Objective To evaluate the influence of lesion size and depth on the diagnostic accuracy and the rate of pneumothorax in patients undergone CT-guided transthoracic aspiration biopsy for pulmonary lesions.Methods CT-guided percutaneous transthoracic biopsy was performed in 398 patients that had surgical resection or clinical follow-up.According to lesion size,lesions were divided into≤2 cm,2～4 cm and ≥4 cm.Lesion depth was measured from the pleura surface to the edge of the lesion.This depth was classified in three categories:≤1 cm,1～3 cm and ≥3 cm.Comparison of the diagnostic accuracy and the frequency of pneumothorax in different size and depth of lesion was performed.Results(1)The overall diagnostic accuracy of CT-guided percutaneous needle aspiration biopsy was 83.2%(331/398).Pneumothorax occurred in 58(14.6%)of 398 biopsy;(2)The diagnostic accurate rate in different size of lesion was 73.3%(44/60),81.5%(176/216)and 91.0%(111/122)respectively,?2=9.91,P0.05.The occurred rate of pneumothorax in different depth lesion was 2.8%(4/141),14.8%(21/142)and 28.7%(33/115),?2=34.03,P

Objective To investigate the factors influencing the diagnostic accuracy in CT-guided percutaneous transthoracic aspiration biopsy of lung lesions. Methods CT-guided percutaneous transthoracic biopsy was performed in 435 patients with surgical pathologic confirmation or clinical follow-up.Univariant statistical analysis and multivariant stepwise Logistic regression analysis were used to study the influence of lesion-related factors(benignancy or malignancy,size,location,depth,presence of cavity),procedure factors(laser-guidence,position of patient) and patient-related factors(sex,age,presence of emphysema);with the accuracy of the diagnosis. Results ① 289 lesions were diagnosed as malignant ones and 146 as benign ones.The accuracy of CT-guided biopsy was(83.4%)(363/435).Univariant analysis showed that the diagnostic accuracies for malignant and benign lesions were(88.9%)(257/289) and(72.6%)(106/146),respectively(?~2=(18.71),P=(0.00002)).Laser-group was superior to non-laser group((88.4%) versus(80.9%),respectively,?~2=(4.00),P=(0.0456)).Mean diameters of lesions in correct diagnostic group and non-correct diagnostic group were(3.78)?(1.64) cm and(3.02)?(1.26) cm,respectively((F=)(13.79),P=(0.0002)).②Multivariant stepwise Logistic regression analysis showed that among the various factors influencing the final benign or malignant diagnoses(Wald ?~2=(14.01),P=(0.0002)) and using laser-guidence(Wald ?~2=(3.92),P=(0.0477)) were significantly associated with the diagnostic accuracy. Conclusions Final correct diagnoses(benign,malignant) are closely related to the application of laser-guidence for determining the diagnostic accuracy in CT-guided transcutaneous thoracic needle aspiration biopsy.

Six compounds were isolated from the leaves of Juglans mandshurica Maxim.. They were characterized by their physico-chemical properties and spectral data as: nonacosanol, 2-octa-cosanol, ?- sitosterol, juglone, 3-methoxy - 7-methylzuglone, butanedioic acid. Except juglone,this secmed to be the first reported isolation of the other five compounds from the title plant to date

Objective To observe the therapeutic effect of sertraline combined with brain function treatment instrument for depressive episodes.Methods According to sequence of hospitalization,80 patients with depression without severe physical disease randomly divided into sertraline with brain function treatment group (40 cases,group A) and only take sertraline group (40 cases,group B),and two groups were given Sertraline 100 mg/day for 8 weeks.24 Hamilton Depression Scale (HAMD-24) and 20 Self-rating Depression Scale (SDS-20) were assessed before and after 1,2,4,6,8 weekend treatment.Results The scores of HAMD-24 and SDS-20 were not significant difference between the two groups before treatment(P＞0.05),but there were statistically significant after treatment (P＜0.05).They were significantly decreased after 8 weeks treatment in group A and were decreased slightly in group B with HAMD-24 and SDS-20.Clinical efficiencies of HAMD of the two groups were 87.2 ％,76.3 ％,respectively,and those of SDS were 89.7 ％,78.9 ％,respectively.Clinical efficacy in group A was significantly better than that in group B (P＜0.05).Conclusion Sertraline with brain function treatment instrument can shorten the onset time and improve its effect.

Objective To investigate nontraumatic avascular necrotic of the femoral head with different etiology whether or not having similar MRI and pathologic findings.Methods MRI features of nontraumatic avascular necrosis of the femoral head caused by differant etiology in 98 patients(152 hips) were retrospectively analysed.The causes of osteonecrosis of the femoral head included steroid-induced in 49 patients(86 hips),alcoholic in 18 patients(25 hips) and idiopathic cause in 31 patients(41hips).Gross section and pathologic examinations were performed on 34 femoral heads obtained after total hip replacement from 25 patients.Results Osteonecrosis of the femoral head with different etiology occurred at the anterior superior part of femoral head.The necrotic zones both on pathological gross section and MRI were consisted of cartilage,necrotic focus,proliferative zone and normal bony zones along the lesions.The proliferative zone surrounded necrotic area was low signal intensity on both T1WI and T2WI.There was correlations between localized MRI signal behavior and specific histopathologic features of femoral head osteonecrosis.Conclusion Nontraumatic osteonecrosis of the femoral heads associated with different etiology have similar characteristics on both MRI and pathology

Objective To investigate the clinical effects of Compound Biejia Ruangan Tablet (CBRT) combined with entecavir in patients with chronic hepatitis B with hepatic fibrosis.Methods Totally 92 cases of patients with hepatic fibrosis of chronic hepatitis B in Ankang people's hospital from January 2013 to May 2016 were divided into observation group (n =45) and control group (n =47),patients in observation group were treated with CBRT combined with entecavir,and patients in the control group were treated with entecavir.Treatment was for 48 weeks.The liver function,liver fibrosis,serum inflammatory factors,and adverse reactions were compared between two groups.Results After treatment,the ALT,AST,TBIL,and ALB/GLB levels of two group were significantly lower than those before treatment (P ＜ 0.05),but there was no significant difference between two groups after treatment.After treatment,the PCⅢ,IV-C,HA,LN,IL-6,IL-4,IL-10,and TNF-α levels of two group were significantly lower than those before treatment (P ＜ 0.05),and the PCⅢ,IV-C,HA,LN,IL-6,IL-4,IL-10,and TNF-α levels of observation group were significantly lower than those of control group (P ＜ 0.05);there was no statistically significant difference in the incidence of adverse reactions between two groups (P ＜ 0.05).Conclusion CBRT combined with entecavir is safe and effective to treat liver fibrosis of chronic hepatitis b,and it could significantly improve liver function,improve the degree of liver fibrosis,and reduce the level of serum inflammatory factors.

Objective To prospectively assess the therapeutic procedure and outcome of MR-guided percutaneous sclerotherapy in patients with venous vascular malformations of the extremities. Methods Fifty-seven percutaneous sclerotherapy treatments were performed under MR guidance in 28 patients with venous vascular malformation. Assessment was conducted to analyze (1) individual success of therapy, (2) improvement of clinical symptoms, ( 3 ) occurrence of complications, (4) volume changes at follow-up examinations, (5) contrast-to -noise ration (CNR) changes. Paired-t test was used to compare the volume and CNR of pre- and postintervention. Results All MR-guided percutaneous sclerotherapy were performed successfully and without serious complications. Individual predominant symptoms were improved, especially about the pain and functional impairment. The mean lesion volumes of pre- and post-intervention were (56. 8 ± 11.7 ) cm3 and ( 27.0 ± 7.2 ) cm3 respectively, which showed significant difference ( t = 8. 90, P < 0. 01 ). The percentage of volume shrinkage ranged from 28. 5% to 74. 4% [ mean ( 54. 4 ± 5. 3 ) % ]. The CNR of the pre and post-interventional images were 21.9 ± 2. 0 and 8.4 ± 0. 9 respectively. There was significant difference(t = 21.76, P < 0.01 ) between them, and the percentages of CNR decrease were 40.0% to 78. 0% [ the mean(61.0 ± 3.6)%]. Conclusion MR-guided sclerotherapy of venous vascular malformations of the extremities is a safe and efficient technique.

Objective To evaluate the diagnostic value of deep venous thrombosis(DVT)on lowerlimb venous ultrasonography combined with right ventricular dysfunction (RVD) on transthoracic echocardiography(TTE) in patients with acute pulmonary thrombo embolism(PTE). Methods This prospective multicenter control trial included 520 patients with confirmed acute PTE from 41 hospitals between June 2002 and February 2005.Results The incidence of RVD and DVT was associated with the severity of PTE.There were 57.0%(207/363)patients with RVD,49.6%(1 80/363)patients with DVT,265(73.0%)patients with RVD and/or DVT,and 121(33.3%)patients with combined sign of DVT plus RVD in the whole population.As to major PTE population,206(99.5%)patients had RVD and 121 (58.5%)patients had DVT.In addition,the rate of RVD was much greater in proximal PTE than in lobar PTE and segmental PTE(78.7%,51.4%and 21.7%,respectively,P＜0.001).DVT occurred more frequently in proximal PTE than in lobar PTE and segmental PTE(61.7%,46.8%and 37.0%,respectively,P＜O.001).The incidence of the combined sign was 51.1%,24.3%and 8.7%,respenctively (P＜0.001).Conclusions The incidence of the combined sign of RVD plus DVT was associated with the severity of PTE and the localization of emboli.The combined sign of RVD plus DVT help diagnose major PTE especially in emergency department.

Objective To assess the prevalance and distribution of pain in Parkinson' s disease (PD) patients, and to describe the relationship between pain and development of disease and its impact on the quality of life. Methods 113 PD patients were assessed with Visual Analog Scale (VAS), Brief Pain Inventory (BPI), Unified Parkinson' s Disease Rating Scale (UPDRS), Hoehn-Yahr Scale (H-Y), Hamilton Anxiety and Depression Scale (HRSD, HAMA) and Pittsburgh Sleep Quality Index (PSQI). Patients were divided into no pain group, PD-pain group and non-PD-pain group. PD-pain group was divided into PD-pain direct group and PD-pain indirect group. And statistical analysis was performed for each group. Results The incidence of PD-pain was 42. 5% (48/113). And compared with no pain group, PD-pain group had earlier age at onset of disease, longer duration, higher HAMA, HRSD, UPDRS and H-Y score, higher daily L-dopa dose, with statistical significance. Compared with non-PD pain group, the differences in the onset of age (57.4±9.6 vs 65.9±8.7, t= -2.596, P =0.012), HRSD(12. 9±7.9 vs 8.7±3.7, t =2.605, P=0.014) and VAS (61.6±25.9 vs 38.0 ± 30. 1, U = -2.290, P =0.022) were also statistically significant. BPI was different between PD-pain direct group and PD-pain indirect group except normal work and relations with other people. Conclusion Pain is frequent in Parkinsonian population. Most pain was chronic and related to PD (PD-pain). These patients always have earlier onset age and poorer quality of life.

Objective To investigate the relationship between G protein-coupled receptor kinase 6 (GRK6) and N-methyl-D-aspartate (NMDA) receptor in the mechanism study underlying motor complications in Parkinson's disease (PD).Methods The rat models (n= 25) of Parkinsonism related motor complications were established and were randomly divided into levodopa-induced dyskinesia (LID) group (n= 10,intraperitoneal injection of levodopa for 23 d),MK-801 treatment group (n= 10,intraperitoneal injection of MK-801 at day23 after intraperitoneal injection with levodopa for 22 days) and PD group (n= 5,intraperitoneal injection of vitamin C).Another 5 rats were served as controls (sham-operation group).The behavior changes of rats in MK-801 treatment group were observed,and the expression of GRK6 in the striate of rats was detected by immunohistochemistry and Western blot.Results After the chronic treatment with levodopa methyl ester,PD rats displayed abnormal involuntary movements,which was similar to levodopainduced dyskinesia in PD patients.Immunohistochemistry showed that GRK6-positive cells of lesion side were decreased in LID rats as compared with PD rats [(3.23±0.41 ) × 103 vs.(4.81 ± 1.31 ) ×103,P＜0.01].Rats in MK-801 treatment group displayed the decreased AIM scores and increased peak rotation,and the increased GRK6-positive cells of lesion side as compared with LID rats (P＜0.05).Western blot showed that the levels of GRK6 was 83.7% ±2.1% in PD group (presented as lesion side/unlesion side),76.8% ± 2.2% in LID group and 91.1% ± 2.7% in MK-801 treatment group (intergroups comparison:all P＜0.05).These results were in accordance with the results of immunohistochemistry.Conclusions Antagonist of NMDA receptor can be used to reduce the motor complications in rats.It may be due to increased GRK6 which inhibits the overactivation of glutamic acid receptors.