Objective To investigate the clinical value of multi-slice spiral CTA ( MSCTA ) and image-post processing techniques in diagnosis of acute aortic syndrome ( AAS) .Methods 71 patients with AAS were scanned by TOSHIBA Aquilion 64-slice spiral CT,the images on axial and 2D/3D were analyzed.Results 71 cases included 48 cases of aortic dissection ( AD) ,10 cases of intramural hematoma ( IMH) and 13 cases of penetrating atheroscle-rotic ulcer ( PAU) .MSCT depicted the imaging features of AAS:AD showed intimal flap and true and false lumens;IMH showed crescent or circular thickening of aortic wall .PAU showed a niche filling with contrast medium and pro-truding the aortic lumen ,where narrow neck signwas shown .The location ,radiological diagnosis and complications of AAS were observed in 71 patients.Intervention treatment or surgical treatment was conducted in 27 cases after defi-nite diagnosis .Conclusion MSCT is a fast and noninvasive examination technique , and it can provide important information for the diagnosis and treatment of AAS .

This paper reports a case of Ancylostoma duodenale parasitized in the hepatic flexure of colon and the case was misdiagnosed at the beginning. The causes of misdiagnosis are analyzed and the laboratory examination methods of hookworm are summarized.

Objective To discuss and evaluate the value of multi slice spiral CT angiography in the diagno -sis of penetrating atherosclerotic ulcer materials .Methods 17 patients of PAU were collected and examined with MSCT,the location,radiological diagnosis and complications of PAU on axial ,CTA and 2D/3D images were analyzed. Results Ulcer-like aortic projections were observed of 17 patients,and connected with aortic cavity ,where narrow neck sign was showed .The indirect signs included localized or extensive IMH ,calcification of aortic wall and dilata-tion of aorta .Conclusion Multi slice spiral CT angiography is an effective method for the diagnosis of PAU by provi -ding valuable information for the diagnosis and treatment .

Quality variation and ecotype classification of Chinese herbal medicine are important scientific problems in Daodi herbal medicine research. The diversity of natural environmental conditions has led to form unique multi-Daodi, multi-product areas that produce particular Chinese herbal medicine. China is one of three big American ginseng (Panax quinquefolium L.) producing areas worldwide, with over 300 years of application and 40 years of cultivation history. Long-term production practice has led to the formation of three big advocate produce areas in China: Northeast province, Beijing and Shandong. P. quinquefolium L. grown under certain environmental conditions will develop long-term adaptations that will lead to more stable strains (different ecotypes). P. quinquefolium L., can vary greatly in quality; however, the ecological mechanisms causing this variation are still unclear. Root samples were collected from four-year-old cultivated P. quinquefolium L. plants in the three major genuine (Daodi) American ginseng-producing areas of Northeast province, Beijing and Shandong province, China. Ultra-performance liquid chromatography was used to analyze the contents of eight ginsenosides (Rg1, Re, Rb1, Rb2, Rb3, Rc, Rd, Rg2). Data for nine ecological factors, including temperature, moisture and sunlight, were obtained from the ecological database of Geographic Information System for Traditional Chinese Medicine. Soil samples from the sampling sites were collected. Effective boron and iron, available nitrogen and potassium, as well as other trace elements and soil nutrients, were determined by conventional soil physicochemical property assay methods. Analytical methods of biostatistics and numerical taxonomy were used to divide ecotypes of the three main Panax quinquefolium L. producing areas in China based on ginsenoside content, climate, soil and other ecological factors. To our knowledge, this is the first time that ecological division of P. quinquefolium L. producing areas in China has ever been conducted. The results show that there are two chemoecotypes of P. quinquefolium L. in China: ginsenoside Rb1-Re from outside Shanhaiguan, and ginsenoside Rg2-Rd from inside Shanhaiguan. Similarly, there are two types of climatic characteristics: inside Shanhaiguan (Beijing, Shandong) and outside Shanhaiguan (Northeast). This suggests that the formation and differentiation of chemoecotypes of P. quinquefolium L. is closely related to variability of the climatic and geographical environment. Additionally, ecological variation of the three main producing areas, characteristics of two climatic ecotypes, and soil characteristics are also discussed and summarized. These results provide experimental scientific evidence of the quality variation and ecological adaptation of P. quinquefolium L. from different producing areas. They also deepen our understanding of the biological nature of Daodi P. quinquefolium L. formation, and offer novel research models for other multi-origin, multi-Daodi Chinese herbal medicines ecotypes. In addition, the results demonstrate the critical need for improving quality, appropriate ecological regionalization and promoting industrialized development of P. quinquefolium L.

Objective To explore the nursing problems and application value of intrauterine instruments positioning in assistance of tubal interventional treatment. Methods Uterine probe or expanding-uterus stick was used in 66 cases who had abortde with routine methods for rectifying the position of uterus or adhesion re-lease, then the selected catheter was inserted to the targeted fallopian tube for interventional aim. Nurses paid at-tention to the nursing cooperation and summarized the nursing points during the whole processes. Results With this technique, the achievement ratio of selected insertion to fallopian tube was 100% and that of recanaliza-tion was 92.68%. The major adverse effects were hypogastralgia and little vaginal bleeding. Pneumogastric nervereactions were found in 3.03% cases. Conchusions The assistant-immanent could elevate the achievement ra-tio of selected insertion to the targeted fallopian tubes, but the nursing problems shouldn't be neglected.

OBJECTIVETo probe the significance of specific IgG4 in sera of patients with cerebral cysticercosis for diagnosis and therapeutic evaluation.

METHODSSpecific IgG4 in sera of patients with cerebral cysticercosis was assessed using colloidal gold-labeled mouse-anti-human IgG4 McAb as probe. The results were compared with the CT image manifestation.

RESULTSThe specific IgG4 positive rate in sera of patients with cerebral cysticercosis was 97.8%, whereas sera from patients with other kinds of parasitosis or central nerve system disease and the control group were all negative, except for a weak cross-reaction of sera from patients with hepatic echinococoosis. The determination of specific IgG4 in sera of patients with cerebral cysticercosis during different times of treatment showed that along with an increase in treatment time and improvement of clinical symptoms, specific IgG4 level gradually decreased. The positive rate and intensity of specific IgG4 in sera from patients with cerebral cysticercosis were consistent with the number of cysticercus parasites in the brain and pathologic changes, such as survival, disintegration, death and calcification. Survival of cysticercus in the brain was objectively evaluated using this technique.

CONCLUSIONSThe determination of specific IgG4 in sera is a practical method for diagnosis and therapeutic evaluation of cerebral cysticercosis.

Animals ; Antibodies, Monoclonal ; immunology ; Antibody Specificity ; Humans ; Immunoglobulin G ; blood ; immunology ; Mice ; Mice, Inbred BALB C ; Neurocysticercosis ; blood ; diagnosis ; therapy ; Predictive Value of Tests ; Tomography, X-Ray Computed

Objective To compare delivery accuracy and precision of nutrients as well as physicochemical property between self-made homogenate diet an d commercial dairy based enteral nutrition product and investigate the clinical significances.Methods GB methods were used to examine and analyze the nutrients in self-made homogenate diet and commercial dairy based protein product.Results Self-made homogenate diet exhibited high viscosity (20,000±2121.32) cps because of high water content.The actual values for macronutrients and energy were all lower than 10％ of designed values.The actual values for lipid soluble vitamins A and E were only 49.32％ and 56.47％ of designed values,while the actual values for water soluble vitamins B1,B6 and C were all very low that were close to or lower than detection levels.All minerals,except for potassium were lower than the designed values,wherein iron was only 25.16％ of designed value.For commercial enteral nutrition product,the actual contents of energy,macro-and micro-nutrients including vitamins and minerals were all higher than the designed values and the difference between the contents of minerals and its designed values were controlled within deviation range (5％ ～ 10％).Conclusion For vitamins and minerals in self-made homogenate diet,non-linear correlation was identified between the testing value and designed value.Commercial enteral nutrition product can provide more accurate nutrient level to reach the designed value,and has better flexibility on individual nutrient fortification.

Objective To investigate the antimicrobial resistance profile of the clinical isolates collected from selected hospitals across China. Methods Twenty-nine general hospitals and five children's hospitals were involved in this program. Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems. Results were interpreted according to CLSI 2017 breakpoints. Results A total of 190 610 clinical isolates were collected from January to December 2017, of which gram negative organisms accounted for 70.8％ (134 951/190 610) and gram positive cocci 29.2％ (55 649/190 610). The prevalence of methicillin-resistant strains was 35.3％ in S. aureus (MRSA) and 80.3％ in coagulase negative Staphylococcus (MRCNS) on average. MR strains showed much higher resistance rates to most of the other antimicrobial agents than MS strains. However, 91.6％ of MRSA strains were still susceptible to trimethoprim-sulfamethoxazole, while 86.2％ of MRCNS strains were susceptible to rifampin. No staphylococcal strains were found resistant to vancomycin. E. faecalis strains showed much lower resistance rates to most of the drugs tested (except chloramphenicol) than E. faecium. Vancomycin-resistant Enterococcus (VRE) was identified in both E. faecalis and E. faecium. The identified VRE strains were mainly vanA, vanB or vanM type based on phenotype or genotype. The proportion of PSSP or PRSP strains in the non-meningitis S.pneumoniae strains isolated from children decreased but the proportion of PISP strains increased when compared to the data of 2016. Enterobacteriaceae strains were still highly susceptible to carbapenems. Overall, less than 10％ of these strains (excluding Klebsiella spp.) were resistant to carbapenems. The prevalence of imipenem-resistant K. pneumoniae increased from 3.0％ in 2005 to 20.9％ in 2017, and meropenem-resistant K. pneumoniae increased from 2.9％ in 2005 to 24.0％ in 2017, more than 8-fold increase. About 66.7％ and 69.3％ of Acinetobacter (A. baumannii accounts for 91.5％) strains were resistant to imipenem and meropenem, respectively. Compared with the data of year 2016, P. aeruginosa strains showed decreasing resistance rate to carbapenems. Conclusions Bacterial resistance is still on the rise. It is necessary to strengthen hospital infection control and stewardship of antimicrobial agents. The communication between laboratorians and clinicians should be further improved in addition to surveillance of bacterial resistance.

This study aimed to evaluate the efficacy of Chinese herbal medicine (CHM) in patients with severe/critical coronavirus disease 2019 (COVID-19). In this retrospective study, data were collected from 662 patients with severe/critical COVID-19 who were admitted to a designated hospital to treat patients with severe COVID-19 in Wuhan before March 20, 2020. All patients were divided into an exposed group (CHM users) and a control group (non-users). After propensity score matching in a 1:1 ratio, 156 CHM users were matched by propensity score to 156 non-users. No significant differences in seven baseline clinical variables were found between the two groups of patients. All-cause mortality was reported in 13 CHM users who died and 36 non-users who died. After multivariate adjustment, the mortality risk of CHM users was reduced by 82.2% (odds ratio 0.178, 95% CI 0.076-0.418; P < 0.001) compared with the non-users. Secondly, age (odds ratio 1.053, 95% CI 1.023-1.084; P < 0.001) and the proportion of severe/critical patients (odds ratio 0.063, 95% CI 0.028-0.143; P < 0.001) were the risk factors of mortality. These results show that the use of CHM may reduce the mortality of patients with severe/critical COVID-19.
Age Factors ; Aged ; COVID-19/therapy* ; China ; Drugs, Chinese Herbal/therapeutic use* ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Odds Ratio ; Propensity Score ; Retrospective Studies ; Survival Rate