Objective To investigate the clinical significance of the plasma adrenomedullin(ADM) and endothelin(ET-1) concentrations in patients with serious injuries complicated by hemorrhagic shock.Method Plasma ADM and ET-1 concentrations were measured by radioimmunoassay in 38 hemorrhagic shock patients(A group)and 36 non-hemorrhagic shock patients(B group)among 74 serious injury patients in the early stage and 30 age-sexmatched healthy(C group) control subjects.Results Plasma ADM and ET-1 concentrations in B group and A group,including mild(A_1 group),middle(A_2 group) and serious(A_3 group) hemorrhagic shock patients were significantly higher than those of C group.The plasma ADM and ET-1levels were greatly higher in A group than in B group.Their levels in A_1,A_2 and A_3 groups were progressively increased.There were statistical differences between A_1 and A_2 group,A_1 and A_3 group,A_2 and A_3 group respectively.There were similar increases of the plasma ET-1/ADM ratio in A group,and the ratios in A_1,A_2 and A_3 group were progressively increased also.There were positive correlations between increased plasma ADM levels and the increased plasma ET-1 levels in both A group and B group patients(r=0.492,0.438,P

Objective To study the effects of lucentis preventing vitreous hemorrhage after vitrectomy for diabetic retinopathy combined with iris neovascularization.Methods The clinical data of 70 patients (70 eyes) underwent vitrectomy for diabetic retinopathy combined with iris neovascularization during 2009 to 2015 in our hospital were retrospectively analyzed.The control group (30 eyes) accepted panretinal photocoagulation (PRP),re-vitrectomy,cyclocryotherapy,and the study group (40 eyes) had the 0.5mg lucentis in addition.The follow-up time was 3 months,and the visual acuity,IOP,vitreous hemorrhage,INV regression and complication were observed.Results At 1 month,2 months in the follow-up,the visual acuity of study group was better than the control group,but there was no significant difference along with the follow up.The average preoperative IOP was (26.312 ±4.566) mmHg (1 kPa =7.5 mmHg) in the study group and (24.586 ±5.783) mmHg in the control group,and at the end of the follow up,IOP was (18.576 ±4.762) mmHg in the study group and (28.587 ±7.786) mmHg in the control group,there was statistical difference between the two groups (P =0.041).The intraoperative and postoperative anterior chamber or vitreous hemorrhage occurred in 15 cases,5 cases of the control group,and 3 cases,1 case of the control group,there were significant differences (all P =0.000).At the end of the follow up,3 eyes (7.5％) developed to NVG in the study group and 10 eyes (33.3％) in the control group,there was statistical difference (P ＜ 0.05).Conclusion Lucentis can effectively eliminate the new vessels,reduce the incidence of neovascularization glaucoma and vitreous hemorrhage for patients after vitrectomy for diabetic retinopathy combined with iris neovascularization,and improve the visual acuity in a short time.

Objective:To explore the imaging features of 18F-fluorodeoxyglucose (FDG) PET/CT (high-resolution CT, HRCT) imaging in focal organizing pneumonia (FOP). Methods:Patients with solid nodular FOP ( n=45; 33 males, 12 females, age (58±9) years) and early peripheral non-mucinous solid lung adenocarcinoma ( n=47; 21 males, 26 females, age (63±10) years) confirmed by postsurgical pathology between May 2012 and December 2018 in Zhongshan Hospital, Fudan University were retrospectively analyzed. All patients underwent 18F-FDG PET/CT (HRCT) imaging followed by surgery within 3 weeks. The imaging findings and characteristics of the lesions were recorded. Differences of the maximum standardized uptake value (SUV max) and maximum diameter between FOP and adenocarcinoma were analyzed by Mann-Whitney U test or t′ test. Spearman correlation or Pearson correlation analysis was performed to analyze the relation between SUV max and maximum diameter. Binary logistic regression analysis was performed to identify the predictive factors for FOP. Finally, the receiver operating characteristic (ROC) curve analysis was used for evaluation of diagnostic efficiency. Results:The SUV max of FOP was lower than that of lung adenocarcinoma (3.1(1.7, 4.9) vs 6.5(3.8, 9.3); z=-4.598, P<0.01), and the maximum diameter of FOP was smaller than that of lung adenocarcinoma ((18.0±6.3) mm vs (21.8±4.3) mm; t′=-3.424, P<0.01). The SUV max was positively correlated with the maximum diameter in FOP group ( r s=0.509, P<0.01), while the SUV max of lung adenocarcinoma was not correlated with the lesion size ( r=0.076, P>0.05). HRCT of the PET/CT system showed the fusiform shape were more common in FOP ( χ2=9.549, P<0.05). Multivariate regression analysis identified that SUV max≤7.1, diameter≤18.3 mm, and fusiform shape were independent factors to predict FOP, with odds ratio ( OR) of 10.585, 4.674, 9.073, respectively (all P<0.05). ROC curve analysis showed that the area under the curve (AUC) of SUV max≤7.1 combined with diameter≤18.3 mm and fusiform nodule was 0.860, and the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 97.8%(44/45), 70.2%(33/47), 75.9%(44/58), 97.1%(33/34), and 83.7%(77/92), respectively. Conclusion:SUV max≤ 7.1 combined with maximum diameter≤ 18.3 mm and fusiform shape may predict solid nodular FOP.