Objective To explore and evaluate the predictive value of the coagulopathy in patients with community-acquired pneumonia (CAP).Methods A retrospective study was carried out for investigating the prothrombin time (PT),activated partial thromboplastin time (APTT),plasma fibrinogen (FIB),thrombin time (TT),plateslets (PLT),D-dimer in 385 patients with CAP and 146 patients without infection,tumor,trauma,thrombosis as controls.All the patients were admitted to the Respiratory Medical Department from June,2010 to May,2011.The results of the aforementioned biomarkers were analyzed and compared between two groups.The Pneumonia Severity Index (PSI) was calculated to evaluate the correlation between coagulopathy and PSI.Results The comparisons of the abnormal rates of PLT,PT,APTT,Fib,D-dimer between the patients with CAP and the controls were 92/385 vs.9/146,39/385 vs.1/146,108/385 vs.7/ 146,331/385 vs.47/146,348/385 vs.5/146,respectively.The differences were statistically significant (x2 =21.608,13.557,33.747,149.280,365.619,respectively,P ＜ 0.01),while difference in TT was not statistically significant (8/385 and 0/146,x2 =1.839,P ＞ 0.05).The differences in abnormal rate of PLT,PT,D-dimer between high-risk group of CAP and the low-risk group of CAP were 45/148 vs.47/237,26/148 vs.13/237,146/148vs.202/237,respectively,and the differences were statistically significant (x2 =5.602,14.609,23.442,respectively,P ＜0.05),while there were no differences in TT,APTT,FIB between two groups (6/148 vs.2/237,47/148 vs.61/237,123/148 vs.208/237,x2 =4.614,1.635,1.638,respectively,P ＞0.05).D-dimer in patients with CAP was (3.8 ±6.1) mg/L,compared with the controls (0.3 ±0.1) mg/L,and D-dimer in high-risk patients with CAP was (7.5 ±8.3) mg/L compared with the low-risk group (1.6 ±2.0) mg/L (P ＜ 0.001).Rank correlation existed between D-dimer and PSI (r =0.798,P ＜ 0.01),while there was no correlation between PLT and PSI (x2 =6.040,P ＞0.05).Conclusions The coagulopathy commonly occurs in patients with CAP.D-dimer was significantly higher in patients with CAP.D-dimer level is positively correlated with severity of CAP.D-dimer can be an ideal biomarker to assess the severity of patients with CAP.

To investigate the protective effects of Naoshuantong, a compound traditional Chinese herbal medicine, on the main components of neurovascular unit in rats with cerebral ischemia/reperfusion injury.

Objective To observe the effect of isolating and harvesting the chondrocytes from rabbits rib cartilage with the method of three-step enzymatic digestion, and the biological characteristic of the isolated chondrocytes during cultivation in vitro to evaluate their biological activity. Methods The method of three-step enzymatic digestion was designed that the rib cartilage was digested one by one with 1 g/L trypsin and 1 g/L EDTA, 1 g/L hyaluronidase and 2 g/L collagenaseⅠ in the culture medium to isolate chondrocytes. The harvesting and viability rate of the primary chondrocytes were detected. During the passage cultivation in vitro, the changes of the chondrocyte shape and growth were observed, and the changes of the collagen typeⅠ and Ⅱ and aggrecan in the extracellular matrix were detected. Results ① The extracellular matrix of rib cartilage was completely dissolved by the three-step enzymatic digestion, and the chondrocytes were completely isolated from the solid matrix. The number of the harvested chondrocytes from every gram of wet cartilage was (4 295.7)?10~(4) on average,and their viability rate was 97.2% on average. ②The primary and first passage chondrocytes had triangle or multi-angle shape, and became elliptic shape at the growing confluence with the positive immunohistochemical staining of collagen type Ⅱ and the strong heterochromia to toluidine blue. The content of sulfate glycosaminoglycans(GAG) in the extracellular matrix of the primary passage cells was (80.61?11.40) ?g/cm~(2). The chondrocytes after the third passage gradually became spindle shape with the negative staining of collagen typeⅡ and the weak heterochromia to toluidine blue. The content of sulfate GAG of the fourth passage cells was (44.74?10.18) ?g/cm~(2). Conclusion ① The method of three-step enzymatic digestion can make the extracellular matix of rib cartilage to be completely degraded, and has advantages of the high efficiency of harvesting primary chondrocytes with high cellular viability rate and simple manipulation. ②The primary and first passage chondrocytes have fine biological activity.

Purpose To evaluate the clinical value of triple-rule-out (TRO) computed tomographic angiography using adaptive prospective ECG triggering for chest pain patients.Materials and Methods Sixty patients with chest pain were prospectively collected and randomly divided into group A and group B:group A (n=30) performed prospectively gated axial scan and group B (n=30) performed retrospectively gated helical scan.The vascular density,noise and muscle density of the vessels including aorta,pulmonary artery,coronary artery between the two groups were measured and analyzed.The vascular density/noise ratio,contrast noise ratio and effective dose (ED) between the two groups were calculated.The image quality and scanning radiation dose were compared between the two groups.Results There was no significant difference in the image quality of aorta,pulmonary artery and coronary artery between group A and group B (P＞0.05).The ED in group A was lower than that in group B [(5.90±2.10) mSv vs (11.31 ± 2.12) mSv,P＜0.01].Conclusion The technique of TRO computed tomographic angiography triggered by adaptive prospective ECG can significantly reduce the radiation dose while ensuring image quality.

Objective To evaluate the value of medical treatment in the management of SAP.Methods From January 2000 to December 2011,a total of 1064 cases out of 931 SAP patients were admitted and retrospectively analyzed.The etiologies,severity score,complication rates,therapies,effectiveness and costs of those SAP cases were summarized.Results There were 559 males and 372 females with a mean age of (51 ± 15)years old.The main cause was biliary tract disease (58.3％),followed by fat-rich diet (31.2％),hyperlipidemia (13.6％) and alcohol (7.1％).At the time of admission,95.5％ of SAP patients presented with level D disease according to Balthazar CT severity index,26.0％ had a Ranson score ≥3 and 30.1％ had an APACHE Ⅱ score ≥ 8.There were 42.7％ cases complicated with systemic inflammatory response syndrome (SIRS).Acute lung injury and acute respiratory distress syndrome (ARDS),acute kidney injury,shock or heart failure,acute liver dysfunction,and diffuse intravascular clotting (DIC)occurred in 24.0％,8.1％,5.4％,3.2％,and 1％ of all patients,respectively.Other complications of SAP included abdominal cavity bleeding (n =17),pseudocyst bleeding (n =9),pancreatic abscess (n =78) and gastrointestinal fistula (n =33).Totally 25 (2.3％) patients died in hospital and 36 (3.4％) patients were discharged against advice,with an overall treatment success rate of 94.3％.The mean hospital stay was (23.7 ± 19.2) d,and the average cost was 52.3 thousands of RMB.Conclusions A comprehensive treatment pathway relying on medical treatment,focusing on organ function support and assisted by miniinvasive intervention may improve the treatment success rate of SAP,which is worth of further application.

Objective: To analyze the normal value of the iodine content in the left ventricular myocardium of healthy subjects and to observe if there is a segmental differences on iodine distribution by using the second generation dual-source dual-energy computed tomography myocardial first perfusion imaging. Methods: In this retrospective study, 42 healthy subjects, who admitted to our department between January to June 2016, with normal second generation dual-source dual-energy computed tomography and coronary CT angioghphy (CTA), electrocardiogram (ECG) results, normal cardiac, hepatic, renal function, normal myocardial enzymes results were enrolled, data from 38 out of 42 subjects with satisfactory image quality were analyzed using Siemens Dual Energy-Heart PBV image processing software.In accordance with the standards of the American Heart Association myocardial 17 fractionation method, content of iodine was measured at different segmental left ventricular myocardium and aorta (left coronary artery from the opening level). The standardized containing iodine value (nIC) was calculated. Results: The iodine content of left ventricular myocardium in normal subjects was 3.1-7.8 mg/ml.The nIC of myocardium from 1st to 17th segments was 0.28±0.06, 0.31±0.07, 0.30±0.07, 0.30±0.04, 0.28±0.04, 0.29±0.05, 0.29±0.01, 0.30±0.07, 0.31±0.07, 0.27±0.06, 0.28±0.08, 0.28±0.07, 0.29±0.08, 0.31±0.07, 0.27±0.06, 0.29±0.06 and 0.21±0.07, respectively.The nIC of the 17th segment was the lowest and was significantly lower than in other segments (all P<0.05), the nIC was similar among the rest 16 segments (all P>0.05). Conclusion The normal iodine content range in left ventricle myocardium is 3.1-7.8 mg/ml, and the lowest iodine content is detected in the apex and which is significantly lower than the other left ventricular segments.

Objective:To investigate the clinical efficacy of Yiqi Yangyin decoction combined with metformin and irbesartan in treating type 2 diabetes complicated by hypertension with qi and yin deficiency syndrome. Methods:A case-control study was performed to retrospectively analyze the clinical data of 92 patients with type 2 diabetes complicated by hypertension with qi and yin deficiency syndrome. These patients received treatment at the First People's Hospital of Huzhou from February 2021 to April 2023. They were divided into two groups, with 46 patients in each group, based on different treatment methods. The control group received metformin and irbesartan, while the observation group was treated with Yiqi Yangyin decoction in addition to the treatment provided to the control group. Both groups underwent treatment for 1 month. The clinical efficacy of the two groups was evaluated, and the changes in traditional Chinese medicine symptom scores, blood glucose levels, blood pressure, and the occurrence of adverse reactions were compared between the two groups before and after treatment. Results:The total response rate of the observation group was 93.48% (43/46), which was significantly higher than that of the control group [82.61% (38/46), χ2 = 5.63, P < 0.05). After treatment, the traditional Chinese medicine symptom score for the observation group was (9.43 ± 2.11) points, which was significantly lower than that of the control group [(12.11 ± 2.32) points, t = 11.34, P < 0.001]. The fasting blood glucose, 2-hour postprandial blood glucose, and glycosylated hemoglobin levels in the observation group were (7.51 ± 1.34) mmol/L, (9.06 ± 2.11) mmol/L, and (6.23 ± 0.76)%, respectively, all of which were significantly lower than those in the control group [(8.75 ± 2.12) mmol/L, (11.15 ± 2.43) mmol/L, (7.11 ± 1.02)%, t = 4.13, 6.14, 4.01, all P < 0.05]. The systolic blood pressure in the observation group was (125.48 ± 8.14) mmHg (1 mmHg = 0.133 kPa), which was significantly lower than that in the control group [(131.32 ± 9.22) mmHg, t = 6.76, P < 0.001]. The difference in the incidence of adverse reactions between the two groups was not statistically significant ( P > 0.05). Conclusion:Yiqi Yangyin decoction combined with metformin and irbesartan is highly effective in treating type 2 diabetes complicated by hypertension with qi and yin deficiency syndrome. This combined therapy can effectively lower the traditional Chinese medicine symptom score, improve patients' blood glucose and blood pressure levels, and has a low incidence of adverse reactions.

Objective To explore the risk,diagnosis,treatment and prognosis of newborns suffering from congenital latent tuberculosis infection (CLTBI) by vertical transfer of mycobacterium tuberculosis(VTRTB) from mothers with active tuberculosis (TB) mothers during pregnancy.Methods The clinical data of 7 children with CLTBI follow-up of 1-6 years in Children's Hospital of Nanjing Medical University and 2 cases from literatures were reviewed,and they were divided into simple CLTBI group (n =5) and active TB group (n =4).Combined with the maternal history,the epidemiology,clinical features,treatment,prognosis and relative factors of the children were analyzed.Results Eight mothers had active TB during pregnancy,and premature delivery rate and low birth weight rate were 55.56％ (5/9 cases) respectively.The positive conversion rates of purified protein derivative tests (PPD),acid-fast bacilli (AFB) and TB culture were 6/9 cases,0/9 cases and 1/9 cases,respectively.Positive results of T cell enzyme-linked immunospot tuberculous test (T-SPOT.TB) and TB-DNA by fluorescent quantitative polymerase chain reaction (FQ-TB-DNA) were detected in 4 cases respectively,1 of 3 patients with T-SPOT.TB and 1 of 3 patients with FQ-TB-DNA were positive.There were 5 cases with chemoprophylaxis of anti-TB drugs for 1-6 years with isonicid or rifampicin;3 cases with pulmonary hilar or mediastinal lymph nodes enlargement,and 3 cases with pulmonary diffuse punctate,nodular or patchy high density shadow in 3 cases;the rate of VTRTB in 9 cases was 8/9 (88.89％) based on laboratory examination of etiology and immunology,and the risk of active TB in infants and early childhood was close to 50％ in neonates with CLTBI;the incidence of active TB was reduced from 100％ (4/4 cases) of non-intervention down to 0 (0/5 case) of intervention.Conclusions Etiology,immunology,imaging examination of TB and clinical efficacy,can prompt active TB and retrospective diagnosis of CLTBI,and application of T-SPOT.TB and FQ-TB-DNA for early diagnosis of CLTBI has a higher applied value;prophylactic and treatment of anti-tuberculosis drugs can reduce the progression of CLTBI to active TB and improve outcomes.