Objective To explore the diagnostic values of dual energy lung perfusion in the diagnosis of pulmonary embolism by using dual-source CT (DSCT). Methods Thirty patients with clinically suspected pulmonary embolism underwent dual-energy scanning with dual-source CT. The scanned data were integrated into three groups including 140, 80 kV and coefficient of 0.3. According to the CT pulmonary angiography (CTPA) of the fusion data, the patients were divided into pulmonary embolism group and normal group. The thin-slice reconstruction of data was analyzed using dual-energy perfusion imaging analysis software. The lung field was divided into upper, middle and lower part to make quantitative analysis of lung tissue perfusion. Paired t-tests were used in the normal patients to compare bilateral lungs, and independent samples t-tests were applied to compare the embolism group and normal group, while minimum intensity projection images (MinIP) were utilized in the assessment of lung ventilation. Results Dual energy CT showed symmetrical homogeneous perfusion in 16 normal cases, without significant perfusion defects. Quantitative analysis showed that left and right lung perfusion were (27 ± 7) and (28 ± 8 ) HU respectively, and no significant difference was found between the two sides ( t=-1.73, P ＞0.05 ).Perfusion of the left upper, middle and lower lung was ( 23 ± 6), (24 ± 6), and (28 ± 8) HU respectively, while the perfusion of right upper, middle and lower lung was (26 ±8), (27 ±8), and (28 ±9) HU respectively, showing no statistical significant difference between the two sides (t=-1.91, -1.96,-1.73 ,P＞0.05 ). Angiography of pulmonary embolism group(14 cases)showed filling defects in the pulmonary trunk, segments and sub-segments. Pulmonary perfusion imaging showed low perfusion or defectsin lung field that dominated by embolic vessels. Quantitative analysis showed that the perfusion of the whole lung and the middle and lower lung were (22 ±5), (22 ±8), and (21 ±8) HU in the embolism group,which were significantly different from the normal group (t=-2. 10, -2.32, -2.63, P＜0.05).Minimum intensity projection images showed a good consistency of abnormal ventilation zone area and perfusion abnormalities. Conclusions Pulmonary perfusion status, especially pulmonary embolism, can be analyzed by dual energy CT scanning. It helps to early discover and precisely locate the embolism.

The internal medicine of paediatrics is the important major course in paediatrics. Focusing on strengthening the constructionof staff, we cultivate all levels of teachers from different administrative level and personality, do schorlarly research meticulously,standardizing management and improve the teaching evaluation system. Besides we promote the construction and development of theinternal medicine of paediatrics by carrying out teaching research, impsoving teaching methods and making paediatics the key subjectin China.

Objective To investigate the effects of commonly used inductive agents on peripheral blood monocytic myeloid-derived suppressor cells (M-MDSCs) in renal transplantation recipients and to discuss their possible mechanism.Methods The enrolled patients received rabbit anti-thymocyte globulin (rATG) or basiliximab for induction therapy,with the maintenance immunosuppressive regimen of tacrolimus,mycophenolate mofetil and steroid.The number of CD11 b + CD33 + HLA-DR-CD14 + CD1 5-M-MDSCs and cytokine levels in peripheral blood,including interferon-γ(IFN-γ),interleukin-2 (IL-2),IL-4 and IL-6,were measured by flow cytometry before and 1 week,2 weeks,1 month,2 months,3 months after operation.Results A total of 47 recipients (29 given rATG 29,and 18 given basiliximab) were included in this study.Compared to the patients with basiliximab,asignificant increase in the frequency of M-MDSCs was observed in the rATG group at 2nd month after operation (5.5％ ± 2.8％ vs.3.8％ ± 1.6％,P＜0.001) and at 3rd month after operation (7.0 ％ ± 3.1％vs.4.1％ ± 2.3 ％,P＜ 0.001),while there was no significant difference in the cell number between the two groups.In the cytokine detection,levels of IL-2 and IL-4 in the rATG-treated recipients were significantly higher at 2nd weekpostoperation (Pr2 =0.032,and PIL-4 =0.019)and 1st month postoperation (PIL-2 =0.024,PIL-4 ＜0.001) than the basiliximab group.Conclusions ATG promotes the expansion of M-MDSCs,which is associated with the secretion of IL-2 and IL-4 due to the lymphocytes depletion.The synergistic immunosuppressive effect may contribute to the induction of immune tolerance.

In order to understand the existing problems in the management of medical ethical review,this paper summed up related domestic literature published in 2001 to 2015 with the method of literature analysis.There existed several problems in the construction and management,the ability of ethical review,external supervision,and other aspects of the current medical ethics committee.It suggests that strengthening external continuous supervision,strengthening the ethics committee itself construction and management and participating in standardized certification can help medical ethics committee to solve the above problems and have important significance for the standardized development.

This paper gives a brief introduction on common troubleshooting of fridge used in medicine and the corrective way of maintenance.
Equipment and Supplies, Hospital ; Humans ; Maintenance ; methods ; Refrigeration ; instrumentation

Objective To investigate the diagnostic value of DTI anisotropy parameters in breast malignant tumors.Methods Fifty four patients,including 33 patients with malignant tumors and 21 patients with benign lesions,were retrospectively analyzed.The E1,MD and FA of lesions were measured and compared by paired t test between the malignant tumors and the contralateral healthy breast tissue.The difference between malignant tumors and benign lesions was analyzed by independent sample t test.Logistic regression analysis was made using E1,FA,MD as predictors in detecting and differentiating the malignant tumors,ROC curve analysis was performed to compare diagnostic performance based on the area under the curve (AUC).Results E1,MD and FA in malignant tumors were (0.99 ± 0.12) × 10-3mm2/s,(0.85 ±0.26) × 10-3mm2/s and 0.20 ±0.08 respectively,and those in normal breast tissues were(1.46 ± 0.55) × 10-3 mm2/s、(1.48 ± 0.44) × 10-3 mm2/s and 0.29 ± 0.17 respectively.Those parameters in benign lesions were (1.80 ±0.42) × 10-3mm2/s,(1.38 ±0.52) × 10-3mm2/s and 0.22 ± 0.10 respectively.Significant statistic differences were found between malignant tumors and normal breast tissues in E1,MD and FA (t =-4.889,-6.449,-2.842 ; P ＜ 0.01).Significant statistic differences were also found between malignant tumors and benign lesions in E1 and MD (t =-10.476,-4.394; P ＜ 0.01) with no difference found in FA (P ＞ 0.05).E1,MD and FA are independent predictors in malignant tumors' detection,and the combination of E1,MD and FA significantly improved discrimination between cancer and normal tissue over each one alone with the sensitivity 97.0％ (32/33),specificity 97.0％ (32/33),accuracy 97.0％ (64/66).Combination of E1 and MD had a similar AUC with E1 and a more AUC than MD and FA,with the sensitivity 97.0％ (32/33),specificity 100.0％ (21/21),accuracy 98.1％ (53/54).Conclusion The regression model combining E1,MD and FA is most valuable in breast cancer detection and E1 is the preferred index for the differentiation of breast cancers from benigin lesions.

Objective Identify novel protein kinase Cε(nPKCε)-interacted proteins in the cortex of hypoxic preconditioned mice.Methods Immunoprecipitation (IP) and two-dimensional electrophoresis (2-DE) combining with ImageMaster 2D Platinum software were applied to analyze the differential expressions of nPKCe-interacted proteins;the target protein spots were identified by matrix-associated laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS) and Western blot.Results Compared with control group,there were 34 upregulated protein spots and 20 downregulated protein spots in cytosolic fraction,while 27 upregulated prtein spots and 28 downregulated protein spots were determined in particulate fraction of cerebral cortex of HPC mice.The levels of nPKCε-interacted HSP 70 and 14-3-3γ/protein expressions increased significantly in both cytosolic and particulate fractions;but the protein level of nPKCε-interacted HSP60 increased only in particulate fraction of cerebral cortex of HPC mice.Conclusion nPKCε might be involved in the development of cerebral HPC via the regulation of its interacted proteins such as HSP60,HSP70 and 14-3-3γ.

Objective To investigate the effects of granulocyte-macrophage colony-stimulating factor (GM-CSF) on the generation of human myeloid derived suppressor cells (MDSCs) relied on peripheral blood monocytes,and to establish efficient induction system in vitro of MDSCs.Methods Kidney transplantation recipients between January and March 2017 were included in this study.Purified CD14 + cells isolated from peripheral blood were cultured in the presence of GM-CSF with different concentrations for 7 days.Phenotypes and immunosuppressive abilities of induced MDSCs (iMDSCs) were investigated with FACS analyses.Inducible nitric oxide synthase (iNOS) mRNA expression was detected by qRT-PCR to determine the influence of iNOS-pathway on the immunosuppressive abilities of iMDSCs.Results A total of 11 recipients were included in this study.HLA-DR expression decreased sharply after the culture with GM-CSF.iMDSCs showed the similar phenotype characteristics with monocytic-MDSCs (M-MDSCs) as well as significant ability to suppress T cells proliferation and cytokines production.iMDSCs expressed higher levels of iNOS than monocytes,and the inhibitor effects of iMDSCs were significantly reduced after treatment with L-NMMA (1 mmol/L).The variations of phenotype and suppressive ability were concentrationdependent,and more significant changes could be revealed in the group of 10 μg/L GM-CSF.Conclusion GM-CSF-treated peripheral blood monocytes can be efficiently transformed to M-MDSCs,and suppress T cells proliferation and cytokines secretion via iNOS-dependent pathway.These results may contribute to establish MDSCs induction system,which would provide a basis for the clinical application of MDSCs.

OBJECTIVE: To explore whether there was tissue remodeling in the nasal mucosa of allergic rhinitis (AR) patients and detect the protein expressions of transforming growth factor beta1 (TGF-beta1), matrix metalloproteinases 9 (MMP-9) and tissue inhibitors of matrix metalloproteinases 1 (TIMP-1) in the nasal mucosa of these patients. METHOD: Pathologic staining was used to explore the mucosa of the middle turbinate tissues from 16 patients with mild AR, from 12 patients with severe AR, and from 15 non-AR, respect. The infiltrating of eosinophils and damage of epithelium were examined by the hematoxylin-eosin staining; goblet cells were counted by the alcian blue-periodic acid-schiff staining; the percentage area of extracellular matrix was determined by the MT; the protein expressions were measured by ELISA of TGF-beta1, MMP-9 and TIMP-1 in the middle turbinate tissues. RESULT: Compared with the control group, significant eosinophil infiltration and goblet cells were observed in both AR groups (P < 0.05). Evident epithelial damage and extracellular matrix deposition were observed in severe-AR group (P < 0.05). The expressions of TGF-beta1, MMP-9 and TIMP-1 in AR tissues were significant increased (P < 0.05). CONCLUSION The nasal mucosa remodeling was observed in AR groups. The characteristics were as follows: eosinophils infiltration, epithelial damage, goblet cells hyperplasia and extracellular matrix deposition. TGF-beta1, MMP-9, TIMP-1 may play a role in the tissue remodeling processes.
Adolescent ; Adult ; Case-Control Studies ; Female ; Humans ; Male ; Matrix Metalloproteinase 9 ; metabolism ; Middle Aged ; Nasal Mucosa ; metabolism ; pathology ; Rhinitis, Allergic, Perennial ; metabolism ; pathology ; Tissue Inhibitor of Metalloproteinase-1 ; metabolism ; Transforming Growth Factor beta1 ; metabolism ; Young Adult

Objective To investigate whether conventional protein kinase C (cPKC ) βⅡ-interacting collapsin response mediator protein-2 (CRMP-2) provides neuroprotection against cerebral ischemic (I) injuries. Methods Male BALB/c mice were randomly divided into normoxic control (Nor) , HPC, Nor + Sham, HPC + Sham, Nor + I and HPC + I groups (n = 6 per group). Using our HPC and MCAO mouse models, we applied immunoprecipita-tion, two-dimensional electrophoresis and mass spectrometry to characterize cPKCβⅡ-interacting proteins and combined with SDS-PAGE and Western blot to quantitatively analyze CRMP-2 phosphorylation and degradation levels in the brain of mice after HPC and MCAO. Results The expression level of 10 cPKCβⅡ-interacting proteins changed obviously in cerebral cortex of HPC mice when compared with Nor group. One of these proteins, CRMP-2 protein level increased in particulate fraction and decreased in cytosolic fraction of cerebral cortex of HPC mice. CRMP-2 phosphorylation level in ischemic core (Ic) of cerebral cortex decreased significantly ( P < 0. 05 , n = 6) as compared with that of Nor + sham group, but CRMP-2 phosphorylation level in HPC +I group increased significantly as compared with that of Nor +I group ( P < 0. 05, n = 6). In ischemic cortex, CRMP-2 degradation (proteolysis) was observed as the appearance of 55 ku breakdown products (BDP). However, the CRMP-2 degradation level, BDPs products decreased significantly in penumbra ( P) of ischemic cortex from HPC +I group when we compared with that of Nor +I group (P < 0. 05, n = 6 ). Conclusion CRMP-2 is involved in attenuating the decrease of CRMP-2 phosphorylation in ischemic core and in inhibiting its degradation in penumbra of cerebral cortex of mice thereby to lessen the ischemic injuries.