Objective To evaluate the clinical value of SCTPA and pulmonary V/Q scan in the diagnosis of pulmonary thromboembolism(PTE).Methods Ninety-two patients suspected of having PTE received SCTPA,pulmonary V/Q scan,and other related examinations.Results Thirty-five patients were diagnosed as having PTE in 92 patients investigated,30 cases were revealed by SCTPA,and 20 cases revealed by pulmonary V/Q scan.The area under ROC curve of SCTPA by V/Q scan and combination examination was 0.922,0.824,and 0.933,respectively(P

Objectives To evaluate the effect of N-Acetylcysteine on the airway inflammation and remodeling of obese asthma mice with high-fat diets. Methods Forty female C57BL/6J mice were randomly divided into 4 groups, asthma group (A), obese asthma group (B), treatment group (C) and normal control group (D). Group A were sensitized and challenged by ovalbum (OVA) and normal diets. Group B were sensitized and challenged as group A but fed with high-fat diets, while group C were sensitized, challenged and fed as group B, but administrated N-Acetylcysteine 200 mg/kg. d from the third week after challenge. The cells in BALF were counted and classified after staining, IL-6 and 8-iso-PGF2α(8-iso-PGF2α) in lung tissues were detected by ELISA. WAt, WAm, Pbm, as the remodeling indices, measured in lung pathological section. All parameters were compared among 4 groups. Results In comparison with group D, the leukocytes and EOS in BALF, WAt/Pbm, WAm/Pbm in lung section were increased as well as IL-6 and 8-iso-PGF2α in lung tissue elevated in group A and group B, while the maximum changes were observed in group B (P ＜0. 05). After NAC treatment, the IL-6, 8-iso-PGF2α and WAt/ Pbm were decreased significantly (P ＜0. 05). Pearson correlation analysis showed that WAt/Pbm and IL-6 were in positive correlation with 8-iso-PGF2α (r =0. 817, 0. 737, P ＜0. 01). Conclusions N-Acetylcysteine can alleviate the airway inflammation and remodel reaction of asthma by a substantial inhibition of the oxidative stress reaction in lung.

Objective:To survey the awareness of common primary care clinical guidelines among primary care providers in Qingdao city.Methods:A questionnaire survey on the awareness of common clinical guidelines in primary care was conducted in August 2020 among 659 providers (293 males and 366 females) from 81 primary medical institutions in Qingdao city. The contents of the questionnaire included the general information of primary physicians, the frequency of using the guidelines, the level of understanding of the guidelines, the effect of guidelines in clinical work, the attitudes towards promoting the guidelines, and the interest in learning the guidelines and the way of learning.Results:A total of 659 valid questionnaires were recovered with a recovery rate of 100.0%. The results showed that 14.7% (97/659) practitioners applied the guidelines in most cases, and 31.6% (208/659) frequently used. There were significant differences in use frequency among providers with different practice types, professional titles, education background, practice locations and institutions ( P<0.01). Among participants, 15.2% (100/659) did not know about primary care guidelines, 63.3% (417/659) knew but did not learned guidelines, 21.5% (142/659) knew and studied guidelines carefully. The top five of the learned guidelines (114, 80.3%) were bronchial asthma (113, 79.6%), type 2 diabetes (108, 76.1%), chronic obstructive pulmonary disease (101, 71.1%), and chronic cor pulmonale (83, 58.5%). Most participants who learnt the guidelines viewed the guidelines as quite helpful or very helpful, the score of usefulness for professional knowledge was the highest (4.44±0.60). Most of participants (94.2%, 621/659) thought it was necessary to develop primary care guidelines; and the major factors affecting the promotion were lack of training (79.8%, 526/659), difficulties in access (46.7%, 308/659) and ignorance or neglect (23.2%, 153/659).Most practitioners (93.8%, 618/659) were interested in learning primary care clinical guidelines, and the expected ways of training were online teaching (70.0%, 420/618), training courses(58.3%, 360/618) and special lectures (55.2%, 341/618). Conclusion:The current situation of learning clinical guidelines among primary care providers in Qingdao is not satisfactory, but they are willing to learn the guidelines for improving clinical practice. We should strengthen the training and promotion of primary care guidelines among primary care providers in the future.

Objective This study was aimed to characterize the swine leukocyte antigen( SLA) class I genes of GGTA1 -/ - Wuzhishan minipigs and compare their similarity to human leukocyte antigen( HLA) . It has important implica?tions for understanding the cellular rejection in xenotransplantation. Methods Specimens of ear tissue from six founding GGTA1 -/ - Wuzhishan minipigs were collected, and the SLA class I genes (SLA?1, SLA?3, SLA?2) were amplified by RT?PCR. Purified products were cloned into pEASY?T1 vectors and sequenced, followed by BLAST alignment and using bioin? formatc analysis to characterize the SLA class I genes and compare with the similarity to HLA. Results A total of six al?leles were detected, among them alleles were previously reported (SLA?1?0703,SLA?2?1102, SLA?3?0401, SLA?3?0403), and the other were novel (SLA?1?0401wz01, SLA?2?11wz01). The homology between alleles of SLA class I genes in Wuzhishan minipigs and HLA was from 70?5% to 72?1%. The homology analysis of critical amino acid residues on HLA binding with human CD8 + molecules showed that SLA?1?0401wz01, SLA?1?0703, SLA?2?11wz01, SLA?2?1102 and SLA?3?0401 occurred mutant at amino acid positions 225 and 228 ( T→S,T→M) , whereas the other loci were highly conserved. There was a high homology at amino acid level between SLA?2?11wz01, SLA?2?1102 and HLA class I genes which are NK cell KIRs binding sites. Conclusions The amino acid sequences of SLA class I genes of GGTA1 -/ -Wuzhishan minipigs have a high homology to HLA. From the point of view of cell?mediated xenograft rejection, the amino acid sequences of SLA class I genes of GGTA1 -/ - Wuzhishan minipigs have a high homology to HLA, therefore, Wzhishan minipigs may become a good potential donor for pig?human xenotransplantation.

Objective:The predictive value of LCR and BIS monitoring for delayed encephalopathy in acute severe carbon monoxide poisoning.Methods:Ninety-four patients with acute severe carbon monoxide poisoning treated in the Harrison International Peace Hospital Affiliated to Hebei Medical University between January 2017 and March 2019 were selected. According to whether DEACMP occurred within 60 days after discharge, the patients were divided into the DEACMP group ( n=33) and good prognosis group ( n=61). LCR and BIS of the two groups at different time points were compared, and the correlation between LCR and BIS was analyzed. The predictive value of LCR, BIS and the combination of the two for DEACMP was analyzed by receiver operating characteristic (ROC) curve. Results:The LCR and BIS of the DEACMP group at day 1t, 3 and 5 were significantly lower than those of the good prognosis group ( P<0.05). Pearson correlation analysis showed that there was a positive correlation between BIS and LCR in the DEACMP group at day 1, 3 and 5 ( r=0.371, P<0.05). There was also a positive correlation between LCR and BIS in the good prognosis group at day 1, 3 and 5 ( r=0.373, P<0.05). ROC curve analysis showed that the areas under the curves of LCR, BIS and the combination of the two for predicting the occurrence of DEACMP in patients with ASCOP were 0.803 (95% CI: 0.707~0.897), 0.941 (95% CI: 0.886~0.997), and 0.949 (95% CI: 0.879~1.000), respectively. Conclusions:LCR combined with BIS is of high predictive value for the occurrence of DEACMP in patients with ASCOP.

Objective:To analyze the correlation and predictive value between early BIS monitoring combined with lactic acid resolution (LCR) and delayed encephalopathy with acute severe carbon monoxide poisoning (ASCMP) .Methods:Select 96 cases of our hospital ASCMP patients were analyzed retrospectively in March 2020, and follow-up of 60 days, according to the outcome in patients with acute carbon monoxide poisoning (DEACMP) delayed encephalopathy group with good prognosis, compare two groups of general information, admission BIS average 24 h and 24 h after treatment the LCR, According to the 24h LCR test results, patients were divided into high LCR group (LCR>15%) and low LCR group (LCR≤15%) , analysis the BIS average, the correlation of the LCR with DEACMP and both individual and joint of DEACMP predictive value, Comparing clinical data of patients with high LCR and low LCR.Results:The mean BIS value of the DEACMP group 24 hours after admission was significantly lower than that of the group with good prognosis ( P< 0.05) . LCR of DEACMP group was significantly lower than that of the group with good prognosis after 24 h treatment ( P<0.05) . The prevalence of DEACMP in patients with high LCR was significantly lower than that with low LCR ( P<0.01) ; In the early stage, BIS mean, LCR and DEACMP were negatively correlated ( P< 0.05) , and the area under the curve predicted by BIS mean, LCR and their combination on DEACMP was 0.799, 0.847 and 0.902, respectively. Conclusion:Early BIS monitoring combined with LCR has a significant correlation with DEACMP, and the combined effect of the two is better. Early BIS combined with LCR detection can provide effective guidance for the prognosis assessment of ASCMP patients.

Objective:To analyze the correlation and predictive value between early BIS monitoring combined with lactic acid resolution (LCR) and delayed encephalopathy with acute severe carbon monoxide poisoning (ASCMP) .Methods:Select 96 cases of our hospital ASCMP patients were analyzed retrospectively in March 2020, and follow-up of 60 days, according to the outcome in patients with acute carbon monoxide poisoning (DEACMP) delayed encephalopathy group with good prognosis, compare two groups of general information, admission BIS average 24 h and 24 h after treatment the LCR, According to the 24h LCR test results, patients were divided into high LCR group (LCR>15%) and low LCR group (LCR≤15%) , analysis the BIS average, the correlation of the LCR with DEACMP and both individual and joint of DEACMP predictive value, Comparing clinical data of patients with high LCR and low LCR.Results:The mean BIS value of the DEACMP group 24 hours after admission was significantly lower than that of the group with good prognosis ( P< 0.05) . LCR of DEACMP group was significantly lower than that of the group with good prognosis after 24 h treatment ( P<0.05) . The prevalence of DEACMP in patients with high LCR was significantly lower than that with low LCR ( P<0.01) ; In the early stage, BIS mean, LCR and DEACMP were negatively correlated ( P< 0.05) , and the area under the curve predicted by BIS mean, LCR and their combination on DEACMP was 0.799, 0.847 and 0.902, respectively. Conclusion:Early BIS monitoring combined with LCR has a significant correlation with DEACMP, and the combined effect of the two is better. Early BIS combined with LCR detection can provide effective guidance for the prognosis assessment of ASCMP patients.

Objective:To evaluate the effectiveness of remote pulmonary rehabilitation in the elderly COPD patients in order to provide evidence-based basis for the clinical practice and promotion of remote pulmonary rehabilitation.Methods:We searched databases including Web of Science, PubMed, Cochrane Library, Embase, CINAHL,China Biology Medicine disc, China National Knowledge Internet, VIP, and Wanfang and selected all randomized controlled trials (RCTs) that reported the effects of telerehabilitation on the elderly patients with COPD. The retrieval time was from the establishment of the database to April 26, 2023. Meta-analysis was performed by RevMan 5.3.Results:A total of 24 RCTs involving 2 980 patients with COPD were finally included. Meta-analysis results showed that telerehabilitation in the elderly patients with COPD can improve the lung function (FEV 1/FVC) ( MD=2.09, 95% CI 0.30-3.89, P<0.05), quality of life ( MD=-0.66, 95% CI -1.05--0.26, P<0.05), anxiety ( MD=-0.69, 95% CI -1.32--0.05, P<0.05) and depression ( MD=-0.81, 95% CI -1.59--0.04, P<0.05), and the subgroup for the lung function (FEV 1/FVC) of the elderly patients with COPD emphasized that physical activity, intervention time ≤24 weeks, intervention frequency 1-3 times per week, and use of network platform, there were significant differences between those subgroups (all P<0.01). But there was no statistically significant difference in improving the exercise capacity ( MD=-1.54, 95% CI -14.83-11.75, P>0.05). Conclusions:Telerehabilitation in pulmonary can be considered a supplementary intervention for improving the lung function (FEV 1/FVC), the quality of life and the psychological condition on the elderly patients with COPD.