Objective To evaluate the diagnostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP) quantitative detection in patients with heart failure.Methods Quantitative enzyme-linked immunosorbent assay (ELISA) improvement method was applied to measuring serum level of NT-proBNP in patients with different degree of heart failure.Results The serum level of NT-proBNP was significantly elevated in patients with heart failure. With the increase of extent of heart failure, NT-proBNP increased in exponent. Receiver operator characteristic curve (ROC) showed that area under curve (AUC) was 0.898. The sensitivity and specificity were 91.9% and 92.3% respectively for diagnosis of heart failure.Conclusion Quantitative detection of NT-proBNP is at present the best laboratory test for evaluating heart function of patients with heart failure.

Objective To design an automatic segmentation algorithm for lung region abstraction from CT images in computer-aided diagnosis(CAD) of lung diseases. Methods Based on the optimal threshold segmentation, an automatic region-growing method was adopted to eliminate the trachea and bronchi, the boundary tracking algorithm was modified for background elimination and lung boundary abstraction. Then, lung boundary repair was performed to obtain a fine boundary. To reduce the sensitivity of threshold selection, an iterative process was employed to find the optimal threshold. A trachea/bronchus extraction method based on position of trachea/bronchus in previous slice was introduced, which avoided selecting seed-point by handle in region-growing. Based on previous searching direction, 8-neighborhood searching method was improved to increase its efficiency. Results Experiments with four chest CT data sets showed that this algorithm was able to abstract the lung region automatically, quickly and with better precision. Conclusion The proposed algorithm is quite efficient for automated lung segmentation in the computed-aided diagnosis of lung diseases.

Objective To clarify the actions of tranilast,an anti allergic drug,on chronic constriction mononeuropathy through an experiment using an animal model according to the method of Bennett et al. Methods 36 rats were divided into 2 groups: one was treated with tranilast(200mg/kg?d-1,p.o every experimental day),the other was controlled with solvent only. Chronological changes of heat evoked withdrawal latencies on a hot plate,nerve coducting velocitics, and histopathological changes were compared between the two groups from one to four weeks after loose ligation in the sciatic nerve. Results The changes of the withdrawal latency and nerve conducting velocities in the tranilast treatment group were significantly longer than those in the control. The rats without tranilast treatment showed inflammation in and around the constricted nerve bundles,axonal degeneration,phagocytes invasion and interstitial edematous changes at 7 days,numerous axonal sprouts and remyelination at 14 days,and regeneration in the nerve bundles at 28 days. In contrast,the rats treated with tranilast showed less inflammation or nerve fiber degeneration,and better regeneration than those of the control. Conclusion The actions of tranilast appear to have beneficial effects on prophylaxis of a chronic constriction mononeuropathy and on preservation of the nerve functions in rats.

ObjectiveTo analyze intrathoracic or extrathoracic recurrence pattern after surgical resection of thoracic esophageal squamous cell carcinoma (TESCC) and its help for further modify and improvement on the target of postoperative radiation therapy. Methods One hundred and ninety-five patients who had undergone resection of TESCC at the Cancer Hospital,Chinese Academy of Medical Sciences enrolled from April 1999 to July 2007.Sites of failure on different primary location of esophageal cancer were documented.Results Patients with upper or middle thoracic esophageal cancer had higher proportion of intrathoracic recurrence.Patients with lower thoracic esophageal cancer had more intrathoracic reccurence and abdominal lymph node metastatic recurrence.Histological lymph node status has nothing to do with intrathoracic recurrence,supraclavicular lymph node ( SLN ) metastasis or distant metastasis ( χ2 =1.58,0.06,0.04,P =0.134,0.467,0.489,respectively),whereas the chance of abdominal lymph node metastases in N positive patients was significantly higher than that in N0 patients (28.7％: 10.6％,χ2 =9.94,P =0.001 ),and so did in middle thoracic esophageal cancer ( 20.0％: 5.6％,χ2 =5.67,P =0.015). Anatomic recurrence rate of patients with proximal resection margin no more than 3 cm was significantly higher compared to those more than 3 cm (25.0％: 11.3％,χ2=5.65,P=0.019).ConclusionsMediastinum is the most common recurrence site.According to recurrence site,the following radiation targets are recommended:when tumor was located at the upper or middle thoracic esophagus with negative N status,the mediastinum,the tumor bed and the supraclavicular region should be included as postoperative RT target;when tumor was located at the middle thoracic esophagus with positive N or located at the lower thoracic esophagus,the abdominal lymph node should be added.If the proximal resection margin was no more than 3 cm,the anastomotic-stoma should be included.

Objective To analyze the risk factors for the external hydrocephalus (EH) after traumatic brain injury in the infants. Methods The clinical data of 178 cases of infants and young children with traumatic brain injury from March 2004 to April 2009 were retrospectively analyzed. Univariate and logistic regression analysis were performed to identify the clinical risk factors for EH after traumatic brain injury. Results By univariate regression analysis, age, GCS score after trauma, coma duration, brain contusion, subarachnoid hemorrhage and epilepsy were risk factors for external hydrocephalus in the infants and young children (Ps < 0.05). Gender,traumatic wet lung and usage of mannitol were less relevant to EH (Ps >0. 05). The incidence of EH after traumatic brain injury in the infants and young children was 14% (25/178 ). Age ( OR = 0.5743 ) , coma duration after trauma (OR =3.0628) ,subarachnoid hemorrhage (OR =3.7093),brain contusion(OR = 4.7892) and post-trauma epilepsy (OR =2. 9976) were risk factors for EH (Ps < 0. 05). Conclusion Younger than 2 years old, low GCS score, long coma duration, brain contusion, subarachnoid hemorrhage and epilepsy would increase the risk of EH after traumatic brain injury in the infants and young children. This study provides information for the prevention of EH after traumatic brain injury in the infants and young children.

Objective To observe the clinical effect of HuaYu TongFu KaiQiaoFang on serum homocysteine (Hcy)in patients with acute cerebral infarction. Methods Sixty cases of acute cerebral infarction admitted into the comprehensive ward and intensive care unit(ICU)of the First Affiliated Hospital of Guiyang College of Traditional Chinese Medicine from December 2010 to January 2012 were randomly divided into two groups,each group including 30 cases. The control group was given conventional treatment,and based on the conventional therapy,the treatment group was additionally given HuaYu TongFu KaiQiaoFang(a traditional Chinese medicine decoction including the following ingredients:Safflower 10 g,Chishao 10 g,Chuanxiong 10 g,Notoginseng 10 g,Angelica Sinensis 10 g, Shichangpu 10 g,Polygalae 10 g,Glauber's salt 5 g,Rhubarb 6 g),one dose a day by oral or nasal administration for consecutive 14 days. Before and after treatment in the two groups,the serum Hcy level was detected by enzyme-linked immunosorbent assay(ELISA),and the clinical efficacy was assessed by Pearson or Spearman correlation analysis to observe the correlation between neurological deficit score(NDS)and Hcy levels. Results Before treatment, the difference of serum Hcy(μmol/L)and NDS levels between the two groups was not statistically significant(both P>0.05),while after treatment,the levels in the two groups were significantly decreased in comparison with those before treatment(P<0.05 or P<0.01),and the degree of descent in treatment group was more obvious compared with that in control group(Hcy:7.78±2.51 vs. 10.18±2.41,NDS:10.60±2.25 vs. 14.60±3.70,both P<0.05). After treatment,the total effective rate in the treatment group was significantly higher than that in the control group (90.0%vs. 76.7%,P<0.05). Before treatment,the NDS was positively correlated with Hcy(r=0.675,P<0.05). Conclusion HuaYu TongFu KaiQiaoFang can significantly reduce the level of serum Hcy and improve the nerve function,thus its clinical effect for treatment of acute cerebral infarction is remarkable.

OBJECTIVE: To observe the effect of heat sensitive moxibustion based on the articular injection for knee joint synovitis. METHODS: Sixty-seven patients with knee joint synovitis were randomly assigned into an observation group (34 cases) and a control group (33 cases). Articular injection of triamcinolone was used in the control group for 2 courses, 2 times as a course, once 5 days. Based on the treatment in the control group, heat sensitive moxibustion was used in the observation group for 2 courses, 2 weeks as a course, 5 times a week. The acupoints were Yanglingquan (GB 34), Yinlingquan (SP 9), Liangqiu (ST 34), Xuehai (SP 10), Heding (EX-LE 2) or the pain point, subcutaneous nodules around the patella. American Knee Society (AKS) score was measured before and after treatment and one month after treatment. At the same time, the knee joint synovium thickness was measured by MRI; the knee joint effusion was observed by ultrasound; the serum interleukin-1 (IL-1) and matrix metalloproteinase-3 (MMP-3) were measured. RESULTS: After treatment, the AKS scores increased in the two groups (both <0.05); after treatment and at follow-up, the AKS scores in the observation group were higher than those in the control group (both <0.05); at follow-up, the AKS score in the control group was lower than that after treatment (<0.05). After treatment, the synovium thickness, effusion, IL-1 and MMP-3 were lower than those before treatment in the two groups (all <0.05); after treatment and at follow-up, the four indexes in the observation group were lower than those in the control group (all <0.05); at follow-up, the four indexes in the control group increased than those after treatment (all <0.05). CONCLUSION Heat sensitive moxibustion combined with medicine articular injection can improve synovium inflammatory reaction and the absorption of effusion in the articular cavity,with long-time effect, which are better than simple medicine articular injection.
Acupuncture Points ; Hot Temperature ; Humans ; Knee Joint ; Moxibustion ; Osteoarthritis, Knee ; Synovitis ; therapy ; Treatment Outcome

Objective To investigate the feasibility of using leukocytes that were filtered out by LeukoReduction System ( LRS) to replace conventional human peripheral blood leukocytes in experimental researches and to comparatively analyze the differences between them in vitro biological functions and pheno-types of T cells. Methods Mononuclear cells were isolated from LRS-separated leukocytes and whole blood sample that collected from the same person by using Ficoll. Fluorescence-activated cell sorting ( FACS) was performed to analyze the phenotypes of T cells. CD3+T cells were sorted out by using magnetic beads. The T cells that were collected by using two different ways were incubated with anti-CD3 and anti-CD28 antibodies and IL-2 in vitro for 10 days. Several assays including cell counting, FACS and cytometric beads array ( CBA) were performed to comparatively analyze the differences in biological functions and phenotypes of T cells that were isolated by different methods. Results The phenotypes of T cells isolated from LRS filter and whole blood sample were highly similar at the initial stage. The sorting rate of CD3+T cells form LRS filter reached a high level and met the requirements for experimental researches. No statistically significant differ-ences in cell count, phenotype, expression of costimulatory molecules and cytokine secretion were observed between T cells isolated from LRS filter and whole blood sample. Conclusion This study suggested that the T cells isolated from LRS filter could be used as an alternative to whole blood T cells for fundamental resear-ches since they were similar in cell vitality, phenotype and biological functions. It provided a new way to solve the problem of blood shortage in clinic and scientific research.

Objective To investigate the prognostic factors for chronic heart failure and the prognostic ability of copeptin,big endothelin-1(Big ET-1)and N-terminal pro-brain natriuretic peptide (NT-proBNP)in patients with chronic heart failure. Methods To study 1 5 9 consecutive patients hospitalized for chronic heart failure.Serum concentration of copeptin,NT-proBNP,cTnI,CKMB and plasma Big ET-1 as well as left ventricular ejection fraction (LVEF)and NYHA classⅠtoⅣ on admission were measured.Cardiac events were found by patients to discharge after 360~490 days,prospectively.Results During a median follow-up period of 385 days,the endpoint of recurrence for cardiac events was reached in 65 patients with 159 heart failure.Multivarlate canonical correlation analysis shows the older and the higher NYHA classification as well as the lower LVEF in patients with heart failure.There were higher concentration of copeptin,Big ET-1 and NT-proBNP.On a Cox proportional hazards regression models analyses,age,copeptin,Big ET-1 and NT-proBNP were found to be the inde-pendent predictors of cardiac events.Risk ratio (RR)were 1.215,1.236,4.031 and 13.052,respectively.Logistic regression models analyses,copeptin,Big ET-1 and NT-proBNP were found independent predictors of death.Odd ratio (OR)were 4.003,2.477 and 1.235,respectively.Conclusion Measurement of copeptin,Big ET-1 and NT-proBNP in patients with chronic heart failure can help to identify patients at higher risk for cardiac events and patients for prognosis.

Objective To investegate the influencing factors of intra-abdominal infectious complications after pancreatoduodenectomy(PD). Methods The postoperative intra-abdominal infectious complications occurrence rate and the influencing factors after PD in 196 patients in recent 7 years were retrospectively analyzed.Results After PD,the rate of postoperative intra-abdominal infections was significantly higher than the rate of other complications. The rate of intra-abdominal infections in patients with near normal pancreatic remnent and with pulmonary infections were significantly higher than those in with harder pancreatic remnant and without pulmonary infections(P