Objective To study the value of 64-slice spiral CT digital subtraction technique in the diagnosis of intracranial aneurysms.Methods 36 patients with subarachnoid hemorrhage underwent 64-slice spiral CT examination,including unenhanced CT scan and enhanced CT scan.The image data were used to reconstruct the conventional CTA and digital subtraction CTA(DSCTA).Then the differences of image quality and diagnostic efficiency between the CTA and DSCTA were compared based on the standard of DSA . Results There were 40 intracranial aneurysms in 36 patients . 40 aneurysms were detected completely by DSCTA,the sensitivity and specificity of the DSCTA were both 100% . 37 aneurysms were detected by CTA , and the sensitivity and specificity were 92.5% and 100%,respectively.There was significant difference in image quality between CTA and DSCTA(P＜0.01).Conclusion DSCTA with 64-slice spiral CT might be the first diagnostic tool in screening intracranial aneurysm.

Primary central nervous system germ cell tumors (CNS-GCTs) in children and adolescents have unique clinical features and methods of treatment compared with those in adults. There is little information about Chinese children and adolescents with CNS-GCTs. Therefore, in this study we retrospectively analyzed the clinical features and treatment outcome of Chinese children and adolescents with primary CNS-GCTs. Between January 2002 and December 2012, 57 untreated patients from a single institution were enrolled. They were diagnosed with CNS-GCTs after pathologic or clinical assessment. Of the 57 patients, 41 were males and 16 were females, with a median age of 12.8 years (range, 2.7 to 18.0 years) at diagnosis; 43 (75.4%) had non-germinomatous germ cell tumors (NGGCTs) and 14 (24.6%) had germinomas; 44 (77.2%) had localized disease and 13 (22.8%) had extensive lesions. Fifty-three patients completed the prescribed treatment, of which 18 underwent monotherapy of surgery, radiotherapy, or chemotherapy, and 35 underwent multimodality therapies that included radiotherapy combined with chemotherapy or surgery combined with chemotherapy and/or radiotherapy. PEB (cisplatin, etoposide, and bleomycin) protocol was the major chemotherapy regimen. The median follow-up time was 32.3 months (range, 1.2 to 139 months). Fourteen patients died of relapse or disease progression. The 3-year event-free survival (EFS) and overall survival rates for all patients were 72.2% and 73.8%, respectively. The 3-year EFS was 92.9% for germinomas and 64.8% for NGGCTs (P = 0.064). The 3-year EFS rates for patients with NGGCTs who underwent monotherapy and multimodality therapies were 50.6% and 73.5%, respectively (P = 0.042). Our results indicate that multimodality therapies including chemotherapy plus radiotherapy were better treatment option for children and adolescents with CNS-GCTs.
Adolescent ; Antineoplastic Agents ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bleomycin ; administration & dosage ; Central Nervous System Neoplasms ; therapy ; Child ; Child, Preschool ; Cisplatin ; administration & dosage ; Combined Modality Therapy ; statistics & numerical data ; Disease-Free Survival ; Etoposide ; administration & dosage ; Female ; Humans ; Male ; Neoplasm Recurrence, Local ; Neoplasms, Germ Cell and Embryonal ; therapy ; Retrospective Studies ; Survival Rate ; Treatment Outcome

Objective To evaluate the reliability and validity of the application of condensed Chinese version of the MOS 36-item short form health survey (SF-36) in assessment of quality of life among adult patients with Kashin-Beck disease,and to provide a scientific basis in rehabilitation of the patients.Methods Four hundred and twenty seven eases of adult patients with Kashin-Back disease and 419 healthy individuals randomly selected in Kashin-Beck disease endemic areas in 8 counties of Gansu province were surveyed with the SF-36.The reliability of the SF-36 was assessed by split-half reliability and Cronbach's α coefficient and the validity through principal component factor analysis and correlation analysis,etc.The dimension scores of different people were obtained by analysis of variance and univariate t-test.Results The split-half reliability of all the 8 dimensions was greater than 0.6 and the Cronbach's α coefficient was greater than 0.8; the pearson correlate coefficients of all the items to their dimensions were greater than 0.391.SF-36 contained 8 domains and 2 summary scales in the factor analysis.The score differences of quality of life in different ages of the patients,different stages of the disease were statistically significant (all P ＜ 0.05).Conclusion The SF-36 is practical in studying the quality of life among adult patients with Kashin-Beck Disease.

OBJECTIVEThis study aimed at exploring the feasibility of using dried blood spots (DBS) to detect HIV drug resistance genotyping in China by comparing the results of drug resistance from DBS, plasma and whole blood samples.

METHODSBlood samples were collected from 39 AIDS patients from Anhui (10), Yunnan (13), Hunan (6) and Xinjiang (10) provinces and autonomous regions. The HIV strains that infected these patients covered all the major HIV-1 subtypes prevailing in China (B, CRF01_AE, CRF07_BC). HIV drug resistance genotyping assay was performed on DBS as well as on the whole blood and plasma samples from the same patients simultaneously by using an in-house nest RT-PCR method. Drug resistance levels were determined based on Stanford University HIV drug resistance database, and the results from these three types of samples were compared.

RESULTSThe percentages of successful amplification of protease and reverse transcriptase regions in the pol gene were 95% (37/39) from DBS, 92% (36/39) from whole blood and 100% (39/39) from plasma samples. The sequences from the three types of samples showed more than 99% identity.86% (31/36) of the DBS samples had the same set of drug resistance mutations as those which were detected from plasma samples. The differences probably resulted from mixed bases.

CONCLUSIONSThere was no major difference in detecting HIV drug resistance genotyping among DBS, plasma and whole blood samples. Therefore, DBS is useful for detection of HIV drug resistance genotyping and is particularly valuable in developing countries like China, especially in remote rural regions.

Dried Blood Spot Testing ; Drug Resistance, Viral ; genetics ; Feasibility Studies ; Genotype ; HIV Infections ; blood ; genetics ; virology ; HIV Seropositivity ; blood ; genetics ; virology ; HIV-1 ; drug effects ; genetics ; Humans ; Reverse Transcriptase Polymerase Chain Reaction ; Viral Load

Objective To investigate the incidence and short-term outcome of very preterm infants with physiologic bronchopulmonary dysplasia (BPD).Methods Data of very preterm infants with gestational age of no more than 32 weeks admitted into Guangdong General Hospital between Mar.2011 and Feb.2012 were prospectively collected.Oxygen withdrawing test was performed in these infants at postmenstrual age of 36 weeks.Infants who failed to pass the test or who were ventilated were diagnosed as physiologic BPD.Results Sixty-six infants were admitted,of whom 6 were excluded for more than 36 weeks of postmenstrual age at admission.Eighteen infants(30.0％) were diagnosed as classic BPD.Among them,at testing time point,4 cases did not need supplemental oxygen,13 cases needed oxygen sup-plementation and 1 case needed mechanical ventilation.Thirteen infants underwent oxygen withdrawing test and 6 cases passed.Eight cases (13.3％) were diagnosed as physiologic BPD.The incidences of apnea or bradycardia were of no differences between infants passing or failing to pass oxygen withdrawing test.All infants survived to discharge without supplemental oxygen.Conclusions The incidence of infants with physiologic BPD is significantly lower than that with classic BPD.Restrictive saturation of percutaneous oxygen can decrease the incidence of infants with supplemental oxygen,with no more adverse events.More research are needed on physiologic BPD.

Objective:To analyze the perioperative data of patients with lumbar spinal stenosis who were surgically treated by unilateral biportal endoscopy-unilateral laminectomy for bilateral decompression (UBE-ULBD) technique, and to explore the occurrence, clinical features, and influencing factors for perioperative complications.Methods:A retrospective analysis of the clinical data of 77 patients with lumbar spinal stenosis who underwent UBE-ULBD surgery in the Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University from June 2021 to June 2023 was performed, of which 28 were males and 49 were females, with a mean age of (67.61±15.29) years. The baseline data, surgery-related information, and complications and subjective scores during the perioperative and follow-up periods of the patients were collected. Continuous variables were tested for normality using the Kolmogorov-Smirnov test. Normally distributed continuous variables were expressed as mean ± standard deviation ( ± s), and the Student- t test and analysis of variance for repeated measures information were used for comparison between groups; non-normally distributed continuous variables were expressed as median (interquartile distance) [ M( Q1, Q3)], and and non-parametric tests were used for comparison between groups. Categorical variables were expressed as number of cases and percentage, and the Chi-square test was used for comparison between groups. Variables were analyzed using univariate analysis, and indicators with statistically significant differences in the results of univariate analysis were further included in multivariate Logistic regression analysis to further clarify the independent risk factors for the occurrence of complications. Results:According to the occurrence of postoperative complications, the patients were divided into the non-complication group ( n=73) and the complication group ( n=4). The complication group included 2 cases of dural tear, 1 case of postoperative residual symptoms, and 1 case of postoperative epidural hematoma. Compared with the preoperative results, the Oswestry disability index (ODI) score and visual analogue score (VAS) for low back pain and leg pain on the first day after surgery were improved, and the differences were statistically significant ( P<0.01). Compared with the first day after surgery, except for the ODI scores, the VAS scores for low back pain and leg pain were improved at the third month after surgery, and the differences were statistically significant ( P< 0.01). The differences in intraoperative blood loss and operative time between the two groups were statistically significant ( P<0.05). The variables with statistically significant differences in univariate analysis were included in the multivariate Logistic regression analysis, and the results indicated that prolonged operative time was an independent risk factor for perioperative complications in patients ( OR=1.031, 95% CI: 1.000-1.054, P=0.030). Conclusions:As an effective minimally invasive spinal endoscopic technique for the treatment of lumbar spinal stenosis, the UBE-ULBD technique has the advantages of lower complication rates and faster postoperative recovery. Improvement of surgical proficiency by the operator and appropriate shortening of operative time can help to reduce the incidence of complications such as dural tear.

OBJECTIVE To study and establish the UPLC fingerprint of Scutellaria baicalensis stem-leaf(SBSL)and rapid-ly identify the specific peaks by UPLC-QTOF/MS,and combined with the study of chemical pattern recognition to provide sci-entific basis for resources circulating utilization of the SBSL.METHODS The fingerprint of SBSL was established by UPLC, the samples were conducted by ACQUITY UPLC BEH C18(100 mm×2.1 mm,1.7μm)and eluted with acetonitrile and 0.1%formic acid with the flow rate of 0.4 mL/min.The detection wavelength was set at 254 nm and column temperature was 35℃. Negative ion mode was chosen for qualitative analysis.The capillary voltage was set at 3.0 kV.The nebulization gas was set to 800 L/h at 400℃,and the source temperature was 120 ℃.The similarity evaluation,cluster analysis(CA),and principal component analysis(PCA)were used to deal with the experimental data,in order to find out the similarities and differences a-mong the 11 batches of SBSL from 10 different regions.RESULTS The specific chromatogram of SBSL was obtained,and 19 common peaks were identified by ESI-QTOF/MS.Similarities of the 11 batches of samples from 10 regions were over 0.9,the results of CA and PCA were consistent with similarity evaluation.CONCLUSION The method established in this paper is rap-id,accurate,reliable and reproducible.The establishment of UPLC fingerprint of SBSL and the application of chemical pattern recognition can provide a more comprehensive reference for the quality control of SBSL and the resources circulating utilization value of non-medicinal parts of S.baicalensis.

OBJECTIVETo investigate the therapeutic efficacy of anticoagulation(AC) and its combination with catheter-directed thrombolysis(CDT) for deep venous thrombosis of lower extremities.

METHODSOne hundred and thirty-nine patients with deep venous thrombosis of early lower extremities treated in our hospital from May 2011 to September 2013 were selected and randomly divided into the AC group(n= 66) and CDT+AC group(n= 73). The thrombolytic effects, adverse reactions, post-thrombotic syndrome (PTS) and quality of life were evaluated.

RESULTSThere were no serious adverse events during treatment and after treatment in the 2 groups. Hematomas in 2 cases and gross hematuria in 3 cases were observed in the CDT+AC group. The gums bleed or gross hematuria in 3 cases were observed in the AC group. Compared with the AC group, the number of grade I thrombolysis in CDT+AC group decreased significantly (60.61% vs 9.59%)(P< 0.05), and the number of grade III thrombolysis increased significantly(7.57% vs 49.31%)(P< 0.05). During follow-up, the incidence of PTS in both groups showed increase year by year, and none of the patients had severe PTS. The incidence PTS in CDT+AC group at 12 months and 18 months were lower than those of AC group(17.81% vs 33.33%, 24.66% vs 43.94%)(P< 0.05). Compared with the AC group, the scores of physiological role and vitality in CDT+AC group at 6 months, 12 months and 18 months were higher (P< 0.05).

CONCLUSIONCatheter-directed thrombolysis combined with AC therapy can promote the mitigation of clinical symptoms in patients with DVT of lower extremities and is beneficial to promoting the life quality of patients.

Objective To compare the correlation between transcutaneous bilirubin(TcB) measurement and serum bilirubin (TSB) measurement at covered and exposed skin sites during phototherapy in neonates.Methods Two sites of exposed skin and two sites of covered skin were chosen to measure the transcutaneous bilirubin.The serum bilirubin was monitored at admission and during phototherapy,while the transcutaneous bilirubin was tested and recorded at the same time of monitoring the serum bilirubin.Results A total of 112 cases were included from January 29th to April 15th in 2016.At the four monitoring points during phototherapy,the differences between the transcutaneous bilirubin of the two exposed sites and the serum bilirubin were statistically significant (P＜0.01).For the covered site 4,there were no significant differences between transcutaneous bilirubin and serum bilirubin at every test point (P＞0.05).When the serum bilirubin was higher than 307.8 μmol/L (18mg/dl),the serum bilirubin measurement was larger than the transcutaneous bilirubin measurement.Conclusion The transcutaneous bilirubin level of covered skin was more close to serum bilirubin,especially when the covered median skin of the second rib was chosen to monitor the transcutaneous bilirubin.When the serum bilirubin was greater than 307.8 μmol/L(18mg/dl),the transcutaneous bilirubin couldn't represent serum bilirubin quite well.

Objective:To investigate the intervention effect of modified Shengjiangsan on hypoxia-inducible factor-1α （HIF-1α）/nicotinamide adenine dinucleotide phosphate oxidase 4 （NOX4） signaling pathway in membranous nephropathy （MN） rats and to explore its mechanism to reduce oxidative stress and apoptosis in renal tissues. Method:Cationized bovine serum albumin （C-BSA） was injected into the tail vein of rats to replicate the MN model. Rats were randomly divided into a model group， a modified Shengjiangsan group， and a benazepril group after modeling， and administered by gavage once a day accordingly. At the end of the 4^th week， the 24-h urine total protein （UTP）， urea nitrogen （BUN）， and serum creatinine （SCr） levels of each group were detected. Enzyme-linked immunosorbent assay（ELISA）was used to detect the levels of superoxide dismutase （SOD）， malondialdehyde （MDA）， and reactive oxygen species （ROS） in renal tissues of rats. In situ end labeling（TUNEL） staining was used to detect the cell apoptosis rate. The mRNA and protein expression levels of HIF-1α and NOX4 were detected by real-time fluorescence-based quantitative polymerase chain reaction（Real-time PCR）and Western blot， respectively. The immunohistochemistry method was used to detect the protein expression levels of B-cell lymphomas -2 （Bcl-2）， B-cell lymphomas xl （Bcl-xl）， Bcl-2 associated X protein （Bax）， Bcl-2 cell death regulator antibody （Bim）. Result:Compared with the normal group， the model group showed increased UTP （P<0.05）， decreased SOD， elevated MDA and ROS （P<0.05）， up-regulated mRNA and protein expression of HIF-1α and NOX4 （P<0.05）， enhanced protein expression of Bax and Bim， declining protein expression of Bcl-xl and Bcl-2 （P<0.05）， and increased cell apoptosis in renal tissues. Compared with the model group， the modified Shengjiangsan group and the benazepril group displayed declining UTP （P<0.05）， up-regulated SOD， decreased MDA and ROS （P<0.05）， down-regulated mRNA and protein expression of HIF-1α and NOX4 （P<0.05）， diminished protein expression of Bax and Bim， elevated protein expression of Bcl-xl and Bcl-2 （P<0.05）， and reduced cell apoptosis in renal tissues （P<0.05）. Conclusion:The protective effect of modified Shengjiangsan on the kidney is presumedly achieved by reducing the oxidative stress and apoptosis in renal tissues of MN rats via inhibiting the HIF-1α/NOX4 signaling pathway.