【Objective】 To evaluate the evolution and correlation of CT imaging signs and clinical features of non-severe coronavirus disease 2019 (COVID-19). 【Methods】 We retrospectively analyzed CT images and clinical features of 24 non-severe COVID-19 patients from the onset at a 5-day interval. We recorded CT image signs, clinical manifestations and laboratory results at each stage, and analyzed their dynamic changes and correlations. Categorical variables were presented by rates. The correlation of the total CT score and the total number of lesions with clinical manifestations was analyzed. P<0.05 indicated statistical significance. 【Results】 A total of 92 cases in 24 patients with COVID-19 were analyzed: 12 cases in 0-5 days, 21 in 5-10 days, 22 in 10-15 days, 20 in 15-20 days, and 17 in >20 days. The main CT signs of COVID-19 patients were subpleural and ground-glass opacity; the accompanying CT signs included paving stone sign, thickened blood vessels, fibrous cord shadow, air bronchial sign, leaflet center nodule, halo sign, reversed halo sign, bronchial wall thickening, and lung volume shrinking. On days 0-5, the number of lesions was the largest, acute symptoms were the most severe, the lymphocyte count and ratio were the lowest, and the concentration of high-sensitivity C-reactive protein (H-sCRP) was the highest. On days 5-10, the total CT score, the concentration of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were the highest, and the white blood cell count was the lowest. There were a positive correlation between the CT score and the number of lesions with temperature, ESR, CRP, H-sCRP, and negative correlation with WBC count. 【Conclusion】 CT imaging signs were similar to the change of the clinical features on days 0-10. The total CT score and the number of lesions had correlation with the clinical manifestations.

Objective: To improve the time window of early diagnosis of chronic obstructive pulmonary disease (COPD) and make quantitative evaluation of lung function using the voxel-based quantitative CT. Methods: Early COPD and COPD patients who had received inspiratory and expiratory CT scanning were consecutively recruited from the multi-center study named Digital Lung. Quantitative parameters of functional small-airway disease (fSAD) and emphysema (Emph) were measured. For the all COPD patients, Pearson correlation analysis or Spearman rank correlation analysis was used to test the correlation between the quantitative measurements of CT and pulmonary function. Results: Finally, 37 patients with early COPD and 50 patients with COPD were included. The mean value of Emph in early COPD was (3.50±3.36)% and the average value of fSAD was (18.12±12.73)%. Meanwhile, the mean value of Emph in COPD patients was (13.46±9.03)% and the mean value of fSAD was (36.57±9.88)%. Emph was negatively correlated with FEV1% and FEV1/FVC (r=-0.470, P=0.001; r=-0.334, P=0.018), respectively. fSAD was negatively correlated with FEV1% and FEV1/FVC (r=-0.453, P=0.001; r=-0.320, P=0.001). Conclusion: The voxel-based quantitative CT is helpful in early detection of small airway injury in early COPD with respiratory symptoms but no pulmonary function can be achieved.

Objective To analyze the distribution of allergens in allergic rhinitis (AR) patients and the correlation between the incidence of allergic rhinitis and seasonal climate in Ankang area of Shaanxi Province, and to provide a theoretical basis for the prevention and treatment of AR. Methods A total of 567 AR patients admitted to the Department of Otolaryngology, Ankang Central Hospital from January 2019 to January 2020 were investigated by multi-stage stratified random method. Five mL elbow venous blood were extracted from AR patients, and the supernatants were collected after centrifugation. Allergen specific IgE antibodies were determined by ELISA. Allergens tested included 15 inhalation allergens and 20 ingestion allergens. The number of AR patients per month was counted, and the average air pressure (Hpa), average temperature (℃), average rainfall (mm) and average wind speed (m/s) were recorded during the same period. Pearson correlation analysis was used to analyze the correlation between single climate factor and the incidence of AR. Results Among the 567 AR patients, inhaled allergens were mainly dust mites in 357 cases (62.96%), cat hair in 75 cases (13.23%), mugwort in 37 cases (6.53%), cockroaches in 29 cases (5.11%), and house dust in 26 cases (4.59%); ingestion allergens were mainly shrimp in 49 cases (8.64%), mutton in 36 cases (6.35%), marine fish in 32 cases (5.64%), and soybean in 26 cases (4.59%). There were statistically significant differences in cat hair and mugwort among different ages (P<0.05). The incidence of AR patients in Ankang area of Shaanxi Province was mainly concentrated in summer (32.98%) and autumn (46.38%), and there was statistical significance between mugwort and house dust in different seasons (P<0.05). The number of AR cases was positively correlated with average temperature and rainfall (r=0.481, 0.671, P<0.05). It was negatively correlated with average wind speed and average air pressure (r=-0.413, -0.549, P<0.05). Conclusion Dust mites are the most common allergen in AR patients in Ankang area of Shaanxi Province. The incidence of AR mainly occurs in summer and autumn, which has a certain correlation with the seasonal climate in Ankang area.

Objective: To investigate the effect of sevoflurane anesthesia on hepatic ischemia-reperfusion injury in patients undergoing partial hepatectomy. Methods: A total of 86 patients undergoing partial hepatectomy were divided into sevoflurane group and isoflurane group according to random number table with 43 patients in each group. Both groups received continuous epidural block combined with general anesthesia, sevoflurane group took sevoflurane combined with remifentanil to maintain anesthesia, while isoflurane group took isoflurane remifentanil to maintain anesthesia. The mean arterial pressure (MAP) and heart rate(HR) of different moments, awakening (open-eye time, extubation time, listening to instruction time, orientation recovery time, time of Aldrete score up to 9 minutes), the serum levels of tumor necrosis factor alpha (TNF-α), interleukin 1 (IL-1), aspartate aminotransferase (AST), alanine aminotransferase (ALT), glutamate dehydrogenase (GLDH), alpha glutathione S transferase (α-GST) levels at different moments were compared between the two groups. Results: The MAP and HR at T₁, T₂, T₃ and T₄ in both groups were significantly lower than those at T₀ (P<0.05). The HR at T₁ and T₄ in sevoflurane group were significantly higher than those in isoflurane group (P<0.05). The open-eye time, extubation time, listening to instruction time, orientation recovery time in sevoflurane group were significantly shorter than the isoflurane group (P<0.05). The levels of serum TNF-α, IL-1, AST, ALT, GLDH and α-GST in the two groups at T₂ and T₃ were significantly higher than those at T₀ (P<0.05), and began to fall back to T₄. The levels of serum TNF-α, IL-1, AST, ALT, GLDH and α-GST in the sevoflurane group at T₂ and T₃ were significantly lower than those in the isoflurane group (P<0.05). Conclusions The hepatic hemodynamics in patients undergoing partial hepatectomy with sevoflurane is more stable better than isoflurane during operation, which has faster postoperative recovery and relieved hepatic ischemia-reperfusion injury.

OBJECTIVES: To explore the criminal characteristics of forensic psychiatry expertise in depression patients and schizophrenics with homicide behavior. METHODS: A total of 40 depression （depressive episode） patients and 50 schizophrenics with homicide behavior were randomly assigned into the study group and control group, respectively. Data of demographic and criminal characteristic of the two groups were collected by a self-designed questionnaire, and then were compared. RESULTS: There were no statistical differences in age, education level and career between study and control groups （P>0.05）. Compared with the control group, the victims in the study group were mainly the patient's children and parents, and most offenders had suicidal behavior after homicide （70%）. In study group, the motives of crime were mainly extended suicide and indirect suicide, and most offenders had attempted suicide （85%） and diminished capacity of criminal responsibility （70%）, which in control group had no capacity of criminal responsibility （56%）. Except for criminal site, there were statistical differences in other criminal characteristics between two groups （P<0.05）. CONCLUSIONS There are different criminal characteristics between depression patients and schizophrenics with homicide behavior in forensic psychiatry, and these characteristics should be considered when these two diagnoses are distinguished in forensic psychiatry expertise.
Adult ; Child ; Criminals/psychology* ; Depression/psychology* ; Depressive Disorder ; Forensic Psychiatry ; Homicide/psychology* ; Humans ; Motivation ; Schizophrenia ; Schizophrenic Psychology ; Suicide/psychology* ; Suicide, Attempted

Objective: To study the expression of miRNA 320a in the brain tissue of epileptic rats and analyze its effect on the expression of aquaporin 4 (AQP4). Methods: All rats were performed with the intraperitoneal injection of lithium chloride (3 mmol/kg) and then the intraperitoneal injection of pilocarpine (30 mg/kg) 24 h later (injected twice) to prepare the epileptic model of Wistar rats. Rats in the control group were injected with the equal volume of normal saline. According to the Racine scale, rats with over stage 3 of epilepsy were chosen and the brain tissue was separated quickly and then stored at -80 °C. The immunohistochemistry was used to detect the expression of aquaporin in the brain tissue of epileptic model and the Real-time PCR was employed to determine the difference in the expression of miRNA 320a and AQP4 in the brain tissue of rats between the epileptic model group and control group. Five 5-day neonatal Wistar rats were chosen to collect the cerebral cortex and their primary astrocytes were separated and cultured. They were transfected with miRNA mimic and imitated to the endogenous miRNA 320a to up-regulate the expression of miRNA 320a. Results: In the model group, the expression of AQP4 was significantly higher than the control group (P < 0.01). However, the expression of miRNA 320a in the model group was lower than control group (P < 0.05), which was negatively correlated to AQP4. In the primary astrocytes, the transfection of miRNA 320a mimic could significantly reduce the expression of AQP4, while its inhibitor could up-regulate the expression of AQP4, which indicated that miRNA 320a could reduce the expression of AQP4. Conclusions: In the primary astrocytes of rats, the miRNA 320a could inhibit the expression of AQP4 and after adding the inhibitor of miRNA 320a, the expression of AQP4 was up-regulated.

Objective To investigate the value of ADC and T2WI in differentiating of skull base chordoma and invasive pituitary adenomas(IPA).Methods 15 patients with skull base chordoma and 19 patients with IPA which involve paranasal sinus were reviewed retrospectively.All diagnosis were demonstrated by pathology.Quantitative analysis of minimum ADC, normal ADC and rT2WI values were performed.Differences in minimum ADC, normal ADC and rT2WI values between skull base chordoma and IPA were evaluated using the independent samples t test and receiver operating curves(ROC).Results Statistical analysis revealed a significant difference among normal ADC, minimum ADC and rT2WI values (P<0.01),and the area under the ROC curves decreased in turn.Conclusion Both ADC values and rT2WI SI are effective parameter for differentiating diagnosis of skull base chordoma and IPA.

AIM:To identify the reasons for not improving visual acuity of patients with diabetic macular edema(DME)and its correlation with optical coherent tomography(OCT)imaging characteristics. They were treated with anti-vascular endothelial growth factor(VEGF)again after an interruption of treatment due to the COVID-19 pandemic.METHODS: Retrospective cases study. A total of 31 patients(40 eyes)with DME and treated with anti-VEGF drugs in the Department of Ophthalmology of the First Affiliated Hospital of Xi'an Jiaotong University between December 2019 and July 2020 were selected. All patients had an treatment history of interruption due to COVID-19. Based on the behavioral standard of best corrected visual acuity(BCVA)at 1mo after re-treatment, they were divided into improved visual acuity group(14 eyes)and non-improved visual acuity group(26 eyes). All patients received comprehensive ophthalmic examinations, including BCVA, intraocular pressure, OCT, fundus photography, and fundus fluorescein angiography(FFA). The central retinal thickness(CRT), hyper-reflective retinal dots(HRD), subretinal fluid(SRF), intraretinal fluid(IRF), disorganization of the inner retinal layers(DRIL)and ellipsoid zone disruption(EZD)were quantified by Image J. The correlation between BCVA and CRT, the number of HRD, the diameter of SRF and IRF, and the height of DRIL and EDZ width at 1mo after treatment were analyzed by Spearman correlation.RESULTS: The proportion of HRD in OCT was significantly higher in the non-improved visual acuity group than that in the improved visual acuity group(χ2=5.43, P=0.0072); There was a positive correlation between the difference of BCVA(LogMAR)and CRT change in DME patients after treatment(rs=0.406, P=0.009); There was a positive correlation between BCVA(LogMAR)and EZD width after treatment(rs=0.358, P=0.023). There was no correlation between BCVA(LogMAR)after treatment and the number of CRT(rs=-0.086,P=0.600)and HRD(rs=-0.115,P=0.482), the diameter and height of SRF(rs=0.102,P=0.530; rs=0.100,P=0.538)and IRF(rs=0.134,P=0.410; rs=-0.014,P=0.932), and the width of DRIL(rs=0.089,P=0.587).CONCLUSION:The probability of retinal HRD was significantly higher in patients with no visual improvement than that in patients with visual improvement after the re-treatment with anti-VEGF due to the treatment interruption during COVID-19. EZD width was also closely correlated to the prognosis of visual acuity. As for these patients, HRD manifestations in OCT should be comprehensively considered, taking intravitreal injection of glucocorticoid as an auxiliary strategy if necessary.

Objective To investigate and study the role of clinical pharmacists in controlling the antibiotics use density (AUD) indicators. Methods Pharmaceutical services were conducted by clinical pharmacists through basic data survey, participation in developing hospital AUD indicators, regular monitoring and analysis, proposal of individualized rectifi-cation recommendations specific to various clinical departments, enhancement of antibiotics prescription comment, or-ganization of training on rational antibiotics use, etc. Results The AUD indicators of our hospital reduced largely and the AUD value had been controlled under 40DDDs since the second half of 2013. Conclusion Clinical pharmacists can give full play to their advantages, propose rational recommendations and effectively reduce the hospital AUD value from the aspect of pharmacy.

Purpose: Most lung adenocarcinoma (LUAD) patients are diagnosed at the advanced stage and have poor prognosis. DNA methylation plays an important role in the prognosis prediction of cancers. The objective of this study was to identify new DNA methylation sites as biomarkers for LUAD prognosis. Materials and Methods: We downloaded DNA methylation data from The Cancer Genome Atlas data portal. Cox proportional hazard regression model and random survival forest algorithm were applied to identify the DNA-methylation sites. Methylation of sites were validated in the Gene Expression Omnibus cohorts. Function annotation were done to explore the biological function of DNA methylated sites signature. Results: Six DNA methylation sites were identified as prognosis signature. The signature yielded acceptable discrimination between the high-risk group and low-risk group. The discrimination effect of this DNA methylation signature for the OS was obvious, with a median OS of 21.89 months vs. 17.74 months for high-risk vs. low-risk groups. This prognostic prediction model was validated by the test group and GEO dataset. The predictive survival value was higher for the prognostic prediction model than that for the tumor node metastasis stage. Adjuvant hemotherapy could not affect the prediction of the signature. Functional analysis indicated that these signature genes were involved in protein binding and cytoplasm. Conclusion We identified the prognostic signature for LUAD by combining six DNA methylation sites. This could service as potential robust and specificity signature in the prognosis prediction of LUAD.