Objective To evaluate the value of three-dimensional surface shaded display (SSD) and volume rendering technique(VRT) in diagnosis of scapular injury. Methods Twenty patients of scapular fractures, who were 15 males and 5 males with an average age of 34 years, were examined with SIEMENS PLUS 4 helical CT. Images were reconstructed in workstation with three-dimensional SSD and VRT, and then analyzed and compared with X-ray and 2D CT images. The regions of interesting consisted of acromion, coracoid process, glenoid cavity, supraspinous fossa, scapular spine, infraspinous fossa, lateral margin, medial margin and inferior angle of scapula. All of imagings were evaluated by two experienced radiologists with double blind method. Results 2D CT findings were clinically or operatively confirmed, and also taken as an evaluative standard to analyze the diagnostic rates of the X-ray, SSD and VRT in this study. The positive rates of diagnosis in plain X-ray and SSD were 94.44% and 97.78%, and the false negative rates was 17.65% and 7.84% respectively; the false positive rate of diagnosis of plain X-ray was 0.76%; the positive rate of diagnosis of VRT was 100%. The difference between plain X-ray, 2D CT, SSD and VRT was not statistically significant for scapular fractures, but the quality of imaging to display the fracture details of 3D CT was the best, while 3D CT might obtain the most objective view of scapular fractures. Eight cases of scapular fractures were examined again post-operatively, the reconstructed images of 3D CT displayed the structure of scapular fractures clearly. VRT could show the contour of scapula and position of the internal fixation, as well as the effect of reduction after operation and the healing status of scapular fractures. Conclusion SSD and VRT of spiral CT are effective methods in diagnosing scapular injury. The images of SSD and VRT of spiral CT may provide exact guidance to preoperative protocol and internal fixation. For complicated scapular fractures, these two techniques could be regarded as imaging techniques of choice. Furthermore, VRT provides more important information to apply the internal fixation devices and assess the result of surgical reduction.

Objective To detect the single nucleotide polymorphism(SNP) of chemokine RANTES promoter of healthy and HIV 1 infected individuals of Han and Uiygur Chinese population, and to evaluate the correlation of their SNPs with HIV 1 infection. Methods Case control study was adopted ,Genotypies of RANTES promoter 403 and 28 from 863 samples were detected by DNA sequencing or by polymerase chain reaction restriction fragment length polymorphism. Results There were two SNPs and six genotypes in Chinese Han and Uiygur. 403 and 28 allelic frequencies were high, but there was no significant difference between the two healthy populations. Strong linkage disequilibrium was observed between the two SNPs. RANTES genotypes were AC/AC, AC/AG, AC/GC, AG/GC, GC/GC, and AG/AG. The haplotypes were GC 62 7% in both rases, AC 28 7% and 30 4%, AG 8 6% and 6 8% in Han and Uiygur, respectively. Compared with AC/AC, odd ratio (OR) of RANTES genotypes AC/AG, AC/GC, AG/GC, and GC/GC was associated with reduced susceptibility to HIV 1 infection. Conclusion Same high RANTES promoter mutation was found in Han and Uiygur populations. Compared with AC/AC, odd ratio (OR) of RANTES genotypes AC/AG, AC/GC, AG/GC 9.9%, and GC/GC might be associated with reduced susceptibility to HIV 1 infection. Further study of the implicated in needed

Image reconstruction is a superior function of multi -slice spiral CT. In this paper, the techniques of image reconstruction for spiral CT are introduced systemically. Combined with experience in actual work, the significance of its clinical application is discussed.

Objective:To compare immune effects of hepatitis B-BCG combined vaccine and hepatitis B vaccine.Methods:The vaccines were administered to the guinea pig at 0, 1, 2 months. The tests were divided into three parts. The immune effects were compared in three kinds of the combined vaccine and hepatitis B vaccine(Part One), in three lots of the combined vaccine and hepatitis B vaccine(Part Two), in the group of combined vaccine and the group of hepatitis B vaccine and BCG(Part Three). After 1 month of each vaccine dose, serum specimens were measured for anti-HBs by ELISA.Results:The several studies have documented the serum anti-HBs concentritious in the group of combined vaccine in first dose were lower than those of the group of control, and the data showed no significantly difference. However, anti-HBs levels of the combined vaccine group in second vaccine dose and third vaccine dose were higher than those of the control group, and this difference was no longer statistically significant in group of combined vaccine and control, and among groups of combined vaccine.Conclusion:The immune efficacy of HBsAg in group of combined vaccine is similar to the group of hepatitis B vaccine in three doses immunization schedules.

Objective To evaluate the impact of the re-modified Sugiura procedure on portal hemodynamics and liver function in cirrhotic patients with portal hypertension.Methods Forty patients with cirrhosis and portal hypertension who underwent the re-modified Sugiura procedure in the Yichang Second People's Hospital from June 2006 to October 2014 were studied.Changes in the free portal pressure (FPP),portal venous flow (PVF) and liver functions before and after operation were analyzed.Results (1) The FPP at different phases of the operation (after opening the abdomen,after splenectomy,and after devascularization) were (43.2 ± 1.8) cmH2O,(34.8 ± 1.6) cmH2O and (35.2 ± 1.7) cmH2O,respectively.There were significant differences in FPP between the phases of after splenectomy and after opening the abdomen,as well as after devascularization and after opening the abdomen (P ＜ 0.05).There was no significant difference in FPP between after devascularization and after splenectomy (P ＞ O.05).(2) The PVF,which were measured with Doppler sonography at 4 time points (preoperative 1 day,postoperative 10 days,postoperative 6 months,postoperative 18 months),were (1 420.4 ± 137.7) ml/min,(1 205.2 ± 126.7) ml/min,(875.8 ± 118.0) ml/min and (893.8 ± 114.7) n1/min,respectively.There were significant differences in PVF between postoperative 10 days and preoperative 1 day,between postoperative 6 months and postoperative 10 days,as well as between postoperative 18 months and preoperative 1 day (P ＜0.05).There was no significant difference in PVF between postoperative 18 months and postoperative 6 months (P ＞0.05).(3)The liver functions were evaluated using the Child-Pugh score at 4 time points (preoperative 1 day,postoperative 10 days,postoperative 6 months,postoperative 18 months).There were no significant differences among the time points,(P ＞ 0.05).Conclusion The re-modified Sugiura's procedure durably,appropriately and effectively reduced the PVF and FPP,but it did not have any negative effects on the liver functions of patients with cirrhosis.

Background Researches showed that elevatory blood glucose level results in long-term damage of cells and tissue,or metabolic memory phenomenon,and manipulation of hyperglycemic memory is a good approach in the prevention of diabetic complications.However,its mechanism is not clear.It is speculated that the pathogenesis of diabetic retinopathy (DR) in diabetic patients may be associated to related mechanisms.Uncoupling proteins (UCPs) can decrease the production of reactive oxygen species (ROS),which may be related to DR.Objective This study was to explore the association between DR and the single nucleotide polymorphisms (SNPs) of UCP genes in Chinese Han population with type 2 diabetes.Methods A cross-sectional study was performed.This study was approved by Ethic Committee of Affiliated First Hospital of Shanghai Jiao Tong University and complied with Declaration of Helsinki,and written informed consent was obtained from each subject prior to any medical examination.One thousand eight hundreds and seventy-five patients with type 2 diabetes mellitus were enrolled in Xinjing district of Shanghai city by cluster sampling from November 2014 to January 2015.The demographic and medical baseline characteristics,ocular examination and laboratory tests were obtained and periphery blood of 2 ml was collected for extraction of DNA.Eight tag SNPs of UCP1,three tag SNPs of UCP2,and seven tag SNPs of UCP3 were selected as marker locus for the detection of genotype by Sequenom Mass ARRAY.Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry platform were used for genotyping.Hardy-Weinberg equilibrium (HWE) analysis,allele and genotype frequencies,haplotype analysis,and association tests for DR and SNPs were performed by SAS and SHEsis software.Results A total of 530 DR patients were checked out from 1 875 subjects with type 2 diabetes mellitus,with the detection rate of 28.27％.rs660339 locn of UCP2 gene and rs1626521,rs668514 locus of UCP3 gene appeared to have low detectable rates,and the secondary allele base frequency of rs632862 in UCP2 gene was ＜0.01 and rs15763 of UCP3 gene was unmatched with HWE,therefore,these locus analysis was not included.In 13 SNPs locus included in the analysis,only 2 SNPs of UCP1 gene were related to DR.Compared with the non-diabetic retinopathy (NDR) patients,the G allele frequency of rs10011540 was increased (P =0.03,OR =1.31,95 ％ confidence interval[CI] =1.03-1.67,and T allele frequency of rs3811787 was decreased (P=0.04,OR=0.86,95％ CI=0.75-0.99) in DR patients.Genotyping detection showed that the C/C and A/A frequencies of rs3811790 in UCP1 gene were significantly more and C/A frequency was less in DR patients than those in NDR patients (all at P＜0.01).The logistic regression analysis indicated an association of SNPs of rs10011540 and rs3811787 with DR independent from glucose and disease duration.Conclusions The SNPs of rs10011540 and rs3811787 locus in UCP1 gene are associated with DR in Chinese type 2 diabetes patients.

Objective:To explore the efficacy and safety of BCL-2 inhibitor-based treatment in patients with relapsed/refractory t (11; 14) primary systemic light chain amyloidosis.Methods:This was a retrospective case series study. Ten patients with relapsed/refractory t(11;14) primary systemic light chain amyloidosis who had all received treatment with a combination regimen including the BCL-2 inhibitor venetoclax from January 2018 to November 2022 at the Hematology Department of Peking University People′s Hospital were included. Adverse events, and hematological and organ responses were evaluated.Results:The median age of the ten enrolled patients was 59 (range 41-78) years, and the male to female ratio was 8∶2. Except for one patient, a very good partial or better response was achieved in 8/9 patients and one patient obtained a partial response. The overall response rate was 100%. The median time to achieve a hematological response was 60 (range 24-236) days. At least one organ response was observed in 7/9 patients. With a median follow-up of 18 months, one patient experienced hematological progression and one patient died. Grade 3 adverse events included lymphocytopenia (3 cases), anemia (1 case), diarrhea (1 case), and appendicitis (1 case). One patient died of pulmonary fungal infection two months after completion of treatment, which was not excluded as being treatment related.Conclusion:A combination regimen including BCL-2 inhibitors in patients with relapsed/refractory t(11;14) primary systemic light chain amyloidosis is a potentially safe and effective treatment option that warrants further investigation.

In 2022, the American Gastroenterological Association(AGA)published an expert consensus on the AGA's clinical practice update on PPI prescription cancellation in the Journal of Gastroenterology.In view of the excessive and unreasonable use of proton pump inhibitors(PPIs), experts were organized to formulate a set of ten practical suggestions on how to guide outpatient patients to reduce and stop using PPI.Based on the current situation of PPI use in China and the needs of clinical practice, this paper interpreted the consensus from the perspective of pharmacists, so as to provide reference for further regulating the rational use of PPI and reducing the excessive use and adverse reactions of PPI.

The management model of chronic noncommunicable diseases(chronic diseases)in the elderly is related to the outcome and outcome of patients.The main advantages of chronic disease management in foreign countries are the burden of medical insurance, the interconnection of medical institutions in a limited scope, the primary health workers leading, and the active participation of patients.Although the form of chronic disease management in the community is also included in China and guidance documents have been issued, there is still a need for improvement in policy implementation, information system, community resources and patient education.

ObjectiveTo evaluate the clinical safety of Naoxintong （NXT） capsules after marketing， find out the potential risk factors of the drug as soon as possible， and reveal the incidence， nature， and clinical manifestations of the adverse events （ADE） and adverse reactions （ADR） of NXT capsules， so as to provide a basis for safe use of the drug in clinical practice. MethodA prospective， large-sample， multi-center observational cohort study was conducted to monitor all the 7 345 inpatients and outpatients orally taking NXT in 14 hospitals in China from January to December in 2018， with at least one follow-up. The demographic characteristics， disease type， NXT medication， ADR occurrence， characteristics， and prognosis of the patients were collected. SPSS 23.0 was used for single-factor and multivariate logistic regression to predict the influencing factors of ADR. ResultThe male and female patients accounted for similar proportions. There were 5 081 patients （79.40%） aged ≥60 years and 3 153 patients （49.27%） with body mass index （BMI） exceeding the normal standard. There were 344 （5.38%） patients with a history of allergy to medicines and food， 9 （0.14%） patients with a family history of allergy， and 52 （0.81%） patients with a history of allergic diseases. The ADRs associated with NXT occurred in 22 patients， with the incidence of 0.34%. The clinical manifestations of ADR appeared in 31 cases， involving 10 organs/systems， of which gastrointestinal system damage was the most common （17， 54.84%）. All ADRs were mild or moderate. Most ADRs （19， 86.36%） occurred within 4 weeks after administration. The patients with alleviated NXT-associated ADRs accounted for 81.82%. No indicators related to significant increases in ADR risks were found. ConclusionNXT is well tolerated in the general population. The hospital centralized monitoring for the clinical safety of oral Chinese patent drugs based on HIS data and Web tracking and follow-up system is an essential means for the post-market research on the safety of drugs.