB). Whether ICIs is suitable for NSCLC patients with EGFR mutation has been controversial. Clinical studies have shown that immunomonotherapy has no significant effect on patients with EGFR mutant NSCLC. ICIs combined with chemotherapy and antiangiogenic drugs show good survival benefits. This paper overviews the clinical research and related mechanism of ICIs single drug or combination therapy inadvanced NSCLC patients with EGFR mutation.
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B7-H1 Antigen/metabolism* ; Carcinoma, Non-Small-Cell Lung/pathology* ; ErbB Receptors/metabolism* ; Humans ; Immune Checkpoint Inhibitors/therapeutic use* ; Ligands ; Lung Neoplasms/pathology* ; Mutation ; Tumor Microenvironment