5.5 the separation was not achieved.The compound of cyclodextrin and terbutaline increased with the increase of cyclodextrin when the volume rate of cyclodextrin was 0.4% 1.6%,making terbutaline easier for separation.Conclusion:The types of ? CD,the concentration and pH of buffer are the major factors influencing the separation of terbutaline and it can be completely separated.

0.05).The results differentiated by Sysmex XS-800i showed excellent correlation with those by handwork.Conclusion The performance of the Sysmex XS-800i automated hematology analyzer is satisfied.

Objective To preliminarily study on the values of microembolic signal(MES)monitoring in the evaluation of anti-Platelet agent or anti-Platelet agent+statins in patients with acute ischemic cerebrovascular disease.Methods Among the patients with acute ischemic cerebrovascular disease in the cm'otid system who performed MES monitoring the MES-positive patients were ramaomly allocated into dual antiplatelet group(aspirin 100 mg/d+clopidogrel 75 mg/d)and dual antiplatelet + atorvastatin goup (aspirin 100 mg/d + clopidogrel 75 mg/d +atorvastatin 20 me4d).MEss were monitored by transcranial Doppler ultrasound.Results Among the 60 patients with acute cerebrovascular disease in the carotid system,13(21.7%)were MES positive.in which,6 and 7 were randomly divided into dual antiplatelet group and dual antiplatelet + atorvastatin group respectively.There were no significant differences in the constituent ratios of sex hypertmsion,diabetes,coronary heart disease,smoking,alcohol consumption,and history of previous stroke as well as the age,time from onset to microembolic monitoring,and time from onset to drug intervention between the 2 groups.There were no significant differences in the numbers of microemboli(8.83±1.17/h vs.9.00±1.83/h)before treatment between the dual alltiplatelet group and dual antiplatdet + atorvastatin group (P=0.851);2 and 7 days after treatment,the numbers of micromixfli were 4.17±1.47 and 2.17±0.75/h respevtively in the dutral antiplatelet group,and they were significantly higher than 1.43±0.976 and 0.71±0.488/h)respevtively in the dual antiplatelet + atorvastatin group (P=0.002 and P=0.003).They were followed up for 8 days;and there were 110 ischemic events in both groups.Conclusions The dual antiplatelet agents or those in combination with statins might reduce the number of MES,but when they were used in combination with statins,the number Of MES reduced more significant.However.because there are only a few patients in the study,this conclusion still needs to be further validatod in a large-scale multicenter randomized controlled trial.The MES monitoring has a certain value in the evaluation of anti-platelet drugs or those in combination with statins

Objective To investigate the changes of serum CXCL16 levels in patients with acute cerebral infarction and their relationship with the Trial of Org10172 in Acute Stroke Treatment (TOAST) etiological types of cerebral infarction. Methods The serum CXCL16 levels in 113 patients with acute cerebral infarction were measured by enzyme-linked immunosorbent assay (ELISA), and they were grouped according to TOAST types. The patients between all the subgroups and/or 32 healthy controls were compared. Results The serum CXCL16 levels in patient group were significantly higher than those in control group (2.29 ± 0.21 ng/mlvs.1.75±0.21 ng/ml, t= 12.863, P= 0.000); The serum CXCL16 levels in large artery atherosclerotic (LAA) stroke group were significantly higher than those in small artery occlusive (SAO) stroke group (2.38 ±0.23 ng/mL vs. 2.21 ±0.11 ng/ml, 1 =5. 743, P =0. 000), and both were significantly higher than those in the control group (q = 20. 501, P = 0. 000; q =13. 527, P= 0. 000). In the LAA group, there were no significant differences between the serum CXCL16 levels in ≥2 artery stenosis group and those in only 1 artery stenosis group (2.34 ±0.24 ng/ml vs. 2.46 ± 0. 19 ng/ml, t = - 1.969, P = 0. 054). Multivariate logistic regression analysis showed that CXCL16 (OR =0.972, 95% CI0.956-0. 978, P =0.001)and hyperlipidemia (OR =3.547, 95%CI 1.160-10. 848, P=0. 020) were the independent risk factors for cerebral infarction. Conclusions The serum CXCL16 levels increased in acute cerebral infarction, it closely related with the occurrence of cerebral infarction, and the LAA stroke group was significantly higher than the SAO stroke group.

Objective To investigate the braking time in diagnosis of lipohemarthrosis by ultrasound. Methods Experiment group:After 20 tubes containing fresh blood and pig marrow were uniformly mixed, they were instantly continuously detected by high-frequency linear array transducer in fixed-area at short-interval.Clinical group: Ten walking patients with lipohemarthrosis were examined with continuous detection by ultrasound,CT and MR before operation.Results Experiment group: Cloudy echo and slowly floating up of lipoids were detected at the beginning.After 2.7 to 3.7 minutes (average 3.17 minutes), the liquid was divided into two layers with vague boundary.After 5.3 to 8.0 minutes (average 6.75 minutes) ,the liquid was divided into 3 layers with thickening serum laye.Clinical group: Ultrasound findings: Cloudy medium echo was detected at first.After 2.0 to 4.0 minutes (average 3.08 minutes),the liquid was divided into two layers.After 4.4 to 10.0 minutes (average 6.92 minutes) , the liquid was divided into 3 layers with thickening serum layers.Three knees showed fracture line and 2 knees with occult fracture were diagnosed as lipohemarthrosis.CT and MR findings: Ten knees showed fracture line in CT examination,of which 7 knees showed double liquid-liquid layer and 3 knees showed single liquid-liquid layer in the suprapatellar bursa.Ten knees showed fracture line in MR examination,6 knees showed double liquid-liquid layer and 4 knees showed single liquid-liquid layer in the suprapatellar bursa. Conclusions The best braking time in diagnosing lipohemarthrosis by ultrasound can be shorten to 10 minutes and the necessary braking time is 2 to 4 minutes.

Objective To explore the correlation between ultrasonographic findings and relevant technical factors in traumatic lipohemarthrosis. Methods Fifty-two patients with traumatic lipohemarthrosis underwent ultrasonic examination in supine position (26 in unbent, 16 in external rotary position, 10 in unbent and 45° rotation) before operation, and 22 of them underwent dynamic examination. Findings of ultrasography were compared with manifestations of MRI and CT regarded as gold standard.Results Fifty-two patients with traumatic lipohemarthrosis were diagnosed correctly. The best effect of ultrasonic examination of lipohemarthrosis was observed on suprapatellar bursa. Superior border of patella were showed well in supine straight position, then turned to the level of patella, and the structure below patella were showed badly. The best posture was in supine genuflex position with 45° rotation when the joint effusion presented, by which thicker layer liquids could be displayed than in straight position. Three layer liquids could not be displayed synchronously in mild external rotary rest position of lower extremity, and the combination of findings at internal and external side were favorable to the diagnosis. Liquids bed changed from one layer to two layers and then to three layers, from fuzzy to clear gradually in dynamic examination.Conclusion Ultrasonic manifestations of traumatic lipohemarthrosis are closely correlated to the position, posture and arresting time during examination.

Objective · To investigate whether the quality of embryos will result in biochemical pregnancy or arrest of embryo development in the freezing and thawing cycles of in-vitro fertiliazation-embryo transfer (IVF-ET). Methods · The clinical data of patients who accepted IVF-ET in Center of Reproductive Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 2015 to June 2016 were retrospectively studied. The data includes 115 cycles of biochemical pregnancy, 64 cycles of arrest of early embryonic development and 871 cycles of ongoing pregnancy after frozen thawed embryo transfer. We compared the embryo score on the third day after embryo transfer (D3), the blastocyst development rate and the blastocyst grade in the three groups. Results · There were no significant differences in the period of infertility, the age of the patients and their spouses, the endometrial thickness, the estrogen and progestogen levels of the day of transplantation among the three groups (P > 0.05). The scores of most frozen thawed embryos on D3 were from 6 to 8, and the scores were not statistically significant among the three groups (P > 0.05). The proportion of transplanted blastocyst on D5 was higher than that on D6 in the three groups, but there was no significant difference among the three groups (P > 0.05). There was no significant difference in the proportion of inner cell mass of blastocysts which were scored as Grade A&B or Grade C among the three groups. Nevertheless, in the arrest of early embryonic development group, the proportion (52.2%) of the trophoblast of blastocysts which were cored as Grade C was significantly higher than the proportion (35%) in biochemical pregnancy group and the proportion (29.3%) in ongoing pregnancy group (P<0.05). Conclusion · The quality of embryos is not necessarily related to biochemical pregnancy, but the score of trophoblastic may be related to the arrest of early embryo growth.

Objective:To explore the value of high frequency ultrasound elastography in the differential diagnosis of Hashimoto’s thyroiditis (HT) with thyroid nodules.Methods:112 HT patients complicated with thyroid nodule disease in Department of Ultrasound in Yantai Yantaishan Hospital from Jan. 2017 to Jan. 2020 were randomly selected for prospective study. All patients were diagnosed by routine ultrasound and high-frequency ultrasound elastography, and underwent surgical exploration and pathological diagnosis. Taking the postoperative pathological results as the gold standard, the specificity, sensitivity, negative-positive predictive value of conventional ultrasound and high-frequency ultrasound elastography in HT complicated with thyroid nodular disease were compared and analyzed, and the diagnostic efficacy was evaluated.Results:There were 138 nodules in 112 cases, including 47 benign nodules and 91 malignant nodules. The specificity and sensitivity of routine ultrasonography were 80.85% and 78.02%, respectively; The specificity and sensitivity of high frequency ultrasound elastography were 87.23% and 90.11%. Compared with conventional ultrasound, high frequency ultrasound elastography had higher specificity and sensitivity in detecting lesions ( χ2=4.54, 4.25, P=0.026, 0.039) . The negative predictive value of routine ultrasonography was 65.52%, the positive predictive value was 88.75%, and the ROC was 0.775. The best diagnostic cut-off point was 3.04. The negative predictive value of high frequency ultrasound elastography was 82.00%, the positive predictive value was 93.18%, the ROC was 0.812, and the best diagnostic cut-off point was 32.89 kpa. Compared with conventional ultrasound, high frequency ultrasound elastography had higher negative and positive predictive values ( χ2=4.35, 4.48, P=0.031, 0.027) . Conclusion:High frequency ultrasound elastography can improve the negative predictive value and sensitivity in the diagnosis of Hashimoto’s thyroiditis and thyroid cancer, judge the benign and malignant lesions, and provide more accurate data for early surgical treatment.

Tocilizumab has been reported to attenuate the "cytokine storm" in COVID-19 patients. We attempted to verify the effectiveness and safety of tocilizumab therapy in COVID-19 and identify patients most likely to benefit from this treatment. We conducted a randomized, controlled, open-label multicenter trial among COVID-19 patients. The patients were randomly assigned in a 1:1 ratio to receive either tocilizumab in addition to standard care or standard care alone. The cure rate, changes of oxygen saturation and interference, and inflammation biomarkers were observed. Thirty-three patients were randomized to the tocilizumab group, and 32 patients to the control group. The cure rate in the tocilizumab group was higher than that in the control group, but the difference was not statistically significant (94.12% vs. 87.10%, rate difference 95% CI-7.19%-21.23%, P = 0.4133). The improvement in hypoxia for the tocilizumab group was higher from day 4 onward and statistically significant from day 12 (P = 0.0359). In moderate disease patients with bilateral pulmonary lesions, the hypoxia ameliorated earlier after tocilizumab treatment, and less patients (1/12, 8.33%) needed an increase of inhaled oxygen concentration compared with the controls (4/6, 66.67%; rate difference 95% CI-99.17% to-17.50%, P = 0.0217). No severe adverse events occurred. More mild temporary adverse events were recorded in tocilizumab recipients (20/34, 58.82%) than the controls (4/31, 12.90%). Tocilizumab can improve hypoxia without unacceptable side effect profile and significant influences on the time virus load becomes negative. For patients with bilateral pulmonary lesions and elevated IL-6 levels, tocilizumab could be recommended to improve outcome.
Antibodies, Monoclonal, Humanized ; COVID-19/drug therapy* ; Humans ; SARS-CoV-2 ; Treatment Outcome