Child, Preschool ; Fever ; etiology ; Histoplasmosis ; complications ; diagnosis ; pathology ; Humans ; Jaundice ; etiology ; Male

Objective To understand the distribution situation of respiratory viral infection among adult inpatients with respiratory infection in the emergency department.Methods The detection results data of 5 kinds of viruses RSV,IVA,IVB,PIV1,PIV2,PIV3 and ADV by indirect immune fluorescence assay in 384 adults patients with respiratory infection in the emergency department of our hospital from January 2014 to December 2015 were collected.The epidemic characteristics of different viruses were analyzed.Results Among 384 specimens,208 cases were positive in respiratory virus IgM antibody,the viral infection positive rate was 54.17%.The mixed virus infection and influenza B virus infection were most common,their viral positive rates were 26.56% and 23.44% respectively,In the mixed viral infection,the positive rate of IVA + IVB mixed infection was highest,accounting for 87.25%,which was higher than that of other kinds of mixed viral infection.The viral infection positive rate had no statistical difference between different genders(P>0.05).The viral infection rate was higher in autumn and winter,which were 66.06% and 68.37% respectively and higher than 42.31% and 34.25% in spring and summer,the difference was statistically significant(P<0.05).The viral infection rates of youth (18-45 years old) and middle-aged (>45-60 years old) were 64.94% and 63.86% respectively,which were higher than 48.45%,44.92% and 55.56% in pre-elderly (>60-75 years old),elderly (>75-90 years old) and longevous elderly (>90 years old),the differences were statistically significant(P<0.05).Conclusion The respiratory virus mixed infection and IVB infection are most common in the emergency wards,moreover the viral infection situation shows the seasonal and age characteristics,but which is not affected by sex factor.

Purpose To explore the clinical value of reducing the incidence of reflux and improving patients' comfort by low pressure contrast injection during transvaginal ultrasound real time three-dimensional hysterosalpingo-contrast sonography (TVS RT-3D-HyCoSy).Materials and Methods Data ofTVS RT-3D HyCoSy using low pressure contrast injection of 498 infertile women were analyzed.The peak pressure,the incidence of reflux and adverse reactions were recorded.Compared these parameters between bilateral tubals.Results The peak pressure in patency,partially patency and fully obstructed of bilateral tubals were (22.47±5.96) kPa,(37.24±8.83) kPa and (44.64±7.73) kPa.There was significant difference among the three groups (F=70.35,P＜0.05).Among all 498 patients,the incidence of reflux was 26.31％.The incidence in patency,partially patency and fully obstructed of bilateral tubals were 18.00％,30.21％ and 43.59％.There was significant difference among the three groups (x2=15.59,P＜0.05).Different degrees of adverse reactions were 88.96％,10.64％ and 0.4％.Conclusion By using low pressure contrast injection during HyCoSy,the incidence of reflux can be reduced and examination comfort can be improved.

Objective To evaluate the precision of GFR using Gates method and compared with the results from renal pathological changes. Methods Twenty-seven patients whose 99Tcm-DTPA renograms had no obvious uptake phase were enrolled in Group A, and 27 patients whose 99Tcm-DTPA renograms had obvious uptake phase were enrolled in Group B. The measurement of GFR by Gates method was compared to the creatinine clearance measured and predicted by Cockroft-Gault (C-G), modification of diet in renal disease (MDRD) and SCr level. Renal pathological changes in two groups were compared using Pearson correlation and t test analysis. Results In Group A, GFR determined by Gates method did not show correlation with that estimated by C-G or 1/SCr (r = 0. 357,0. 376, both P ＞0.05), but was significantly correlated with GFR estimated by MDRD(r = 0. 440, P ＜ 0.05). In Group B, GFR determined by Gates method showed significantly correlation among GFR estimated by MDRD, C-G, and 1/SCr (r =0. 471, 0. 527,0. 452, all P ＜ 0.05). Renal tubulointerstitial damage score in Group A was higher than that in Group B (7.15±2.32, 3.70±3.06, t=4.66, P ＜0.001). Conclusions GFR determined by Gates method is less precise when 99Tcm-DTPA renogram has no obvious uptake phase than that when 99Tcm-DTPA renogram has obvious uptake phase. Renal tubulointerstitial damage is a strong indicator of no obvious uptake phase in 99Tcm-DTPA renogram.

ObjectiveTo evaluate the safety and feasibility of the tracheal stent implantation for treatment of malignant tracheal stenosis under general anaesthesia. Methods Eighteen patients with malignant tracheal stenosis underwent preoperative 64-slice spiral CT scan and airway reconstruction. The stenotic sites were located in main tracheal trunk(5 patients),in right main bronchus( 1 patient),in trachea and left main bronchus (4 patients),in trachea and right main bronchus (3 patients),in main tracheal trunk and bilateral main bronchus(5 patients).The degree of stenosis was rated 51％ to 70％ in 7 cases,71％ to 90％ in 11 cases.All patients,17 patients of ASA grade 1V and 1 patient of grade Ⅲ,presented with severe dyspnea. Under general anaesthesia,implantation of metallic stent was performed through the sputum aspiration hole of the connecting tubing with DSA guidance.The NBP,ECG,RR,SaO2 of the patients were recorded and compared with t test during the entire procedure. At the end of the procedure,relief of dyspnea,complications related to anesthesia and operation were recorded. Results The success rate of stent placement was 18/18,and dyspnea was significantly relived in all patients. Slightly bloody sputum occurred in 7 cases.The stent was obstructed by sputum in 1case,and the patient was treated with medication.There were no severe complications.The operative course were rated 11 to 9 in 17 cases,and 6 to 8 in 1 case.All 18 patients were cooperative during the procedure.Sixteen patients rated the procedure as very comfortable and 2 rated the procedure as comfortable.Respiratory rate (RR) and heart rate (HR) decreased in all patients after the operation [ ( 37.1 ± 2.8 )/min and ( 106.5 ± 14.2 ) bpm before the operation respectively,( 18.6 ± 1.4)/min and ( 73.2 ± 7.6) bpm after the operation respectively ],t =17.81 and 3.80,P ＜ 0.01.Pulse oxygen saturation ( SaO2 ) during the operation [ ( 91.2 ± 1.8 ) ％ ]increased [ (76.3 ± 8.6 )％ before the operation ] and increased further after the operation [ (94.5 ±4.3 ) ％ ],t =2.06 and 2.26,P ＜ 0.01.Blood pressure (BP) showed no changes throughout the operation (P ＞ 0.05 ).The conprehensive assessment of operation were favorable in all patients. Conclusion With careful preoperative evaluation and planning, tracheal stent implantation under general anaesthesia in patients with malignant tracheal stenosis is feasible and safe.

Objective To investigate the clinical significance of narrow-band imaging (NBI) system in the diagnosis and treatment of Peutz-Jeghers syndrome (PJS) in children. Methods To retrospectively summarize the clinical data of 15 cases diagnosed with PJS, and compare with 70 cases diagnosed with juvenile polyp. And all of the polyps were further diagnosed with pathological examination and the histological type should be analyzed.The polyps of 15 children with PJS were diagnosed with the white light imaging (WLI) and the NBI system, respectively. The pit patterns of various polyps was observed with NBI. We made a comparison between the sensitivity and speciifcity of NBI and WLI in diagnosis of adenomatous polyps. Result 76 lesions in 15 cases were detected by the WLI and NBI system,including adenomatous polyps (12) and harmatoma (64) which were further diagnosed by pathological examinations.By using the NBI system,69.7% (53/76)PJS polyps (pit patterns)were diagnosed as typeⅠand 27.6%(21/76) PJS polyps were diagnosed as typeⅡorⅢ.By using the NBI system,the sensitivity and speciifcity for diagnosing PJS polyps were 83.3%(10/12)and 98.4%(63/64),which were obviously higher than those by using the WLI system (P<0.05). Conclusion Observation of pit patterns of polyps by the NBI system can help predict the pathological changes of PJS polyps.By using the NBI system,the sensitivity and speciifcity of the diagnosis of adenomatous polyps are higher than those by using the WLI system.It has guiding signiifcance to choose the method to remove a polyp.

AIM: To evaluate the protective effect of rapid phase of ischemic preconditioning against spinal cord ischemic injury in rabbits. METHODS: Thirty six male New Zealands white rabbits were randomly assigned to 3 groups (12 in each group): ischemia and reperfusion injury group (IR group), ischemic preconditioning + IR group (IPC+IR group) and sham operation group (sham). In IR group, spinal cord ischemia was induced by an infrarenal aorta clamping for 20 min; The rabbits in IPC+IR group underwent a 6 min ischemic preconditioning followed by 30 min of reperfusion before the 20 min clamping; The rabbits in sham group underwent the same procedures as the IR group except for infrarental aortic unclamping. Neurologic status was scored at 8, 12, 24 and 48 h after reperfusion. All animals were sacrificed at 48 h after reperfusion and the spinal cords (L_(5-7)) were removed for histopathologic study and determination of the activity of Na~+, K~+-ATPase. RESULTS: The neurologic function scores in sham group and IPC+IR group at each observation interval were higher than those in IR group (P

OBJECTIVETo study the clinical effects of Fuzheng Huayu Gantang comprehensive therapeutic program (FHGP) on post-hepatitis B liver cirrhosis associated with glyco-metabolic abnormality (LCGA).

METHODSThe patients with LCGA enrolled in the randomized controlled clinical trial were assigned to 2 groups, the treated group (68 cases) and the control group (74 cases), they were treated respectively by FHGP and conventional TCM and Western medicine therapeutic program for 3 months. Indexes including fasting plasma glucose (FPG), 2 h postprandial plasma glucose (2 h PG), fasting insulin (FINS) were detected, homeostasis model assessment insulin resistance (HOMA-IR) was calculated, and the score of syndrome was recorded before and after treatment. Then the effects on syndrome and glyco-metabolic abnormality were evaluated through statistical analysis.

RESULTSLevel of 2 h PG after treatment was lowered in both groups (P < 0.01), but significant difference was found in the pre-treatment to post-treatment decrement of FPG and HOMA-IR between the two groups (P < 0.05). The syndrome improving rate and the total effective rate on glyco-metabolic abnormality in the treated group were significantly better than those in the control group respectively (85.3% vs 64.9% , P < 0.01; 80.9% vs 62.2%, P < 0.05).

CONCLUSIONFHGP has the capability to improve the syndrome and glyco-metabolic abnormality of patients with LCGA.

Adolescent ; Adult ; Aged ; Blood Glucose ; metabolism ; Combined Modality Therapy ; Drug Therapy ; methods ; Female ; Hepatitis B, Chronic ; complications ; Humans ; Insulin Resistance ; Liver Cirrhosis ; etiology ; metabolism ; therapy ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Phytotherapy ; methods ; Treatment Outcome

OBJECTIVETo observe the effect of Jianpi Bushen Qingchang Huashi Recipe (JBQHR) on proliferation and migration of bone marrow mesenchymal stem cells (BMSCs).

METHODSBMSCs were isolated and cultured in vitro with adherence screening method to prepare cell suspension. No drug intervention was given to BMSCs in the vehicle control group. JBQHR at 0.39, 0.78, 1.56 µg/mL was added in BMSCs of low, mid, and high dose JBQHR groups for co-incubation. Its effect on the proliferation of BMSCs was detected by CCK-8. BMSCs migration and chemotactic ability was detected using Transwell method. Each dose JBQHR combined ERK kinase inhibitor U0126 was set up as control. The phosphorylation of extracellular regulated protein kinase (ERK) and CAMP responsive element-binding protein (CREB) were detected by Western blot.

RESULTSCompared with the vehicle control group, the proliferation of BMSCs and BMSCs migration number could be promoted in the 3 JBQHR groups (P < 0.05). Besides, the proliferation of BMSCs was better in mid and high dose JBQHR groups than in the low dose JBQHR group (P < 0.05). Compared with the vehicle control group, the phosphorylation of ERK and CREB could be elevated in the 3 JBQHR groups (P < 0.05), and could be inhibited by U0126 (P < 0.01). Compared with the low dose JBQHR group, the phosphorylation of ERK increased in mid and high dose JBQHR groups with statistical difference (P < 0.05).

CONCLUSIONJBQHR could promote the proliferation and migration of BMSCs, and its mechanism might be related to ERK/CREB signaling pathway

Cell Movement ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Cyclic AMP Response Element-Binding Protein ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Extracellular Signal-Regulated MAP Kinases ; metabolism ; Humans ; MAP Kinase Signaling System ; Mesenchymal Stromal Cells ; cytology ; drug effects

Objective To assess the value of contrast-enhanced ultrasound (CEUS) on quantitative analysis of re?nal cortex perfusion in hypertensive rabbits model. Methods Hypertensive rabbit modal (n=10) were established by inject?ing N-nitro-L-arginin methylester (L-NAME). CEUS and Cystatin C (CysC) serum level analysis were performed at differ?ent time points:before and the 2nd, 4th, 6th and 8th week after injecting L-NAME. Time-intensity curve and area under curve (AUC) were analyzed quantatively while correlation of AUC and CysC were also analyzed. Results Serum level of Cys C in?creased significantly at the 6th week after L-NAME administration which is earlier than the increase of serum levels of Scr and BUN. AUC decreased at first then increased after L-NAME administration. Upon addition of L-NAME, rise time (RT) and peak intensity (PI) decreased while mean transit time (MTT), time from peak to one half (HPT) and time to peak (TTP) in?creased. Our study confirmed a positive correlation between AUC and Cys C (r=0.950, P<0.001). Conclusion Setting up rabbits model by L-NAME is convenient and reproducible, which is an useful tool in experimental study of preclinical and clinical phase of hypertensive renal injury. CEUS combining with CysC serum level analysis is considered as an effective technology for evaluating renal function in hypertensive patients.