Objective To test the hypothesis that nebulised budesonide (NB) might be an alternative to systemic corticosteroids in treatment of patients with exacerbated chronic obstructive pulmonary disease (ECOPD).Methods Patients hospitalised with ECOPD (n = 78) were randomnized into three groups.Group 1 received only standard bronchodilator treatment (SBDT),group 2 received systemic corticosteroids (SC 40 mg methylprednisolone) plus SBDT,and group 3 received nebulised budesonide ( NB 1000 mg budesonide q.i.d.) plus SBDT.Complete blood counts,detailed biochemical analysis,spirometric measurements and arterial blood gas analysis were carried out at admission.In addition,the following were recorded:adverse effects,discharging percentage of patients at 10 day and 15 day after hospitalization,exacerbation and re-hospitalization ratio within 1month after discharge.Results The improvement of SO2,PO2,FEV1 and discharge rates was ( 5.3± 0.9 ) %、(5.9 ±0.4)%、(8.7 ±0.5)% ,(8.1 ±0.8)%,(4.9 ±0.4)% and (7.2 ±0.5)% ,which were higher than that in SBDT group.These indexes were not different between 2 group and 3 group.The fraction of patients discharged on the 10th day and 15th were not different.The deteriorate rate was higher in 1 group than in 2 group and 3 group(P ＜0.05 ).Re-admission ratio in one month is higher in 1 group( 12% ) than in 2 group( 5% ) and 3 group(9% ) ( P ＜0.05 ).Absolute blood glucose level was found to be significantly higher in group 2 in 10th day (7.4 ± 1.6)mmol/L,which is greater than that in 1 group ( 5.1 ± 0.8 ) mmol/L and 3 group ( 5.6 ± 1.2 ) mmol/L ( P ＜ 0.05 ).Dysphoria and deliration appear in one patient in group 2.Conclusions Nebulised budesonide,an effective and safe alternative to systemic corticosteroids in treatment of exacerbated COPD,may substitute systemic corticosteroids in clinical practice.

OBJECTIVE: To study the antidepressant effects of total flavone of A( TFA) on post stroke depression ( PSD) in rats. METHODS: Middle cerebral artery occlusion ( MCAO) followed by isolation feed and irritable stimuli was used to induce PSD. Behaviours of rats were detected by open- field test . The effects of TFA on the indexes of hemorheology and brain homogenate lipid peroxidation were also tested. RESULTS: TFA could increase the crossing and rearing scores in open- field test, inhibit the elevation of whole blood viscosity as well as plasma viscosity at high- middle- low shear rates, increase the erythrocyte deformation, enhance the activities of Superoxide Dismutase ( SOD) and Glutathione Peroxidase ( GSH- Px) , and reduce Malondialdehyde ( MDA) content in brain homogenate in PSD in rats. CONCLUSIONS: TFA produces an antidepressant- like effect in PSD rats. This mechanism may be in association with attenuating hemorheological parameters and decreasing lipid peroxidative damage.

AIM: To establish a quantitative analytical method of ferulic acid in Kexintong Dripping Pills (Moschus, Rhizoma Chuaxiong, Rhizoma Corydalis, etc.) based on the capillary zone electrophoresis. METHODS: P-Nitrobenzoic acid was adopted as the internal substauce with a 30 mmol?L -1 borax solution at equal electrophoresis current of 50 ?A, detection wavelength at 295 nm, uncoated fused silica capillary of 75 ?m?50 cm, temperature at 20 ℃. Sample was injected for 5 s at pressure of 20PSI. RESULTS: Good linearity was showed in the concentration range of 4～264 mg?L -1 , RSD was 1.71%(n=6), and the recovery was 100.47%?2.1%. CONCLUSION: The result indicates the proposed method is convenient, rapid, accurate and reliable, it is a proper method for the quantitative analysis of ferulic acid in Kexintong Dripping Pills.

Purpose To explore brain MRI features in newborn infants with incontinentia pigmenti,and to enhance the understanding and diagnosis level of this disease.Materials and Methods A retrospective analysis on MRI data of 13 neonates with incontinentia pigmenti admitted to Hunan Children's Hospital from January 2009 to December 2016 and further confirmed by clinical,pathology and gene diagnosis were conducted.Such conventional MRI sequences as T1WI and T2WI as well as DWI and SWI sequences wereincorporated.Results Five out of 13 newborn infants with incontinentia pigmenti were abnormal in the MRI features.In the conventional sequence,slightly short T1 signals in bilateral frontal lobe and right parietal occipital cortex were identified in 3 cases,right basal ganglia hemorrhage in 1 case.Slightly short TI and long T2 signals in bilateral basal ganglia were observed in 1 case;1 case of subarachnoid hemorrhage and 1 ease of bilateral lateral ventriculomegaly were noticed as well.The lesion sites of 4 cases were observed high density signal in DWI findings,three of which were widely distributed in abnormal signals.Lobes deep in bilateral cerebral hemispheres and subcortical white matter,bilateral basal ganglia,thalamus,internal capsule,corpus callosum,brain stem and cerebellum were the most affected areas.DWI could detect lesion area earlier and more accurate thanconventional sequences.Conclusion Incontinentia pigmenti among newborn infants demonstrates a high incidence.MRI examination should be adopted the moment neurological symptoms occur.Incontinentia pigmenti is relatively distinct in DWI findings,and hence is helpful for early detection of lesions and evaluation of clinical prognosis.

To find a new preventive strategy for the infection of Schistosoma japonica, plasmid pIRES-Sj97-Sj14-Sj26 that contains fatty binding protein (Sj14), GST (Sj26) and paramyocin (Sj97) that are expressed on the membrane, was constructed. RT-PCR was used to detect the expression of Sj14 mRNA, Sj26 mRNA and Sj97 mRNA in the Hela cells, the indirect immunofluorescent test was employed for the detection of the expression of trans-membrane Sj26 after the plasmid was trans-fected into Hela cells. Fifty BALB/c mice were randomly divided into 5 groups and pIRES-Sj97-Sj14-Sj26 plasmid DNA, pIRES-Sj14-Sj26 plasmid DNA, plRES-Sj26 plasmid DNA,plRES blank vector and normal saline were respectively injected into the quadriceps muscles of thigh.Eight weeks after the immunization the mice were killed and significantly higher level of IgG was detected in the pIRES-Sj97-Sj14-Sj26 group as compared with the plRES blank vector, normal saline and pIRES-Sj26 groups (P<0.01) and the pIRES-Sj14-Sj26(P<0.05). Single splenocyte suspension was prepared to detected the level of IFN-γ by ELISA and the lymphocyte stimulating index (SI) by MTT SI was significantly higher of in the pIRES-Sj97-Sj14-Sj26 group than in other groups (P<0.01), while the IFN-γ, level was significantly higher the pIRES-Sj97-Sj14-Sj26 group than in pIRES blank vector and normal saline groups (P<0.01), but no significant differences were found when compared with pIRES-Sj14-Sj26 and pIRES-Sj26 groups. Flow cytometery showed that the percent-ages of CD4+ and CD8+ T cells were much higher in the pIRES-Sj97-Sj14-Sj26 group (P<0.01,P<0.05). It was concluded that pIRES-Sj97-Sj14-Sj26 vaccine may induce stronger immune response in BALB/c mice.

Objective:To explore the application value of deep learning reconstruction (DLR) in low-dose brain CT imaging in children with craniocerebral trauma.Methods:The CT data of 51 children with craniocerebral trauma complicated with intracerebral hemorrhage who received low dose brain CT were retrospectively collected in Hunan Children′s Hospital between June 2020 and February 2021. All images were reconstructed at 1.25 mm and 5 mm slice thickness utilizing two reconstruction algorithms and divided into six subgroups: ASIR-V with three different blending ratios (0, 50%, 100%), and DLR with three different reconstruction strengths [low (L), media (M) and high (H)]. The objective parameters including CT value, signal to noise ratio (SNR) and contrast to noise ratio (CNR) of dorsal thalamus (grey matter), white matter of frontal lobe and hemorrhagic lesion, as well as basicranial artifact noise (SD) and background SD were measured and calculated. Subjective evaluation was performed with a 5-point scale scoring. Objective parameters and subjective scores were compared among different groups using randomized block analysis of variance and Friedman test, respectively. The objective and subjective differences between 1.25 mm DLR-H and ASIR-V50% images were analyzed using paired samples t-test and correlated sample rank sum test. Results:The average CT dose index volume, dose length product and size-specific dose estimate of head CT were 17.7 (11.9, 21.1) mGy, 248.4 (142.2, 338.1) mGy·cm and (15.7±2.8) mGy. With the same thickness, the difference of CT values between the DLR and ASIR-V groups were stastistically significant ( P<0.05). The subjective scores of DLR groups were significantly better than those of ASIR-V; the higher was the reconstruction grade of ASIR-V and DLR, the higher SNR and CNR values and the lower SD value were obtained for each structure (all P<0.05). DLR images showed better objective parameters than ASIR-V50% images. Background:SD was lowest on DLR-H and ASIR-V100% images, with no significant difference found between these two groups. Using 1.25 mm thickness, DLR-H images showed higher SNR (for both gray matter and white matter) and CNR than ASIR-V100% images ( P<0.05). The subjective score was decreased with the slice thickness reduced. However, the average subjective scores of 1.25 mm DLR images were all over 3 points, while those of 1.25 mm ASIR-V images were less than 3 points, which could not fully meet the needs of diagnosis. Images of 1.25 mm DLR-H had higher background SD and artifact SD than 5 mm ASIR-V50% images ( t=2.96, 2.83, P=0.005, 0.007), while the score and other objective parameters were not statistically different between these two groups ( P>0.05). Conclusion:In children′s low-dose cerebral CT, DLR can improve image quality, with the DLR-H images displaying the highest image quality. It can also increase the SNR and CNR of gray and white matter of images with thin thickness.

Objective To verify the validity of standard air cushion inflation method, and to explore the relationship between patients' body mass index (BMI) and the optimal air cushion inflation pressure. Methods A total of 90 orthopedic patients who were treated in Liangxiang Hospital of Fangshan District in Beijing from June 2017 to March 2018 were randomly divided into experimental group and control group, with 45 cases in each group. The control group used air cushion bed routinely according to the experience of nurses, while the observation group used standard air cushion bed inflation method according to previous research. Comparing the skin pressure and the feeling of using the mattress softness and hardness between the two groups, and analyzing the relationship between the pressure value of the mattress and the BMI of the patients in the observation group, the regression equation was obtained.Results The local skin redness rate of the observation group was 4.4％, 2.2％ and 4.4％ after 2, 48 and 72 hours of using air cushion mattress, which was lower than that of the control group 22.2％, 31.1％ and 33.3％. The result was statistically significant (P<0.01). Within 72 hours, the satisfaction degree of the observation group was higher than that of the control group, and the difference was statistically significant (P < 0.05). The BMI of the patients in the observation group was linearly correlated with the optimal air cushion pressure (R2=0.962). The air cushion pressure (kpa)=3.835+BMI×0.379. Conclusions Reasonable adjustment of the pressure of the air cushion bed can improve the effect of using air cushion bed. The method of adjusting the pressure of the air cushion bed based on patient BMI is convenient for nurses to master and operate.

Objective To analyze the correlation between T lymphocyte subsets,neutrophil/lymphocyte ratio(NLR),procalcitonin(PCT)and the severity of sepsis.Methods A prospective research method was adopted.A total of 78 sepsis patients admitted to the department of intensive care medicine of Zibo Central Hospital from January 2021 to December 2022 were selected as the research subjects.Patients were divided into a septic shock group(37 cases)and a sepsis group(41 cases)based on the severity of their condition,with 40 healthy examinees from our hospital as the healthy control group.Using flow cytometry to measure the levels of CD4+ T lymphocytes count(CD4+ T)and CD8+ T lymphocytes count(CD8+ T)in three groups of subjects,calculate the CD4+ T/CD8+ T lymphocyte ratio(CD4+ T/CD8+ T)and NLR.The levels of PCT and interleukin-6(IL-6)were measured using electrochemiluminescence immunoassay,and the levels of C-reactive protein(CRP)were measured using immunoassay turbidimetry.Acute physiology and chronic health evaluationⅡ(APACHEⅡ)score within 24 hours was recorded for the two groups of patients,and the differences in lymphocyte subsets and various inflammatory indicators were compared between the groups.Pearson correlation analysis was used to analyze the correlation between various indicators and APACHEⅡscore.Results The CD4+ T,CD8+ T,and CD4+T/CD8+T levels in the septic shock and sepsis groups were significantly lower than those in the healthy control group[CD4+ T(×106/L):168.27±76.68,266.08±131.57 vs.789.60±173.78,CD8+ T(×106/L):156.50±68.37,205.81±75.60 vs.636.42±90.59,CD4+ T/CD8+ T:1.09±0.39,1.27±0.34 vs.1.44±0.38,all P<0.01],NLR,PCT,CRP and IL-6 were significantly higher than those in the healthy control group[NLR:25.85±11.62,15.94±8.72 vs.2.68±1.31,PCT(μg/L):21.82±15.28,9.09±4.96 vs.0.13±0.10,CRP(mg/L):158.65±62.33,106.97±51.49 vs.6.48±2.08,IL-6(ng/L):1 344.64±899.21,245.31±176.99 vs.3.25±1.83,all P<0.01].The APACHEⅡscore in the septic shock group was significantly higher than that in the sepsis group(32.00±1.00 vs.22.01±1.09,P<0.05).Correlation analysis showed that the levels of CD4+ T,CD8+ T,CD4+ T/CD8+ T in two groups of sepsis patients were negatively correlated with the APACHEⅡscore(r values were-0.571,-0.506,and-0.555,respectively,all P<0.01),while the levels of NLR,PCT,CRP,and IL-6 were positively correlated with the APACHEⅡscore(r values were 0.711,0.709,0.777,and 0.707,respectively,all P<0.01).Conclusions As the levels of T lymphocyte subsets decrease,inflammatory indicators like NLR and PCT rise,indicating a more severe sepsis condition.Therefore,T lymphocyte subsets and levels of various inflammatory indicators can serve as markers for evaluating the severity of sepsis.

We report a case of a female teenage with monogenic diabetes mellitus caused by glucokinase regulator (GCKR) gene mutation who presented with diabetic ketosis and misdiagnosed as type 1 diabetes. The patient was treated with insulin for 3 years since diagnosis. The islet function was well preserved, but polycystic ovary syndrome was developed. Whole-exome gene sequencing revealed a GCKR gene c. 69delG heterozygous mutation. After molecular diagnosis, the insulin dosage was gradually reduced to full cessation, and only metformin sustained-release tablets were taken to control blood glucose. It is necessary to regular evaluate islet function of patient with type 1 diabetes, and genetic test is of significance for accurate diagnosis and treatment.

Objective:To explore the effects of interpregnancy interval (IPI) on pregnancy outcomes of subsequent pregnancy.Methods:A multicenter retrospective study was conducted in 21 hospitals in China. Information of age, height, pre-pregnancy weight, IPI, history of diseases, complications of pregnancy, gestational age of delivery, delivery mode, and pregnancy outcomes of the participants were collected by consulting medical records of pregnant women who had two consecutive deliveries in the same hospital during 2011 to 2018. The participants were divided into 4 groups according to IPI:<18 months, 18-23 months, 24-59 months and ≥60 months. According to the WHO′s recommendation, with the IPI of 24-59 months group as a reference, to the effects of IPI on pregnancy outcomes of subsequent pregnancy were analyzed. Stratified analysis was further carried out based on age, history of gestational diabetes mellitus (GDM), macrosomia, and premature delivery, to explore the differences in the effects of IPI on pregnancy outcomes among women with different characteristics.Results:A total of 8 026 women were included in this study. There were 423, 623, 5 512 and 1 468 participants in <18 months group, 18-23 months group, 24-59 months group and ≥60 months group, respectively. (1) The age, pre-pregnancy body mass index (BMI), history of cesarean section, GDM, gestational hypertension and cesarean section delivery rate of <18 months group, 18-23 months group, 24-59 months group and ≥60 months group were gradually increased, and the differences were statistically significant ( P<0.05). (2) After adjusting for potential confounding factors, compared with women in the IPI of 24-59 months group, the risk of premature delivery, premature rupture of membranes, and oligohydramnios were increased by 42% ( OR=1.42, 95% CI: 1.07-1.88, P=0.015), 46% ( OR=1.46, 95% CI: 1.13-1.88, P=0.004), and 64% ( OR=1.64, 95% CI: 1.13-2.38, P=0.009) respectively for women in the IPI≥60 months group. No effects of IPI on other pregnancy outcomes were found in this study ( P>0.05). (3) After stratified by age and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of oligohydramnios for women with advanced age ( OR=2.87, 95% CI: 1.41-5.83, P=0.004); and <18 months could increase the risk of premature rupture of membranes for women under the age of 35 ( OR=1.59, 95% CI: 1.04-2.43, P=0.032). Both the risk of premature rupture of membranes ( OR=1.58, 95% CI: 1.18-2.13, P=0.002) and premature delivery ( OR=1.52, 95% CI: 1.07-2.17, P=0.020) were significantly increased in the IPI≥60 months group. After stratified by history of GDM and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would lead to an increased risk of postpartum hemorrhage for women with a history of GDM ( OR=5.34, 95% CI: 1.45-19.70, P=0.012) and an increased risk of premature rupture of membranes for women without a history of GDM ( OR=1.44, 95% CI: 1.10-1.90, P=0.009). After stratified by history of macrosomia and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months could increase the proportion of cesarean section for women with a history of macrosomia ( OR=4.11, 95% CI: 1.18-14.27, P=0.026) and the risk of premature rupture of membranes for women without a history of macrosomia ( OR=1.46, 95% CI: 1.12-1.89, P=0.005). After stratified by history of premature delivery and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of premature rupture of membranes for women without a history of premature delivery ( OR=1.47, 95% CI: 1.13-1.92, P=0.004). Conclusions:Both IPI≥60 months and <18 months would increase the risk of adverse pregnancy outcomes in the subsequent pregnancy. Healthcare education and consultation should be conducted for women of reproductive age to maintain an appropriate IPI when they plan to pregnant again, to reduce the risk of adverse pregnancy outcomes in the subsequent pregnancy.