Objective To compare radionuclide bone scan and MRI for vertebral metastasis detection fromlung cancer tumor.Methods 45 cases with lung cancer were collected for radionuclide bone scan and MRI scan,the scanning time within 15 days.Three deputy directors read the piece,the detection rate of two kinds of examination methods was compared.Results 35 cases were detected by radionuclide bone scan and MRI (x2 =0.135,P ＞0.05).It was detected 84 positive bone metastases vertebral,detected in 45 of radionuclide bone scan,MRI detected73,the difference was significant (x2 =15.300,P ＜ 0.05).Conclusion MRI can effectively detect lung cancer spine bone vertebral metastasis loci without false positive lesions,which contribute to the diagnosis and treatment of disease,worthy of clinical promotion.

The clinical manifestation of acute invasive fungal sinusitis was associated with facial pain,altered sense of smell, blindness and headache. Physical examinations show that dark brown nasal secretions with bone resorption in paranasal sinus. Radiographi parameters showed uneven density in paranasal sinus and intraorbital extension. Fungus smears and pathological examination can make a definitive diagnosis.
Acute Disease ; Facial Pain ; etiology ; Fungi ; isolation & purification ; Headache ; etiology ; Humans ; Mycoses ; complications ; pathology ; Paranasal Sinuses ; Sinusitis ; complications ; microbiology ; pathology

Objective To impove the cognition of allergic bronchopulmonary aspergillosis by analyzing its clinical characteristics.Methods 22 patients diagnosed as having allergic bronchopulmonary aspergillosis in our hospital were studied in their clinical characteristics,imaging findings,laboratory inspections,pathologies,therapies and follow-up results.Results (1)The patients consisted of 13males and 9 femailes.Asthma was present in 16 patients,and absent in 6 cases,some of which had no wheezing heard in lung auscultation.(2)Central bronchiectasis was present in 19 cases,with the upper lobe bronchial mainly involved.(3)Simple glucocorticoid therapy was used in 2 cases,the joint anti-fungal therapy in 19 cases(one case improved combined with itraconazole therapy after recurrence and one case improved with the joint itraconazole treatment,followed by recurrence of the symptoms after discontinued antifungal therapy and by the combination therapy again).Conclusion Clinical asthma is the most common symptom of ABPA.However,there are one-third of cases without history of asthma.Central bronchiectasis with formation of mucus suppository is a characteristic feature of ABPA which can prompt diagnosis and help in the prognosis.The combination of antifungal treatment can lead to improvement and reduce or eliminate the need of glucocorticoid therapy.

The aim of the present study was to explore the prevalence characteristics of brucellosis in Hainan by investigating the biological characteristics and clinical type of pathogenic bacteria isolated from the blood of a patient infected by infective endocarditis.Bacteriological experiments were conducted according to the standard identification methods of Brucella including morphology,cultural characters,biochemistry characters,serological test and phage test,etc.At the same time,systematic analysis on the information about epidemiology,clinical manifestation and laboratory data of the patient was carried on.The Brucella melitensis was identified as Brucella melitensis biotype 2 and was significantly different from the Brucella melitensis biotypes 1 and 3 isolated in China reported in recent years.The urease test result of Brucella melitensis was variable and there is no strong positive result reported except the isolates in Hainan.As Brucellosis cause by Brucella melitensis biotype 2 was firstly reported in Hainan Province,great importance should be attached to its point-like prevalence.

Objective:To understand the epidemic characteristics and risk factors of severe fever with thrombocytopenia syndrome (SFTS) in Zhaoyuan City, and to provide basis for the improvement of prevention and control strategies.Methods:Retrospective analysis was performed to collect the SFTS surveillance data and epidemiological investigation results of confirmed cases in Zhaoyuan City from 2011 to 2018 from the "Infectious Disease Report Information Management System of the China Disease Prevention and Control Information System", and the general situation and epidemiological characteristics, onset and treatment, clinical manifestations and contact history of SFTS cases were analyzed by descriptive epidemiology method; 60 cases of SFTS confirmed cases and 120 healthy people in the same village, same sex, and same age group as the confirmed case were selected by case-control study to analyze the risk factors of SFTS.Results:A total of 140 confirmed SFTS cases were reported in Zhaoyuan City from 2011 to 2018, with a fatality rate of 18.57% (27/140); the onset time was mainly from May to August, accounting for 83.57% (117/140); the age of onset was mainly 50 - 80 years old, accounting for 90.00%(126/140); the sex ratio of men to women was 1.06 ∶ 1.00 (72 ∶ 68); the occupation distribution was dominated by farmers, accounting for 92.14% (129/140). In 140 cases of SFTS, the average time intervals from onset to first visit and from first visit to confirmation of diagnosis were 4 and 6 days, respectively; and the average medical visit history from onset to diagnosis was 2 times, 60.71% (85/140) of the cases were first diagnosed by township medical institutions, 86.43% (121/140) of the cases were diagnosed by municipal hospitals; the first symptom was fever, which accounted for 92.86% (130/140). The logistic regression analysis showed that domestic animals [odds ratio ( OR)=9.209, 95% confidence interval ( CI): 2.064-41.083] and tick bites ( OR = 16.818, 95% CI: 1.553 - 182.164) were risk factors for SFTS. Conclusions:The onset time of SFTS is mainly from May to August in Zhaoyuan City, and farmers over 50 years old are the key population; domestic animals and tick bites are the risk factors for the onset of SFTS. The publicity and health education of SFTS prevention and control knowledge for key populations should be strengthened.

Chest contusion is the soft-tissue injury disorders that the external violence directly destroys the chest wall and the soft tissues, causing chest pain, fullness, and symptoms aggravate when the chest moves. Chinese medicine showed many treatments with clinical efficacy. Therefore, Chinese medicine has been widely used in clinics. This paper was to review the research progress of Chinese medicine treatment for chest contusion.

Objective To express and purify EGF-TCS fusion protein and observe the targeted and selective killing effect on cancer cells of the fusion protein.Methods The recombinant expression plasmid PQE30/EGF-TCS was transformed to E.coli.M15 and the fusion protein(EGF-TCS) was expressed.Ni-NTA Agrose affinity chromatography was used to purify the protein,flow cytometry to detect EGFR expression rate in cancer cells(BEL-7402,MCF-7,BGC-823) and normal liver LO2 cells,and the killing test to verify selective killing ability of EGF-TCS;The cell apoptosis detection by flow cytometry and microscopic observation were used to confirm the selective killing ability of EGF-TCS.Results Recombinant expression plasmid PQE30/EGF-TCS was expressed in E.coli.M15 stably and effectively.The purity of EGF-TCS was over 95% by chromatography.EGFR expression rate was highest in hepatoma cells BEL-7402(72.33%) and lowest in normal liver LO2 cells(5.51%).The killing ability of recombinant protein was more effective to cancer cells(IC50 of BEL-7402,MCF-7 and BGC-823 was 11.4,22.47 and 12.53 ?g/ml respectively) and was weak to normal cells(IC50 53.19 ?g/ml).Conclusion The recombinant protein EGF-TCS that induces apoptosis of cancer cells was successfully constructed by gene engineering technology.

Objective To investigate the mechanism of Smad ubiquitination-related factor 2 (Smurf2)neddylation. Methods The Smurf2 protein level was tested by overexpression of Nedd8,while the method of immunoprecipitation(IP) and Western blotting were used to analyz Smurf2-Nedd8 modification.The GST-pulldown experiment was conducted to prove protein interactions.The protein was obtained by grinding mouse tissue and Western blotting was used to test the protein expression level.Results Over expression of Nedd8 could lead to the down regulation of the Smurf2′s protein level.Smurf1 and Smurf2 could interact in the GST-pulldown experiment. Smurf1 could enhance Smurf2-Nedd8 modification.The Smurf2′s protein level was up-regulated in mouse tissue of Smurf1 C426A.Conclusion There is some relationship and also difference between Smurf1 and Smurf2.Smurf1 can enhance Smurf2-Nedd8 modification.

Objective To assess the effects of fluid resuscitation in elderly patients with septic shock by right ventricular end-diastolic volume index (RVEDVI). Method Thirty elderly patients with septic shock with-in 6 hours after onset, admired to intensive care unit of Zhejiang Hospital from January 2007 to October 2008, were randomly divided into control group (n = 15) and experimental group (n = 15). Homodynamic profile of the right ventricular was monitored by using modified Swan-Ganz catheter. Fluid resuscitation was given to the patients of control group monitored by right atria pressure (RAP). The expected efficacy of treatment was the RAP elevated to 8 ～ 12 mmHg. The goal of fluid resuscitation in patients of experimental group was 100～ 200 mL/m~2 RVEDVI corrected by right ventricular ejection fraction (RVEF). RAP, pulmonary artery occlusion pressure (PAOP), RVEF, RVEDVI, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and mixed venous oxygen sat-uration (SvO_2) were recorded before and after the treatment for 6 hours in both groups. The concentration of lactate and the lactate clearance rate of patients in both groups after fluid resuscitation were detected. The relationship between lactate clearance rate and ARVEDVI was evaluated by using correlation analysis. Results The percentage of patients reaching goal of resuscitation in experimental group (86.7%) was higher than that in control group (80%), however, there was no significant difference statistically. In goals-achieving group, RVEDVI, △RVEDVI, RVEF(%), RAP and lactate clearance rate(%) of the patients in experimental group were signifi-cantly higher than those in control group [(119.92 ± 15.65) mL/m~2, (38.54 ± 6.63) mL/m~2, (36.08 ± 3.40), (14.46±1.13) mmHg,(58.31 ± 13.36) vs. (99.92±11.71) mL/m~2,(21.00±11.01) mL/m~2,(32.42± 2.47),(13.08±1.08) mmHg,(43.99±16.26); P <0.05]. However, there was no significant difference in PAOP, APACHE Ⅱ and SvO_2 between two groups (P >0.05). The lactate clearance rate in goals-achieving pa-tients with septic shock has a significant correlation with RVEDVI and △RVEDVI (P < 0.01). Conclusions Fluid resuscitation guided by RVEDVI in elderly patients with septic shock is safe and more effective than that guided by RAP.

Objective To investigate the influence of left ventricular-arterial coupling(VAC) on clinical prognosis of elderly patients with septic shock.Methods A total of 56 elderly septic shoek patients were enrolled in this study,all of whom were admitted to Department of Intensive Care Unit in Zhejiang Hospital from August 2014 to October 2015.The patients were divided into two groups according to the status of left ventricular-arterial coupling when septic shock was diagnosed,which were left ventricular-arterial uncoupling group(UC group) and left ventricular-arterial coupling group(C group).Various parameters were recorded,including blood lactate level,central venous oxygen saturation(ScvO2),serum level of N-terminal pro-brain natriuretic peptide(NT-proBNP) and cardiac troponin Ⅰ (cTN Ⅰ),dose of vasoactive drugs,the total fluid volume and urine volume per hour within 24 hours.The 28-day survival rate was a key index of prognosis.Multivariate logistic regression was taken to analyze risk factors related to death within 28 day.Results Compared with C group,UC group had lower values of left ventricular ejection fraction[(42.43 ±4.76)％ vs (53.17±3.01)％;P＜0.01] and cardiac index[(2.36±0.68) L· min-1 · m 2vs (2.93±0.45)L · min-1 · m-2;P ＜0.01].Yet serum levels of NT-proBNP[lg NT-proBNP 3.93 ±0.53 vs 3.40 ±0.63;P =0.004] and cTN Ⅰ [lg cTN Ⅰ-0.16 ± 0.68 vs-1.03 ± 0.69;P ＜ 0.001] in UC group were higher than those in C group.Moreover,the total fluid volume within 24 hours [(3 806.3 ± 831.4) ml vs (3 142.0±770.0) ml;P =0.016],blood lactate level[(5.61 ±2.68) mmol/L vs (3.93 ± 1.59)mmol/L;P =0.043] and dose of norepinephrine[(0.630 ±0.300) μg · kg-1 · min-1 vs (0.292 ±0.234)μg · kg-1 · min-1;P =0.001] in UC group were greater than those in C group,while ScvO2 [(60.75 ±2.91)％ vs (64.42 ±2.19)％;P＜0.001] and urine volume per hour[(0.518 ±0.358) ml vs (0.926 ±0.678) ml;P =0.007] were less than those in C group.Compared with C group,UC group had a lower 28-day survival rate [43.2％ (19/44) vs 9/12;P =0.049].Ea/Ees ratio was negatively correlated with LVEF,ScvO2 (r =-0.686,P ＜ 0.001;r =-0.411,P =0.002),positively correlated with NT-proBNP,cTN Ⅰ (r =0.294,P =0.028;r =0.363,P =0.006),yet no obvious correlation was noticed with blood lactate level (r =0.170,P =0.21).Multiple logistic regression analysis showed that VAC(OR =11.187,95％ CI 2.489-50.285;P =0.002),lactate level (OR =1.727,95 ％ CI 1.164-2.563;P =0.007) and lg cTN Ⅰ (OR =0.247,95 ％ CI 0.079-0.779;P =0.017) were independent risk factors affecting 28-day mortality.Conclutions In elderly patients with septic shock,left ventricular-arterial uncoupling indicates a lower 28-day survival rate,worse cardiac function and tissue perfusion.Ea/Ees ratio might sever as a predictive indicator of 28-day mortality.