Objective To explore the clinical values of applying contact-mode argon plasma coagulation (APC) for retroflex colonoscopic treatment of ultra-lower rectal polyps. Methods 46 wide outsole and applanate polyps smaller than 1.0 cm located at ultra-lower rectum in 17 cases of patients were treated by contact-mode APC under U-type retroflex colonoscopy after failure in regular colonoscopic treatment. Then observe the contacting rate of APC probe with polyps, success rate of curing polyps, rate of probe being adhered and blocked by the solidification structures, incidence of submucosal emphysemas, and incidence of colonoscope ambustion. Results Under U-type retroflex colonoscopy, the probe could contact with polyps in 17 patients. The polyps in every patient were cured by APC in the first time of colonoscopic treatment, whereas all 46 polyps were cured by 97 times of APC spurt. Mild adhesions occurred between the probe and solidification structures at 5 times (5.15 %) among 97 times of APC spurt, without injuries to the coagulation surface from which when the probe separated. The solidification structures blocked the probe only twice (2.06 %). When the solidification structures were cleared, efficiency of the probe restored. No sub-mucosal emphysemas and colonoscope ambustion happened. Conclusion Applying contact-mode APC for retroflex colonoscopic treatment of ultra-lower rectal polyps is safe and effective, it can prevent the damage of colonoscope from the argon knife.

Objective To explore the diagnostic value of the CT angiography (CTA) in the detection of mechanical obstructive cause of deep venous thrombosis of lower extremity. Methods Forty-seven cases of CTA and DSA image data of DVT in lower extremity with mechanical obstruction were retrospectively analyzed. The CTA three-dimensional reconstruction images were compared with DSA results, and the position and size of thrombus, collateral circulation of blood vessels, vascular compression area and the corresponding outside vascular lesions were evaluated. The causes of venous occlusion were analyzed. Diagnostic agreement of CTA and DSA was assessed by Kappa statistics. The difference of the accuracy between CTA and DSA in the diagnosis of the left and right iliac femoral vein, inferior vena cava, internal iliac vein thrombosis were analyzed with χ2 test. Results There were 47 patients with lower extremity DVT. Of them, DVT was detected in the left leg in 28 patients, in the right leg in 14 patients and in both lower extremities in 5 patients. Mechanical obstruction caused DVT in all of them. There were 27 patients of iliac vein compression syndrome(IVCS)complicated with lower limb DVT. The left iliac vein was oppressed by the right common iliac artery with compression degree from 55.41%to 100.00%,and mean of(77.1 ± 16.8)%. There was congenital stenosis or occlusion of inferior vena cava in 3 patients. There was Budd-Chiari syndrome in 2 patients. There was pelvic mass pressing the common iliac vein in 4 patients. Enlarged right inguinal lymph nodes oppressed the right femoral vein in 3 patients and enlarged left inguinal lymph nodes oppressed the left femoral vein in 2 patients. Other mechanical obstruction factors caused DVT in 6 patients, including right iliac artery aneurysms,spontaneous hematoma, etc. The agreement of CTA and DSA on the diagnosis of the iliac femoral thrombosis was good (Kappa=0.978), the diagnosis agreement on the inferior vena cava thrombus was good (Kappa = 0.737), while the diagnosis agreement on the internal iliac vein thrombosis was poor (Kappa=0.189). The difference of CTA and DSA in the diagnosis of left and right iliac femoral venous thrombosis was not statistically significant (52,51 case;χ2=0.00, P>0.05), neither was the diagnostic difference of inferior vena cava thrombus (21,17 cases;χ2=1.50, P>1.50). However, the difference of the diagnosis of the iliac vein thrombosis was statistically significant (14,2 cases;χ2=8.33, P<0.05) . Conclusions CTA can clearly show the location and scope of the thrombus. Compared with conventional DSA, CTA shows higher diagnostic coincidence rate, and can accurately determine the mechanical obstruction causes of lower extremity DVT.

Objective To assess the value of thickness and arterial resistive index (RI) of wrist synovium in differentiation from activity to non-activity of rheumatoid arthritis (RA). Methods Ninety-two clinically confirmed RA patients underwent high frequency ultrasonography. Maximum thickness and arterial RI of the wrist synovium were measured in active and nonactive stage. Results Thickened synovium was found in 75 of 92 patients. Color signal in the synovium was detected and then RI was measured in 67 patients, including 31 in active stage and 36 in nonactive stage. The wrist synovium thickness of 67 patients was (2.97±1.49) mm and arterial RI was 0.74±0.17. RI decreased significantly in patients in active stage compared with that in nonactive stage (P<0.001). Conclusion Arterial RI measurement with high frequency ultrasonography may be served as an objective marker of synovial membrane disease in RA. The thickness of synovium cannot predict the activity of RA.

Objectives To explore the route of ESBL producing bacteria in neonatal faeces, and to investigate the gene and drug resistance of ESBL producing bacteria in intestinal tract of neonates. Methods Fecal samples of healthy newborns and their mothers were collected, and bacterial cultures were carried out using selective ESBL medium. The positive strains were identified by Time-of-flight mass spectrometry. ESBL genotyping and resistance gene detection were performed by whole genome sequencing technique. Results In 146 neonatal fecal specimens, the positive rate of ESBL producing bacteria was 8.90％,and the positive rate in the first time stool was 3.23％. Seventy-two hours after birth, the positive rate of fecal ESBL producing bacteria was 13.10％. Among the 13 ESBL producing strains, there were 9 strains of CTX type, 3 strains of TEM type and 1 strain of SHV type. Nine strains of CTX include five types such as CTX-M-24, CTX-M-18, CTX-M-27, CTX-M-42 and CTX-M-15. The positive rate of ESBL producing bacteria was 21.6％ in 167 mothers' fecal specimens. The ESBL genotype included 24 strains of CTX type, 6 strains of TEM type, 4 strains of SHV type and 2 strains of QnrS type. Twenty-four strains of CTX include CTX-M-24, CTX-M-14, CTX-M-18, CTX-M-27, CTX-M-42 and CTX-M-15. There were 2 or 3 ESBL genotypes in 12 maternal and neonatal specimens. It was detected to have 6 types of resistance gene such as aadA5, strA, strB, sul1, sul2 and dfrA17 in 49 strains of ESBL producing bacteria in maternal and neonatal strains. Resistance genes were exactly the same in the neonates as in mothers who were detected to have ESBL producing bacteria. A variety of resistance genes were detected in feces in 7 neonates and 23 mothers. Conclusions The neonates in hospital may be detected to have ESBL produing bacteria in the intestinal tract at the same time as their mothers or separately. However, there are many ways for neonates to have ESBL producing bacteria in intestinal tract. There are many genotypes and resistance genes of ESBL producing bacteria.

Objective To explore the clinic application value of ultrasonography examination of optic nerve sheath diameter(ONSD) in brain injury.Methods From July 2008-June 2011,90 cases of brain injured patients were chosen as experimental group including light (A group),medium (B group),and heavy (C group) brain injured patients according to the admission GCS score ;50 cases of conventional physical examination and 90 cases of volunteers 50 in neurosurgical outpatient were chosen as control group.The ONSD of both groups were measured 3 mm behind the globe through orbital using color sonographic with different time after admission.3 times measurements were carried out for every optic nerve sheath.All client's ONSD mean and standard deviation were calculated.In 0.5 h after color dopplar ultrasound examination,lumbar vertebra puncturing measured intracranial pressure in different groups.Results After admission (1d,3 d,7 d,14 d),the ONSD of A group was (4.54 ±0.32)mm,(4.42 ±0.30)mm,(4.44 ±0.32) m,and (4.43 ± 0.25) mm,respectively; The ONSD of B groups was (4.48 ± 0.28) mm,(4.52 ± 0.24) mm,(4.46 ±0.28)mm,and (4.38 ±0.22)mm,respectively; The ONSD of C group was (5.67 ±0.35)mm,(6.36 ± 0.42) mm,(5.65 ± 0.23) mm,and (4.76 ± 0.35) mm,respectively.After admission (1 d,3 d,7 d,14 d),the intracranial pressure (IP) of A group was (82 ± 11) mmH2O,(79 ± 12) mmH2O,(90 ±15) mmH2O,and (86 ± 14) mmH2O,respectively; The IP of B group was (78 ± 15) mmH2O,(85 ± 10)mmH2O,(78 ± 16) mmH2O,(80 ± 11) mmH2O,The IP of C group was (225 ± 26) mmH2 O,(288 ± 23)mmH2O,(256 ± 23) mmH2O,(122 ± 18) mmH2O,respectively.Group D had the ONSD average of (4.58± 0.41)mm and IP of (88 ± 10)mmH2O after eyeball 3-mm place.No difference was found between A and B,A and D,or B and D (P＞0.05) ; A difference was found between A and C,B and C,or D and C (t =12.24～24.67,P＜0.01).Conclusions The ONSD and IP in light medium brain injured patients had no change.In patients with severe brain injury,IP changed with the time after injury,the ONSD increased with the IP,the ultrasonography examination of ONSD with the important value in the diagnosis and treatment can respond the IP increase,which is a non-invasion,convenient,fast,and feasible method for evaluation of cranial high pressure.

The highly virulent PRRSV isolate strain HN-1/06 was cultivated on Marc-145. To study the viral entry mechanisms, the GP5 gene of PRRSV isolate was amplified by RT-PCR and cloned into pcDNA3.0 to generate the expressing plasmid pcDNA-GP5. pcDNA-GP5 was transfected into 293T by the calcium phosphate precipitation method. Analysis of flow cytometry confirmed that the GP5 proteins were expressed in surface of the 293T cells. Then 293T cells were transfected with pcDNA-GP5, pHIT60 and pHIT111 plasmids to generate pseudotyping virus. The pseudotyping virus supernatant was harvested 48 hours post-transfection and was detected by Western blotting and infection assay. Western blotting indicated that the GP5 glycoproteins were incorporated into the retroviral pseudotyped virus. Infection assay showed that the pseudotyped virus infected 293T and Mark-145 cell. The pseudotyped virus could be used to further study infectious mechanism of PRRSV.
Animals ; Cell Line ; Cloning, Molecular ; Endothelial Cells ; cytology ; metabolism ; virology ; Leukemia Virus, Murine ; genetics ; metabolism ; Mice ; Porcine respiratory and reproductive syndrome virus ; chemistry ; genetics ; Recombinant Proteins ; biosynthesis ; genetics ; Swine ; Transfection ; Viral Envelope Proteins ; biosynthesis ; genetics ; Virion ; genetics ; metabolism

Objective:To evaluate the clinical efficacy of rituximab injection combined with CHOP regimen (cyclophosphamide+doxorubicin+vincristine+prednisolone) in the treatment of diffuse large B-cell lymphoma (DLBCL).Methods:One hundred and twenty patients with DLBCL who treatment in the First Affiliated Hospital of Xinjiang Medical University from June 2019 to June 2022 were selected as the study object. They were randomly divided into the study group (60 cases) and the control group (60 cases). The control group was treated with CHOP regimen, and the study group was treated with rituximab injection on the basis of CHOP regimen. The clinical efficacy, inflammatory reaction, immune function and adverse reaction were evaluated after 6 courses of treatment.Results:After treatment, the total clinical effective rate in the study group was higher than that in the control group: 88.33%(53/60) vs. 70.00%(42/60), there was statistical difference ( χ2 = 6.11, P<0.05). Before treatment, the levels of serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in the two groups had no significant differences ( P>0.05); after treatment, the levels of serum IL-6 and TNF-α were decreased, and the levels of serum IL-6 and TNF-α in the study group were lower than those in the control group: (223.56 ± 21.28) ng/L vs. (267.35 ± 25.36) ng/L, (9.34 ± 2.75) μg/L vs. (11.96 ± 3.83) μg/L, there were statistical differences ( P<0.05). Before treatment, the levels of serum immunoglobulin (Ig) A, IgM and IgG in the two groups had no significant differences ( P>0.05); after treatment, the levels of serum IgA, IgM and IgG were decreased, but the levels of serum IgA, IgM and IgG in the study group were higher than those in the control group: (1.83 ± 0.46) g/L vs. (1.34 ± 0.34) g/L, (1.15 ± 0.22) g/L vs. (0.83 ± 0.24) g/L, (10.67 ± 1.65) g/L vs. (8.02 ± 1.62) g/L, there were statistical differences ( P<0.05). After treatment, the incidence of thrombocytopenia, leucopenia, gastrointestinal reaction, bone marrow suppression and liver function injury in the study group were lower than those in the control group: 6.67%(4/60) vs. 20.00%(12/60), 15.00%(9/60) vs. 31.67%(19/60), 30.00%(18/60) vs. 58.33%(35/60), 5.00%(3/60) vs. 16.67%(10/60), 10.00%(6/60) vs. 25.00%(15/60), there were statistical differences ( χ2 = 4.62, 4.66, 9.77, 4.33, 4.88, P<0.05). Conclusions:The treatment effect of rituximab injection combined with CHOP regimen in DLBCL is significant, which can reduce the inflammatory reaction of the body, reduce the damage of immune function, and reduce the adverse reactions of chemotherapy.

Objective:To explore the correlation between Traditional Chinese Medicine (TCM) excessive patterns and clinical characteristics of acute exacerbation of chronic obstructive pulmonary disease (COPD) complicated with chronic pulmonary heart disease (CPHD) in high altitude environment.Methods:Patients with acute exacerbation of COPD complicated with CPHD admitted to the Pulmonology Department of Qinghai Provincial Hospital of Traditional Chinese Medicine from December 2016 to November 2017 were selected. Demographic data and clinical medical characteristics data of the patients were collected, and TCM patterns differentiation was conducted. The correlation between each pattern type and clinical characteristics and all collected laboratory indexes were analyzed by multivariate logistic regression.Results:Phlegm obstructing lung pattern showed a negative correlation relationship with mMRC score [ OR=0.419, 95% CI (0.219-0.802), P=0.009], PCT [ OR=8.132×10 -11, 95% CI (1.632×10 -16-4.1×10 -5), P<0.001], Hb [ OR=0.971, 95% CI (0.952-0.989), P=0.002] and PaCO 2[ OR=0.914, 95% CI (0.853-0.980), P=0.011]; turbid phlegm obstructing lung pattern showed a negative correlation relationship with gender(0 male, 1 female) [ OR=0.427, 95% CI (0.204-0.892), P=0.024], Hb [ OR=0.960, 95% CI (0.945-0.975), P<0.001], and there was a positive correlation relationship with LVEF [ OR=1.061, 95% CI (1.006-1.118), P=0.028]; phlegm-heat obstructing lung pattern showed a negative correlation relationship with Hb [ OR=0.950, 95% CI (0.927-0.974), P<0.001]and cardiac function grade [ OR=0.468, 95% CI (0.248,0.881), P=0.019], and there was a positive correlation relationship with PCT [ OR=1.118×10 8, 95% CI (1.466×10 4-8.523×10 11), P<0.001] and D-D [ OR=2.283, 95% CI (1.300-4.010), P=0.004]; there was a negative correlation between phlegm and stasis blocking lung pattern with cardiac function grade[ OR=0.309, 95% CI (0.167-0.570), P<0.001], and there was a positive correlation relationship with Hb[ OR=1.060, 95% CI (1.042-1.078), P<0.001]; there was a negative correlation between wet phlegm and blood stasis heat pattern with PCT [ OR=1.266×10 -13, 95% CI (1.658×10 -21-0.1×10 -4), P<0.001], SaO 2 [ OR=0.934, 95% CI (0.892-0.979), P=0.004], LVEF [ OR=0.896, 95% CI (0.826-0.971), P=0.008], D-D [ OR=0.030, 95% CI (0.002-0.508), P=0.015], and there was a positive correlation relationship with CRP [ OR=1.042, 95% CI (1.018-1.067), P<0.001], RBC [ OR=3.411, 95% CI (1.684-6.910), P<0.001], cardiac function grade [ OR=8.573, 95% CI (2.410-30.504), P<0.001], pulmonary arterial pressure difference [ OR=2.091, 95% CI (1.243-3.516), P=0.005]. Conclusions:Male patients are more prone to phlegm and turbidities than female patients. PCT and D-D were the main risk factors of phlegm-heat obstruction syndrome. Elevated hemoglobin is a risk factor for patients with phlegm stasis and lung syndrome. Heart function classification is the main risk factor of phlegm-dampness-stasis heat syndrome.

Objective: To study the epidemiological characteristics of tsutsugamushi disease, and to confirm the existence of the disease's epidemic foci in Taizhou. Methods: From 2013 to 2014, Dongxing town hospital and Xingqiao town hospital were selected as specimen collection sites in Jingjiang city. Blood samples (5 ml) were collected from 40 patients with acute tsutsugamushi disease. A total of 59 rodents were captured with cage night method in the survey sites at 5, 7, 9, 10, and 11 months in 2013, from which, the spleen, liver, and kidney specimens were selected. Chigger mites were captured by small blackboard method and from the ears of the captured rodents. A total of 226 small blackboards were laid, 27 mites were captured, and the samples were grounded into suspension. Nested-polymerase chain reaction and cell and tissue culture techniques were used to test the specimen from the probable patients, host animals and chigger mites. Results: Among the 40 acute tsutsugamushi disease blood samples, 29 were found to meet the test requirements, 17 were positive for orientia tsutsugamushi nucleic acid with 59% of the positive rate, and 1 stran orientia tsutsugamushi was isolated. 59 rats were captured and the density of mice was 5.5%. Among them, there were 26 Mus musculus (2.4%), 18 Rattus flavipectus (1.7%) and 15 Smelly shrew (density 1.4%). 1 Smelly shrew was tested positive for orientia tsutsugamushi nucleic acid, and the negative results were found in the other rodent specimens. 27 Chigge mites were collected by small blackboard method and the density of mites was 0.12 for each blackboard, among which 3 larvae and 24 nymphs were found. 33 Chigger mites were collected from the ears of 3 Smelly shrew, and the density of the mite was 11 per mouse. All the captured Chigger mites were identified as Leptotrombidium scutellare and 1 group of specimens of Chigger mites from the external environment were positive for orientia tsutsugamushi nucleic acid. Conclusion There was a high density of mice in the epidemic area from May to November and the species of the chigger mites were Chigger mites in Taizhou. The nucleic acid of the oriental tsutsugamushi was detected in the patients with acute scrub typhus, rodents and vectors. According to the above-mentioned results, it was considered that the scrub typhus epidemic area of Taizhou city has the natural foci of scrub typhus.