Objective To investigate the value of procalcitonin(PCT),hypersensitive C-reactive protein (Hs-CRP),D-Dimer(DD)in the diagnosis and prognosis judgment of pulmonary embolism(PE). Methods A total of 201 patients were enrolled in the study since the PE diagnosis were made in hospital from JAN. 2013 to DEC. 2016,in which they were divided into high-risk group(n=52),intermediate-risk group(n=88),low-risk group (n = 61),cure-patient group (n = 67) and 36 normal individuals were selected respectively as a blank control group. Results The average of the PCT,Hs-CRP and DD level in the high,intermediate and low-risk group were significant difference comparing with the cure-patient and control group(P<0.05). Conclusions Teh concertration of PCT and Hs-CRP were associated with different risk stratification of PE. Combined with DD , the level of PCT and Hs-CRP can be used to evaluate the risk stratification of PE and help to judge prognosis and guide treatment.

Objective:The aim of this study was to investigate the prognostic value of vitamin B12 as the non-invasive biomarker to predict long-term rebleeding rate in cirrhotic patients with esophagogastric varices.Methods:From Dec 1, 2016 to Dec 31, 2017, cirrhotic patients with esophagogastric varices who had been admitted to Zhongshan Hospital affiliated to Fudan University were enrolled. All these patients received endoscopic treatment to prevent variceal rebleeding. The serum vitamin B12 and folic acid levels were measured in all of them. The receiver operating characteristic (ROC) analysis, Kaplan-Meier analysis, univariate and multivariate cox regression analysis were conducted to explore the value of vitamin B12 in predicting 3-year variceal rebleeding in cirrhotic patients with esophagogastric varices after endoscopic treatment.Results:115 patients were included. The ROC curve analysis indicated that the optimal cutoff value of vitamin B12 for 3-year variceal rebleeding was 567.25 pg/ml. According to the cut-off value, the patients were divided into high-level vitamin B12 group ( n=49) and low-level vitamin B12 group ( n=66). Compared with the low vitamin B12 group, the high vitamin B12 group had lower albumin level, less male (63.3% vs 80.3%), and higher 3-year rebleeding rate ( P<0.05). Cox analysis showed that vitamin B12 and platelet were independent prognostic factors for 3-year rebleeding in patients with variceal bleeding. Conclusions:Elevated peripheral blood vitamin B12 predicts a higher risk of long-term rebleeding in patients with liver cirrhosis and esophagogastric varices.

Objective To study the accuracy and the clinical significance of sentinel lymph node biopsy (SLNB)after neoadjuvant chemotherapy for breast cancer.Methods A total of 90 patients with StageⅡorⅢbreast cancer and negative axillary node after neoadjuvant chemotherapy were enrolled in the study.Mapping proce- dure and SLNB were performed using methylene blue injected at the site of the primary breast cancer,followed by the axillary lymph node dissection.Results The sentinel lymph node(SLN)was successfully identified in 82 out of 90 patients(91.1%).The number of sentinel harvested nodes ranged from 1 to 4(average 1.6).The accuracy of SLNB to predict the axillary lymph node status was 93.9 %(77/82),the sensitivity,positive predictive value,nega- tive predictive value and false negative rate were 87.5 %(40/45),100 %,88.1% and 11.1%(5/45),respectively. The SLN identification rate tended to be higher and false negative rate tended to be lower in patients with T2 prima- ry tumor before neoadjuvant chemotherapy.Conclusion Our study indicated that SLNB after neoadjuvant chemotherapy in patients with StageⅡorⅢbreast cancer had a similar effect as SLNB in non-neoadjuvant studies. SLNB was considered to be able to accurately predict the axillary lymph node status in patients with T2 primary tu- mor before neoadjuvant chemotherapy.

AIM: To observe the role of c-fos in the protection by cholecystokinin-octapeptide (CCK-8) against pulmonary artery smooth muscle cell (PASMC) injury induced by lipopolysaccharide (LPS). METHODS: The ultrastructure of PASMC was observed under transmission electron microscope (TEM). MDA content,LDH release and the rate of trypan blue in PASMC were measured,and immunocytochemistry technique was adopted to observe the c-fos protein expression. RESULTS: The TEM results showed significant PASMC structural injury in LPS group and alleviated structural changes in LPS+CCK-8 group. CCK-8 reduced the increase in the rate of trypan blue uptake,MDA content and LDH release in PASMC induced by LPS. LPS lightly increased c-fos protein expression,which was enhanced by CCK-8. CONCLUSION: CCK-8 attenuated the injury of PASMC induced by LPS,which may be concerned with the increase in c-fos protein expression.

OBJECTIVETo establish a set of suitable and reliable methods for HBV genotyping and to study the distribution of HBV genotypes.

METHODSType-specific nucleotides were searched through alignment of S genes (more than 1000 sequences) listed in GenBank. Then, type-specific primers were designed and type-specific primer PCR was used to genotype the 238 HBV strains. S genes of the untyped strains were further amplified and sequenced to find out their genotypes with type-specific nucleotide analysis.

RESULTSAll the 238 HBV strains were genotyped. 159 (66.8%) cases were genotype B, 69 (28.9%) were genotype C, 6 (2.5%) were mixtures of genotypes B and C and 4 (1.6%) were mixtures of genotypes B and D. No genotypes of A, E, F, G, and H were found.

CONCLUSIONGenotypes B and C are the most common types for HBV strains. Mixtures of genotypes B and C or genotypes B and D coinfection rarely existed. There is no relationship between the gender of the patients and HBV genotypes (X2 = 0.794, P more than 0.05).

DNA Primers ; DNA, Viral ; blood ; genetics ; Female ; Genotype ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; virology ; Humans ; Male ; Nucleotides ; genetics ; Polymerase Chain Reaction ; methods ; Sequence Analysis, DNA

OBJECTIVETo study the factors affecting extracellular glycerol (Gly) in patients with severe traumatic brain injury (STBI).

METHODSPerilesional extracellular Gly and cerebral blood flow (CBF) in 53 patients with STBI were consecutively monitored. Simultaneously, the intracranial pressure (ICP) and cerebral perfusion pressure (CCP) were monitored. The hourly minimum of CCP and CBF and the hourly maximum of ICP levels were matched with the hourly Gly. Gly values were divided into several groups according to regional ICP (less than 15 mm Hg or larger than 15 mm Hg), CCP (less than 70 mm Hg or larger than 70 mm Hg), CBF (less than 50 AU or 50-150 AU) and the outcomes (death or persistent vegetative state group, severe or moderate disability group, and good recovery group).

RESULTSIn comparison with the severe or moderate disability group, the Gly concentration of the death or persistent vegetative state group increased significantly, but CBF and CCP decreased significantly. In comparison with the good recovery group, the Gly concentration of the severe or moderate disability group increased significantly, but CBF and CCP decreased significantly. The Gly concentrations in patients with ICP larger than 15 mm Hg, CCP less than 70 mm Hg and CBF less than 50 AU were respectively higher than those of patients with ICP less than 15 mm Hg, CCP larger than 70 mm Hg and 50 AU less than CBF less than 150 AU. In patients with diffuse axial injury, the mean Gly concentration was (201.17+/-55.00) micromol/L, which was significantly higher than that of the patients with epidural hematoma (n equal to 7, 73.26+/-8.37, P less than 0.05) or subdural hematoma (n equal to 9, 114.67+/-62.88, P less than 0.05), but it did not increase significantly when compared with those in patients with contusion(n equal to 24, 167.48+/-52.63).

CONCLUSIONGly can be taken as a marker for degradation of membrane phospholipids and ischemia, which reflects the severity of primary or secondary insult.

Adolescent ; Adult ; Biomarkers ; analysis ; Brain Chemistry ; Brain Injuries ; diagnostic imaging ; metabolism ; Extracellular Space ; chemistry ; Female ; Glycerol ; analysis ; Humans ; Male ; Microdialysis ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVETo study the effect of mild hypothermia on glucose metabolism and glycerol of brain tissue in patients with severe traumatic brain injury (STBI) using clinical microdialysis.

METHODSThirty-one patients with STBI(GCS less than or equal to 8) were randomly divided into hypothermic group(Group A) and control group(Group B). Microdialysis catheters were inserted into the cerebral cortex of perilesional and normal brain tissue. All samples were analyzed using CMA microdialysis analyzer.

RESULTSIn comparison with the control group, lactate/glucose ratio(L/G), lactate/pyruvate ratio(L/P) and glycerol(Gly) in perilensional tissue were significantly decreased; L/P in normal brain tissue was significantly decreased. In control group, L/G, L/P and Gly in perilensional tissue were higher than that in normal brain tissue. In the hypothermic group, L/P in perilensional tissue was higher than that in relative normal brain.

CONCLUSIONSMild hypothermia protects brain tissues by decreasing L/G, L/P and Gly in perilensional tissue and L/P in "normal brain" tissues. The energy crisis and membrane phospholipid degradation in perilensional tissue are easier to happen after traumatic brain injury, and mild hypothermia protects brain better in perilensional tissue than in normal brain tissue.

Adolescent ; Adult ; Brain ; metabolism ; Brain Injuries ; metabolism ; therapy ; Glucose ; metabolism ; Glycerol ; analysis ; Humans ; Hypothermia, Induced ; methods ; Microdialysis ; Middle Aged

Objective To investigate the feasibility of the adaptive cardio sequence prospective ECG-gated dual-source CT coronary angiography (CTCA).Methods Thirty one patients underwent prospective ECG-gated dual-source CTCA. The patients were divided into two groups: group A, heart rate ≤ 75 times / minutes, 70% of R-R interval was chose; group B, heart rate> 75 times / minutes, 40% of R-R interval was chose. Two experienced radiologists assessed the image quality of 15 segments of coronary arteries in a double blinded fashion in a four score scale. Student t test was used to compare the image quality between two groups. CT dose index(CTDIvol) and effective dose(ED) were also calculated for both groups. Results 437 segments of coronary arteries in 31 patients were included this analysis, 408 segments (93.4%) had assessable image quality, while 29 segments (6.6%) had non assessable image quality. Of 226 segments in group A, 12 segments (5.3%) had non assessable image quality; however, 17 segments (8.1%) of 211 segments in group B had non assessable image quality. The average score of image quality was 3.57±0.64 in 31 patients. There was no statistical difference for mean image quality of group A (3.65±0.39) and group B (3.41±0.43)( t=1.62,P=0.12 ) . There was a statistical difference for mean image quality for segment 10 on a per segment basis ( t = 3.8 ,P＜0.05). CTDIvol and ED were (18.88±5.04) mGy and (4.31±1.05) mSv, respectively.Conclusion Adaptive cardio sequence prospective ECG-gated dual source CT can acquire assessable image quality of coronary artery with lower radiation dose to the patients, which has the potential to be a routine CTCA technique.

Animals ; Arsenites ; therapeutic use ; Catheter Ablation ; Liver Neoplasms ; therapy ; Male ; Rabbits

The purpose of the present study was to investigate the effect of melatonin (MT) on the abnormal reactivity of thoracic aorta and pulmonary artery induced by lipopolysaccharide (LPS) in rats. Sprague-Dawley rats were divided into four groups randomly: (1) Vehicle group; (2) LPS group: LPS (4 mg/kg, i.p.); (3) LPS+MT group: MT (5 mg/ml, i.p.) was given 30 min before LPS and 60 min after LPS (4 mg/kg ,i.p); (4) MT group: received two doses of MT, 90 min after the first injection of MT another dose of MT was given. Six hours after LPS injection,the rats were killed and both thoracic aortic rings (TARs) and pulmonary artery rings (PARs)were prepared. The reactivity of TARs and PARs in the four subgroups was tested separately. The contraction response to phenylephrine (PE) and the endothelium-dependent relaxation response (EDRR) to ACh were observed with the isolated artery ring technique. Concentration-response curves were generated with ACh or PE (1 x 10(-8) - 1 x 10(-5) mol/L). Superoxide dismutes (SOD) activity and the content of malondialhyde (MDA) in artery tissues were detected. For TARs, LPS significantly reduced the contraction response to PE compared with the vehicle group (P<0.01) and the curve of cumulative dose responses to PE in the LPS group shifted downward. Although EDRR to ACh in the LPS group had the tendency to decrease but still showed no significant difference compared with the vehicle group (P>0.05). For PARs, EDRR to ACh was depressed significantly in the LPS group (P<0.01), while no effect on contraction response to PE in the LPS group was observed, compared with the vehicle group (P> 0.05). Compared with the LPS group, TARs in the LPS+MT group exhibited an increased contraction response to PE, but were still lower than that in the vehicle group. Similarly, EDRR to ACh of PARs in the LPS+MT group was improved significantly and there was no difference between the LPS+MT group and the vehicle group. The vascular reactivity was unaffected in MT group compared with the vehicle group in both TARs and PARs. SOD activity in the LPS +MT group increased significantly and the content of MDA decreased markedly compared with the LPS group. These results suggest that MT may improve the vascular reactivity in endotoxemia rats due to its antioxidant properties.
Animals ; Aorta, Thoracic ; physiopathology ; Endotoxemia ; chemically induced ; physiopathology ; Free Radical Scavengers ; pharmacology ; Lipopolysaccharides ; Male ; Melatonin ; pharmacology ; Pulmonary Artery ; physiopathology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase ; metabolism ; Vasoconstriction ; drug effects ; Vasodilation ; drug effects