Objective To study CT findings of solitary inflammatory lung lesion,and improve CT diagnostic accuracy.Methods In 21 cases with solitary inflammatory lung lesion,four cases were treated with surgery,four cases were punctured with CT guided biopsy,and other cases were treated with anti-inflammatory agents under being followed up with CT.All were scanned with 2～5 mm thin slice.Results ①The lesions showed square,triangle and irregularity (13 cases).②Part of margin blurred(12 cases).③The density at the edge of the mass was lower than at the central area(9 cases).④After anti-inflammatory therapy,most lesions gradually reduced in size(11 cases).Conclusion Anlysizing CT findings helps to diagnose solitary inflammatory lung lesion,and improves diagnostic accuracy through puncturing with CT guided biopsy necessitiously.To the basic hospital,to scan with 2～5 mm thin slice is important especially.

Objective To construct a novel M.tb DNA vaccine (p846) co-expressing mycobacterial triple antigens including Rv3615c, Mtb10.4 and Rv2660c, and evaluate its cellular immune response and protective efficacy against tuberculosis infection in BALB/c mice. Methods We constructed the p846 by using the cloning technology. The 6- to -8-week old female BALB/c mice were randomly divided into 4 groups: p846, pcDNA3.1, PBS and the BCG group. All mice were administrated intramuscularly with 50 μg recombinant plasmids at 0, 2, 4, 6 week. A single dose of BCG was injected subcutaneously in the BCG group. Two weeks after the final immunization, 10 mice in each group were used for cell proliferation, ELISPOT and FCM assay, BCG challenge experiment and HE staining of lung were performed at 4, 6 weeks later, respectively. Results The p846 vaccine could effectively induce the specific T cell proliferation(P < 0.001) and increase the numbers of IFN-γ+T cells(P <0.001), compared with those in the PBS group and the vector conreol group. The mouse lung tissue presented very mild lung inflammation in the p846 group, compared with other groups. Conclusion Vaccine p846 could not only induce strong cellular immune response, but also efficiently protect BALB/c mice against M.tb infection.

Objective o investigate the prophylactic and therapeutic effects of montelukast,a cysteinyl leukotriene receptor-1 (CysLT1R) antagonist,on the delayed neuropsychological sequelae (DNS) in rat model of carbon monoxide (CO) poisoning and to explore the possible underlying mechanism.Methods A total of 90 rats were acclimated for one week prior to screening rat by Morris water maze test.Ten rats were randomly assigned to control group (Con group),and the remaining 80 rats were subjected to modified method of intraperitoneal injection of CO gas to establish animal model of acute CO poisoning,Thereafter,the survival rats randomized into CO poisoning group (Mod group),low-dose montelukast group (ML group),medium-dose montelukast group (MM group),high-dose montelukast group (MH group) (n =10 each).Montelukast was accordingly administered via intragastric tube at different intervals (30 min,4 h and 12 h) after CO poisoning,and then montelukast was administered every 12 hours for 7 consecutive days.The rats of control group and Mod group received equal volume of normal saline instead at given intervals.Twenty-one days after CO exposure,the average escape latency was measured by Morris water maze test to screen DNS rats followed by H-E staining to observe the pathological changes of cortex and hippocampal CA1 region and TUNEL was used to assess the apoptosis of neurons in cortex and hippocampal CA1 region after rats sacrificed.Results All CO-exposed rats exhibited cognition function lowered,and the escape latency (seconds) in Mod group (43.3 ± 15.5),ML group (31.5 ± 13.2) and MH groups (30.1 ± 12.2) was significantly prolonged compared with Con group (12.1 ± 3.0) (P ＜ 0.05),whereas the difference between MM group (15.0 ± 6.6) and Con group was statistically insignificant (P ＞ 0.05).Compared with Mod group,the escape latency in montelukast treatment groups was shortened,whereas the significant difference in escape latency only found between Mod group and MM group (P ＜ 0.05).Except for Con group,DNS was evident in CO-exposed groups,and the numbers of DNS rats in Mod,ML,MM and MH groups were 8,5,1,4,respectively,which made statistically significant differences to Con group (P ＜ 0.05) except MM group.The DNS incidence in MM group was lower than that in Mod group (P ＜ 0.05).Mod group exhibited severe histopathological injury to the brain,with evident apoptosis of neural cells,whereas in the groups with montelukast treatment,histopathological damage to the brain was mitigated and the number of apoptotic neuronal cells was diminished noticeably in MM group.Conclusion Montelukast can ameliorate the cognitive function of rats,decrease the incidence of DNS and reduce the apoptosis of neural cells as well as attenuate neuronal cell injury,thus exerting neuroprotection against DNS in rats with CO poisoning.

Objective To investigate the factors related to outcome (recovery of motor, activities of daily living, and balance) of stroke patients. Methods 67 stroke patients with hemiplegia were evaluated with the Ueda Classfication of upper and lower limbs function, Functional Independence Measure (FIM), Berg balance scale (BBS) before and after treatment. The scores of all the assessment were as the dependent variable respectively, and regression analyzed with the factors possiblely related to the outcome. Results The positive factors for lower limbs function included rehabilitation intervention, time of rehabilitation, and hypercholesterolemia; while the negative factors were body mass index (BMI), and damage of superficial sensibility. The positive factors for upper limbs function were rehabilitation intervention and time of rehabilitation; while the negative factors were BMI, dysphagia, damage of superficial sensibility, and frequency of attack. The positive factors for hand function were rehabilitation interventions and interval from diagnosis to rehabilitation, while the negative factors were the muscle tension, incontinence, and frequency of attack. The positive factors for FIM were the rehabilitation intervention, while the negative factors were BMI, incontinence, hypercholesterolemia, gender and residence status. The positive factors for BBS were the rehabilitation intervention, while the negative factors were BMI, frequency of attack, and hyperglycemia. Conclusion Rehabilitation promotes the recovery of stroke patients, but the BMI may block it.

Zygomaticomaxillary complex (ZMC) fracture is a common type of maxillofacial fracture. In addition to facial depression and diplopia, paresthesia of the lower eyelid, malar regions, nose skin, upper lip skin, and mucous membranes occurs because of infraorbital nerve injury. This article reviewed the anatomy, diagnosis, assessment, treatment, and prognosis of ZMC fracture-related infraorbital nerve injury.
Cheek ; Humans ; Male ; Nose ; Skin ; Zygomatic Fractures

Objective To analyze the characteristics of preoperative CTO lesions by coronary CT angiography (CCTA) and to compare the lesion characteristics and clinical data of patients with subsequent vs failed PCI.Methods A total of 113 patients were randomly selected and 116 vessels were analyzed by CCTA before PCI.The patients were further investigated as PCI success group vs PCI failure group according to their PCI result.Multivariate logistic regression analysis was used to determine the factors that affected the success of CTO intervention.The ROC curve was used to determine and evaluate the CT-CTO score and J-CTO score for diagnostic efficacy.Results The success rate of PCI was 55.2％.64 lesions were successfully opened,with the success rate of 72.4％.The prevalence of smoking in patients in the PCI failure group was significantly higher than that in PCI success group (65.4％ vs.42.2％,P ＜ 0.05).There were no significant differences between the two groups in age,gender,history of hypertension,diabetes mellitus,and myocardial infarction(P ＞ 0.05).Statistical differences were observed between the PCI success group and the PCI failure group in the presence of occlusion segment head-end bifurcation,occlusion severe incision,severe calcification (calcification ≥ 180°),occlusion segment length ≥ 20 mm,occlusion of calcification lesions,occlusion segment distal shape of the unambiguous of fiber cap shape of the distal occlusion segment under CCTA(P ＜ 0.05).In the PCI failure group,approximately 17.3％ of the patients had previous attempt to open the CTO lesions,which were higher than the PCI success group (9.4％).However,The difference was not statistically significant (P ＞ 0.05).Multivariate logistic regression analysis showed that the unambiguous distal fibrous cap of the occlusion segment and the occlusion of the proximal branch and the occlusion length ≥20 mm were the main factors affecting the failure of CTO intervention.In terms of prediction,the predictive value 30 CT-CTO score yielded a higher area under the ROC curve than that of the J-CTO score (0.8776 vs 0.7387,P ≤ 0.05).Conclusion CT angiography can predict the success rate of intervention for CTO lesions.Compared with J-CTO score,CT-CTO score has a higher predictive value.Unambiguous fiber cap shape,occlusion segment head end bifurcation,occlusion segment length ≥20 mm were the independent risk factors that affecting the success of CTO operation.

Objective To make a system evaluation regarding the effect and safety of the"Nourishing Kidney and Activating Blood"method in the treatment of diabetic cognitive impairment.Methods According to the requirements of evidence-based medicine,the domestic and foreign databases were searched comprehensively,and the time limit was from the establishment of databases to June 2022,so as to find out the clinical randomized controlled trials of"Nourishing Kidney and Activating Blood"method in treating diabetic cognitive impairment.Revman5.3 was used for meta-analysis and risk bias evaluation,TSA0.9 for sequential analysis,Stata15.0 for publication bias evaluation,and GRADE3.6 for evidence quality evaluation.Results Eventually,14 RCTs were included with a sample size of 1126 cases.Meta-analysis showed that compared with conventional western medicine treatment,the"Nourishing Kidney and Activating Blood"method could significantly improve the effective rate of treating cognitive dysfunction in diabetes[OR=5.06,95%CI(3.38,7.57),P<0.00001],and significantly improve the total MoCA score of patients[MD=2.11,95%CI(1.76,2.47),P<0.00001],MMSE score[MD=1.86,95%CI(1.13,2.59),P<0.00001],MQ score[MD=13.40,95%CI(11.23,15.57),P<0.00001]and HDS score[MD=-3.36,95%CI(2.61,4.11),P<0.00001].Meanwhile,the"Nourishing Kidney and Activating Blood"method could reduce the level of glycosylated hemoglobin in DCI patients[MD=-0.84,95%CI(-1.37,-0.32),P=0.002].However,since the drugs used in the control group have no hypoglycemic effect,this conclusion needs to be further verified.In addition,the ability of the"Nourishing Kidney and Activating Blood"method to improve CDR score[MD=-0.01,95%CI(-0.08,0.07),P=0.84],ADL score[MD=2.10,95%CI(-1.62,5.82),P=0.27],TCM syndrome score[MD=-4.46,95%CI(-10.94,2.02),P=0.18]and reduce adverse reactions[OR=0.36,95%CI(0.08,1.60),P=0.18]was equivalent to that of conventional western medicine.Begg's test and Egger's test suggested that there might be some publication bias in the research.Metaninf command chart and sequential analysis of experiments indicated that the stability of research results was relatively good.The quality evaluation of evidence showed that the evidence of effective rate,glycosylated hemoglobin,MoCA scale score,MMSE score and MQ score was medium quality,the evidence of fasting blood glucose,CDR score and HDS score was low quality,and the evidence of ADL score,TCM syndrome score and adverse reactions was extremely low quality.Conclusion The existing literature evidence showed that the"Nourishing Kidney and Activating Blood"method had a good clinical effect in treating diabetic cognitive impairment,and it could reduce the blood glucose level and improve the cognitive function of patients,with certain safety.However,the above conclusions still needed more large samples and multi-center RCT to be further verified due to the limitation of the quality and quantity of the included literature.

Objective:To explore the mechanism of cisplatin-induced renal interstitial fibrosis and provide a new idea for the prevention and treatment of renal interstitial fibrosis.Methods:Eight-week-old male C57BL/6 mice (specific pathogen-free) were used to carry out the experiment. The mice were divided into cisplatin group (10 mg/kg, n=6) and saline group ( n=6) with intraperitoneal injection on day 0, 7 and 21, and sacrificed on day 28. The kidney tissues were collected for RNA Illumina high-throughput sequencing, real-time PCR, Western blotting, Masson staining and bioinformatics analysis. Results:Through real-time PCR, Western blotting and Masson staining, a mouse model with cisplatin-induced renal interstitial fibrosis was successfully established. Through RNA Illumina high-throughput sequencing, 387 long noncoding RNA (lncRNA) and 2 427 mRNA were differently expressed between cisplatin group and saline group. The expression of the top two lncRNA was confirmed by real-time PCR with the same tendency as RNA sequencing. Complement C3 was found to be at the top among the different expressed mRNA by RNA sequencing. Several terms related to immunity were found to be within the top 20 terms through Gene Ontology (GO) enrichment analysis. Systemic lupus erythematous pathway (ko05322, Q=3.4E-17), including the complement cascade pathway, was found to be the top pathway through Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. The mRNA expression levels of C1q, C2, C3 and C4 were up-regulated remarkably in the cisplatin group by RNA sequencing than those in saline group (all P<0.05) and confirmed by real-time PCR. Conclusions:Renal interstitial fibrosis can be induced by intraperitoneal injection of cisplatin periodically in mice, with complement cascade pathway activation in the diseased kidney.

【Objective】 To analyze the correlation between CT attenuation value of renal papilla and occurrence and development of renal calculi. 【Methods】 The clinical data of 100 patients with calcium oxalate stones treated during Aug.2020 and Jul.2022 were retrospectively analyzed, including 60 with primary stones, and 40 with recurrent stones. The 30 healthy volunteers were enrolled in the control group. CT attenuation value of renal papilla was measured with plain scan CT, and risk factors were identified with the receiver operating characteristic (ROC) curve. The correlation of CT attenuation value and 24 h urine metabolism was analyzed. 【Results】 The CT attenuation value of renal papilla was significantly higher in the primary group [34.92 (IQR: 3.84)] and recurrent group [43.00 (IQR: 8.74)] than in the control group [32.58 (IQR: 5.21)] (P<0.05). Compared with the primary group, the recurrent group had decreased citric acid level but increased calcium level in 24 h urine (P<0.05). The citrate ion and calcium ion were correlated with the CT attenuation value (P<0.05). 【Conclusion】 Patients with high renal papilla density have a high risk of stone formation and recurrence. Increased renal papilla density is a warning signal for the development of stones. The high calcium and low citric acid in 24 h urine have certain effects on the occurrence and development of urolithiasis. Intake of calcium should be limited and citric acid should be supplemented in patients with calcium oxalate stones.