Objective To investigate the feasibility and clinical application of prospective ECG-gated scan and adaptive cardio se-quence scan of dual-source CT coronary angiography.Methods 255 patients who underwent coronary CT angiography using a dual-source CT scanner were divided into two groups:group A underwent prospective scan,group B underwent retrospective scan.The two groups were further subdivided into low heart rate group and high heart rate group,recorded as A1(n=51),A2(n=89),B1(n=26), B2(n=89),respectively.Group A1 preceded with prospective ECG gated scan;group A2 performed with adaptive cardio sequence scan;group B1 and B2 underwent retrospective scan.All of them applied ATCM (automatic tube current modulation)technique. Effective dose was recorded.The image quality was assessed by two experienced radiologists with a four-point grading scale.Results The excellent or good image quality (score 1 and 2)of the four groups were above 95%,and no statistical differences in images scores was detected in A1 and B1 (P =0.726),A2 and B2 (P =0.079).Effective dose was significantly different in A1 and B1(P <0.001),A2 and B2 (P <0.001),and the former decreased 50% and 40% as compared with the latter.Conclusion Using prospective ECG gated scan and adaptive cardio sequence scan,assessable image quality of coronary artery can be acquired with dual source CT (heart rate<90 beast per minute),and radiation dose can be obviously reduced.

Objective To observe the effect of Weidongfang and hydrotalcite in treatment of bile reflux gastrifis.Methods Bile reflux gastritis were randomly assigned to 2 groups.30 eases in the Weidongfang group were treated with Weidongfang and hydrotalcite;30 cases in the mosapride group were treated with mosapride and hydrotalcite;and the course of treatment was 4 weeks for all.The clinical symptoms of bile reflux gastritis,the classify of extent of bile reflux and the accumulated points of pathological change of the gastric mucosa below gastroscope were evalumed before and after treatment.Results The significant and total effective rate in the Weidongfang group were 33.3% and 86.7%.Mosapride group 43.3% and 83.3%.Butthe classify of extent of bile reflux and the accumulated points of pathological change of the gastric mucosa of Weidongfang group were Similar to Mosapfide group below gastroscope.Conclusion Weidongfang and hydrotalcite were effective medicine in treatment of bile reflux gastritis.

OBJECTIVETo explore the effect of Qingfei Huoxue Recipe (QHR) combined azithromycin in treatment of intractable pediatric mycoplasma pneumonia.

METHODSTotally 124 intractable pediatric mycoplasma pneumonia patients at our hospital were recruited in this study, and randomly assigned to the treatment group and the control group, 62 in each group. Patients in the control group took azithromycin, while those in the treatment group additionally took QHR. All patients received omnibearing systematic nursing. Therapeutic efficacy, clinical indices (such as disappearance time of cough and rales, recovery time of body temperature) , and the incidence of adverse reactions were observed.

RESULTSAfter treatment the total effective rate was 91.94% (57/62 cases) in the treatment group and 77. 42% (48/62 cases) in the control group with statistical difference (P < 0.05). Compared with the control group, disappearance time of cough and rales, recovery time of body temperature were obviously shortened in the treatment group with statistical difference (P < 0.01). There was statistical difference in the incidence of adverse reactions between the two groups [3.23% (2/62 cases) vs 38.71% (24/62 cases) , P < 0.01].

CONCLUSIONIn clinical treatment for intractable pediatric mycoplasma pneumonia, Chinese medicine combined Western medicine plus scientific and systematic nursing showed more obvious advantages with significant efficacy, which was worth spreading.

Azithromycin ; Biomedical Research ; Child ; Cough ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, East Asian Traditional ; Phytotherapy ; Pneumonia, Mycoplasma ; drug therapy

ObjectiveTo observe the clinical effects of mirabilite external application and neostigmine injection at Zusanli acupoint combined with Xuebijing intravenous injection on patients with severe sepsis.Methods A history-prospective controlled study was conducted. Patients with severe sepsis admitted to the Fourth People's Hospital of Jiangsu University from January 2012 to November 2015 were enrolled. Twenty-one cases admitted from January 2014 to November 2015 were assigned as a research group and treated with application of mirabilite external application, Zusanli acupoint injection of neostigmine combined with intravenous Xuebijing injection; 22 patients with Xubijing treatment from January 2012 to November 2015 were included in a Xubijing group; 21 patients with routine therapy from January 2012 to November 2013 were included in a control group. The changes of white blood cell count (WBC), C-reactive protein (CRP), procalcitonin (PCT), mean arterial pressure (MAP), oxygenation index (OI), serum creatinine (SCr), acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) score, sequential organ failure assessment (SOFA), gastrointestinal function score, blood platelet count (PLT), plasma prothrombin time (PT), activated partial thromboplastin time (APTT), and D-dimmer in three groups before and after treatment were observed; the length of stay in ICU and the 28-day mortality were compared among the three groups. Results Compared with those before treatment, WBC, PCT, CRP, SCr, APACHE Ⅱ score, SOFA score, gastrointestinal function score, APTT, PT, and D-dimer were all obviously lower after treatment for 7 days in various groups; OI, MAP, PLT were significantly higher, and the improvement degree of WBC, PCT, CRP, SCr, APACHE Ⅱ score, SOFA score, gastrointestinal function score, OI in research group was more significant than those of control group and Xubijing group [WBC (×109/L): 7.52±0.75 vs. 12.87±4.13, 10.88±0.66, PCT (μg/L): 1.14±0.55 vs. 6.32±1.39, 3.47±1.94, CRP (mg/L): 21.0±9.2 vs. 65.0±13.6, 35.0±13.9, OI (mmHg, 1 mmHg = 0.133 kPa): 357.0±20.4 vs. 295.0±20.4, 309.0±21.4, SCr (μmol/L): 7.89±2.35 vs. 14.33±9.17, 11.27±4.65, APACHE Ⅱ score: 10.38±0.75 vs. 18.27±2.57, 13.09±4.10, SOFA score: 1.05±0.66 vs. 6.01±2.33, 3.26±1.03, gastrointestinal function score: 0.31±0.11 vs. 2.01±0.46, 1.85±0.29, all P < 0.05], the improvement of PLT, APTT, PT, D-dimer indicators in the research group was more significant than those in control group, but the above improvement compared with that in Xubijing group, no statistically significant difference was found [PLT (×109/L): 220.32±32.44 vs. 105.56±44.03, 170.56±54.03, APTT (s): 30.16±5.23 vs. 39.09±10.11, 29.56±6.85, PT (s): 10.74±1.25 vs. 13.56±4.65, 10.05±1.44, D-dimer (mg/L): 1.13±1.98 vs. 4.03±2.65, 1.13±0.54]. The length of stay in ICU was shortened in research group than that in control group and Xubijing group (days: 13.23±9.45 vs. 25.22±15.46, 18.56±10.33, P < 0.05); the 28-day mortality was significantly lower in the research group than that in the control group [28.6% (6/21) vs. 47.6% (10/21), P < 0.05], but there was no statistically significant difference compared with that in Xubijing group [28.6% (6/21) vs. 31.8% (7/22), P > 0.05]. Conclusions The treatment of mirabilite external application and neostigmine injection at Zusanli acupoint combined with Xuebijing intravenous injection can obviously improve the clinical symptoms, blood coagulation indexes and organ functions, reduce the levels of inflammatory indexes, shorten the time of the length of stay in ICU and elevate the survival rate of patients with severe sepsis.

Objective To evaluate if the assay of platelet-associated immunoglobulin G (PAIgG) can improve the sensitivity of monoclonal antibody immobilization of platelet antigens assay (MAIPA) in immune thrombocytopenic purpura (ITP).Methods Anti-GP Ⅱb/Ⅲa and anti-GP Ⅰb/Ⅸ autoantibodies were detected by a modified MAIPA;PAIgG was detected by competitive ELISA.MAIPA and PAIgG were done simultaneously in 190 patients with thrombocytopenia,in which 132 were diagnosed as ITP according to the diagnostic criteria Kappa test was used to analyze the concordance between MAIPA and PAIgG.Results The sensitivities of PAIgG alone or in parallel with MAIPA to ITP were 32.6% and 37.2% higher than MAIPA alone respectively,while their specifieities were 51.7% and 56.9% lower respectively.The sensitivity,specificity,positive predictive value,negative predictive value of PAIgG in series with MAIPA were all not superior to MAIPA alone.The kappa values between MAIPA and PAIgG in ITP and non-immune thrombocytopenia were 0.129 and 0.012 respectively,which meant the concordance between them was poor.Conclusion The detection of PAIgG should not be used as screening before MAIPA in distinguishing immune from non-immune thrombocytopenia.

To construct the eukaryotic expression plasmid containing the p55 gene fragment of Pneumocystis and to investigate the efficient expression in COS-7 cells, the gene fragment conaining the whole length of p55 gene was used as template to amplify this fragment with PCR and the amplified fragment was then cloned to vector pGEM-T. After enzyme digestion, p55 gene was cloned to the eukaryotic expression vector pcDNA3.1(+) to construct the plasmid pcDNA3.1(+)-582. This plasmid was then transfected to the eukaryotic expression cells COS-7 and PCR and SDS-PAGE assays were used to confirm the presence of target protein in these cells. In these ways, the eukaryotic expression vector for the p55 gene of Pneumocystis of rats was successfully constructed and expressed in COS-7 cells, thus providing the basis for further studies on the nucleic acid vaccine.

ObjecfiveTo explore clinical value of 64-slice spiral CT coronary angiography in diagnosing coronary atherosclerotic heart disease. as compared to that with selective coronary angiography.MethodsOne hundred and thirteen patients who underwent both 64-slice spiral CT coronary angiography as well as selective coronary angiography at an interval of no more than one month at Zhongshan Hospital.Shanghm in 2006 were selected for the study and their imaging reports were analyzed and compared.ResultsImages of 910 segments of coronary arteries were collected and assessed.Sensitivity,specificity and likelihood ratio for negative test result of 64-slice spiral CT coronary angiography in diagnosis of coronary atherosclerotic heart disease were 73.8 percent.97.0 percent and 24.4,respectively,with an overall agreement of 93.2 percent,positive predictive value of 82.7 percent and negative predictive value of 95.0 percenL ConclusionsSixty-four-slice spiral CT coronary angiography has hish specificity,negative predictive value and positive likelihood ratio,with high accuracy,in diagnosing coronary atherosclemtic heart disease.

Objective:To investigate the quantification of CD4~+CD25~+ regulatory T cells and distribution of CD4~+CD8~+ T lymphocyte subgroup in peripheral blood of patients in chronic hepatitis B (CHB),and to reveal relationship between CD4~+CD25~+ regulatory T cells,CD4~+CD8~+ T lymphocyte subgroup and HBV infetion as well.Methods:CD4~+CD25~(high),CD4~+CD25~+Foxp3~+Treg and CD3~+CD4~+CD8~+T lymphocyte subgroup in peripheral blood from 50 patients with CHB and 20 healthy controls was analyzed using flow cytometry.HBV DNA was detected by fluorescence quantitative PCR.Results:The number of CD4~+CD25~(high)Tregs in patients with CHB was obviously higher than that in healthy controls(P＜0.01)and increased with copies of HBV DNA.The same with the change of CD4~+CD25~+Foxp3~+Tregs in patients with CHB and there was a positive correlation between CD4~+CD25~(high)Tregs and CD4~+CD25~+Foxp3~+Tregs(r=0.890,P＜0.001).Compared with healthy controls,the frequency of CD4~+T cells and the ratio of CD4~+/CD8~+ in patients with CHB was declined,but there was no significant difference in the frequency of CD3~+T cells and CD8~+T cells between them(P＞0.05).The variation in the number of CD4~+CD25~(high)Tregs was correlated positively with the copies of HBV DNA(r=0.782,P＜0.001)and glutamic-pyruvic transaminase(ALT)(r=0.432,P＜0.005)separately,but negatively with the frequency of CD3~+,CD4~+,CD8~+T cells and the ratio of CD4~+/CD8~+(P＞0.05).The variation in the frequency of CD3~+,CD4~+,CD8~+T cells and the ratio of CD4~+/CD8~+ was also correlated negatively with the copies of HBV DNA(P＞0.05).Conclusion:The number of CD4~+CD25~(high)Tregs increases in patients with CHB and is in accordance with the copies of HBV DNA and increased level of ALT.Further studies should be done to investigate weather CD4~+CD8~+ T lymphocyte subgroup could be used to monitor the state of community.

OBJECTIVE: To establish a hepatocyte immunotoxicity model for screening of liver protective medications. METHODS: Cytotoxicity was induced by coincubating BCG-pretreated rat hepatocytes in vivo and with 10 mg/L LPS in vitro. Biphenyldimethylesterate (DDB), malotilate(MLT), silybin(SB) and glycyrrhizin (GRZ) were coincubated along with LPS to prevent the hepatocyte injury and verify the applicability and reliability of the model. AST, LDH and nitric oxide (NO) were measured in both the serum and supernatant. The liver and spleen index were calculated and the liver histopathologic changes were examined microscopically. RESULTS: Supernatant AST, LDH and NO in the BCG combined LPS group were increased in comparison with the control group (P<0.01). This increase was attenuated by the addition of DDB, MLT, SB and GRZ (P<0.05). The serum AST, NO and liver and spleen index were also increased significantly compared with the control group (P<0.01). Microscopic exam revealed serious histopathologic changes in the BCG combined LPS group. Hepatoxicity with associated liver enzyme elevation but histopathologic changes were attenuated by DDB, MLT, SB and GRZ. CONCLUSION: BCG combined LPS-induced hepatocyte immunotoxicity in an in vitro rat model may be a useful technique to assess the effectiveness of liver protective medications.

OBJECTIVETo explore the theory of "Fei and Dachang being interior-exteriorly related" and the pathogenesis of lung injury by observing changes of inflammatory cytokines and oxygen free radicals in ulcerative colitis (UC) rats.

METHODSTotally 50 healthy male Wistar rats were randomly divided into two groups, the normal control group and the model group, 25 rats in each group. The UC model was established by allergizing colon mucosa combined with TNBS-alcohol (50%) enema. Another 25 rats were recruited as the normal control group. At week 2 and 4 after modeling, the pathomorphological changes of the lung were observed. Furthermore, the contents of tumor necrosis factor alpha (TNF-alpha) and IL-1beta were determined by ELISA. The activities of superoxide dismutase (SOD) and malondialdehyde (MDA) were evaluated with colorimetry.

RESULTSCompared with the normal control group, the pathomorphology of the lung tissue in the model group appeared abnormal at week 2 and 4. Compared with the normal control group, levels of TNF-alpha, IL-1beta, and MDA in the lung tissue significantly increased in the model group (P < 0. 01) and the activities of SOD significantly decreased (P < 0.05, P < 0.01).

CONCLUSIONTNF-alpha, IL-1beta, SOD, and MDA might be common material bases for the large intestine involved in lung disease of UC patients, thus providing a modern scientific basis for the theory of Fei and Dachang being interior-exteriorly related.

Animals ; Colitis, Ulcerative ; diagnosis ; metabolism ; pathology ; Cytokines ; metabolism ; Interleukin-1beta ; metabolism ; Lung ; metabolism ; Male ; Malondialdehyde ; metabolism ; Medicine, Chinese Traditional ; Rats ; Rats, Wistar ; Reactive Oxygen Species ; metabolism ; Superoxide Dismutase ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism