Objective To analyze spiral CT manifestations and the diagnostic value of pulmonary embolism (PE).Methods Spiral CT pulmonary angiography (SCTPA) and chest plain CT scan were performed in 25 cases with highly-suspected PE. CT findings were retrospectively analyzed.Results The direct signs of PE appeared as complete or partial filling defect within pulmonary arteriae on SCTPA.191 branches of pulmonary artery were involved in all cases,of them, 44 branches were centrally located(23.0%), 115 branches were eccentrically located (60.2%),7 branches were mural filling defect (3.7%), 25 branches were complete occlusion (13.1%).The indirect signs of PE included irregular consolidation (n=15), patchy ground glass opacities (n=6),local streak shadows(n=4),"mosaic"sign (n=5), pleural effusion(n=16) ,pericardial effusion (n=3)and simple emboli no other signs(n=3).Conclusion SCTPA is a fast ,effective, security and non-invasive diagnostic method for PE .

In this study, hollow fiber membrane extraction combined with ambient ionization mass spectrometry ( AMS) was developed for the simultaneous determination of 7 perfluorinated compounds ( PFCs) in aqueous solution, including perfluoroheptanoic acid ( PFHpA ) , perfluorooctanoic acid ( PFOA ) , perfluorooctane sulfonate acid ( PFOS ) , perfluorononanoic acid ( PFNA ) , perfluorodecanoic acid ( PFDA ) , perfluoroundecanoic acid ( PFUdA) , and perfluorododecanoic acid ( PFDoA) . PFCs were detected in negative ion mode using selective reaction monitoring ( SRM) mode. The extraction time and the pH value of extraction solution were optimized. 13 C4-PFOS and 13 C4-PFOA were used as internal standards for quantitative analysis. The method showed good linearity with correlation coefficient values ( r2 ) greater than 0. 991 for the seven target PFCs. With the exception of PFHpA, the limit of detection ( LOD) for other six PFCs was within ranges from 0. 8 to 2. 7 ng/L while the limit of quantitative (LOQ) was from 2. 7 ng/L to 8. 9 ng/L. The enrichment factor of five PFCs was more than two hundred. The developed method was applied to detect the seven PFCs in tap water and Pearl River water, and they were all not detected. The recoveries were within the ranges of 88. 5%-108. 3% and 94. 2%-116. 7% when 40 ng/L and 400 ng/L PFCs were spiked into tap water, respectively. In terms of the Pearl River water, the recoveries were within the ranges of 75. 0%-102. 6% and 81. 2%-97. 6% when 40 ng/L and 400 ng/L PFCs were spiked, respectively.

Objective To monitor and compare the breathing mechanics on PC,VC and PRVC during pneumoperitoneum,and to discuss the significance of the clinic use of PRVC.Method Ninety laparoscopic cholecystectomy patients were equally divided into 3 groups (PC,VC,PRVC).Levels of PES,PAWM,PAP,PaCO2,ETCO2,TV MAP and HR were detected before pneumoperitoneum,and at 5,10,15 and 20 minutes postpneumoperitoneum.Results Pneumoperitoneum made three respiratory patterns with different levels of PAWM,PAP,and PES.PES post-pneumoperitoneum in the VC model was obviously higher than that in the PC and PRVC group.At 10 min post-pneumoperitoneum,levels of PaCO2 and ETCO2 increased obviously in the PC and VC group(P ＜ 0.05).Levels of PaCO2 and ETCO2 were increased in the PC group,but TV level post-pneumoperitoneum was significantly lower than that in the other two groups (P ＜ 0.05).Level of PaCO2 and ETCO2 were increased in the PC and VC group post-pneumoperitoneum,along with increases of MAP and HR (P ＜ 0.05).Levels of MAP and HR in the PRVC group post-pneumoperitoneum were significantly lower than those in the PC and VC group (P ＜ 0.05).Conclusion PRVC mode can effectively reduce the increases of pneumoperitoneum-induced PAWM,PAP,PES,without the unusual increase of PaCO2 and ETCO2 during surgeries,contributing to the stability of vital signs of perioperative patients.

Thirty patients with malignant obstructive jaundice were treated with biliary stent implantation+brachytherapy+conformal radiotherapy (study group; n=15) or biliary stent implantation alone (control group; n=15). Total bilirubin (TBIL) levels significantly declined within 1 month in both groups. However, at 6 months, TBIL values began to increase in the control group and continuously declined in the study group. Maximum tumor diameter increased in the control group, while decreased in the study group (remission rate, 13/15 ). As for the study group, the survival rate at 0. 5, 1, and 2 years was 15/15,14/15, and 10/15, respectively, higher than the control group (15/15,5/15,and 1/15) . Combining biliary stent implantation with brachytherapy and conformal radiotherapy might be a safe and effective treatment of choice for patients with malignant obstructive jaundice.

Objective To investigate the clinical value of cardiac troponin Ⅰ(cTnⅠ) and creatinine kinase MB(CK-MB) in early diagnosis of myocardial injury(MCI) in neonatal asphyxia.Methods The serum cTnⅠ and CK-MB in neonates [34 with asphyxia and MCI,38 with asphyxia but no MCI(NMCI)],and 30 cases of normal control(NC) were measured with direct immunoassay chemiluminometric technology and immunoinhibition enzymes-activated assay.Results The cTnⅠ level in NC group had no changes within 10 days after birth,MCI group were significantly higher than those in NMCI and NC groups(all P0.05).The diagnostic sensitivity,specificity and accuracy of cTnⅠ for neonates with MCI were 91%,88% and 89%,respectively;and of CK-MB were 85%,68% and 74%,respectively.Conclusions cTnⅠ and CK-MB can be taken as early diagnostic markers of MCI in neonates with asphyxia,(cTnⅠ) is better than CK-MB.

BACKGROUNDA link between postoperative pain intensity and heart rate variability (HRV) had not been well established. This study aimed to investigate the correlation between post-operative pain intensity and HRV.

METHODSThe subjects in this cross-sectional correlation study comprised of patients who had undergone abdominal surgery in a regional teaching hospital in central Taiwan during the period July 2009 - November 2009. The visual analogue scale (VAS) and the short-form McGill pain questionnaire (SF-MPQ) were used to measure post-operative pain. HRV was measured as the standard deviation of normal RR interval, and by power spectral analysis that included high frequency (HF), low frequency (LF), very low frequency power, and LF/HF ratio.

RESULTSA total of 34 subjects were included in this study. We found that the day after the surgery, the mean VAS score was 47.50 ± 20.98 and the mean SF-MPQ score was 18.06 ± 8.90, indicating a moderate degree of pain. Moderate to severe degrees of tenderness were reported by 70.6% of the patients, moderate to severe degrees of gnawing pain were experienced by 67.7% of the patients, moderate to severe degrees of tiring-exhaustion pain were reported by 64.7% of the patients, and 41.2% of the patients who experienced moderate to severe pain believed that the pain was punishing-cruel. The standard deviation of normal RR interval and high frequency values obtained from male patients or married patients were higher than female patients or unmarried (P < 0.05). The correlation of the standard deviation of normal RR interval, high frequency, very low frequency value and patient's age were negative (P < 0.05). The total SF-MPQ pain scores positively correlated with the LF/HF ratio (P < 0.05).

CONCLUSIONSThe multidimensional pain assessment tool (SF-MPQ) reflects better the patients' post-operative pain than the single-dimensional assessment tool (VAS). HRV positively correlated with SF-MPQ scores in patients after abdominal surgery.

Abdomen ; surgery ; Adolescent ; Adult ; Aged ; Heart Rate ; physiology ; Humans ; Middle Aged ; Pain ; etiology ; physiopathology ; Surveys and Questionnaires ; Young Adult

Objective To assess the efficacy of HIV/AIDS prevention and control among long-distance drivers in China. Methods Based on the principles and methods of Cochrane systematic reviews, we searched literature from CBM (from 1978 to 2009), VIP (1989 to 2009) CNKI (1980 to 2009) , and MEDLINE (1950 to 2009) and also assessed the risk of bias of the included before-after studies according to Newcastle-Ottawa scale and their characteristics. Cochrane Collaboration's software RevMan 5.0 was used for Meta-analysis. Results 13 studies were included, with most of them were of low quality as having high risk of bias. (1) Knowledge index 1 :We included 7 'pre-posr'studies. Meta-analysis showed that AIDS/HIV prevention and control was effective in promoting the knowledge index 1 among long-distance drivers (RD=0.15, 95% CI:0.04-0.26). (2) Knowledge index 2: We included 10 pre-post studies, in which the results from Meta-analysis showed that AIDS/HIV prevention and control was effective in promoting the knowledge index 2 among long-distance drivers (RD = 0.24,95 %CI: 0.17-0.30). (3) Behavior index:We included 6 pre-post studies in which the results from Meta-analysis showed that AIDS/HIV prevention and control was effective in promoting the behavior index among long-distance drivers (RD=0.15,95% CI 0.10-0.19). Conclusion Current evidence demonstrated that HIV/AIDS prevention and control programs were effective.

OBJECTIVETo study psychiatric features and the manifestations of central nervous system involvement in Chinese patients with primary Sjogren's syndrome (PSS).

METHODSThe Minnesota Multiphasic Personality Inventory (MMPI) was used to study 27 PSS female patients and 57 healthy women. The results from two groups were compared. Ten SS patients were evaluated by electroencephalography (EEG), transcranial doppler ultrasound (TCD) and magnetic resonance imaging (MRI).

RESULTSOf 27 patients tested, the three highest clinical mean scales included Hypochondriasis (Hs), Hysteria (Hy), Psychasthenia (Pt) were found. When PSS group was compared with normal control, T scores of SS patients were significantly higher than the healthy women in Hs, Hy. Abnormal EEG was found in 3 of 9 PSS patients. TCD was abnormal in 5 of 9 patients. MRI in 1 patient showed abnormality.

CONCLUSIONSThis study shows that the personality of PSS patients is abnormal, the features are neuroticism. Central nervous system was markedly involved in Chinese patients with PSS, including abnormal EEG and TCD. The changes of central nervous system may be related to abnormalities of psychiatric changes.

Adult ; Aged ; Electroencephalography ; Female ; Humans ; MMPI ; Magnetic Resonance Imaging ; Middle Aged ; Sjogren's Syndrome ; diagnostic imaging ; physiopathology ; psychology ; Ultrasonography, Doppler, Transcranial

OBJECTIVETo manufacture the individual polyurethane (PUR) auricular framework using the rapid prototyping (RP) technique and to evaluate its feasibility in ear reconstruction.

METHODS3-D models of the patient's auricle were reconstructed according to the computed tomography (CT) data. The supporting and drainage structures were created. Then the individual PUR auricular frameworks were manufactured using RP technique. The frameworks were tested for the fatigue strength and elasticity. The frameworks were also put at the subcutaneous layer of rat. At 1, 2, 4, 8, 12 weeks after operation, the shape of the reconstructed ears was observed and the histological examination was performed.

RESULTSThe PUR framework had good elasticity and a much better fatigue strength than high density polyethylene (HDPE) framework. The shape of reconstructed ear matched the prototype very well. The around tissue grew into the implant pore and adhered tightly to the framework 2 weeks after implantation. Histologic examination showed integrated capsule four weeks later without lymphocytes infiltration. The shape kept very well twelve weeks later.

CONCLUSIONSPUR auricular framework manufactured by the 3D reconstruction and RP techniques has very good shape, intensity and elasticity. It can be selected to replace the autograft of rib cartilage framework.

Animals ; Computer-Aided Design ; Ear, External ; surgery ; Humans ; Otologic Surgical Procedures ; instrumentation ; Prosthesis Design ; Rats ; Rats, Wistar ; Reconstructive Surgical Procedures ; instrumentation ; Stents

OBJECTIVETo establish a mouse model of asthmatic airway remodeling and investigate the effects of 1,25-(OH)2D3 on airway structure and T cell immunoglobulin mucin protein-4 (TIM-4) expression in asthmatic mice.

METHODSThirty female mice (BALB/c strain) were randomly divided into control, asthma and 1,25-(OH)2D3 intervention groups. An asthmatic mouse model was induced using ovalbumin. Lung tissue of the mice was collected, mRNA expression of TIM-4 was evaluated by RT-PCR and airway remodeling and protein expression of TIM-4 were observed by hematoxylineosin staining and immunohistochemistry.

RESULTSTypical airway remodeling was found in the asthma group, and TIM-4 expression in this group was significantly higher than in the control group (105±9 vs 42±5; P<0.05). Compared with the asthma group, the 1,25-(OH)2D3 intervention group showed improvement in airway remodeling and a decrease in TIM-4 expression (78±6) (P<0.05).

CONCLUSIONSTIM-4 may be involved in the airway remodeling of mice. As a new type of immunoregulator, 1,25-(OH)2D3 can downregulate expression of TIM-4 in the lungs and improve airway remodeling in asthmatic mice.

Airway Remodeling ; Animals ; Asthma ; metabolism ; Calcitriol ; pharmacology ; Female ; Gene Expression Regulation ; drug effects ; Lung ; metabolism ; Membrane Proteins ; analysis ; genetics ; physiology ; Mice ; Mice, Inbred BALB C ; RNA, Messenger ; analysis