Humans ; Mycoplasma pneumoniae ; Pneumonia, Mycoplasma ; complications ; Pulmonary Embolism ; complications

Objective To investigate the development of early myocardial perfusion with myocardial contrast echocardiography (MCE) combined with dipyridamole stress echocardiography in diabetic rats . Methods The diabetes mellitus (DM) group comprised 40 male diabetic rats ,induced with streptozotocin . The control group comprised 40 normal male rats ,comparable body weights with the DM group .The DM group was divided into four subgroups (0 week ,2 weeks ,4 weeks and 8 weeks after diabetic model established) and the control group was also divided into four subgroups matched with the DM group .Each rat was performed with conventional echocardiography ,MCE at baseline and after dipyridamole stress .The reserve parameters were compared between the control group and the DM group .In addition ,the differences among four subgroups in the control group and the DM group were compared ,respectively .Results MCE demonstrated that the 4 weeks and 8 weeks DM subgroup had lower myocardial blood velocity reserve and myocardial blood flow reserve than the control subgroup .The myocardial blood volume reserve was reduced in the 8 weeks DM subgroup ,too .Conclusions The impairment of myocardial perfusion in the DM rats are detected earlier with the MCE combined with dipyridamole stress .

Objective:To study the modulatory effect of hydrogen sulfide (H2S) on oxidative stress in the development of pulmonary hypertension induced by hypoxia. Methods:Twenty male Wistar rats were randomly divided into control group (n=6), hypoxic group (n=6) and hypoxia+NaHS group (n=8). Hypoxic challenge was performed everyday for 21 days. NaHS solution was injected intra-peritoneally everyday before hypoxic challenge for rats in the hypoxia+NaHS group. After 21 days of hypoxia, the mean pulmonary artery pressure(mPAP) was measured by cardiac catheterization. The weight ratio of right ventricle to left ventricle+septum [RV/(LV+SP) ] was also measured. The lung homogenates were assayed for total antioxidant capacity(T-AOC), superoxide dismutase (SOD), oxidized glutathione (GSSG), reduced glutathione (GSH), malondiadehyde(MDA) and hydroxy radical(?OH), and the SOD mRNA levels were assayed by real time polymerse chain reaction. Results: After three weeks of hypoxic disposure, hypoxic hypertension and vascular remodeling developed. Compared with the control group, the mPAP[(23.7?2.2) mm Hg vs. (16.3?3.7) mm Hg,P

OBJECTIVE To know the disinfection efficacy of electrolyzed oxidizing water(EOW) and glutaraldehyde on clinical used gastroscope and enteroscope in our hospital and to analyze their stability and probable harm.METHODS The gastroscope and enteroscope before and after use on randomly selected outpatients and inpatients were examined on their contamination,and the efficacy of EOW was compared with that of glutaraldehyde.RESULTS After using EOW and glutaraldehyde to disinfect the gastroscope and enteroscope the former showed that its killing rate on commonly encountered pathogens for 1 min was 93.75-98.22%,for 3 min was 81.20-89.29%,and for 5 min was 100.00%;the latter showed that its killing rate for 3 min was 81.20-89.29%,for 5 min was 90.38-93.04%,and for 10 min was 99.92-99.96%.EOW was non-irritative to mucosa,and didn′t cause allergic reaction,but its stability was poor.The glutaraldehyle could bring some side effects,such as some allergy,and mucosa stimulation.CONCLUSIONS It only needs 3-5 min for EOW to kill polluted bacteria on gastroscope and enteroscope to attain the disinfection eligibility,but glutaraldehyde needs more than 10 min to get to the disinfection eligibility.The effect of EOW is strong,rapid,active and environment-safe,it is worthy of application,but it must be applied immediately as soon as possible after production.The use of glutaraldehyde must strengthen the measures of personal protection.

Objective:To analyze the clinical characteristics of lower respiratory tract infection of influenza virus-related critical illness in children, and provide reference for early diagnosis and treatment of the disease.Methods:Thirty influenza virus-related critical cases of lower respiratory tract infection admitted to Shenzhen Children′s Hospital from October 2018 to October 2019 were enrolled in our study, and the clinical data were compared with influenza virus-related common severe cases with lower respiratory tract infection.Results:We reported that 63.33% of children with critical illness were less than five years old, and most of them were male(25 cases, 83.33%). The incidence of critical cases in the summer was significantly higher compared with common severe cases( χ2=7.050, P=0.008). In addition, pulmonary rales were the most common lung signs in critical cases( χ2=5.222, P=0.022), and the incidence of severe pneumonia increased significantly( χ2=32.651, P<0.001). Besides, we noticed that 60.00% of critical cases had respiratory failure, and the prevalence rates of plastic bronchitis among critical cases significantly increased( χ2=7.797, P=0.005). The absolute counts of neutrophil and the proportion of C-reactive protein in critical cases were higher than those in common severe cases ( Z=-3.805, P<0.001; χ2=5.833, P=0.016). We also found that 30.00% of critically-ill cases had Streptococcus Pneumoniae in lavage, of whom Epstein-Barr(EB) virus detection rate was higher than that of common severe cases ( χ2=6.909, P=0.009). Conclusion:Critically ill cases of lower respiratory tract with influenza virus infection are more common in children under five years old.These cases mainly occur in summer.When patients with lung rales, the absolute counts of neutrophil and the C-reactive protein increased significantly, and specifically with streptococcus pneumoniae and EB virus infection, which are more likely to progress to severe cases.Severe pneumonia, plastic bronchitis and respiratory failure need to be close monitored as the serious complications of critical illness.Early anti-influenza viral and anti-bacterial treatment, as well as active symptomatic life support can improve the prognosis of the disease.

Objective To investigate the value of serum high sensitive C reactive protein(hs-CRP) in the risk stratification and prognosis evaluation in the patients with coronary heart disease and PCI operation.Methods One hundred and sixty-three cases of coronary heart disease and undergoing PCI in this hospital from March 2013 to September 2015 were selected and performed the coronary angiography examination before operation.Then the patients were divided into 3 groups according to the hs-CRP level.The Gensini score was used to judge the blood vessel stenosis degree.The patients were followed up within six months after surgery.The major cardiovascular events were recorded and the relationship between the hs-CRP level with the number of diseased vessels,Gensini score,MACE and other coronary heart disease risk factors was analyzed.Results Hypertension and hs-CRP level had statistically significant difference among 3 groups(P＜0.05);preoperative hs-CRP level showed positive correlation with hs-cTnT level (r =0.44,P＜ 0.001),while the hs-CRP was negatively correlated with the HDL-C level (r =-0.18,P =0.003);with the Gemini score elevation,the hs-CRP level was similarly elevated,the hs-CRP levels in the patients with severe,moderate and mild vascular stenosis evaluated by Gensini's score were(17.11±9.58),(10.02±3.59),(4.11±1.62)mg/L respectively,the difference among them had statistical significance(F=37.21,P＜0.05).Within postoperative six months,the MACE occurrence rates in 3 groups were 32.1％,52.9 ％ and 59.2 ％ respectively,the differences among the three groups were statistically significant(x2 =13.523,P =0.001),and the target lesion blood supply reconstruction rate had statistically significant difference(x2 =7.522,P =0.022).The hsCRP level was an independent risk factor of MACE occurrence(OR =2.06,95 ％ CI:1.31-3.42,P=0.005).Conclusion Serum hs-CRP is an independent risk factor for cardiovascular events occurrence after PCI surgery in the patients with coronary heart disease.

Objective:To explore any effect of inhaling hyperbaric oxygen on edema resulting from cerebral hemorrhage.Methods:Cerebral hemorrhage was modeled using collagenase in 125 Wistar rats, with 5 others used as controls. The injured rats were randomly divided into a second control group without any hyperbaric oxygen intervention, and groups which inhaled hyperbaric oxygen for 40 min, 60 min, 80 min or 100 min. There were 25 rats in each group. The inhalation began 6 hours after the modeling and was administered once a day. On the 2nd, 4th, 6th, 8th and 16th day of the treatment, 5 rats from each group were sacrificed and the expression of the B lymphoblastoma-2 gene (Bcl-2) and BCL2-associated protein X (Bax) in the brain tissue around the hematoma was detected using immunohistochemical methods.Results:The average Bax expression in all of the HBO groups was significantly lower than in the second control group at each time point, but with significant differences between the HBO 60 min and HBO 40 min groups, as well as between the HBO 80 min and HBO 100 min groups. By the 4th day the average Bcl-2 expression in the HBO 40 min group was significantly different from that in the HBO 80 min group, and the same was true of the HBO 60 min and HBO 100 min groups.Conclusions:One of the mechanisms by which HBO treats intracerebral hemorrhage may be related to down-regulating the expression of Bax and increasing the expression of Bcl-2. The best everyday treatment duration is 80 min.

Objective:To explore the possible mechanism of exacerbation of anxiety-like behavior in db/db mice after distal middle cerebral artery occlusion (dMCAO).Methods:The db/db mice was used to establish a type 2 diabetes mellitus model. Meanwhile, heterozygous db/+ mice and C57 wild-type (WT) mice were chosen as double control groups. Then a permanent distal middle cerebral artery occlusion model was employed as an acute ischemic stroke model. The blood glucose levels before and post-dMCAO surgery on day1, day3, and day5 were detected. The brain tissue loss at 35 days after stroke was measured by immunofluorescent staining of MAP2. The open-field test was performed to estimate anxiety-like behavior and general motor and exploring ability of the animals. Axons and myelin were immunostained with non-phosphorylated neurofilaments (SMI32) and myelin basic protein (MBP), respectively, to evaluate differences in white matter integrity in WT, db/+ and db/db mice 35 days after stroke. The correlation between SMI32/MBP and open field test parameters (time in center and corner) was analyzed. Flow cytometry was employed to detect the amount of T cells and B cells, including regulatory T cells (Tregs) in the brain tissue.Results:Blood glucose levels in db/db mice were significantly higher than db/+ mice and WT mice in both sham and dMCAO groups ( P<0.01). There was no significant difference in brain tissue loss 35 days post-stroke among db/db mice, db/+ mice, and WT mice. In the open field test, there were significant differences in the total distance of db/db mice, db/+ and WT mice in the sham and dMCAO groups. Db/db mice shorter than db/+ mice ( P<0.05), WT mice ( P<0.01), and db/+ mice shorter than WT mice ( P<0.05). There were significant time differences in the center among db/db, db/+, and WT mice in sham and dMCAO groups. In both the sham and dMCAO groups, db/db mice spent less time in the center area of the open field than WT mice ( P<0.01). In the sham group, db/+ mice spent less time in the center area than WT mice ( P<0.05). In dMCAO group, db/db mice spent less time in the center area than db/+mice ( P<0.05), and db/+ mice spent less time in the center area than WT mice ( P<0.01). For the time in the corner, in both the sham and dMCAO groups, db/db mice and db/+ mice consumed more time than WT mice ( P<0.01 or <0.05). In the dMCAO group, db/db mice spent more time in the corner than db/+ mice ( P<0.05). Referring to white matter injury, an increased SMI32/MBP ratio in EC area and CTX area (data was not shown in this article) after dMCAO in db/db, db/+ and WT mice were detected. In EC area, db/db mice have a higher SMI32 ratio than db/+ mice and WT mice: 4.24 ± 0.37 vs. 1.96 ± 0.37, 1.80 ± 0.36, both have significant differences ( P<0.01). For db/db mice and WT mice, the SMI32/MBP ratio negatively correlates with time in center and positive correlation with time in the corner. Three days after dMCAO, the total cells of CD 3+ T cells, CD 8+ cells, Tregs, in db/db mice group have significantly decreased compared to WT group: 4 079 ± 1 345 vs. 70 055 ± 3 374, 141.30 ± 28.36 vs. 2 714.00 ± 463.20, 148.00 ± 61.15 vs. 3 007.00 ± 639.90 ( P<0.01), while B cell has no change between two groups. Conclusions:By comparing the severity of anxiety-like behavior of db/db mice, the severity of white matter injury, and the number of T cells and B cells in brain tissue after dMCAO, immune-mediated brain white matter injury may aggravate db/db mice′s post-dMCAO anxiety-like behavior. Due to the gene dose effect, db/+ mice are not suitable as a control group for db/db mice in animal experiments involving anxiety-like behavior assessment.

Objective:To investigate the predictive value of measurement parameters of left atrial appendage by coronary CTA (CCTA) for the risk of cardiogenic stroke (CS) in patients with nonvalvular atrial fibrillation (NVAF).Methods:The clinical and examination data of 179 patients with NVAF who underwent CCTA examination were retrospectively analyzed. The selected patients were grouped according to the outbreak of acute ischemic stroke and TIA within 2 years after CCTA examination. Patients who met the criteria for CS were selected as cases (87 patients), and those with neither stroke nor TIA as controls (92 patients). The diameter and area of left atrial appendage (LAA) orifice, the LAA depth, and the LAA volume were measured by using dedicated software. The parameter was corrected using the body surface area (BSA) to obtain the correction index of corresponding parameter. The independent samples t test, Mann-Whitney U test, and Chi-square test were used to compare the differences in various indicators between the two groups. Binary logistic regression was used to analyze the impacts of body mass index (BMI), hyperlipidemia, the duration years of atrial fibrillation, left atrial appendage area index (LAAOA Index), and the left atrial appendage emptying fraction (LAAEF) on the risk of CS. The ROC curve was used to evaluate the predictive value of LAAOA Index and LAAEF for the onset of CS. Results:The correction index of the left atrial appendage orifice maximum and minimum diameter, the left atrial appendage orifice area, and the maximum & minimum left atrial appendage volume and the LAAEF in the case group were (1.80±0.21) cm/m 2, (1.19±0.17) cm/m 2, (3.20±0.71) cm 2/m 2, (7.91±1.92) ml/m 2, (5.03±1.40) ml/m 2, (36.20±10.54)%, and those value in the control group were (1.64±0.24) cm/m 2, (1.06±0.19) cm/m 2, (2.65±0.64) cm 2/m 2, (6.61±1.68) ml/m 2, (3.67±1.28) ml/m 2, (45.25±10.07)%, the differences were statistically significant ( t= 4.783, 4.647, 5.481, 4.826, 6.823, and -5.875, all P<0.001). Binary logistic regression analysis showed that the increase in LAAOA Index ( P= 0.005) and the decrease in LAAEF ( P<0.001) were independent risk factors for CS in NVAF patients. The area under the ROC curve (AUC) of LAAOA Index was 0.712 (95%CI 0.639-0.777), and the best diagnostic cut-off was 3.16 cm 2/m 2; the AUC of LAAEF was 0.734 (95%CI 0.663-0.797), the cut-off was 38.71%; the AUC of LAAOA Index-LAAEF was 0.786 (95%CI 0.718-0.843). The difference of AUC value between LAAOA Index and LAAEF was not statistically significant ( Z= 0.448, P= 0.654). The difference of AUC between the LAAOA Index-LAAEF and LAAOA Index ( Z=2.667, P=0.008) and between the LAAOA Index-LAAEF and LAAEF ( Z=2.061, P=0.039) were statistically significant. Conclusions:CCTA can provide a one-stop and relatively accurate evaluation of the size and function of the left atrial appendage by post-processing the coronary vascular scan data. Left atrial appendage measurement parameters from CCTA can be used as a supplement to the CHA2DS2-VASc score, and provide quantitative indicators for the risk assessment of CS in patients with NVAF.