Objective To explore the diagnostic value of CT-guided percutaneous lung biopsy for pulmonary solid lesions.Methods CT-guided percutaneous lung biopsy was performed in 97 cases of pulmonary solid lesions. The lesions were 2~10 cm (mean, 4.2 cm) in diameter, and the distance to the pleura was 0~8 cm (mean, 3.4 cm). Results Confirmative diagnoses were achieved in 73 cases of lung cancer and 21 cases of benign lesions (inflammation, tuberculosis, or sarcoidosis). The diagnostic rate was 96.9% (94/97). The biopsy could not indicate the accurate diagnosis in 3 cases, 2 of which were identified as having squamous cell carcinoma by operation, and 1 of which was followed for 2 years with no changes. Postoperative complications included 8 cases of pneumothorax, 2 cases of hemothorax, and 2 cases of emptysis. Conclusions CT-guided percutaneous lung biopsy is safe and offers a high diagnostic rate, especially suitable for lesions near the pleura.

Objective: To study the effects of different origins, collection and processing methods on the quality of Taraxacum mongolicum. Methods:The HPLC fingerprints of Taraxacum mongolicum were established. Totally 11 batches of Taraxacum mongoli-cum were analyzed by similarity evaluation and cluster analysis. Results:According to the results of HPLC, 11 batches of Taraxacum mongolicum had good baseline separation and showed 5 common peaks. Based on the established HPLC method, the quality of different batches of Taraxacum mongolicum showed difference according to the results of similarity evaluation and cluster analysis. The quality of batch 121231-1 was the best. Conclusion:The origin, collection and processing method show notable influence on the quality of Ta-raxacum mongolicum, and the comprehensive score method can be applied in the quality evaluation of Chinese herbs.

Objective To investigate effect of emodin on cell membrane, protein and nucleic acid synthesis of MRSA41577, and systematically investigate the anti-bacterial mechanism of emodin.Methods TTC assay was used to detected the anti-bacterial activity of emodin on MRSA 41577. Conductivity and macromolecular were detected to investigate the effect of emodin on MRSA41577 cell membrane .SDS-PAGE was used to detect the effect of emodin on the soluble protein synthesis.DAPI staining was used to detect the effect of emodin on nucleic acid synthesis.UV-visible spectrophotometric was used to detected the interaction between emodin and DNA.ResuIts Emodin has significant inhibitory activity on MRSA41577, and the minimum inhibitory concentration was 8μg/mL.After treated with 8 μg/mL emodin for 6h, compared with control group, the macromolecular and conductivity improved (71.48 ±0.026)% (P<0.01) and (2.39 ±0.102)%(P<0.05), sepreatly.Compared with control, after treated with 8μg/ml emodin for 16h,the protein reduced 32.8%, and the contents of DNA and RNA reduced (4.82 ±1.06)%(P<0.05,) and (6.67 ±0.36)%(P<0.053).The UV-visible spectrophotometric results indicated that emodin could integrate with DNA through hydrogen bond.ConcIusion The anti-bacterial mechanism of emodin mainly through damage the cell membrane , inhibit the replication and transcription of DNA through hydrogen bond , inhibit the synthesis of protein, and thus inhibit the biological function of bacteria.

Objective To know the epidemiological characteristics of hand-foot-mouth disease in Yangpu District and provide evidence for specific strategies and measures of hand-foot-mouth disease activity prevention and control. Methods Descriptive analysis of the data from hand-foot-mouth disease epidemic situation in Yangpu District from 2005 to 2008 was made. Results 1 348 cases were reported in the whole Yangpu District from 2005 to 2008, and no severe cases, no death. The average morbidity in Yangpu District was 27.48/100 000. The male to female ratio was 1.46∶1. The infection occurred to infants aged from 1 year to 5 years (85.39%). The incidence of the native population children aged 2 to 3 exceeded 10/100 000. The season peak appeared from May to July (70.18%), and outbreaks used to occur at nurseries and kindergartens. The typical clinical presentations mainly included fever and rash. The rash mainly occurred to hands, feet, mouth, buttocks and so on. Conclusions Incidence varied significantly between different sexes, seasons and ages. It can cause large-scale epidemic in a short period of time, the epidemic was very difficult to control, but the leaders attach importance to take the early warning and monitoring, accuratey deal with emergencies, health education promotion and training of comprehensive measures, the epidemic can be effectively controlled.

Objective To investigate the long-term prognosis and possible risk factors of acute kidney injury(AKI)following cardiac surgeries. Methods Clinical data of 941 patients undergoing open heart surgery from January 2004 to June 2007 were retrospectively analyzed.Survival and renal function of above patients were informed through telephone or clinic follow-up till February 2010.Long-term survival was analyzed using risk-adjusted Cox proportional hazards regression model. Results Of the 941 patients after cardiac surgery,275(29.2%)developed AKI and 666(70.8%)did not.Survival was worse in patients with AKI(67.8%vs 85.6%,P<0.01)and was proportional to its severity (AKIN 1,2 and 3 stages:70.7%,62.3%and 58.6%,P<0.01).Although 90.5% of patients had complete renal recovery after AKI at discharge of hospital,they still had an increased risk for death during follow-up compared with patients without AKI (69.6% vs 85.6%,P<0.01).In the Cox proportional hazards regression model,age(HR=2.238),anemia (HR=1.625),prolonged operation time (HR=1.153),AKI severity (HR=1.473)were independent risk factors for long-term prognosis after cardiac surgery.At the end of the follow-up,patients with AKI had statistically higher Scr than non-AKI patients(107.6 μmol/L vs 83.0 μmol/L,P=0.014),and among those AKI patients,34.0%progressed into CKD 3-5 stages,34.8%developed double serum creatinine. Conclusions AKI is a risk factor for the long-term prognosis of cardiac surgery.Patients with complete renal recovery after AKI still has an increased risk for death and poor renal function compared with patients without AKI.

[Objective] To investigate the efficacy of Xiangsha Yangwei Wan (XYW) on the inhibition of chemotherapy-induced chemical gastritis and upper gastrointestinal symptoms. [Methods] A randomized controlled trial (RCT) was carried out in 87 cases of maligant tumor confirmed by histopathological and cytological examination. All the cases were treated with chemotherapy regimen of adriamycin ( ADM) , adcarbazine ( DTIC) , platinum-based agents, irinotecan (CPT-11) and fluorouraeil (5-FU). Meanwhile, 41 cases in group A were also treated with dexamethason and 5-HT3 receptor antagonist as an essential anti-emesis and with XYW to regulate gastrointestinal function; other 46 cases in group B were given dexamethason and 5-HT3 receptor antagonist only. Seven days after treatment, incidences of chemical gastritis and upper gastrointestinal symptoms were observed and compared between the two groups. [Results] Seven days after chemotherapy, upper gastrointestinal symptoms and signs were relieved in 95.1% (39/41) of the patients of group A and in 76.1 % (35/46) of group B; the occurring rate of chemical gastritis with symptoms was 2.4% (1/41) in group A and 19.6% (9/46) in group B, the differences being significant statistically between the two groups( P - 0.0122) . [ Conclusion ] XYW has an inhibitory effect on chemotherapy-induced chemical gastritis and upper gastrointestinal symptoms.

Objective To investigate the value of urinary liver-type fatty acid-binding protein (L-FABP),neutrophil gelatinase-associated lipocalin (NGAL) and their combination in predicting the development and the severity of acute kidney injury (AKI) following cardiac surgery in adults. Methods Scr,urinary L-FABP and NGAL corrected by urine creatinine at preoperation,0 h and 2 h postoperative time points were examined.The differences of above indexes between AKI and non-AKI groups were compared.Receiver operating characteristic (ROC)curves and area under curves (AUC) were used to evaluate the diagnostic value of urinary L-FABP,NGAL and their combination for AKI. Results The cohort consisted of 109 patients,26(23.9％) developed AKI,and AKIN stage Ⅰ, Ⅱ and Ⅲ was 46.2％,34.6％ and 19.2％ respectively.Levels of urinary L-FABP and NGAL were significantly higher in AKI patients at 0 h and 2 h postoperatively.AUC to predict AKI or AKI stage Ⅱ-Ⅲ was 0.81 to 0.87 using either of the biomarkers.The performance of combining two biomarkers was better with AUC of 0.911 to 0.927. Conclusions Urinary L-FABP and NGAL increase at the early stage after cardiac surgery.Combination of these two biomarkers enhances the accuracy of the early diagnosis of postoperative AKI after cardiac surgery before a rise of Scr.

OBJECTIVETo evaluate the diagnostic value of salivary and plasma miR-21 in patients with esophageal cancer (EC).

METHODSTotal RNA was extracted from saliva and plasma samples from 50 stage I and 50 stage II patients with EC and 50 healthy controls for measurement of miR-21 levels using qPCR. The diagnostic values of salivary and plasma miR-21 levels were assessed for stage I, stage II, and stage I+II EC.

RESULTSSalivary and plasma miR-21 were significantly higher in the EC patients than in the control group. The diagnostic sensitivities of plasma miR-21 for stage I, stage II, and stage I+II EC were 96%, 64% and 97%, with specificities of 44%, 84%, and 56%, respectively; the sensitivities of salivary miR-21 were 90%, 88%, and 89%, respectively, with the same specificities of 64%. Regardless of EC staging, the expression of plasma miR-21 showed a significant positive correlation with that of salivary miR-21, and their diagnostic values were comparable.

CONCLUSIONBoth salivary and plasmatic miR-21 can be sensitive biomarkers for EC, and salivary miR-21 detection has the potential to replace plasma detection for EC diagnosis.

Biomarkers, Tumor ; blood ; chemistry ; Esophageal Neoplasms ; blood ; diagnosis ; Humans ; MicroRNAs ; blood ; Plasma ; chemistry ; Real-Time Polymerase Chain Reaction ; Saliva ; chemistry ; Sensitivity and Specificity

Objective To validate the effect of Renji acute kidney injury score (RAKIS) on predicting patients with acute kidney injury (AKI) after cardiac surgeries,and make comparison with Cleveland score,simplified renal index (SRI) and acute kidney injury following cardiac surgery (AKICS).Methods Patients undergoing open heart surgery from 2008/01/01 to 2010/10/31 in Renji hospital were enrolled,and their scores of those four scoring models were calculated.AKI patients were diagnosed by KDIGO,and those scores of AKI patients and non-AKI patients were compared.Receiver operating characteristic (ROC) curve and area under curve (AUC) were used to decide the predictive values of those models.Results A total of 1126 patients were chosen in this cohort,with the average age of (58.43±14.88) years (rang from 18 to 88).The male to female ratio was 1.47:1.And 355(31.5％) patients were developed AKI.AKI stage Ⅰ,Ⅱ and Ⅲ were 65.4％,23.7％ and 11.0％ respectively.RAKIS was significantly higher in AKI patients than in non-AKI patients (17.5 vs 9.0,P ＜ 0.001).The AUCs of RAKIS to predict AKI,AKI Ⅱ-Ⅲ stages,renal replacement therapy (RRT)and in-hospital death were 0.818,0.819,0.800 and 0.784 respectively.The AUCs of Cleveland score and SRI were 0.659 to 0.710,lower than those of RAKIS and AKICS.AKICS had lower value for predicting AKI and AKI Ⅱ-Ⅲ stages (AUC 0.766 and 0.793),but good value in predicting RRT and inhospital death after surgery (AUC 0.804 and 0.835) as compared with RAKIS.Conclusions RAKIS is valid and accurate in the discrimination of KDIGO defined AKI patients,while for predicting the composite end point,AKICS may be more useful.

Objective: To evaluate the success rate during ultrasound-guided percutaneous nephrolithotomy (PCNL) and analyze the reasons of puncture failure. Methods: A retrospective analysis was performed based on the data of 58 patients who underwent ultrasound-guided PCNL by 4 experienced urologists(10 years' experience of PCNL and more than 80 cases per year)in our center from August 2018 to November 2018. Of all the 58 patients, there were 36 males and 22 females (aged from 22 to 73 years) with the mean age of 51 years. The calculi ranged from 9 mm to 93 mm, with the average of 26.5 mm. The separation of renal collecting system ranged from 5 mm to 30 mm, with the average of 15.1 mm. All of the 58 patients underwent one-stage PCNL and the numbers of punctures, the numbers of percutaneous tubes and the reasons for failure were recorded. Results: All percutaneous tubes and surgeries were established and done successfully. Of all the 118 punctures, 74 punctures succeeded by detecting the urine and 68 surgery tracts were established (6 punctures failed because of the dilation). The total puncture success rate was 62.7%(74/118). Of the total 74 successful punctures, 56.8%(42/74)succeeded at the first puncture, 28.4%(21/74)succeeded at the second puncture and 14.9%(11/74)succeeded at least after three punctures. The success puncture rate of the 4 urologists were 59.2%(29/49), 64.1%(25/39), 66.7%(16/24), 66.7%(4/6)respectively, and there were no statistical differences between the puncture success rates of the urologists (P=0.679). Each channel needed 1.7 punctures on average. Fouty-four punctures failed without detecting the urine, including 20 failed punctures because of the puncture tract deviation, 17 punctures without seeing the urine after the core needle being removed, 7 punctures no display on the ultrasound imagine. There were 33 punctures to be tubeless while other 35 indwelling the nephrostomy tubes. Five nephrostomy tubes' position were different with the preoperationally predicted position which means the discrepancy rate was 14.3%(5/35). One patient had complications and classified as Grade II or above on the modified Clavien Grading System of aerothorax. Conclusions The puncture success rate during ultrasound-guided PCNL is not satisfied. The main reasons of puncture failure are the deviation of puncture tract, unclear imaging of puncture tract and other unclear reasons( puncture needle went too deep or superficially or tip of the needle embedded into the stone).