Objective:To evaluate the clinical application of 64-slice spiral computer tomography pulmonary angiography (CTPA)in diagnosis of pulmonary embolism(PE).Methods:Sixty-two patients suspected of PE were examined by 64-slice spiral CTPA.The image findings combined with their clinical data were retrospectively analyzed.Results:Twenty-four of the 62 patients were confirmed to have PE by clinical data,laboratory examination and follow-up examination.64-slice spiral CTPA discovered 152 involved branches in the 24 PE patients,including 4 branches in left and right pulmonary trunk,52 in lobar pulmonary arteries,82 in segmental pulmonary arteries,and 14 in subsegmental arteries.Four types of PE were detected in our group,including eccentric filling defect in 58 branches,central filling defect in 49 branches,total occlusion of the pulmonary arteries in 21 branches,and mural embolism of host artery in 24 branches.The diagnosis accuracy of 64-slice spiral CTPA in the present group of patients was 100%,with no missed diagnosis and misdiagnosis.Besides,64-slice spiral CTPA could reflect the location,morphology,involvement and degrees of PE.Conclusion:64-slice spiral CTPA is a rapid,accurate and non-invasive diagnostic approach for PE.It is the first choice in clinical screening of PE and may serve as a gold standard for diagnosis of pulmonary embolism.

In this study, 101 strains of bacteria were isolated from arct ic water and sediment samples. The methanol extracts of the fermented broth prod uced by these strains were screened in vitro for anti-tumor activity on mou se tsFT210 cells using the method of flow cytometry, and screened for antibacter ial activity by the method of paper disk diffusion. The result showed that one strain exhibited anti-tumor activity and eight strains had antibacterial activ ity. The stability of the antibacterial components produced by strain AR084 an d its optimum medium were also studied. The research indicated that arctic bac teria had potential application in pharmaceutics.

MALDI-TOF MS is a revolutionary and innovative technologyin clinical microbiological diagnosis. Due to its advantages of speed, specificity and ease of operation, MALDI-TOF MS has been rapidly accepted and approved by clinical laboratory. However, many challenges appeared when applied in clinical application. For example, sample preparation needs to be further optimized. Identification techniques have limitations. The quality improvement of database and the diversity of microbial species are still under discussion.The application of antimicrobial susceptibility testing is still controversial.The way ofrare identification resultstransmitting into clinical treatment is still being explored. But the application of MALDI-TOF MS in clinical microbiological diagnosis still needs to be improved.(Chin J Lab Med, 2018, 41: 559-562)

Chinese traditional patent medicine for promoting blood circulation and removing blood stasis(PBCRBS) originated from traditional Chinese medicine theory and had approved efficacy and safety standards. However, its compatibility regularity and anti-thrombotic mechanism is not clear. To analyze the compatibility regularity and anti-thrombotic mechanism of Chinese traditional patent medicine for PBCRBS, a statistical and bioinformatics analysis was carried out using traditional Chinese medicine inheritance support system (TICMISS, V2.0) and ingenuity pathway analysis (IPA). The compatibility regularity analysis shows that the most commonly used herb combinations are Danshen (Salvia miltiorrhiza Bge.), Chuanxiong (Ligusticum chuanxiong Hort.) and Honghua (Carthamustinctorius L.). The anti-thrombotic mechanism analysis reveals that 25 ingredients have an effect on 29 thrombosis related molecules which 23 molecules are related to inflammation response. Furthermore, there are 5 inflammation molecules (NOS2, PTGS2, IL6, TNF, IL1β) served as major targets. At the same time, Danshen, Chuangxiong and Honghua mainly used as sovereign herb or minister herb in the application of cardiovascular and cerebrovascular diseases. Therefore, Chinese traditional patent medicine for PBCRBS probably has an effect on anti-thrombotic activity through inhibiting the inflammatory response. In summary, the most commonly used herb combinations of Chinese traditional patent medicine for PBCRBS are Danshen, Chuanxiong and Honghua. Inhibiting inflammatory response, especially inflammation related molecules (NOS2, PTGS2, IL6, TNF and IL1β), is probably a new starting point to clarify the anti-thrombotic mechanism of Chinese patent medicine for PBCRBS.
Anti-Inflammatory Agents ; pharmacology ; Carthamus tinctorius ; Computational Biology ; Drugs, Chinese Herbal ; pharmacology ; Fibrinolytic Agents ; pharmacology ; Humans ; Inflammation ; drug therapy ; Medicine, Chinese Traditional

Objective:To evaluate whether midazolam with propofol target controlled infusion (TCI intravenous sedation during the mandibular third molar extraction influences patients' perioperative anxiety.Methods:The subjects were patients who planned to undergo the mandibular third molar extraction in Peking University School and Hospital of Stomatology,whose state anxiety inventory (SAI) scores were ≥ 38 at the initial visit.They were divided into intravenous sedation group (IVS) and local anesthesia group (LA) on the basis of the planned intravenous sedation.Each group was divided into two subgroups according to the overall SAI scores at the initial visit:IVS-Ⅰ,LA-Ⅰ (SAI:38-50) and IVS-Ⅱ,LAⅡ (SAI:51-80).The anxiety before and after the surgery was evaluated by the SAI scores at the initial visit (T1),before surgery (T2) and 7 days after surgery (T3).The anxiety during the surgery was evaluated by the heart rate,blood pressure and visual analogue scale (VAS) scores.Results:There were no significant differences on SAI at T1,T2,and T3 in the two groups (P ＞ 0.05).The heart rate,blood pressure and VAS pain scores of IVS group were significantly lower than those of LA group during the surgery (P ＜ 0.001).Conclusion:Intravenous sedation with midazolam and propofol TCI was effective on the patients' anxiety during the third molar extraction,which successfully made the patients more comfortable and their heart rate,blood pressure and oxygen saturation more stable during the surgery.But there were no significant differences on the patients' anxiety at the initial visit (T1),before surgery (T2) and 7 days after surgery (T3) according to the SAI scores in the two groups.

Objective To study the clinical and imaging features of patients with bone metastases from breast cancer and identify the factors related to the incidence of bone metastases. Methods Three hundred and thirty-four patients with breast cancer were recruited into this study. Whole-body 99Tcm-methylene disphosphonate (MDP) bone scan, clinical staging, pathological, immunohistochemical and serological test results were analyzed retrospectively. χ2 test was used for statistical analysis. Results The incidence rate of bone metastases for patients with and without lymph node metastases was 71% (152/214) and 22. 5% (27/120), respectively (χ2 =72.80, P =0.000). The incidence rate of bone metastases from infiltrated non-specified and specified breast cancer was 69% (203/294) and 41.7% (5/12), respectively (χ2 =3. 97, P=0.046). Alkaline phosphatase (ALP) was elevated in 28.5% (51/179) and 14.9%(11/74) of patients with and without bone metastases, respectively (χ2 = 5. 25, P = 0.022 ). Carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 15-3, CA125, CA19-9 increased in 68.7% ( 123/179) and 27.0% (20/74) of patients with and without bone metastases, respectively (χ2 = 37. 03, P =0. 000). Conclusions The incidence of bone metastases from breast cancer is correlated to pathological types of primary tumor and lymph node metastases. Bone metastases occurs more frequently in patients with infiltrated, non-specified, primary cancer and with lymph node metastases. Serum ALP, CEA, CA15-3,CA125, CA19-9 might be the tumor makers for early diagnosis of bone metastases from breast cancer.

Objective To determine the value of 2-18F-2-deoxy-β-D-glucose (18F-FDG)PET/CT in malignancy tumor detection of patients suspected as having paraneoplastic syndrome (PNS).Methods The clinical data of 54 patients suspected as having PNS, underwent PET/CT study in our hospital fiom June 2007 to December 2009, were retrospectively analyzed. The efficacy of 18F-FDG PET/CT on positive detection rate, positive predictive value of malignant tumors and on the detection of malignant tumor markers were analyzed with the results of pathological findings and clinical data;whether the course of disease could affect these detection was also analyzed. Results Positive results of 18F-FDG PET/CT were noted in 17 patients (31.5%), and 13 of them were confirmed as malignant tumors with pathological results. The positive predictive value of 18F-FDG PET/CT was 76.5%. The durations of patients with malignancies were not different from those of patients without malignancies.PET/CT enjoyed a significantly higher efficacy rate in identifying malignant tumors in patients with elevated tumor markers than in patients with tumor markers in normal range (P＜0.05). Conclusion 18F-FDG PET/CT improves the tumor detection rate in PNS suspects, especially in patients enjoying elevated tumor markers.

BACKGROUNDThere are few studies to assess whether the effect-site concentration of propofol can predict anesthetic depth during the target-controlled infusion (TCI) induction in elderly patients. This study aimed to evaluate the relationship between effect-site concentration of propofol and depth of anesthesia during the TCI induction in elderly patients.

METHODSNinety patients (60 - 80 years) with an American Society of Anesthesiologists (ASA) physical status of 1 - 3, undergoing scheduled abdominal and thoracic surgery under general anesthesia were randomly allocated into one of three groups, Group S1, S2 and S3 (30 patients in each group). The patients in Group S1 received propofol with a target plasma concentration of 4.0 microg/ml; patients in Group S2 received propofol with an initial target plasma concentrations of 2.0 microg/ml that was raised to 4.0 microg/ml 3 minutes later; patients in Group S3 received an infused scheme of 3 steps; starting from a target plasma concentration of 2.0 microg/ml that was increased stepwised by 1 microg/ml until a target plasma concentration of 4.0 microg/ml was achieved, the interval between the two steps was 3 minutes. When an Observer's Assessment of Alertness/Sedation (OAA/S) score of 1 was achieved, remifentanil (effect-site concentration (Ce) of 4.0 ng/ml) and rocuronium 0.9 mg/kg were administered. Tracheal intubation was started 2 minutes after rocuronium injection. Changes of propofol Ce, blood pressure (BP), heart rate (HR), and bispectral index (BIS) were recorded.

RESULTSWhen an OAA/S score of 1 was achieved, Ce of propofol were (1.7 +/- 0.4) microg/ml, (1.9 +/- 0.3) microg/ml, (1.9 +/- 0.4) microg/ml and the BIS values were 64 +/- 5, 65 +/- 8, and 62 +/- 8 in Groups S1, S2 and S3. Before intubation, Ce of propofol was (2.8 +/- 0.2) microg/ml, (2.8 +/- 0.3) microg/ml, (2.7 +/- 0.3) microg/ml, and the BIS values were 48 +/- 7, 51 +/- 7, and 47 +/- 5 in Groups S1, S2 and S3. By linear regression analysis, a significant correlation between Ce of propofol and BIS values was found (r = -0.580, P < 0.01). Systolic blood pressure (SBP) before intubation was significantly lower in Group S1 than in Groups S2 and S3. SBP and HR after intubation in the three groups were significantly increased when compared with pre-intubation values, but they did not exceed baseline values.

CONCLUSIONSDuring the TCI induction, Ce of propofol with (1.9 +/- 0.3) microg/ml may make the elderly patients unconscious. When remifentanil with a Ce of 4.0 ng/ml is added a Ce of propofol with (2.8 +/- 0.3) microg/ml is suitable for intubation. The Ce of propofol has a close correlation with the BIS values. Also, a two-step TCI technique seems to be a more suitable method of anesthesia induction in elderly patients compared with the no-stepwise TCI technique and three-step TCI technique.

Aged ; Aged, 80 and over ; Androstanols ; therapeutic use ; Anesthesia, General ; methods ; Anesthesia, Intravenous ; methods ; Anesthetics, Intravenous ; administration & dosage ; pharmacokinetics ; therapeutic use ; Awareness ; physiology ; Female ; Humans ; Infusions, Intravenous ; methods ; Intubation, Intratracheal ; Linear Models ; Male ; Middle Aged ; Neuromuscular Nondepolarizing Agents ; therapeutic use ; Piperidines ; therapeutic use ; Propofol ; administration & dosage ; pharmacokinetics ; therapeutic use

A group of 25 rabies viruses (RABVs),recovered from 24 dogs and one human case,were collected from various areas in China between 2004 and 2006.Genetic and phylogenetic analyses of the G-L intergenic region were carried out in 25 street RABV isolates and CTN vaccine strains of 7 generations.The study was based on the comparison of a 519 bp nucleotide sequence,encompassing the G-L intergenic region.The nucleotide sequence homologies of Chinese street strains were from 95.5% to 100%.The phylogenetic analysis showed that all Chinese isolates clearly supported the placement of all Chinese viruses in Lyssavirus genotype 1 and they were distributed according to their geographical origins.All of the Chinese strains were closely related but they could still be divided into two groups:group of street strains and group of CTN strains.This study presents details about the molecular epidemiology of rabies viruses based on the sequences of the G-L Intergenic region.

Objective To investigate hepatocyte growth factor(HGF)gene expression and biological effect after gene transfection into penumbra tissue in rat cerebral ischemic model.Methods Human HGF cDNA was ligated to pIRES2-EGFP vector.The recombinant plasmid was transfected into the penumbra tissue with liposome.Brains of treated and control animals were analyzed 7 days later.Expression of HGF protein was determined by fluorescence microscopy and immunohistochemistry.Vessel numbers were quantified.Changes of cerebral blood flow(CBF)was detected by CT perfusion.Results Enzymatic digestion and electrophoresis confirmed that HGF fragment had been correctly cloned into BamH I and Sal I sites of pIRES2-EGFP.After HGF gene transfection,expression of HGF in transfected neurocytes was observed with fluorescence microscopy and immunohistochemistry.The number of vessels was significantly increased in penumbra tissue transfected with HGF vector as compared with control vector(46.71?7.11, 20.43?3.21,18.00?3.27,respective,F = 74.447;P