Objective To evaluate MRI in diagnosing brachial plexus preganglionic injury.Methods Twenty cases with brachial plexus preganglionic injury underwent M R scanning before operation.MR imaging was obtained by GE Signa EXCITE 1.5 T scanner.The scanning sequences included SE T1 WI,FSE T2 WI,T2 WI STIR and 3D Fast imaging employing steady state with phase cycled(3D-FIESTA-c).All the patients had exploration of the supraclavicular plexus and electrophysiology examination. And the accuracy, sensitivity and specificity of MRI in diagnosing preganglionic brachial plexus iniury were calculated with the standards of surgical and EMG results.Results Among the 73 pairs of i,jured roots.MR imaging detected the abnormalities in 63 pairs.The accuracy, sensitivity and specificity of MRI in diagnosing preganglionic brachial plexus injury were 86.5/(83/96),86.3/(63/73).87.0/(20/23),respectively.The direct signs of brachial plexus preganglionic injury included (1) lack or mutilation of netwe root in 54 pairs (85.7/),(2)coarsening,bending,stiff course and unable to be traced to the intervertebral foramen continuously in 9 pairs (14.3/).The indirect signs included (1)cystic cerebrospinal fluid gathering in the vertebral canal,posttraumatic spinal meningocele in 46 pairs (73.0/),(2)abnormal shape of nerve sleeve in 13 pairs(20.6/),(3)displacement and deformity of spinal cord in 50 pairs(79.4/),(4)abnormal signal of paravertebral muscles in 1 9 patients.Conclusion MRI can distinctly show the nerve rootlets within the vertebral canal,so it is helpful in making a correct diagnosis of brachial plexus preganglionic injuries.

Objective To evaluate the MRI application in the common non-traumatic brachial plexopathies.Methods Twenty-seven patients with non-traumatic brachial plexopathies were retrospectively analyzed,which consisted of 10 males and 17 females with age range from 22 to 70 years old.Among the patients,2 were neurofibromatosis,8 were schwannoma,3 were metastases,2 were radiation plexopathy,1 was multifocal motor neuropathy (MMN),and 11 were typical thoracic outlet syndrome (TOS).Before treatment,all patients underwent MRI of brachial plexus,in which 8 patients underwent Gd-DTPA enhanced MRI.Results In 2 cases of neurofibromatosis,the tumors appeared as fusiform,bead-like masses,growing along the course of brachial plexus with involvement of rootlets in vertebral canal,and iso-to little hypointensity on T1WI,inhomogeneous hyperintensity on T2WI and inhomogeneously enhanced.Schwannoma of 8 cases displayed as fusiform mass,eccentric to the original nerve with sharply defined edge,and hypointensity or inhomogeneous hyperintensity on T1WI,inhomogeneous hyperintensity on T2WI with cystic necrosis in 3 cases which was inhomogeneously enhanced.Two of the 3 cases of metastases manifested as multiple masses besides brachial plexus,the other one appeared as widespread lesion infiltrating brachial plexus and surrounding structures.Two cases of radiation plexopathy displayed as diffused thickened nerves,with increased signal intensity on short time inversion recovery (STIR),clear structure and no mass surrounding the plexus.One case of MMN showed thickened nerves with increased signal intensity on STIR.Eleven cases of typical TOS manifested as arched elevation of C8,T1 and inferior trunk,with thickened nerves and increased signal intensity on STIR.Elevated subclavian artery could be seen in 8 cases.And in one case of TOS,a mass in the end of cervical rib compressed the local brachial plexus.Conclusions MRI can clearly show the location,involved scope and the relationship with adjacent structures.So MRI can provide reliable information for clinical diagnosis and treatment.

Objective To observe serum sCD40L,MMP9 levels and their relevance with different types of coronary heart disease(CHD).Methods The present study was involved in 90 patients with CHD,including acute myocardial infarction(AMI)30 case,unstable angina pectoris(UAP)31 case,stable angina pectoris (SAP)29 case and another 25 normal controls.The serum MMP9 and sCD40L levels were detected with enzyme-linked immunosor-bent assay.Results The levels of MMP9,sCD40L in AMI and UAP group were significantly higher than those in SAP group[(69.48 ±4.76)ng/mL,(66.61 ±5.30)ng/mL,(30.44 ±7.66)ng/mL,t=1.425,0.075,all P<0.05], there were no statistically significant differences in the serum MMP9,sCD40L levels between AMI group with UAP group (all P>0.05 ),and also there were no ststitically signiticant differeces in the serum MMP9,sCD40L levels between SAP group with control group (all P>0.05).MMP9 level in AMI and UAP group was positively related with sCD40L (r=0.96,P<0.01 and r=0.97,P<0.01 ).Conclusion The serum sCD40L and MMP9 levels of acute coronary syndrome(ACS)increase significantly,and can be used as an important index to assess the severity of CAD and predict the instability of plaque in CAD patients.

Objective To observe the changes of ischemia modified albumin (IMA),high -sensitivity C -reactive protein (hs -CRP)after percutaneous coronary intervention (PCI).The factors related to intervention procedures to patients with IMA and hs -CRP elevation after PCI and impact of the risk of IMA and hs -CRP on the clinical outcomes were investigated.Methods IMA,hs -CRP from vein blood of 90 cases received PCI were detec-ted before operation and after operation at time of 30 min,2h,6h and 24h.The clinical characteristics of patients and factors related to intervention procedures were recorded.The number of lesion vessels and the relative factors in PCI were compared.The clinical outcomes of the patients were followed up.Results After operation,IMA was significantly different compared with that before operation (t =2.293,P <0.05).The concentration of IMA peaked at 2h after operation,which was significantly different from that before surgery (t =1.116,P <0.01).The increase of IMA and hs -CRP were closely related with the inflation pressure,total times of inflation,dilated times,length and diameter of stent and the number of stents (t =3.678,P <0.01 ).The angina onset was more common and length of stay was longer in the patients with the rise of IMA and hs -CRP.Conclusion PCI may cause myocardial injury,which is associated to inflation pressure,total time of inflation,dilated times,length and diameter of stent and the number of stents.To a certain extent the level of troponin can predict the outcomes.

Content-based image retrieval aims at searching the similar images using low level features,and medical image retrieval needs it for the retrieval of similar images. Medical images contain not only a lot of content data, but also a lot of semantic information. This paper presents an approach by combining digital imaging and communications in medicine (DICOM) features and low level features to perform retrieval on medical image databases. At the first step, the semantic information is extracted from DICOM header for the pre-filtering of the images, and then dual-tree complex wavelet transfrom(DT-CWT) features of pre-filtered images and example images are extracted to retrieve similar images. Experimental results show that by combining the high level semantics (DICOM features) and low level content features (texture) the retrieval time is reduced and the performance of medical image retrieval is increased.
Algorithms ; Artificial Intelligence ; Diagnostic Imaging ; Humans ; Image Processing, Computer-Assisted ; methods ; Information Storage and Retrieval ; Radiology Information Systems ; Systems Integration ; User-Computer Interface

Several antigen epitopes were designed according to the sequences of Swine influenza virus hemagglutinin (HA) genes and lined with the interval. The gene was amplified by PCR and sub cloned into pET30a (+) vector. The fusion protein was expressed in E. coli BL21 (DE3) by induced with IPTG and purified by affinity chromatography. The molecular weight of the protein was about 20 kD in SDS-PAGE. Immunological activity of the fusion protein was analyzed by Western blot. The results showed that the fusion protein could interact with anti-His antibody and the rabbit antiserum against SIV. The immunized mouse can produced antibodies against the target peptide and HI antibody against SIV H1N1 or H3N2. This study provides a new vaccine candidate for SIV.
Amino Acid Sequence ; Animals ; Antibodies, Viral ; blood ; Antigens, Viral ; biosynthesis ; genetics ; immunology ; Base Sequence ; Epitopes ; genetics ; immunology ; metabolism ; Escherichia coli ; genetics ; metabolism ; Hemagglutinins ; genetics ; immunology ; Humans ; Immunization ; Influenza A Virus, H1N1 Subtype ; genetics ; immunology ; Influenza A Virus, H3N2 Subtype ; genetics ; immunology ; Mice ; Mice, Inbred BALB C ; Molecular Sequence Data ; Random Allocation ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; immunology

Objective To investigate the clinicopathologic features and possible causes of granulomatous lobular mastitis(GLM). Methods Three hundred cases of GLM were collected from surgical specimens diagnosed at Longhua Hospital, Shanghai University of Traditional Chinese Medicine from January 2015 to November 2017. Morphologic features were reviewed using HE staining. A total of 116 cases were investigated by Gram staining. The expression of CD3, CD20, CD68, IgG, IgG4, CD38 and CD138 was detected by immunohistochemical staining. Results The age of the patients was 23 to 47 years and the median age was 32 years. All patients were female, 96.7% (290/300) had a history of lactation.There were 143 cases of left breasts, 138 cases of right breast and 19 cases of bilateral breasts. Serum prolactin increased in 39.7%(119/300) patients. Within 15.7%(47/300) of patients were associated with nodular erythema or joint swelling and pain of the lower extremities. Pathological observation showed that lobular?centric suppurative granulomatous inflammation, accompanied by dilatation of intralobular and interlobular ducts. There were 16 cases accompanied with duct ectasia. Immunohistochemistry showed CD3?positive lymphocytes were more than CD20?positive lymphocytes in the peripheral aggregation zone of neutrophils within granulomatous lesions. Gram positive bacteria were found in the lipid vacuoles of the 51.7%(60/116) patients. Conclusions GLM has distinctive histologic features. It may be related to corynebacterium infection, or accompanied by the increase of serum prolactin and erythrocyte sedimentation rate. The age, location and history of the disease are importance in the diagnosis and differential diagnosis.

Objective:To explore the rapid evaluation of the early pathogen of severe Chlamydophila psittaci pneumonia by bedside diagnostic bronchoscopy, so as to start effective anti-infection treatment before the results of macrogenome next generation sequencing (mNGS) test. Methods:The clinical data of three patients with severe Chlamydophila psittaci pneumonia who were successfully treated in the First Affiliated Hospital of Xinjiang Medical University, the First People's Hospital of Aksu District, and the First Division Hospital of Xinjiang Production and Construction Corps from October 2020 to June 2021 were retrospectively analyzed, including the rapid assessment of early pathogens by bedside diagnostic bronchoscopy and the use of antibiotics to start anti-infection treatment. These patients were successfully treated. Results:The three patients were male, aged 63, 45 and 58 years old, respectively. Before the onset of the penumonia, they had a clear medical history of bird exposure. The clinical manifestations mainly included fever, dry cough, shortness of breath and dyspnea. One case had abdominal pain and lethargy. The results of laboratory examination indicated that the peripheral blood white blood cell count (WBC) of two patients were high [(10.2-11.9)×10 9/L], the percentage of neutrophils increased (85.2%-94.6%) and the percentage of lymphocytes decreased (3.2%-7.7%) in all 3 patients after admission to hospital and entering into intensive care unit (ICU). The procalcitonin (PCT) of 3 patients increased after admission, and still increased when entering ICU (0.3-4.8 ng/L), so did C-reactive protein (CRP, 58.0-162.0 mg/L) and erythrocyte sedimentation rate (ESR, 36.0-90.0 mm/1 h). After admission, serum alanine transaminase (ALT) increased in 2 cases (136.7 U/L, 220.5 U/L), so did aspartate transaminase (AST) in 2 cases (249.6 U/L, 164.2 U/L). ALT (162.2-267.9 U/L) and AST (189.8-223.2 U/L) increased in 3 patients when they entered ICU. The level of serum creatinine (SCr) of 3 patients were normal after admission and entering ICU. The chest computed tomography (CT) findings of 3 patients were acute interstitial pneumonia, bronchopneumonia and lung consolidation, of which 2 cases were accompanied by a small amount of pleural effusion, and 1 case was accompanied by more regular small air sacs. Multiple lung lobes were involved, but mainly one lung lobe. The oxygenation index (PaO 2/FiO 2) of the 3 patients admitting to ICU were 100.0, 57.5 and 105.4 mmHg (1 mmHg ≈ 0.133 kPa), respectively, which met with the diagnostic criteria of moderate and severe acute respiratory distress syndrome (ARDS). All three patients received endotracheal intubation and mechanical ventilation. Under the bedside bronchoscope, the bronchial mucosa of 3 patients were obviously congested and edematous, without purulent secretion, and there was 1 case with mucosal hemorrhage. Three patients underwent bedside diagnostic bronchoscopy, and the evaluation result of the pathogen was that it might be atypical pathogen infection, so they were given moxifloxacin, cisromet and doxycycline intravenously, respectively, and combined with carbapenem antibiotics intravenously. After 3 days, the detection results of mNGS in bronchoalveolar lavage fluid (BALF) showed that only Chlamydia psittaci was infected. At this time, the condition was significantly improved, and PaO 2/FiO 2 was significantly increased. Therefore, the antibiotic treatment scheme remained unchanged, and mNGS only served to verify the initial diagnosis. Two patients were extubated on the 7th and 12th day of admission to the ICU, respectively, while one patient was extubated on the 16th day of admission to the ICU due to nosocomial infection. All 3 patients were transferred to the respiratory ward after the condition was stable. Conclusion:The bedside diagnostic bronchoscopy based on clinical characteristics is conducive to not only the rapid assessment of the early pathogens of severe Chlamydia psittaci pneumonia, but also effective anti-infection treatment before the returning of mNGS test results, which can make up for the lag and uncertainty of the mNGS test results.