Adolescent ; Adult ; Burns, Chemical ; Eye Burns ; Fisheries ; Humans ; Hydrogen Sulfide ; Middle Aged ; Occupational Injuries ; Young Adult

Objective:To explore the diagnostic value of C-TIRADS combined with artificial intelligence-assisted diagnosis S-Detect technology in the differential diagnosis of thyroid nodules.Methods:A total of 237 thyroid nodules patients (237 thyroid nodules)with ultrasound examination and definitive pathologic results in Henan Cancer Hospital from April to September 2020 were retrospectively analyzed. The nodules were diagnosed according to C-TIRADS guidelines, and then by S-Detect technology combined with C-TIRADS guidelines. The ROC curve was plotted with the pathological results as the gold standard, and the area under the ROC curve, sensitivity, specificity and accuracy of the diagnosis results between the two groups were compared.Results:Among the 237 thyroid nodules, 105 were benign and 132 were malignant.The area under the ROC curve of C-TIRADS diagnosis alone and C-TIRADS diagnosis combined with artificial intelligence were 0.869 and 0.942 respectively, the difference between the two groups was statistically significant (χ 2=36.11, P<0.001); When Category 4A was used as the cutoff value of benign and malignant differential diagnosis, the specificity and accuracy of C-TIRADS classification of artificial intelligence-assisted diagnosis was significantly higher than that of C-TIRADS alone, and the difference was statistically significant(83.81% vs 47.62%, 90.72% vs 75.53%, all P<0.05). Conclusions:C-TIRADS combined with artificial intelligence-assisted diagnosis S-Detect technology has a high efficiency in the diagnosis of thyroid nodules and can improve the specificity and accuracy of thyroid nodules diagnosis and reduce unnecessary biopsy.

Infrared (IR) spectroscopy was employed to identify the Artemisinin and Piperaquine Tablets. Artemisinin and piperaquine was extracted separately by different solvents, and IR spectra were collected. IR absorption spectrum of the extract was concordant with the reference spectrum recorded in the Atlas of Infrared Spectra of Drugs, except for a group of small absorptions at 1 574 cm-1 for the artemisinin extract. It was concluded that IR method is stable and accurate, which can be used to identify the Artemisinin and Piperaquine Tablets.

Natural product is an important source of new drug research and development (R&D). Traditional Chinese medicine (TCM) innovation is the key step for its modernization and internationalization. However, due to the complexity of TCM, there are many difficulties and confusions in this process. Target-based drug discovery is the mainstream model and method of R&D. TTD, short for therapeutic target database, is developed by National University of Singapore. Besides a large amount of information on drug targets, the database also contains considerable information related to natural products. This paper briefly introduces the TTD, analyzes the natural products derived drugs/compounds recorded in TTD, which we think might provide some inspiration for the innovation of TCM.

Objective To retrospectively evalute the value and accuracy of adenosine stress and rest SPECT myocardial perfusion imaging. Methods A total of 1858 patients who were suspected or known for coronary artery disease (CAD) underwent 99Tcm-methoxyisobutylisonitrile ( MIBI ) myocardial perfusionSPECT with adenosine infusion using the standard 2-day protocol. Images were interpreted by two or more experienced nuclear medicine physicians . Coronary angiography was carried out in all patients within one month. Kappa test was used to analyze the correlation between the two imaging studies. Results By coronary angiography, there were 957 patients diagnosed of CAD (one-, two-, three-vessel disease: 506,256,195, respectively) and 901 normal. Stenosis was found in 1603 vessels, including left anterior descending coronary artery (LAD): 765, left circumflex coronary artery (LCX): 399 and right coronary artery (RCA): 439. By adenosine induced stress myocardial perfusion imaging, 876 patients were diagnosed of myocardial ischemia ( sensitivity: 876/957, 91.54% ) and 651 patients had negative findings ( specificity:651/901,72.25 % ). The positive and negative predictive values were 77.80% ( 876/1126 ) and 88.93% (651/732), respectively. The correlation coefficient between the two imaging studies was 0.641. The vessel-based sensitivity was 81.31% (622/765) for LAD, 56.64% (226/399) for LCX and 70.62% (310/439) for RCA, respectively. The sensitivity for detection of one-, two-, three-vessel stenosis was 87.55% (443/506), 94.92% (243/256) and 97.44% (190/195), respectively. The side-effects was mild and transient with an incidence rate of 84.12% ( 1563/1858), without major cardiac events. Conclusion Stress myocardial perfusion imaging induced by adenosine is reliable for the evaluation of myocardial blood supply in CAD patients.

Objective To explore the influence of acupuncture point massage combined with limb function exercise on ankle brachial index (ABI) and pulse wave velocity (PWV) in patients with coronary heart disease (CHD). Methods According to scores by grace score scale, 180 CHD patients were divided into three groups: low risk group (n=58), moderate risk group (n=68) and high risk group (n=54). Within the three groups, the patients were divided into the experiment group and the control group by using the random digital table. The control group was treated with routine nursing intervention , while the experiment groups accepted acupuncture point massage and limb function exercise training on the basis of control groups. We collected the values of ABI and PWV at four points-in-time: before intervention, 7 days after intervention, 30 days after intervention and 90 days after intervention. Results Repeated measurement data analysis of the experiment group and control group suggested that:in the moderate and high risk groups, there was statistically significant difference (P<0.05) in the data at the four time points. There was no statistically significant difference (P > 0.05) in time and group interaction effect. The difference between the experiment group and control group was statistically significant (P<0.05). Repeated measurement data analysis showed that there was no statistically significant difference (P>0.05) in ABI&PWV interaction effect at the four time points between the experiment group and control group. In the low-risk group,the differences in time points compared with the main effect were insignificant (all P>0.05). In comparison of main effect at all the four time points, there was significant different in the moderate and high risk group (P<0.05), And it suggested that time and group interaction, namely effect of time factor (1 d, 7 d, 30 d, 90 d), was not decided by the division of groups. In comparison of main effect, the difference was statistically significant (all P < 0.01) in the moderate and high-risk group, which indicated the main effect (intervention) playing main role. However, there was no statistically significant difference (P>0.05) of ABI&PWV before and 90-days after intervention. Conclusion Acupuncture point massage combined with limb function exercise can effectively improve the peripheral artery blood supply in CHD patients, lower ABI and promote PWV.

OBJECTIVETo study the causes of poorer antiviral response to neutralizing anti-interferon-alpha antibodies (NA) in male chronic hepatitis B patients treated with recombinant interferon-alpha (rIFN-alpha).

METHODSTwo hundred sixty-nine patients (198 males and 71 females) with histologically proven chronic hepatitis B were treated with 5 MU recombinant interferon-alpha 1b (rIFN-alpha 1b) subcutaneously thrice weekly for 6-37 (median 10.0) months. For each patient, serum HBV DNA levels were detected with fluorescent-quantitative PCR, HBeAg with enzymoimmunoassay, and NA with an antiviral neutralizing biological assay during therapy.

RESULTSNA was found in 70 (35.4%) of the 198 males and in 15 (21.1%) of the 71 females during treatment (x2 = 4.894, P = 0.027). At the end of treatment combined-response was achieved in 21 (24.7%) of the 85 NA-positive patients and in 100 (54.3%) of the 184 NA-negative cases (x2 = 20.642). Stratification analysis by NA showed that combined-response rate was significantly lower in males than in females (18.6%, 13/70 vs. 53.3%, 8/15, x2 = 8.024) among NA-positive patients while it was similar in males and in females (50.8%, 65/128, vs. 62.5%, 35/56, x2 = 2.156) among NA-negative patients. In stratification analysis by gender, it was significantly lower in NA-positive patients than in NA-negative ones (18.6%, 13/70 vs. 53.3%, 8/15, x2 = 8.024) among males but there was no significant difference between combined-response rates among females.

CONCLUSIONThe poorer antiviral response to recombinant interferon-alpha in male chronic hepatitis B patients than in female patients is related to the neutralizing anti-interferon antibodies.

Antibodies ; blood ; Antiviral Agents ; immunology ; therapeutic use ; DNA, Viral ; blood ; Female ; Hepatitis B, Chronic ; drug therapy ; immunology ; Humans ; Interferon Type I ; immunology ; therapeutic use ; Male ; Neutralization Tests ; Recombinant Proteins ; Sex Factors ; Treatment Outcome

OBJECTIVETo investigate the clinical significance of neutralizing anti-interferon-alpha antibodies (NA) in chronic hepatitis B patients treated with recombinant interferon-alpha(rIFN-alpha).

METHODSOne hundred and eighty-one patients (128 male and 53 female) with histological proven chronic hepatitis B were treated with 5 MU recombinant interferon-alpha 1b (rIFN-alpha 1b) subcutaneously thrice weekly for 6 to 37 (median 10) months. For each patient, Specific detection of serum HBV DNA level with fluorescent-quantitative PCR, HBeAg with enzymoimmunoassay and NA with an antiviral neutralizing biological assay were performed during therapy.

RESULTSNA was found in 61 (33.7%) of 181 patients. At the end of treatment, complete-response was achieved in 17 (27.9%) of 61 patients with NA and in 54 (45.0%) of 120 patients without NA, respectively (chi2=4.979). For NA positive patients, the complete-response rate was significantly lower in those who had not achieved partial-response prior to or at the same time as NA occurred than in those who did (3.8%, 1/26, vs. 45.7%, 16/35, chi2 = 7.457). Moreover, it was lower in patients who either had 20pg/ml of serum HBV DNA or above or HBV DNA had being reduced by less than 60% recent 3 months, but higher in those who had less than 20pg/ml of HBV DNA and HBV DNA had being reduced by 60% or above (20.0%, 9/45, vs. 56.3%, 9/16, chi2 = 11.009).

CONCLUSIONNA may negate the antiviral effects of rIFN-alpha in chronic hepatitis B patients treated with rIFN-alpha, especially if they appear before partial-response or at the occasion at which serum HBV DNA level was not below 20pg/ml or HBV DNA had being reduced by less than 60% recent 3 months.

Antibodies ; blood ; DNA, Viral ; blood ; Female ; Hepatitis B, Chronic ; drug therapy ; virology ; Humans ; Interferon-alpha ; immunology ; therapeutic use ; Male ; Recombinant Proteins ; therapeutic use

Objective To observe the clinical outcomes of the superior gluteal neurocutaneous flap for sacrococcygeal pressure sores. Methods Twelve cases with sacrococcygeal pressure sores were covered by the superior gluteal neurocutaneous flap from May 2005 to Nov. 2009. The sore size ranged from 15 cm ×30 cm to 5 cm × 8 cm, while the flap size ranged from 17 cm × 32 cm to 10 cm× 12 cm. Results All 12 flaps survived totally with the pressure sores healed. The longest follow-up time was four years, the short follow-up time was half a year, the average time was 2.5 years. The superior gluteal neurocutaneous flap was good blood circulation, pressure sores not recur. Conclusion The superior gluteal neurocutaneous flap is a good treatment for sacrococcygeal pressure sores for its reliable blood supply and simple harvesting.

BACKGROUND: High-volume hemofiltration (HVHF) is technically possible in severe acute pancreatitis (SAP) patients complicated with multiple organ dysfunction syndrome (MODS). Continuous HVHF is expected to become a beneficial adjunct therapy for SAP complicated with MODS. In this study, we aimed to explore the effects of fluid resuscitation and HVHF on alveolar-arterial oxygen exchange, the Acute Physiology and Chronic Health Evaluation II (APACHE II) score in patients with refractory septic shock. METHODS: A total of 89 refractory septic shock patients, who were admitted to ICU, the Provincial Hospital affiliated to Shandong University from August 2006 to December 2009, were enrolled in this retrospective study. The patients were randomly divided into two groups: fluid resuscitation (group A, n=41), and fluid resuscitation plus high-volume hemofiltration (group B, n=48). The levels of O2 content of central venous blood (CcvO2), arterial oxygen content (CaO2), alveolar-arterial oxygen pressure difference P(A-a)DO2, ratio of arterial oxygen pressure/alveolar oxygen pressure (PaO2/PAO2), respiratory index (RI) and oxygenation index (OI) were determined. The oxygen exchange levels of the two groups were examined based on the arterial blood gas analysis at different times (0, 24, 72 hours and 7 days of treatment) in the two groups. The APACHE II score was calculated before and after 7-day treatment in the two groups. RESULTS: The levels of CcvO2, CaO2 on day 7 in group A were significantly lower than those in group B (CcvO2: 0.60±0.24 vs. 0.72±0.28, P<0.05; CaO2: 0.84±0.43 vs. 0.94±0.46, P<0.05). The level of oxygen extraction rate (O2ER) in group A on the 7th day was significantly higher than that in group B ( 28.7±2.4 vs. 21.7±3.4, P<0.01). The levels of P(A-a)DO2 and RI in group B on the 7th day were significantly lower than those in group A. The levels of PaO2/PAO2 and OI in group B on 7th day were significantly higher than those in group A (P<0.05 or P<0.01). The APACHE II score in the two groups reduced gradually after 7-day treatment, and the APACHE II score on the 7th day in group B was significantly lower than that in group A (8.2±3.8 vs. 17.2±6.8, P<0.01). CONCLUSION: HVHF combined with fluid resuscitation can improve alveolar- arterial-oxygen exchange, decrease the APACHE II score in patients with refractory septic shock, and thus it increases the survival rate of patients.