Objective To explore a reasonable,accuracy and effectual proposition model for medical imaging examination.Methods Mean scores and their standard deviation and distribution as well as the difficulty,discrimination,reliability and validity of the test paper were analyzed for the 2005 grade 7-year program students by using SPSS 13.0 statistic software.Results The scores of the 67 copies of test paper displayed a normal distribution,with the mean score of 73.76 and standard deviation of 11.88.The difficulty,reliability and validity indexes of the test paper were 0.74,0.78 and 0.25 respectively.The difficulty,discrimination,reliability and validity indexes of subjective items were higher than those of objective items(0.76 vs.0.73,0.94 vs.0.90,0.71 vs.0.68,0.32 vs.0.22,respectively).Conclusions We should keep quite high proportion of subjective items and make detailed scoring standard in medical imaging examination.Furthermore,as a supplement,objectively items such as multiple choice questions can expand the scope of knowledge examined.

Objective To explore the feasibility and methodology of radiofrequency catheter ablation (RFCA) guided by 3D navigation system (Ensite-NavX) for right atrioventricular accessory pathway.Method Thirty-three cases of right accessory pathway atrioventricular reentrant tachycardia including 16 cases in right free wall,3 in right middle septum,14 in right posterior septum; 23 cases of dominant accessory pathway and 10 cases of concealed were treated by RFCA guided by NavX navigation.NavX navigation modeling method or spatial localization method was exploited to locate target positioning.Result All patients were successfully ablated without serious complications.Among them,25 cases were operated without exposure to X-ray,7 patients were exposed for several seconds to verify catheter position,1 case in right free wall was ablated under X-ray combined with Swartz sheath ablation.Conclusion Nonfluoroscopy or less fluoroscopy RFCA for right atrioventricular accessory pathway with Ensite-NavX is safe and feasible,modeling or spatial orientation method are helpful to locate the ablation target positioning.

Objective To explore the efficacy of sodium valproate and haloperidol in the treatment of Tourette's syndrome in children and the effects on serum levels of insulin-like growth factor 1(IGF-1),neuron specific enolase(NSE)and S100β.Methods Children with Tourette's syndrome were divided into treatment group and control group.Control group was given oral administration of haloperidol 2 mg every time,twice or three times a day for 3 months,treatment group was given oral administration of 20 mg·kg-1·d-1 sodium valproate for every 12 hours,totally treatment for 3 months.The clinical efficacy,Yale Global Tourette Severity Scale(YGTSS),levels of serum IGF-1,NSE and S100β,neurotransmitters,cytokines,and occurrence of adverse drug reactions were compared between the two groups of patients.Results A total of 150 patients were included in this study,including 5 cases of shedding during the trial,thus 73 cases in treatment group and 72 cases in control group were finally enrolled.The total effective rates of treatment in treatment group and control group were 91.78％(67 cases/73 cases)and 79.17％(57 cases/72 cases),with significant difference(P＜0.05).The scores of motor tic of YGTSS in treatment group and control group after treatment were(9.79±1.73)and(11.05±2.18)points;the vocal tic scores were(10.52±2.06)and(11.37±2.24)points;the total scores of YGTSS were(20.31±2.57)and(22.42±2.57)points;serum levels of IGF-1 were(60.37±3.29)and(58.04±3.16)μg·L-1;levels of NSE were(95.26±10.19)and(101.81±10.54)ng·L-1,S100β levels were(83.69±10.33)and(87.05±9.76)ng·L-1;levels of 5-HT were(59.05±5.69)and(61.37±5.52)ng·mL-1;levels of GABA were(2.37±0.32)and(2.04±0.39)ng·mL-1;levels of NE were(32.85±4.63)and(29.24±4.02)ng·mL-1;levels of IL-6 in were(19.05±2.97)and(21.31±4.01)ng·mL-1,all with significant difference(all P＜0.05).The recurrence rate in treatment group and control group were 16.44％(12 cases/73 cases)and 23.61％(17 cases/72 cases),with no significant difference(P＞0.05).There was no significant difference in the incidence of adverse drug reactions between the two groups(P＞0.05).Conclusion Compared with haloperidol,sodium valproate has higher effective rate in the treatment of children with Tourette's syndrome,and it can better relieve the clinical symptoms,improve the neurological function,and help to reduce the levels of serum IGF-1,NSE,S100βand inflammatory factors.

OBJECTIVETo observe the effect of the estrogen on the mRNA expression of osteoprotegerin (OPG), osteoclast differentiation factor (ODF) and macrophage colony stimulating factor (M-CSF) in bone tissue of ovariectomized rats, and investigate the possible pathway of estrogen in preventing and treating postmenopausal osteoporosis. METHODS; Thirty healthy adult SD rats were randomly divided into sham operation group, ovariectomized group and estrogen-treated group. All rats were ovariectomized except those in the sham operation group. Bone density of the L3-L6 vertebra was detected 12 weeks after the operation. The total RNA were extracted from the femur to examine mRNA expression of OPG, ODF and M-CSF by real-time PCR.

RESULTSEstrogen increased the bone density of the ovariectomized rat lumbar vertebra and up-regulated the expression of OPG, whereas down-regulated the expression of M-CSF and lowered ODF:OPG ratio.

CONCLUSIONThe effect of estrogen in treating postmenopausal osteoporosis is closely correlated with the regulation of OPG and M-CSF expressions and ODF:OPG ratio.

Animals ; Bone and Bones ; metabolism ; Estrogens ; pharmacology ; therapeutic use ; Female ; Macrophage Colony-Stimulating Factor ; biosynthesis ; genetics ; Osteoporosis ; drug therapy ; Osteoprotegerin ; biosynthesis ; genetics ; Ovariectomy ; RANK Ligand ; biosynthesis ; genetics ; RNA, Messenger ; biosynthesis ; genetics ; Rats ; Rats, Sprague-Dawley

Animals ; Antibodies, Monoclonal ; immunology ; Atrazine ; analysis ; immunology ; Chromatography, Gas ; Chromatography, High Pressure Liquid ; Enzyme-Linked Immunosorbent Assay ; Food Contamination ; analysis ; Herbicides ; analysis ; immunology ; Mass Spectrometry

OBJECTIVETo study the effect of Shenfu Injection (SF) on the apoptosis of prostate cancer PC-3 cells and its possible mechanism.

METHODSWe divided prostate cancer PC-3 cells into a blank control group and three experimental groups, the latter treated with SF at 50, 100, and 200 microl/ml, respectively, for 24, 48, and 72 hours. Then we determined the proliferation of the cells by MTT assay, measured their apoptosis by Annexin V/PI flow cytometry, and detected the expression of P53 mRNA by RT-qPCR.

RESULTSCompared with the blank control group, the survival rates of the prostate cancer PC-3 cells in the 50, 100, and 200 microl/ml SF groups were (93.76 +/- 2.63)%, (81.21 +/- 1.80)% and (18.01 +/- 3.84)% at 24 hours, (94.67 +/-1.11)%, (78.33 +/- 2.89)% and (10.34 +/- 1.44)% at48 hours, and (91.30 +/- 0.47)%, (36.67 +/- 1.56)% and (1.33 +/- 0.32)% at 72 hours, all significantly increased in a dose- and time-dependent manner (P < 0.05). The expression of p53 mRNA was also markedly increased in all the three experimental groups at 48 hours (P < 0. 05).

CONCLUSIONSF can inhibit the proliferation and induce the apoptosis of PC-3 cells, which may due to its upregulation of the p53 mRNA expression.

Apoptosis ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Male ; Prostatic Neoplasms ; metabolism ; pathology ; Tumor Suppressor Protein p53 ; metabolism

BACKGROUNDAlthough bronchoscopy has been widely performed in China, little has been known about its current state and development. In order to investigate the clinical application of bronchoscopy and make instructions for future education and development, the Chinese Society of Respiratory Diseases conducted postal surveys in both 2008 and 2010 in China.

METHODQuestionnaires were sent to 40 tertiary grade A hospitals in 2008 and 58 tertiary grade A hospitals in 2010 to investigate bronchoscopies performed in 2007 and 2009 respectively.

RESULTSThirty (75%) hospitals returned the completed questionnaires in 2008 and forty-one (71%) hospitals in 2010. All the respondents possessed flexible bronchoscopes. Fifty percent of the respondents had less than five in 2007, while more than 50% of the respondents had 5-9 bronchoscopes in 2009. All the respondents performed a radiograph or CT scan before bronchoscopy. Percentage of general anesthesia and no pre-medication before bronchoscopy increased, while atropine usage decreased in 2009 compared to 2007. During bronchoscopy, pulse oximetry was the most widely used monitoring method. Most respondents used the nasal route to perform routine bronchoscopy. After the procedure, they used sinks to wash and glutaraldehyde to disinfect the bronchoscopes. The total number of flexible bronchoscopies performed during 2007 was 37 874 and the average was 1262. Whereas in 2009, the total number was 60 178 and the average was 1468. Diagnostic bronchoscopy was more widely used than therapeutic bronchoscopy. The mortality rate was 0.076‰ in 2007 and 0.032‰ in 2009.

CONCLUSIONSThe two surveys, to some extent, reflected the current status and development of bronchoscopy in China. The results are worthy of future education and developing of new guidelines. Regular surveys and monitoring of bronchoscopies across China are needed.

Bronchoscopy ; methods ; utilization ; China ; Hospitals ; statistics & numerical data ; Humans ; Surveys and Questionnaires

We herein report the case of a 50-year-old woman who presented with persistent fever and a large mass in her right breast. Haematology, liver function, and other blood test results were abnormal. Computed tomography and positron emission tomography indicated that the lesion had spread to multiple organs. Immunohistochemical staining confirmed that the patient had plasmablastic lymphoma, an invasive and rare form of diffuse large B-cell lymphoma, and an underlying infection by the Epstein-Barr virus. After three rounds of CHOPE chemotherapy, followed by hyperCVAD and ESHAP, the patient achieved rapid and complete remission. This case is unusual in that the patient presented with a large breast mass and her recovery was extremely rapid.
Antineoplastic Combined Chemotherapy Protocols ; Breast Neoplasms ; diagnosis ; pathology ; Cyclophosphamide ; administration & dosage ; Doxorubicin ; administration & dosage ; Epstein-Barr Virus Infections ; diagnosis ; Female ; Glucocorticoids ; administration & dosage ; Herpesvirus 4, Human ; Humans ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; drug therapy ; Middle Aged ; Remission Induction ; Tomography, X-Ray Computed

Objective To construct an artificial intelligence assisted diagnosis model based on deep learning for dynamically recognizing gastric lesions and their locations under gastroscopy in real time,and to evaluate its ability to detect and recognize gastric lesions and their locations.Methods The gastroscopy videos of 104 patients in our hospital was retrospectively analyzed,and the video frames were manually annotated.The annotated picture frames of lesion category were divided into the training set and the validation set according to the ratio of 8∶2,and the annotated picture frames of location category were divided into the training set and the validation set according to the patient sources at the ratio of 8∶2.These sets were utilized for training and validating the respective models.YoloV4 model was used for the training of lesion recognition,and ResNet152 model was used for the training of location recognition.The accuracy,sensitivity,specificity,positive predictive value,negative predictive value and location recognition accuracy of the auxiliary diagnostic model were evaluated.Results A total of 68 351 image frames were annotated,with 54 872 frames used as the training set,including 41 692 frames for lesion categories and 13 180 frames for location categories.The validation set consisted of 13 479 frames,comprising 10 422 frames for lesion categories and 3 057 frames for location categories.The lesion recognition model achieved an overall accuracy of 98.8%,with a sensitivity of 96.6%,specificity of 99.3%,positive predictive value of 96.3%,and negative predictive value of 99.3% in validation set.Meanwhile,the location recognition model demonstrated an top-5 accuracy of 87.1% .Conclusion The artificial intelligence assisted diagnosis model based on deep learning for real-time dynamic recognition of gastric lesions and their locations under gastroscopy has good ability in lesion detection and location recognition,and has great clinical application prospects.

BACKGROUNDBacteria-induced respiratory infection has been long considered to be the major cause of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Therefore, a clear picture about the distribution and drug-resistance of pathogenic bacteria in the lower airways should be helpful for treatment of the disease. So far, data on this topic among Chinese are lacking.

METHODSA surveillance study was performed in consecutive patients with AECOPD at five areas in China between October 2006 and April 2008. The sputum from these patients was cultured and isolated for bacteria. Agar dilution method was used to determine the minimal inhibitory concentrations (MICs) of levofoxacin and other 15 antibiotics against these strains.

RESULTSThree hundred and fifty-nine pathogenic bacterial strains were isolated among 884 patients with AECOPD. The predominant bacteria were Pseudomonas aeruginosa (21.7%), Klebsiella pneumoniae (12.3%), Haemophilus influenzae (14.2%) and Streptococcus pneumoniae (11.7%), followed by Haemophilus parainfluenzae (9.5%), Acinetobacter baumannii (7.8%), Moraxella catarrhalis (6.4%) and Escherichia coli (3.6%). The majority of bacterial pathogens isolated in this study were susceptible to fuoroquinolones, ceftazidime, cefepime and imipenem.

CONCLUSIONSGram-negative bacilli are the leading pathogens in patients with AECOPD in China. Haemophilus parainfluenzae may be one of the most important pathogens in AECOPD. This study provides evidence for local surveillance of AECOPD pathogens and appropriate choice of antimicrobials in China.

Acute Disease ; Aged ; Bacteria ; drug effects ; Drug Resistance, Bacterial ; Female ; Humans ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Pulmonary Disease, Chronic Obstructive ; complications ; microbiology