Objective To explore the clinical value of tuberculous infection of T cells spot test (T-SPOT. TB)for diagnosing tuberculous pleurisy in immunocompromised patients. Methods The sensitivities of T-SPOT. TB,ADA, TB-DNA and tuberculosis antibodies to tuberculous pleurisy in 54 immunocompromised patients were compared.Among these patients,22 were retested by T-SPOT. TB after 2 months anti-tuberculosis treatment. Spot forming cells(SFCs) were compared before and after treatment. Results The diagnostic sensitivity of T-SPOT.TB (79.63%)was significantly higher than those of ADA (64.81%),TB-DNA (48.15%)and tuberculosis antibodies (55.56%) (P<0.05).22 patients were retested by the T-SPOT.TB after anti-TB treatment (2 months), the results showed that the positive rate of T-SPOT.TB was 90.91%,not significantly than previous tests (P<0.05).Both ESAT-6 and CFP-10 specific SFCs decreased significantly compared with those before anti-TB treatment (t=2.728 and 2.400,P<0.05 respectively). Conclusions T-SPOT.TB assay has satisfactory sensitivity and could be used in diagnosis of tuberculous pleurisy in immunocompromised patients.

Objective To investigate the significance of serum cortisol and high‐sensitivity C‐reactive protein (hs‐CRP) test in elderly patients with neurasthenia .Methods A total of 160 elderly patients with neurasthenia in our hospital from January 2012 to June 2015 were selected as the research subjects (observation group) and 160 individuals undergoing the physical examination as the control group .The differences of serum BDNF ,CORT and hs‐CRP levels were compared between the two groups .The patients were divided into the obvious anxiety group and anxiety group according to the Hamilton Anxiety Scale (HAMD) .The differences of serum BDNF ,CORT and hs‐CRP levels were compared between these two groups ;meanwhile serum BDNF ,CORT and hs‐CRP levels after treatment in the patients with ideal curative effect were detected and the detection results were statistically compared with those before treatment .Results The BDNF and CORT levels in the observation group were significantly lower than those in the control group ,while the hs‐CRP level was significantly higher than that in the control group ;the BDNF and CORT levels in the obvious anxiety group were significantly lower than those in the anxiety group ,while the hs‐CRP level was significantly higher than that in the anxiety group ;the treatment outcome also showed that the BDNF and CORT levels after treatment in the patients obtai‐ning the ideal effect were significantly increased compared with the pre‐treatment levels ;while the hs‐CRP level was significantly decreased .Conclusion BDNF ,CORT and hs‐CRP are significantly correlated with neurasthenia occurrence and its severity ,which deserves to pay attention to in clinical practice .

Objective To observe the protection of Caspase inhibitor(zVAD-fmk,benzyloxycarbonyl-Val-Ala-Asp-fluoromethyl ketone) on neonatal rat with hypoxic-ischemic brain damage(HIBD).Methods Thirty-six neonatal rats,7 days old,were randomly divided into hypoxic-ischemic(HI) control group(A),zVAD-fmk treated group(B) and sham group(C).Before HI insult,a pan-Caspase inhibitor,zVAD-fmk or normal buffer solution was injected into the cerebral ventricle.The water content of cerebral hemisphere was measured and the percentage of apoptofic cells in hippocampal neurons was measured by Flow cytometer(Annexin V/PI) at 24 hours after HI insult.The effect on body weights(percentage of increased weight,WIP) and macroscopical changes(percentage of cortox and hippocampal dead neurons) were assessed at 14 days.Results Compared with group A,the water content of ischemic hemisphere and apoptosis percentage of hippocampal neurons in group B reduced significantly.The difference of percentage of increased weight at 14 days in group B was not significantly.Microscopic examination showed that cortox and hippocampus neural death rate in group B was proved significantly reduced compared with that in group A.Conclusion Intracerebral administration of zVAD-fmk has protective effects on hypoxic-ischemic brain damage in neonatal rat.

Objective To observe the occurrence of vascular calcification in maintenance hemedialysis (MHD) patients. Method Sixty-nine MHD patients were enrolled in this study. Vascular calcification was evaluated by plain X-my films of chest, upper and lower extremites. Analyzed the relationship of vascular calcification and cardiovascular disease. Results Vascular calcification on X-ray films presented in 38 cases (55%). Of the 23 cases with calcification on arteries of extremites, 14 cases were found to have both intimal calcification and medial calcification. Patients with vascular calcification were older. Ischemic heart disease and cardiac failure appeared more frequently in the patients with vascular calcification. Conclusions Both intimal calcification and medial calcification are frequently found in the MHD patients. Vascular calcification is probablly associated with cardiovascular disease in MHD patients.

Humans ; Infant, Newborn ; Lung Diseases ; Pulmonary Artery ; Thrombosis

Objective To explore the use of enzyme-linked immunosorbent assay(ELISA) to test the serological BP180NC16A-ELISA index in patients with bullous pemphigoid (BP) and investigate the relationship of this index with disease monitoring and therapeutic guidance.Methods The serological BP180NC16a-ELISA index at different times was examined in twenty BP patients with ELISA kit and monitor changes of pre-treatment BP180NC16a-ELISA index condition score and efficacy relationship..Results Twenty patients tested by ELISA had 19 cases of positive patients with positive rate of 95.0％ and one case negative with negative rate of 5.0％.After treatment,19 cases (19.60 ±4.63)d became stable,and condition score was (3.75 ± 1.37) points.After continued treatment (28.75 ± 6.11) d entering clinical remission,condition score was (2.25 ± 1.21)points.Compared with the score before treatment condition [(5.55 ± 1.61) points],differences were statistically significant (Z =-3.808,-3.965,P ＜ 0.01),and clinical remission score below clinically stable condition (Z =-3.808,P ＜0.01).A total of 19 cases of patients' pre-ELISA treatment index were positive correlation with after treatment stable period and clinical remission period (rs =0.788,0.752,P ＜ 0.01).Conclusions This study demonstrated that ELISA-detected BP180NCI6a-ELISA index was positively correlated with the BP disease severity and clinical course,which could be as the guideline to monitor and clinical treatment.

Objective To investigate the clinical efficiency of Isophane Protamine Biosynthetic Human Insulin Injection (pre‐mixed 30R)(Novolin 30R) combined with insulin pump therapy in patients with diabetes mellitus complicated with pulmonary in‐fection ,and to analyze the detection indexes .Methods From Jan .2010 to Feb .2013 ,90 cases of patients with diabetes mellitus com‐plicated with pulmonary infection were selected and divided into the observation group and control group .The control group re‐ceived Novolin 30R treatment and conventional treatment ,the observation group were given insulin pump therapy based on the treatment of control group .The clinical efficiency and detection indexes were compared and analyzed .Results The cure rate and to‐tal effective rate were 51 .11% and 82 .22% respectively in the control group ,and were 84 .44% and 100 .00% in the observation group respectively .There were significant differences of both cure rate and total effective rate between the two groups (P<0 .05) . There were statistically significant differences of hospitalization time ,the time for reaching target of glucose ,insulin dose ,recovery time of body temperature ,hospital costs ,incidence rate of complications ,serum levels of sodium ,potassium and urea nitrogen ,os‐molality and PH value between the two groups(P<0 .05) .Conclusion The combination of Novolin 30R and insulin pump therapy could provide satisfactory clinical efficiency in patients with diabetes mellitus complicated with pulmonary infection .

Objective:To investigate the clinical manifestations and imaging features of spastic paraplegia caused by spinal cord Wallerian degeneration after pontine infarction, and to analyze its occurrence process and mechanism.Methods:The clinical manifestations and imaging features of two patients with spastic paraplegia caused by spinal cord Wallerian degeneration after pontine infarction were reported for the first time in China. Combined with anatomy and review of the literature, the mechanism, imaging manifestations and clinical features of Wallerian degeneration of lateral funiculus of spinal cord after pontine infarction were analyzed systematically.Results:Case 1 was a 65 years old female, and case 2 was a 58 years old male, who were treated in Qilu Hospital of Shandong University on December 7, 2018 and June 23, 2019 respectively. All the two patients presented with strength weakness of both limbs, hypertonia, symmetric hyperreflexia, and bilateral extensor plantar responses, which suggested spastic paraplegia secondary to upper motor neuron involvement. Spastic paraplegia appeared eight months after pontine infarction in case 1 and appeared six months after pontine infarction in case 2. Magnetic resonance imaging revealed continuous iso-T 1 and high-T 2 signals of bilateral pyramidal tracts below the pontine foci. Case 1 showed lesions of lateral cord of medulla oblongata, cervical spinal cord and thoracic spinal cord, and case 2 showed lesions of lateral cord of medulla oblongata and cervical spinal cord. At the same time, motor neuron disease and metabolic disease were excluded by electromyography and laboratory examination, inflammatory demyelinating disease was excluded by cerebrospinal fluid examination in one case. The syndromes, in combination with a continuous strip of abnormal signal revealed by magnetic resonance imaging which was consistent with the pyramidal tract and connected with the primary lesion suggested wallerian degeneration of spinal cord secondary to pontine infarction. The clinical symptoms of two cases were gradually aggravated in follow-up. Conclusions:Spinal cord Wallerian degeneration is a sequel after pontine infarction, which is related to the prognosis of the disease. A full understanding of its clinical manifestations and imaging features can avoid clinical misdiagnosis as other diseases.

Sleep disorders are commonly occurred among patients with Parkinson's disease,such as difficulties in the initiation of sleep,fragmented sleep,sleep behavior disorder and excessive daytime sleepiness.The mechanism of sleep disorders associated with Parkinson's disease is not clear,which may be associated with the injury of brain stem,nuclei of median raphe,nuclei fasciculi solitarii,thalamencephalon and the changes of neurotransmitters as dopamine,hypocretin(orexin) and melatonin.This article gives an overview of the mechanism of sleep disorders associated with Parkinson's disease.