Adult ; Diagnostic Errors ; Female ; Humans ; Middle Aged ; Myasthenia Gravis ; diagnosis

Objective To detect the mutation of A379,we develop a TaqMan fluorogenic probe based amplification refractory mutation system (TaqMan-ARMS) and investigate whether the A379V variant and activity of Lp-PLA2 are the risk factors for CAD.Methods According to the amplification refractory mutation system(ARMS-PCR)combined with a TaqMan fluorogenic probe,we established and evaluated the assay teehnique of TaqMan-ARMS for measuring the genotype of variant.At the same time,we tested the aetivity of Lp-PLA2 in 395 patients with coronary heartdisease and 396 controls,whose clinical information [ages,CHO,GLU,TG,HDL,LDL,Hs-CRP,Lp (a)] were collected.Date was analyzed by using Independent-samples t test,Chi-square test,One-Way ANOVA,Binary Logistic Regression.Results CAD group had significantly higher Lp-PLA2 activity than the controls(31.51 nmol · ml-1 · min-1 ＞21.31 nmol ·ml-1 · min-1,F =16.40,P ＜ 0.001).Comparing the highest quartile of Lp-PLA2 activitv to the bottom quartile,OR was 7.50 (95％ CI:2.34-24.05) after adjustment for various traditional cardiovascular risk factors,including ages,sex,CHO,TG,Hs-CRP,Lp (a) and GLU; the genotype VV of A379V was associated with higher risk of CAD (OR =2.95; 95％ CI:1.22-7.15,P ＜ 0.05).Conclusions The TaqMan-ARMS real time PCR technique is established to analyze A379V genotype.Lp-PLA2 activity is significantly higher in CAD group and is a risk factor for CAD; the genotype VV of A379V is also a risk factor for CAD.

OBJECTIVE:To provide new identification method for processed medicinal material Chinese polyphaga(Eupolyph-aga sinensis,Steleophaga plancyi) and their adulterants by establishing molecular identification method based on Cytb genes. METHODS:The total DNA of Chinese polyphaga and their adulterants was extracted using modified saturation sodium chloride method. The Cytb genes of all samples were amplified with PCR using general primers REVCB2H and REVCBJ. The phylogenetic tree of all samples was constructed with Neighbor-Joining(NJ)method using MEGA 5.1 software. The sequences of the Cytb gene of all sampled were compared by using DNAMAN sofetware. The difference between genuine product and their adulterants were analyzed,and the specific primers Esin-F and Esin-R were designed for molecular identification in different regions. RESULTS:DNA extracted from processed medicinal insects was successful to amplify Cytb gene segments. The phylogenetic tree of all sam-ples was consistent with their genetic relationship. A fragment was amplified only from genuine product but not from other adulter-ants with the designed specific primers Esin-F and Esin-R. CONCLUSIONS:DNA extraction method from processed Chinese polyphaga and their adulterants have been established. Designed specific primers are highly specific to genuine product Chinese polyphaga,and can be used for the identification of Chinese polyphaga and their adulterants.

Objective To evaluate the features of cervical lesions on real-time elastography.Methods The elastograms of cervical lesions were analyzed and all of them were evaluated by improved elastographic strain scores,which were classified into 5,and by strain ratio,with pathologic analysis as the reference standard.Results The elasticity scores of all normal cervixes were 1.The score of 95 ％ of benign lesions was not more than 2,the strain ratios of benign lesions were 0.75 ± 0.32.The score of 90％ of the cervical cancer was not less than 3,the strain ratios of 38 malignant lesions were 3.31 ± 1.47.There were significant difference between benign lesions and malignant lesions in elastic scores and elastic strain ratios (P ＜0.001).Conclusions There are some typical features of different cervical lesions on elastography.

Objective To compare the dosimetric difference of volumetric modulated arc therapy (VMAT) plans for the loco-regionally advanced nasopharyngeal carcinoma (NPC) patients using 6 MV X-ray flattening filter-free (FFF) and flattening filter (FF) modes.Methods Ten previously treated patients with loco-regionally advanced nasopharyngeal carcinoma were retrospectively included and replanned using FFF and FF VMAT,respectively.Meeting all clinical criteria,the dose-volume histograms (DVH),dose distribution of target volume and organs at risk (OARs),target conformity index (CI),total monitor unites (MUs) and treatment time were compared across the plans.Results VMAT plans suing either FFF and FF modes can meet the clinical objectives.The maximum and mean target dose of FFF VMAT plans were significantly higher than that of FF VMAT plans (t =-0.31,-O.35,P ＜ O.05).Yet the planning target volume (PTV) CI of FF mode was slightly better than of FFF mode (t =5.42,P ＜0.05).The maximum doses of lenses in FFF VMAT plans were lower than that of FF VMAT plans (t =25.87,17.45,P ＜ 0.05),and other OARs displayed no significant difference.The mean total MUs of FFF and FF VMAT plans were (699 ± 16) and (628 ± 12) MUs respectively.The mean treatment time of two modes were consistent (about 2 min).Conclusions The plan qualities of FFF and FF VMAT plans were comparable and both clinically acceptable.The OARs at the edge of radiation field,such as lens,could be spared better using FFF VMAT mode.The total MUs of FFF VMAT plans were higher than FF VMAT plans,yet were delivered within the same time.

Objective To investigate the clinical effect of preoperative nutritional treatment and perioperative nutrition support for the patients with esophageal cancer.Methods According to the digital table,90 patients with esophageal cancer were divided into the control group(15 cases),preoperative nutrition group(25 cases),postoperation nutrition group(25 cases)and preoperative nutrition + postoperation nutrition group(25 cases).The postoperative quality of life and the complications were compared.Results Postoperative quality of life in the preoperative nutrition group,postoperation nutrition group and preoperative nutrition + postoperation nutrition group were all better than that in the control group(t =14.76,15.13,17.87,all P ＜ 0.05).The incidence rate of postoperative complications in patients received nutritional intervention significantly decreased than in the control group(x2 =9.17,12.13,19.18,all P ＜ 0.05).Conclusion The preoperative nutrition and postoperation nutrition can improve the postoperative quality of life and reduce the incidence rate of the complications.

Adolescent ; Adult ; Female ; Hearing Loss, Sudden ; etiology ; psychology ; Humans ; Male ; Middle Aged ; Young Adult

Objective To compare the cardiac function parameters in gated SPECT determined by filtered back projection (FBP) and OSEM reconstruction methods. Methods One hundred and forty-four patients underwent 99Tcm-MIBI gated-SPECT imaging studies. The parameters LVEF, EDV and ESV, were derived using quantitative gated SPECT (QGS), four-dimensional model SPECT (4D-MSPECT) and emory cardiac toolbox (ECToolbox) softwares. Each image was reconstructed by FBP or OSEM. Bland-Altman analysis and paired t-test were applied to evaluate those parameters. Results Correlation coefficients for LVEF, EDV and ESV between FBP and OSEM methods were all more than 0.93 (all P<0.001). EDV calculated by FBP was lower than that by OSEM using QGS software, but became the opposite when using 4D-MSPECT and ECToolbox softwares. (QGS: (82.2±39.1) ml vs (83.5±40.8) ml, t=-2.53, P<0.05; 4D-MSPECT: (93.5±46.9) ml vs (88.8±45.2) ml, t=5.95, P<0.01; ECToolbox: (106.4±51.1) ml vs (100.8±49.0) ml, t=3.99, P<0.01). ESV calculated by FBP was higher than that by OSEM using 4D-MSPECT software (4D-MSPECT:(37.5±41.4) ml vs (34.8±37.6) ml, t=3.92, P<0.01). LVEF calculated by FBP was lower than that by OSEM using QGS software ((62.1±16.9)% vs (63.1±16.1)%, t=-3.14, P<0.05), but higher than that by OSEM using ECToolbox software ((74.1±18.8)% vs (71.3±17.1)%, t=5.28, P<0.01). Conclusion Generally, cardiac functional parameters based on FBP and OSEM construction methods correlated well, although they might have singnificantly different results.

Objective To investigate whether I198T gene polymorphisms and Lp-PLA2 activity were the risk factors of CAD.Methods A case-control study was conducted in 398 people with coronary heart disease and 396 controls whose ages and sex were matched with coronary heart disease from Peking University People's Hospital in October 2009 to May 2010.The Il98T gene polymorphisms were detected by the amplification refractory mutation system (ARMS-PCR) using TaqMan probe.Lp-PLA2 activity,CHO,GLU,TG,HDL,LDL,hs-CRP,Lp (a) were investigated at the same time.The data were analyzed by Independent-samples T Test,Chi-square test,One-Way ANOVA,Binary Logistic Regression.Results LpPLA2 activity was significant higer in CAD group than that in the control group (31.51 nmol · ml-1 · min-1＞21.31 nmol · ml-1 · min-1,F =16.40,P ＜0.05).Adjustment for various traditional cardiovascular risk factors,including ages,sex,CHO,TG,Hs-CRP,Lp(a),and GLU,quartiles of Lp-PLA2 activity were associated with risk of CVD with a OR of 7.5 (95％ CI:2.34-24.05) for comparison of the top to bottom quartile.Lp-PLA2 activity was the highest (22.68 nmol · ml-1 · min-1,P ＜ 0.05) in genotype Ⅱ and the lowest (11.35 nmol · ml-1 · min-1,P ＜ 0.05) in genotype TT,the association between I198T and coronary artery disease was not significant (P ＞ 0.05).Conclusions Lp-PLA2 activity was significantly higher in CAD group and was a risk factor for CAD.There was no significant association between I198T polymorphism and CAD.

Objective: To discuss the selection pattern of points and meridians in acupuncture-moxibustion treatment of gouty arthritis (GA) by analyzing clinical literatures related to GA, and to provide reference for acupuncture-moxibustion treatment of GA. Methods: Clinical literatures related to GA treated with acupuncture-moxibustion published between January 1981 and July 2017 were collected from Chinese databases. The points, meridians, frequency and treatment methods were analyzed. Results: A total of 78 studies were included. For meridians, the top 5 meridians used were the Spleen Meridian (67 times), Liver Meridian (59 times), Stomach Meridian (53 times), Kidney Meridian (49 times) and Large Intestine Meridian (44 times). For points selection, the leading 5 points were Taichong (LR 3) (79 times), Taibai (SP 3) (68 times), Sanyinjiao (SP 6) (61 times), Taixi (KI 3) (57 times) and Yinlingquan (SP 9) (55 times). For major and adjunct points, the 5 most significant major points were Taichong (LR 3) (79 times), Taibai (SP 3) (68 times), Sanyinjiao (SP 6) (61 times), Yinlingquan (SP 9) (37 times) and Taixi (KI 3) (32 times). The 5 most significant adjunct points were Yanglingquan (GB 34) (31 times), Fenglong (ST 40) (30 times), Xuehai (SP 10) (29 times), Taixi (KI 3) (25 times) and Quchi (LI 11) (21 times). For treatment methods, the top 5 methods used were acupuncture-moxibustion alone for 15 studies, acupuncture combined with medicinal herbs for 11 studies, acupuncture-moxibustion combined with medicinal herbs for 10 studies, acupuncture alone for 7 studies, and electroacupuncture combined with bloodletting for 5 studies. Conclusion: The main meridians chosen in acupuncture-moxibustion treatment of GA were the Spleen, Liver, Stomach, Kidney and Large Intestine Meridians, conforming to the syndrome differentiation principle of tonifying spleen and kidney, clearing heat and draining dampness. Points mainly locate at lower limbs and feet around the affected area, which was a reflection of peripheral treatment function of points. The data mining results of meridian and point selection in acupuncture-moxibustion treatment of GA conform to the disease and syndrome differentiation theory and provide references for acupuncture-moxibustion treatment of GA.