Objective To investigate the clinical significance of γ-interferon release test (IGRA) in the diagnosis of entry-exit people with tuberculosis.Methods A total of 64 patients with tuberculosis and 46 healthy people were detected by IGRA,tuberculin skin test (TST),LAM,38× 103 and 16 × 103.The results of different methods were compared and analyzed.Results The sensitivity of IGRA detection method (88.9 ％) and specificity (95.8 ％) were both higher,while the sensitivity (92.7 ％) of the TST method was higher and the specificity (76.7 ％) was lower.Conclusion The sensitivity and specificity of IGRA in the detection of tuberculosis are higher,and it has important clinical application value.

Objective To explore factors affecting long-term compliance to weight management (WM) of patients with congestive heart failure (CHF)and to provide evidence for improving patients' compliance.Methods In-depth semi-structured interviews based on reinforcement theory were conducted among 18 CHF patients who received WM intervention over 6 months.The data were analyzed by Colaizzi analysis program.Results Three themes were found:precipitating factors such as the correct perception of disease and self-efficacy,the factors of positive reinforcement such as early gains from WM,readmission,follow-up,family and social support,as well as the factors of negative reinforcement such as gaining nothing during long period,physical and mental disorders.These above factors made long-term compliance to WM of 50％ of the participants dynamic and fluctuant.Conclusions Medical staff should identify patients'compliance at different stages in time during follow-up,analyze the factors that affect their compliance,and then grasp the optimal timing of intervention to perform targeted,multiform and multiple health education to improve compliance.

Purpose To explore the diagnostic value of double exponential model for pelvic lesions using 3.0T MRI for the diagnosis of pelvic lesion. Materials and Methods Fifty patients with pelvic lesions (30 benign cases and 20 malignant cases) underwent MR750-diffusion weighted imaging (DWI) scans, with b values of 0, 50, 300, 600, 800 and 1200 s/mm2, Functool-MADC software was used on AW 451 workstations for data processing, Slow ADC value, Fast ADC value, Standard ADC value, Fraction of fast ADC value were recorded and compared between benign and malignant lesions, and Standard ADC images were fused with axial T2 fat-suppressed images. Results Slow ADC values [(1.83±0.86)×10-3 mm2/s] and Standard ADC values [(1.79±0.78)×10-3 mm2/s] of benign lesions were larger than those of the malignant lesions [Slow ADC values:(1.05±0.31)×10-3 mm2/s;Standard ADC values:(1.13±0.39)×10-3 mm2/s] (t=3.90, 3.51;P<0.01), and the difference of Slow ADC value was largest between benign and malignant lesions. Slow ADC values of both benign and malignant lesions were significantly less than the Fast ADC values [benign:Slow ADC value=(1.83±0.86)×10-3 mm2/s, Fast ADC value=(16.95±8.63)×10-3 mm2/s; malignant: Slow ADC value=(1.05±0.31)×10-3 mm2/s, Fast ADC value=(15.12±9.90)×10-3 mm2/s] (t=-10.40,-6.29;P<0.01). Conclusion Double exponential decay model is capable of differentiating benign and malignant pelvic tumors, thus is of great significance for clinical preoperative diagnosis.

Objective To investigate the clinical pathological features and imaging findings of primary pulmonary sarcomatoid carcinoma. Methods Fifteen patients with a pathologically verified primary pulmonary sarcomatoid carcinoma were reviewed retrospectively. Fourteen patients had CT examinations and I0 of them had contrast-enhanced CT scan. Nine patients had chest plain films. Results Of 15 patients, 14 were peripheral and 1 was central, diameters ranging from 2.5 cm to 9.5 cm. Five located in the upper, 3 in the middle and 4 in the lower lobe of the right lung. The other 3 located in the upper left lobe. All cases presented with a spheroid solid lung mass on chest plain film and CT examinations. Three had irregular eccentric cavities. Six were well demarcated, 2 were ill defined, 4 were lobulated and 3 were speculated. The central case had obstructive pneumonia and showed ill defined. Ten showed irregular peripheral heterogeneous contrast enhancement. The center part of the tumor showed no enhancement or inhomogeneous enhancement. Seven had thoracic wall or pleural invasion, 4 had hilar or mediastinal lymphopathy and 2 had metastasis. Histopathologically, 8 were pleomorphic carcinoma, 2 were spindle cell carcinoma, 3 were giant cell carcinoma and 3 were pulmonary blastomas. Conclusion The X-ray and CT findings of the primary pulmonary sarcomatoid carcinoma are not specific. The clinicopathologic features were the evidence of diagnosis.

Objective To analyze the dielectrophoresis patterns of the proteome of the Rifampin-dependent and-resistant stains of Mycobacterium tuberculosis,to search and identify the differently expressed proteins,and to provide the proteomic basis for researching the mechanism of anti-tuberculosis drug dependence of M.tuberculosis.Methods The whole somatic proteins were extracted from two strains of M.tuberculosis.The first dimensional ampholine electrophoresis was performed on immobilized pH gradient(IPG) rod gels(pH 4-7).Then the proteins on IPG strips were separated using SDS-PAGE.The stained gels were scanned with image scanner and the images were analyzed by Imagemaster 2D software.The differentially expressed proteins were detected by matrix-assisted laser desorption/ionization time of flight mass spectrometry(MALDI-TOF-MS).Results Seven hundred and fifty-three spots were detected in Rifampin-dependent strain of M.tuberculosis,while 584 spots were detected in Rifampin-resistant strain,including 404 match spots(the match rate: 61.5%).As to the expression in Rifampin-dependent strain,7 spots significantly up-regulated and 35 spots down-regulated,6 spots were absent in expression,and 5 spots expressed separately,most of the spots were small molecular proteins.Ten spots were selected to run MS analysis.Nine spots were identified as representing 7 proteins.Conclusion The Rifampin-dependent strain of M.tuberculosis is characterized by a rapid and vigorous growth mainly by means of the differential expression of enzymes related to energy metabolism and fatty acid biosynthesis.

Objective To observe the protective and anti-apoptosis effects of Rannasangpei (RNSP) on brain ischemia and reperfusion injury in rats. Methods Middle cerebral artery occlusion (MCAO) model was established and the groups were divided as sham group, MCAO group, vehicle + MCAO group and RNSP + MCAO group. Neuronal deficient signs, brain infarct area, the ratio of Bcl-2/Bax and the expression of caspase-3 were evaluated by neuronal deficient score, TTC (2,3,5-Triphenyltetrazolium chloride) staining and Western blot respectively. Results Compared with those parameters in sham group, the neuronal deficient signs, infarct area and caspase-3 expression increased evidently while the ratio of Bcl-2/Bax decreased markedly in MCAO group. But in RNSP+MCAO group, the neuronal deficient signs, infarct area and cas?pase-3 expression decreased greatly while the ratio of Bcl-2/Bax increased markedly compared with those parameters in MCAO group. Conclusion RNSP may have protective effects on brain ischemia and reperfusion, which is related to its an?ti-apoptosis role indicated by upregulation of Bcl-2/Bax ratios and downregulation of caspase-3.

Objective:To analyze the diagnostic value of thickness ratio between noncompacted and compacted myocardium (NC/C ratio) measured by echocardiography at end-systole and end-diastole comparatively in left ventricular noncompaction (LVNC).Methods:Thirty-five patients with suspected LVNC were collected and underwent conventional (2DE) and left ventricular opacification (LVO) in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from June 2019 to June 2020. The distribution and detection rate of two-layered segments, non-compaction (NC) segments and their NC/C ratios were comparatively analyzed at end-diastole and end-systole using 2DE, LVO and combined techniques respectively. With the diagnostic criteria of end-diastolic NC/C ratio>2.3 or end-systolic NC/C ratio>2.0, echocardiographic results were also recorded and compared with cMRI results.Results:Compared with 2DE, the number of detected segments was increased ( P<0.001), but the numbers of two-layered segments and NC segments were not significantly improved in end-systole using 2DE combined with LVO ( P>0.006). The diagnostic accuracy was not statistically significant ( P>0.05). However, when observing in end-diastole, the detected numbers of 3 kinds of segments were significantly increased using 2DE+ LVO in comparison with 2DE (all P<0.001), and the diagnostic accuracy was also significantly improved ( P<0.05). There were no significant differences in the detected rates of two-layered and NC semgents between 2DE+ LVO and cMRI ( P>0.006). 2DE+ LVO in end-diastole resulted in the highest diagnostic sensitivity (88.9%) and accuracy (85.7%), and also the largest area under ROC curve (0.95). Conclusions:The combination of 2DE and LVO can detect more NC segments, and diagnostic accuracy of end-diastolic NC/C ratio is higher than that in end-systolic in patients with LVNC.

Objective To improve the protocols of red blood cells ( RBCs) processing devices ( automatic medical RBC centrifuge, type:BBS926).Methods RBCs separated from 400 ml of whole blood collected from healthy donors were frozen at -80℃.After thawing , the cells were processed by the washing device .Based on the original protocol ( protocol 1), a modified protocol (protocol 2) was established and used to evaluate the quality of the frozen RBCs .In the test group (protocol 2), the amount of washing buffers and the washing steps were revised to form the optimized protocol .RBCs processed with the two protocols were evaluated by different assays .Results The indexes from the standards for frozen-thawed RBCs: the amount of hemoglobin ( Hb) of RBCs from protocol 1 and protocol 2 was 37.55 ±3.58 and 42.18 ±3.35 g(P<0.05),respectively;the amount of free hemoglobin(FHb) was 0.51 ±0.08 g/L and 0.53 ±0.07 g/L (P>0.05);the residual amount of white blood cells (WBCs) was (1.90 ±0.99) ×107 and (1.92 ±1.04) ×107(P>0.05);The osmolarities were 334 ±8.03 mOsm and 327 ±9.06 mOsm(P>0.05);both the bacteria and fungi tests were negative for the RBCs processed with the two protocols .Among other indexes ,the hemolysis rate for RBCs from protocol 1 and protocol 2 was (12.44 ±8.24)%and (12.02 ±5.78)%(P>0.05), the deformation index was 21.40 ±1.41 and 21.42 ±1.45 (P>0.05), the RBC recovery was(72.02 ±3.70)%and (77.18 ±5.58)%(P<0.05),the cell apopto-sis rate was(1.12 ±0.54)%and (1.10 ±0.61)%(P>0.05),and the processing time was (79.00 ±0.71)min and (79.60 ±0.55)min (P>0.05).Conclusion The RBCs processed by the two protocols meet the national standards for frozen-thaw RBCs.Hb amounts and cell recoveries of the RBCs are enhanced by treatment with protocol 2.Protocol 2 proves to be better than protocol 1.

Objective:To investigate the efficacy of liraglutide combined with enpagliflozin in the treatment of obesity complicated by type 2 diabetes mellitus.Methods:A total of 160 obesity patients with type 2 diabetes mellitus who received treatment in Yuyao People's Hospital, China between October 2018 and October 2019 were included in this study. They were randomly assigned to receive repaglinide, insulin detemir and metformin in combination (control group, n = 80) or liraglutide, enpagliflozin and metformin in combination (treatment group, n = 80). After 3 months of treatment, fasting blood glucose, glycosylated hemoglobin, 2-hour postprandial blood glucose, body mass index, tumor necrosis factor-alpha, C-reactive protein, interleukin-6, leptin, adiponectin, and vaspin as well as the incidence of adverse reactions were compared between the control and treatment groups. Results:After treatment, fasting blood glucose, glycosylated hemoglobin, 2-hour postprandial blood glucose and body mass index were reduced in each group. They were (7.89 ± 1.02) mmol/L, (8.10 ± 1.25) %, (11.10 ± 1.59) mmol/L, (23.18 ± 2.19) kg/m 2, respectively in the observation group, which were significantly lower than those in the control group [(9.88 ± 1.27) mmol/L, (11.20 ± 1.85)%, (13.67 ± 2.01) mmol/L, (27.80 ± 2.51) kg/m 2, t1 = 10.927, t2 = 12.418, t3 = 8.969, t4 = 12.405, all P < 0.001). After treatment, tumor necrosis factor-alpha, C-reactive protein and interleukin-6 levels were reduced in each group. Their levels in the observation group were [(51.19 ± 3.19) pg/L, (2.14 ± 0.31) mg/L, (4.07 ± 0.67) pg/L, respectively, which were significantly lower than those in the control group [(62.18 ± 4.10) pg/L, (3.66 ± 0.58) mg/L, (5.96 ± 0.81) pg/L, t1 = 18.922, t2 = 20.672, t3 = 8.969, all P < 0.001). After treatment, leptin and vaspin levels were reduced in each group, and their values in the observation group were (5.48±0.94) μg/L, (1.62 ± 0.37) μg/L, respectively, which were significantly lower than those in the control group [(6.59 ± 0.82) μg/L, (1.99 ± 0.52) μg/L, t1=7.959, t2=10.323, both P < 0.001]. Adiponectin level increased in each group, and it was significantly higher in the observation group than in the control group [(7.13 ± 1.52) mg/L vs. (5.12 ± 0.85) mg/L, t3 = 5.185, P < 0.001]. There was no significant difference in the incidence of adverse reactions between control and observation groups ( χ2 = 0.313, P > 0.05). Conclusion:Liraglutide combined with enpagliflozin for the treatment of obesity complicated by type 2 diabetes mellitus is highly effective. It can effectively lower blood glucose level, reduce body mass and inflammatory reactions, further regulate serum vaspin, leptin and adiponectin levels and is highly safe. Therefore, this method can be widely used in the clinic.

Objective To investigate the clinical manifestations, diagnosis, and treatment of H1N1 influenza A‐associated encephalopathy (IAE) in children. Methods The clinical manifestations, laboratory tests, cranial magnetic resonance imaging (MRI), electroencephalography (EEG) examinations and treatments of seven children with H1N1 IAE hospitalized in Guangzhou Women and Children′s Medical Center from December 2018 to January 2019 were retrospectively analyzed. Results Five of the seven children with H1N1 IAE were female. The age at admission was 4 years and 5 months (range 7 months-9 years). Neurological symptoms occurred simultaneously or early (0-3 days) after the flu‐like symptom appeared. The main clinical manifestations of neurological symptoms were seizures (repeated seizures in five cases and status convulsion in two cases, including one case of unexpected fever and repeated seizures in a nine‐year old girl) accompanied with altered consciousness (drowsiness in five cases and coma in two cases). Cranial MRI in three cases displayed multifocal lesions, mainly in the bilateral thalamus, brainstem and cerebellar hemisphere. MRI also showed reversible splenial lesion in the corpus callusumin in three cases. EEG tracings were characterized by diffuse slow wave activity in four cases, and status epilepticus was monitored in one case. All the 7 cases were treated with oral oseltamivir. Three cases were treated with pulsed methylprednisolone and intravenous immunoglobulin. One case was treated with intravenous immunoglobulin alone and all the patients received oral oseltamivir. All the patients survived, with three patients had minor neurological sequelae at discharge. Conclusions The main clinical manifestations of H1N1 IAE are seizures and altered consciousness. Cranial MRI combined with EEG is helpful for early diagnosis. Intravenous immunoglobulin and (or) methylprednisolone should be considered for severe cases.