OBJECTIVETo evaluate high resolution CT (HRCT) in the diagnosis of diffuse pulmonary nodules.

METHODSFifty normal chest radiographs, conventional CT and HRCT were used to evaluate the visualization of pulmonary lobule. The configuration, distribution and intrinsic structure of lesion in 38 patients with diffuse pulmonary nodules were analyzed by HRCT.

RESULTSThe chest radiographs were not able to show the structure of pulmonary lobule. The visualization rates of pulmonary lobule were 20% by conventional CT and 50% by HRCT (P < 0.05). Of 38 patients with diffuse pulmonary nodules, 19 had interstitial nodules which were located in the pulmonary intestities, the lobular septa and under the pleura. HRCT could clearly show their para-bronchial distribution with clear cut margin. Four had airspace nodules, chiefly shown as solidification of the air spaces. There was no nodule beneath the pleura or in the lobular septa. HRCT revealed even density and hazzy margins. Fifteen had randomly distributed nodules, with the nodules scattered at random. HRCT showed nodules with high density, sizes varying greatly but the margin was clear.

CONCLUSIONHigh resolution CT is able to show the pattern of distribution, intranodular structures and background of the diffuse pulmonary nodules, which is valuable in the diagnosis and differential diagnosis of this disease.

Adult ; Aged ; Diagnosis, Differential ; Female ; Humans ; Lung Neoplasms ; diagnosis ; diagnostic imaging ; Male ; Middle Aged ; Tomography, X-Ray Computed

Objective To investigate the underlying mechanism of Huayu Xiaozheng granule(HYXZ)in the treatment of ectopic pregnancy(EP).Methods The potential ingredients and targets of HYXZ were identified and screened.PPI network,GO enrichment and KEGG pathway analysis were established to understand the potential and intricate mechanism of HYXZ in treating EP.The effects of HYXZ on HTR-8/SVneo cells migration and invasion were detected by wounding healing assay and transwell migration assay respectively,as well as the influence of HYXZ granule on JAK/STAT pathway and associated proteins were assessed by western blot under the control of JAK/STAT pathway inhibitor and agonist.Results A total of 375 active ingredients,45 known targets and 207 predicted targets of HYXZ were obtained.A PPI network has constructed to know the relationship of 252 common targets of drug targets and disease targets,from which we screened out 15 key targets:STAT3,MMP9,TLR4,HIF1A and others.Scratch test showed that HYXZ inhibited the migration of the HTR-8/SVneo cells cells in a time and dose-dependent manner;Transwell test showed that the number of transmembrane cells decreased significantly(P<0.05)after 48 h with various concentrations of HYXZ;Western blot experiment showed that the expression of JAK/STAT pathway protein decreased significantly(P<0.05);and the expression of its related proteins uPA,HIF1and N-cadherin were inhibited(P<0.05),the tendency of which was consistent with the inhibitor AG490,but opposite to the agonist IL-6.Conclusion HYXZ inhibited JAK/STAT pathway,and associated proteins uPA,HIF1A and N-cadherin,thereby suppressing the mobility and invasiveness of the HTR-8/SVneo cells,which is conductive to clarify the mechanism of HYXZ in the treatment of early EP.

Objective:To explore a method of improving the nursing service ability after total hip arthroplasty (THA) among nurses in villages and towns medical health institutions under the county medical community model and to evaluate its effects.Methods:From June 1 2018 to September 30 2019, we took Department of Orthopedics, Dazhu County People's Hospital of Dazhou of Sichuan Province, as the core, and united with county medical community built by villages and towns medical health institutions with the country in organizing the nursing theoretical knowledge and specialist service ability training after THA for 140 nurses of villages and towns medical health institutions within county medical community. Before and after training, we carried out the theoretical test and practice ability test in trainers, and implemented the consistency analysis in scores of nursing assessment scales for specialist service so as to evaluate the subjective training effect. We also compared the incidence of postoperative complications, functional recovery of hip joint as well as the satisfaction among 30 THA patients before (October 2017 to September 2018) and after (October 2018 to September 2019) training so as to explore the clinical effect.Results:Before and after training, scores of theoretical achievements of nurses of villages and towns medical health institutions were 60 (56, 62) and 82 (79, 85) respectively, and scores of practice ability were 52 (47, 62) and 86 (81, 91) respectively with statistical differences ( P<0.01) . After training, the incidence of postoperative complications was lower than that before training (6.67% vs. 26.67%) ; the postoperative satisfaction, scores of Harris Hip Score (HHS) one month and three months after surgery were higher than those before training [90.00% vs. 66.67%, (73.1±6.00) vs. (57.6±6.67) , (86.6±4.49) vs. (74.5±6.20) ]among 30 THA patients with statistical differences ( P<0.05) . Conclusions:Training with the county medical community model can improve the nursing service ability of nurses in villages and towns medical health institutions among THA patients, postoperative function of hip joint of THA patients as well as patient satisfaction.

Objectives:This study aimed to evaluate the predictive value of the CHA 2DS 2-VASc score for in-hospital outcomes of patients with acute myocardial infarction (AMI). Methods:Data of 23 728 patients from the China patient-centered Evaluative Assessment of cardiac Events (China PEACE)Retrospective Acute Myocardial Infarction Study were analyzed retrospectively. The patients were categorized into 3 groups according to the CHA 2DS 2-VASc scores: the low score group (score 1-3), the middle score group (score 4-6) and the high score group (score 7-9). The in-hospital outcomes included major adverse cardiovascular events (MACE), death, death or withdrawal from treatment, reinfarction, ischemic stroke,etc. The CHA 2DS 2-VASc score was incorporated into multivariate Cox regression analyses to determine its independent impact on in-hospital outcomes. Receiver operating Characteristic (ROC) curves were constructed, and the area under the curve (AUC) was used to evaluate the predictive value of the CHA 2DS 2-VASc score for in-hospital mortality and death or withdrawal from treatment, respectively. Results:The patients had a median age of 66 (56,75) years, and 30.7% of them were females. Patients with higher CHA 2DS 2-VASc scores had a higher in-hospital mortality and more in-hospital complications (all P<0.001). After adjustment of baseline covariates, the subjects in the high score group were associated with high risks of in-hospital mortality ( OR=6.13, 95% CI 4.77-7.87, P<0.001), death or treatment withdrawal ( OR=6.43, 95% CI 5.16-8.00, P<0.001) and MACE ( OR=4.94, 95% CI 4.06-6.01, P<0.001). The AUCs of the CHA 2DS 2-VASc score were comparable with those of the mini-global registry of acute coronary events(mini-GRACE)score in evaluation of in-hospital mortality (0.699 vs. 0.696, P=0.752) and the death or treatment withdrawal risk (0.708 vs. 0.713, P=0.489). Conclusions:The CHA 2DS 2-VASc score is an independent predictor of in-hospital outcomes for patients with AMI. Its predictive value was comparable with the mini-GRACE score, which could be used as a simple tool for early and rapid outcome evaluation for AMI patients.

Objective To assess and compare the incidence,clinical characteristics,treatment,and prognosis of acute heart failure patients from different grades hospitals in Beijing.Methods In this prospective internet prognosis registered study (Beijing AHF Registry),a total of 3 335 consecutive patients admitted to 14 emergency departments in Beijing from January 1st 2011 to September 23rd 2012 were enrolled.According to hospital grade,these patients were divided into two groups,349 patients were from secondary hospitals,and 2 956 patients were from tertiary hospitals.Results Among the 3 335 patients,the medium age was 71 (58,79) years,and male accounted for 53.16％.The most common underlying disease were coronary disease (43.27％),hypertension (17.73％),cardiomyopathy (16.07％) etc.The average treatment time in Emergency Department was 66.82 h.The emergency department mortality rate was 3.81％ (127 cases).The 30-day and 1-year cumulative all-cause mortality were 15.3％ and 32.27％,respectively.The 30-day and 1-year cumulative all-cause readmission were 15.64％ and 46.89％,respectively.Compared with patients in tertiary hospitals,patients in secondary hospitals had more onset acute heart failure patients (63.64％ vs.49.93％),shorter emergency department treatment time (12 h vs.41 h),lower discharge rate (3.43％ vs.37.45％) and emergency department mortality(1.58％ vs.4.09％).Compared with those in tertiary hospitals,1-year cumulative all-cause mortality (25.6％ vs.33.2％),cardiovascular disease mortality (20.2％ vs.26.0％),aggravated heart failure mortality (22.4％ vs.28.8％) were lower in secondary hospitals.Following propensity score matching,compared to tertiary hospitals,patients in secondary hospitals showed lower utilization rate of beta-blockers and ACEFARB (4.51％ vs.28.17％,1.41％ vs.9.58％),except the pironolactone.Conclusion Acute heart failure in emergency department is associated with a high mortality rate and readmission rate.There is still a big gap between guidelines recommend medication current treatments for acute heart failure.