Objective To observe the pulmonary X-ray changes of malignant malaria.Methods The chest routine X-ray examination in 86 cases with malaria in company with respiratory tract symptoms such as fever was performed,the pulmonary changes were obsenved.Results Of 86 cases, 58 cases were abnormal on chest filmes,including lung framework marked in 33 cases,miliary,small or large patchy shadow in 24 cases and multiple round opaque mass lesion in one case.Conclusion The pulmonary X-ray changes of malignant malaria are varied,the common characteristic is that most of them are situated at middle and lower portion of the lungs.This may attribute to blood dynamic abnormality resulting from malaria protozoan and the pathological changes of involved tissues.

Objective To investigate the mechanism of anticoagulant proteins defect in patients with unexplained miscarriage. Methods Fifty-seven patients with a history of unexplained abortion in Peking union hospital during may. 1999 to April 2000. were tested for protein S, protein C, and antithrombin(AT)Ⅲ, activated protein C resistance(APC-R).The control group consisted of 50 healthy women with a history of normal pregnancy and delivery. Blood samples were taken for measuring protein S, protein C, AT-Ⅲ and APC-R. Patients with APC-R positive were measured for FV Leiden gene mutation by PCR-RFLP method. Results Of the 57 patients, there were 21.1%?1.8% and 8.8% with protein S?protein C and AT-Ⅲ deficiency respectively. For APC-R 22.8% of the 57 patients were positive .In control group, 4.0% were protein S deficiency; None was protein C and AT-Ⅲ deficiency ; 6.0% were positive for APC-R .No FV Leiden gene mutation was found in all the patients with APC-R positive .The incidence of anticoagulant proteins defect is higher in late spontaneous abortion group than that in early abortion group. Conclusions This study demonstrate that anticoagulant protein defects may be associated with pregnancy loss, especially the late spontaneous abortion.

Objective To explore the predicting value of peripheral blood CD20+ CD24hi CD38hi regulatory B cells (Bregs) on the prognosis of elderly patients with sepsis.Methods A prospective study was conducted. Septic patients aged > 65 years old, compliance with diagnostic criteria for Sepsis-3, admitted to emergency and emergency intensive care unit (ICU) of Shanghai East Hospital of Tongji University from April 2016 to February 2017 were enrolled. Procalcitonin (PCT), C-reaction protein (CRP) and lactate (Lac) were routinely measured. According to the worst clinical index value within 24 hours, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and sequential organ failure assessment (SOFA) score were recorded. The concentrations of peripheral blood CD20+ CD24hi CD38hi Bregs were measured by flow cytometry at 1, 3 and 7 days after diagnosed in elderly patients. All patients with sepsis were followed up for 28 days and then divided into death group and survival group according to 28-day outcome. The difference of clinic data and Bregs were compared between the two groups. The significant different factors of elderly sepsis patients were analyzed by binary logistic regression analysis. The correlation between Bregs level and other indicators was analyzed by Spearman correlation. The receiver operating characteristic curve (ROC) was used to evaluate the prognosis value of Bregs in elderly patients with sepsis.Results Fifty-eight patients were enrolled in the study, with 38 male and 20 female; age of (79.91±7.97) years; 32 in sepsis group, 26 in septic shock group; 35 deaths, 28-day mortality rate was 60.3%. APACHE Ⅱ score and SOFA score in death group exhibited much higher than that in survival group (APACHE Ⅱ: 18.14±4.52 vs. 14.91±3.56, SOFA: 8.80±4.56 vs. 6.35±3.00, bothP < 0.05), the Bregs was significantly decreased at 1, 3 and 7 days in death group [cells/μL: 0.70 (0.20, 1.40) vs. 1.50 (0.70, 2.20), 0.54 (0.20, 1.00) vs. 1.42 (1.10, 2.12), 0.25 (0.10, 0.50) vs. 0.80 (0.50, 1.00), allP < 0.05]. Correlation analysis showed that the concentrations of peripheral blood Bregs at 1 day in elderly patients with sepsis was negatively correlated with APACHE Ⅱ score (r = -0.351,P = 0.007), and it was not correlated with PCT, CRP, Lac or SOFA score. It was shown by binary logistic regression that Bregs [odds ratio (OR) = 1.865,P = 0.028] and APACHE Ⅱ score (OR = 0.853,P = 0.026) were independent risk factors for elderly sepsis outcome. It was shown by ROC curve analysis that the prognostic value of the levels of Bregs at 1, 3, 7 days and APACHE Ⅱ score were higher in the elderly patients with sepsis, and the area under ROC curve (AUC) and 95% confidence interval (95%CI) were 0.842 (0.647-0.954), 0.770 (0.564-0.911), 0.888 (0.703-0.977), 0.855 (0.661-0.961), respectively, allP < 0.01. The 7-day Bregs was most powerful to predict outcome, when the cut-off value was 0.50 cells/μL, the sensitivity was 72.73% and specificity was 86.67%. Conclusions The level of peripheral blood CD20+ CD24hi CD38hi Bregs could predict the clinical outcome of elderly patients with sepsis.

Objective To investigate the effect of human hepatocellular carcinoma HepG2 cell-derived Exosome on the differentiation of mesenchymal stem cells(MSC)into cancer-associated myofibroblasts(CAF)and the impacts of CAF on liver cancer cell proliferation,migration,and invasion. Methods The protein expression of HepG2 cell-derived Exosome was detected by Western blotting. MSCs were separated from human adipose tissue and cultured with HepG2 cell-derived Exosome(100 ng/nl)to initiate differentiation. The expressions of mesenchymal markers and several interleukins were also detected by Western blotting. HepG2 cells were co-cultured with the conditioned media(CM),in which HepG2 Exosome induced the differentiation of MSC into CAF. The expressions of epithelial and mesenchymal markers were detected by real-time polymerase chain reaction(PCR)and Western blotting. Cell proliferation was assessed using MTS assay. Transwell chambers were used in the in vitro migration and invasion assay. Results HepG2 cell-derived particles expressed CD63,70 kilodalton heat shock proteins,and 90 kilodalton heat shock proteins. With the treatment of HepG2 cell-derived Exosome,the expressions of mesenchymal marker α-smooth muscle actin,fibroblast activation protein α,interleukin(IL)-6,IL-8,and IL-1β were up-regulated,while vascular endothelial growth factor had no significant change. The conditioned media which HepG2 Exosome induced MSC differentiation CAF(CAF-CM)could significantly promote HepG2 cells proliferation(1.075±0.104),compared to BSA control(0.874±0.066,P=0.023)and MSC-CM(0.649±0.034,P=0.0005). CAF-CM could significantly enhance cell migration [(42.5±9.1) cells vs.(18.5±3.1) cells,P=0.001] and invasion [(29.0±3.5) cells vs.(13.1±3.7) cells,P=0.009] compared to its control group. Moreover the conditioned medium which HepG2 Exosome induced MSC to differentiate into CAF could also promote the expressions of mesenchyme-related genes Smad interacting protein 1(P=0.040),β-catenin(P=0.038),fibronectin(P=0.029),and Vimentin(P=0.013)and inhibit the expression of epithelial related genes zonula ocdudens-1(P=0.010).Conclusions Exosome extracted from HepG2 cells can induce human adipose-derived MSC to differentiate into cancer-associated myofibroblasts. CAF-like cells can promote the migration of the liver cancer cell line HepG2.

Objective: To explore influence of nursing health education on morning blood pressure surge (MBPS) fluctuations in aged patients with hypertension.Methods: A total of 100 outpatients and inpatients with non-dipper hypertension, who haven't been treated, were selected from Apr 2011 to Sep 2015.According to random number table method, patients were randomly and equally divided into routine treatment group and health education group (received nursing health education based on routine treatment group), both groups were treated for four weeks.MBPS, trough/peak(T/P) ratio and smoothness index (SI) were measured and compared between two groups after treatment.Results: Compared with routine treatment group after four-week treatment, there were significant reductions in systolic blood pressure (SBP) morning surge[(46.95±5.17) mmHg vs.(42.21±5.19) mmHg]and diastolic blood pressure (DBP) morning surge[(16.31±3.23) mmHg vs.(14.21±3.58) mmHg], and significant rise in SBP T/P[(59.22±6.65)% vs.(70.11±6.41)%], DBP T/P[(50.91±5.04)% vs.(56.97±5.12)%], SBP SI[(1.19±0.13) vs.(1.42±0.12)]and DBP SI[(1.11±0.09) vs.(1.29±0.08)]in health education group, P<0.05 all.Conclusion: Health education can effectively improve blood pressure fluctuations and may likely improve prognosis in patients with non-dipper hypertension, which is worth extending.

Objective To observe the effect of extracorporeal shock wave (ESW) on proliferation of chondrocyte in vitro. Methods Chondrocyte from normal rabbit knee using enzymatic digestion was treated with ESW of 0, 1×105, 1.5×105, 2×105, 2.5×105, 3×105, 3.5×105 Pa 0, 300, 600, 900 times in vitro. The pressure and frequency of ESW most promoting chondrocyte proliferation were determined with cartilage cell morphology, HE staining and CCK-8 assay. Results Chondrocyte proliferated most under 1.5×105 Pa and 600 times of ESW, and decreased as the pressure and the frequency increased. Conclusion Chondrocyte is stress-sensitive in vitro. ESW can promote chondrocyte proliferation in certain pressure and frequency

The present study aimed to investigate the impact of hypothyroidism on left ventricular systolic function using real-time three-dimensional speckle tracking imaging (RT3D-STI). Thirty hypothyroidism patients and forty healthy volunteers were recruited and received RT3DSTI measurement of global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), and global area strain (GAS). A comparison of differences between the hypothyroidism patients and those in the healthy group was carried out and we obtained the results as followings. The values of GLS were (-18.93 +/- 3.89) vs. (-21.44 +/- 1.99), with P < 0.01, GRS were (51.13 +/- 11.95) vs. (56.10 +/- 5.76), with P < 0.0; and GAS were (-31.63 +/- 5.38) vs. (-34.40 +/- 2.32), with P < 0.01, i.e. they were lower in hypothyroidism group than those in the health group. While GCS were (-17.75 +/- 1.92) vs. 17.03 +/- 3.45), with P > 0.05, which were not significantly different between the two groups. In linear regres sion, GLS showed significant correlation with both TSH (b = -0.69, P < 0.01) and FT3 (b = 0.71, P < 0.01). Meanwhile, the GRS (b = 2.98, P < 0.05) and GAS (b = 3.11, P < 0.05) linearly correlated with FT3 level. In conclusion, the present study shows that the global longitudinal and radial moves of left ventricular are weaker in patients with hypothyroidism than healthy controls. And the impairment of left ventricular function would aggravate as FSH rises or FT3 declines.
Case-Control Studies ; Echocardiography, Three-Dimensional ; Heart Ventricles ; physiopathology ; Humans ; Hypothyroidism ; complications ; Imaging, Three-Dimensional ; Reproducibility of Results ; Systole ; Ventricular Dysfunction, Left ; complications ; diagnosis ; Ventricular Function, Left

Objective To evaluate the diagnostic value of cerebral perfusion SPECT/CT combined with brain MRI in patients with ischemic cerebrovascular disease.Methods A total of 107 cases with ischemic cerebrovascular disease from August 2011 to August 2013 (71 males,36 females,age:33-84years) were retrospectively studied,including 31 cases with transient ischemic attack,40 cases with the first onset of cerebral infarction,36 cases with recurrent cerebral infarction.99Tcm-ECD SPECT/CT and brain MRI were performed within 7 d after attack.The interval between the two scans was within 5 d.The number of lesions and detection rate by SPECT/CT,SPECT,MRI,CT,and their combination were calculated respectively,and analyzed using x2 test.Results The detection rate was:SPECT/CT+MRI (97.20％,104/107)=SPECT+MRI (97.2％,104/107) ＞SPECT/CT (95.33％,102/107)＞SPECT (90.65％,97/107) ＞MRI (85.05％,91/107)＞CT (65.42％,70/107).No statistically significant difference was observed between the detection rate of SPECT/CT+MRI and SPECT+MRI,SPECT/CT (x2 =0.17,0.13;both P＞0.05),while there was statistically significant difference between SPECT/CT+MRI and SPECT,MRI,or CT (x2 =4.01,9.76,35.50;all P＜0.05).SPECT/CT detected more ischemic lesions located in brain gray matter and revealed crossed cerebellar diaschisis,while MRI was better for detecting small lacunar lesions in basal ganglia,brainstem and deep white matter.Conclusions SPECT/CT is valuable for the detection of ischemic cerebrovascular disease.hnproved assessment may be achieved by the combination of SPECT/CT and MRI.

Objective To investigate the neuroprotective effect of lateral intracerebroventricular injection of Apelin-13 on the YAP expression and the cerebral ischemia/reperfusion (I/R) injury in Wistar rats.Methods Healthy adult male Wistar rats were randomly divided into the sham group, cerebral I/R group and Apelin-13 treatment group.The middle cerebral artery occlusion model was established with ischemia for 1 hour and reperfusion for 24 hours after restricting food and water intake for 12 hours.Apelin-13 was injected into rats' lateral ventricles of Apelin-13 treatment group after reperfusion.Neural function defects was assessed.The volume of infarction was evaluated by TTC staining.The expression levels of YAP were detected by western blot.Results Compared with the cerebral I/R group,the rats in the Apelin-13 treatment group had abetter neurologic score ((2.67±0.33) vs (1.67±0.33) , P＜0.05), the infarction volume was decreased ((30.60± 1.42) ％ vs (23.70± 2.20) ％,P＜0.05) , and YAP expression level was increased in each part of the cerebral tissue(P＜0.05).Conclusion Apelin-13 has a neuroprotective effect,which plays the therapeutic effect by regulating the expression of YAP on cerebral ischemia/ reperfusion (I/R) injury in Wistar rats.

Objective Discussion leukoreduction of red blood cells suspended in two different storage bag placement and he-molysis rate impact on the supernatant free hemoglobin (FHb),to ensure the clinical transfusion is safe and effective.Meth-ods Selected 20 donors to sample 400 ml whole blood per person to make leukodepleted red blood cells,which were evenly divided into 10 bags.The 10 bags were randomly divided into two groups,one to the upright position,one group of horizon-tal.The two groups were stored under the same conditions.Respectively,in the 7,14,21,28,35 day,randomly removed one storage bag from each group,FHb and red blood cell hemolysis rate were measured and analyzed statistically.Results FHb and hemolysis rate results stored in the first 21 days of testing,uprightgroup were (217.310±48.477)mg/L and (0.250± 0.056)%,respectively horizontal group (173.972±39.027)mg/L and (0.189±0.045)%,the results set upright than hori-zontal group,the results were statistically(t=3.114,P =0.003<0.05 and t=3.798,P =0.001<0.05),the difference was statistically significant.Conclusion In the blood storage period,storage bags can be placed horizontally to reduce the de-struction of red blood cells,blood storage is more favorable.