Objective To explore the accuracy and security of introcavitary-ECG guiding peripherally inserted central catheter (PICC) tip positioning.Methods The observation group was defined as the 50 preterm infants who was cathetered PICC between June 2014 to May 2015 while the control group as the other 50 cases was cathetered between August 2012 to May 2014 to review.The latter group was cathetered traditionally and positioned by X-ray while the former was cathered by ECG-monitoring and positioned by the change of P wave on ECG-Ⅱ.X-ray was also used to confirm the PICC tip positioning when the cathere was fixed in the control group.Results The success rate of first puncture in control group was 74％(37/50),significatly lower than the observation group,which was 94％(47/50) (x2=7.440,P ＜ 0.05).Conclusions The technology of ECG makes benefits in increasing the success rate of first puncture,reducing cathetering time,improving work efficiency,reducing the risk of nursing operation and garanteeing security of nurses and patients.

Objective To uncover the possible factors of rapid increasing incidence of syphilis. Methods The clinical data of 100 patients firstly diagnosed as syphilis and their spouses were analyzed. Results There were 65 couples (130 cases) both were infected with syphilis, accounting for 65%. Among these cases, 25 males firstly diagnosed, 15 of them were primary syphilis; and 40 females firstly diagnosed as syphilis, 32 of them were secondary syphilis. Among 65 syphilis couples, 48 spouses were quickly diagnosed as syphilis through contact tracing, but the other 17 spouses were not diagnosed as syphilis until 1~3 months later, and most of them were latent syphilis, accounting for 83.2%(54/65). Chancre, which may be noticed by the patients themselves, was not so common in this group of patients, accounted for only 28.5%(37/130), and mainly in males. Conclusions The infections rate of syphilis between spoused is high, especially latent syphilis, and chancre is low, which might be one of the factors for the rapid spreading of the disease.

In this paper, we propose a new active contour algorithm, i. e. hierarchical contextual active contour (HCAC), and apply it to automatic liver segmentation from three-dimensional CT (3D-CT) images. HCAC is a learning-based method and can be divided into two stages. At the first stage, i.e. the training stage, given a set of abdominal 3D-CT training images and the corresponding manual liver labels, we tried to establish a mapping between automatic segmentations (in each round) and manual reference segmentations via context features, and obtained a series of self-correcting classifiers. At the second stage, i.e. the segmentation stage, we firstly used the basic active contour to segment the image and subsequently used the contextual active contour (CAC) iteratively, which combines the image information and the current shape model, to improve the segmentation result. The current shape model is produced by the corresponding self-correcting classifier (the input is the previous automatic segmentation result). The proposed method was evaluated on the datasets of MICCAI 2007 liver segmentation challenge. The experimental results showed that we would get more and more accurate segmentation results by the iterative steps and the satisfied results would be obtained after about six rounds of iterations.
Algorithms ; Humans ; Imaging, Three-Dimensional ; Liver ; diagnostic imaging ; Models, Theoretical ; Tomography, X-Ray Computed

Sphingolipids as an important regulator play a critical role in the cell biological functions. Among them, ceramide (Cer) and sphingosine (Sph) induce apoptosis and inhibit cell proliferation; on the contrary sphingosine 1-phosphate (S1P) promotes cell survival and proliferation. The balance between ceramide/sphingosine and S1P forms a so-called "sphingolipid-rheostat", which decides the cell fate. Sphingosine kinases, which catalyze the phosphorylation of sphingosine to S1P, are critical regulators of this balance. Here, we review the role of sphingosine kinase 1 (SphK1) in regulating fundamental biological processes and tumorigenesis and the potential of SphK1 as a new target for cancer therapeutics.

Backgroud Numerous studies have confirmed the effectiveness of slowing the progression of atherosclerosis by blood pressure (Bp)control in patients with hypertension and several studies also showed the efficacy of intensive glycemic control in decreasing progression of carotid intima-media thickness (CIMT) in patients with type 1 and type 2 diabetes. However, few studies have compared the relative importance of glycemic vs. Bp control in patients with diabetes and hypertension. We aimed to investigate the association between Bp and glycemic control and subclinical carotid atherosclerosis in older patients with hypertension and type 2 diabetes. Methods In a cross-sectional study, B-mode high-resolution ultrasonography of the carotid artery was performed in 670 subjects (508 males and 162 females) aged 60 years or over who had self-reported hypertension and diabetes but no history of coronary heart disease or stroke. Subjects were categorized by their systolic blood pressure: tight control, < 130 mmHg; usual control, 130-139 mmHg; or uncontrolled, > 140 mmHg, and by their hemoglobin Alc (HbAlc) level: tight control, < 6.5%; usual control, 6.5%-7.5%; or uncontrolled, > 7.5%, respectively. Results The mean CIMT was 8.20±0.11 mm, and carotid plaque was found in 52.5% (352/670) subjects. Overall, 62.1% of the subjects had subclinical carotid atherosclerosis, defined as having either carotid plaque or elevated CIMT (≥ 1.1 mm). The mean CIMT was significantly different between Bp control categories (7.60 ± 0.09 mm, 7.90 ± 0.08 mm, and 8.60±0.12 nun, respectively, P = 0.03) but not between glycemic control categories (8.20 ± 0.10 ram, 8.1 ± 0.08 mm, and 8.40 ± 0.14 mm, respectively, P = 0.13) using ANCOVA analysis. Multivariable logistic regression adjusting for potential confounding factors showed that usual or uncontrolled Bp control were associated with having carotid plaque (OR = 1.08 and OR = 1.42, respectively), or elevated CIMT [Odd ratio (OR) = 1.17, 95% confidence interval (CI)1.04-2.24, and OR = 1.54, 95% CI 1.36-2.96, respectively compared to tight Bp control; but did not show glycemic control as independent predictor of either having carotid plaque or elevated CIMT. Conclusions In older patients with hypertension and diabetes, blood pressure control, but not glycemic control is associated with subclinical carotid atherosclerosis.

Liver fibrosis is a pathological process of the excessive accumulation of extracellular matrix, especially collagen al (I) in liver. Ultimately, hepatic fibrosis leads to cirrhosis or hepatic failure. Liver fibrosis and early cirrhosis can be reversed, thus control of the development of liver fibrosis is very important for preventive treatment of cirrhosis and hepatic failure. This is a review of potential targets for anti-hepatic fibrosis based on plenty of publications, including TGF-β1 and integrin α(v) and so on, aimed at providing novel therapeutic targets in liver fibrosis.

This study is to investigate the inhibitory effect of lidamycin (LDM) and its combination with methotrexate (MTX) on lung metastasis of fibrosarcoma by bioluminescence imaging in athymic mice. A stable luciferase transfected HT-1080 cell line was constructed and the capability to establish experimental lung metastasis in athymic mice was confirmed. The optical imaging system was applied to evaluate the formation of lung metastasis in vivo. In addition, metastatic nodules were counted for the evaluation of inhibition rates. As shown, the fluorescent intensity of luciferase-transfected HT-1080 cells was colinear with the cell population and the minimal detected cell population was 100 cells/well. Optical imaging showed that the fluorescent intensity of treated group was apparently lower than that of the control. The inhibition rates of lung metastasis by LDM alone at 0.025 mg x kg(-1) and 0.05 mg x kg(-1) were 53.9% and 75.9%, respectively, while that of MTX alone at 0.5 mg x kg(-1) was 70.2%. The combination of LDM at 0.025 mg x kg(-1) and MTX at 0.5 mg x kg(-1) showed an inhibition rate of 88.7%. The coefficient of drug interaction (CDI) was 0.82. The results herein demonstrated that LDM alone had strong anti-metastasis effect on human fibrosarcoma HT-1080 and the inhibition efficacy is strengthened when combined with MTX.

Objective To evaluate the effect of sevoflurane anesthesia on left ventricular synchroni?zation in patients undergoing coronary artery bypass grafting ( CABG ) . Methods Twenty?six patients of both sexes, aged 45-75 yr, with body mass index of 19-30 kg∕m2 and body surface area 1.4-2.0 m2 , of American Society of Anesthesiologists physical status Ⅱ or Ⅲ and New York Heart Association class ⅡorⅢ, undergoing elective CABG with cardiopulmonary bypass, were divided into 2 groups using a random number table: control group ( group C, n=11) and sevoflurane group ( group S, n=15) . After induction of general anesthesia, the patients were endotracheally intubated and mechanically ventilated. Anesthesia was maintained with iv infusion of propofol 4-6 mg·kg-1 ·h-1 , remifentanil 0. 2-0. 3 μg·kg-1 ·min-1 and cisatracurium 0.10-0.15 mg·kg-1·h-1, and intermittent iv boluses of fentanyl 0.5 μg∕kg, and bis?pectral index value was maintained at 40-60. In group S, sevoflurane ( end?tidal concentration: 2.05% for 45-49 yr, 1.80% for 50-59 yr, 1.60% for 60-75 yr) was inhaled for 30 min starting from 15 min after termination of cardiopulmonary bypass, followed by 30 min washout. The parameters of cardiac function
were monitored using transesophageal echocardiography. After induction and before sternotomy, immediate?ly before sevoflurane inhalation, at 30 min of sevoflurane inhalation, and at 30 min of washout, heart rate, mean arterial pressure, central venous pressure, pulmonary artery occlusion pressure, cardiac output, left ventricular ejection fraction, standardized standard deviation of time to peak systolic longitudinal strain of R?R interval ( Tssl?SD) of 17 left ventricular segment, and standardized standard deviation of time to peak systolic circumferential strain of R?R interval ( Tssc?SD) of 16 left ventricular segment were recorded. Re?sults Cardiac output and left ventricular ejection fraction were within in the normal ranges in the two groups. Compared with group C, heart rate was significantly decreased at 30 min of sevoflurane inhalation and 30 min of washout, and mean arterial pressure, cardiac output and left ventricular ejection fraction were significantly decreased at 30 min of sevoflurane inhalation in group S (P<0.05 or 0.01). There were no significant differences in standardized Tssl?SD and standardized Tssc?SD between group S and group C ( P>0.05) . Conclusion Sevoflurane anesthesia has no marked effect on the left ventricular synchronization in patients undergoing CABG.

Objective · To evaluate the value of ultrasonic measurement of distance from skin to epiglottis (DSE) for predicting the difficult airway. Methods · 71 patients (20-80 year-old, ASA Ⅰ-Ⅲ ) undergoing endotracheal intubation and general anesthesia for an elective surgical procedure were enrolled. Conventional airway evaluation was performed. The distance from skin at thyroid cartilage upper edge to epiglottis was measured using ultrasound before anesthesia and compared between patients with difficult airway and normal airway. The effects of different methods for evaluating difficult airway were analyzed Results · The ultrasonic measurements of DSE on parasagittal view in patients with difficult airway and normal airway were (23.31±0.43) mm and (19.21±0.27) mm, respectively. The difference was statistically significant (P=0.003). The area under the ROC curve of ultrasonic measurement was 0.799 (95% CI:0.639-0.958) with the best cutoff point of 23.6 mm. The specificity of ultrasonic measurement was significantly increased as compared with Mallampati classification (96.43% vs 71.40%, P=0.004). The difference in sensitivity was not statistically significant (60.00% vs 73.33%, P=0.170). Conclusion · Ultrasonic measurement of DSE on parasagittal view can be used to predict the difficult airway.