Objective To compar the cerebrospinal fluid (CSF) flow between empty sella syndrome (ESS) and normal volunteer in the cerebral aqueduct with MRI in phase contrast cine mode. Methods Thirty-eight ESS patients (ESS group) and 38 normal volunteers (control group ) were involved in this study.The aqueduct CSF flow image was positioned perpendicularly to the midbrain aqueduct at the middle sagittal T1WI or T2WI image. The waveforms were analyzed for the flow direction, flow rate, flow volume rate and cardiac cycle. Results The CSF flow of the aqueduct in control group and ESS group had two directions which was downward flow during the systolic period and upward flow during the diastolic period of the cardiac cycle. The.systolic period downward peak flow rate, diastolic period upward peak flow rate, mean downward flow rate, mean upward flow rate and mean flow rate were (5.231 ± 0.262), (4.902 ± 0.281 ),(3.083 ± 0.191 ), (3.032 ± 0.151 ), (3.151 ± 0.162) cm/s in control group, and (6.244 ± 0.356), (6.091 ±0.430), (3.916 ± 0.196), (3.812 ± 0.273 ), (3.690 ± 0.291 ) cm/s in ESS group respectively,and there was no significant difference between the two groups ( P ＞ 0.05 ). The systolic period downward peak flow volume rate, diastolic period upward peak flow volume rate, mean downward flow volume rate,mean upward flow volume rate and mean flow volume rate were (0.050 ± 0.003 ), (0.050 ± 0.004), (0.030± 0.002), (0.031 ±0.002), (0.030 ± 0.003 ), ( 0.004 ± 0.001 )ml/s in control group, and (0.058 ± 0.003 ), (0.063 ± 0.005),(0.039 ±0.002), (0.038 ±0.003), (0.038 ±0.003), (0.004 ±0.001) ml/s in ESS group respectively,and there was no significant difference between the two groups(P ＞ 0.05 ). The correspond cardiac cycle of systolic period downward peak flow rate, correspond cardiac cycle of diastolic period upward peak flow rate, mean cardiac cycle were (40.890 ± 37.096), (501.026 ± 19.374), (719.511 ± 14.946) ms in control group,and (35.921 ±6.218), (531.553 ± 16.764), (770.700 ±21.579) ms in ESS group,and there was no significant difference between the two groups (P ＞ 0.05 ). Conclusion Part of CSF flows into the area of saddle in ESS patients, but it has no effect on CSF indexes in area of cerebral aqueduct.

ObjectiveTo investigate the clinical effect of nape acupuncture on post-stroke dysphagia by a meta-analysis.Method Domestic literature on clinical randomized controlled trials of nape acupuncture treatment of post-stroke dysphagia published from Jun. 2004 to Jun. 2014 were obtained by a computer search ofChina National Knowledge Internet(CNKI), Wanfang Data medical information system (WF), VIP information resource system (VIP) and Chinese Biomedical Literature Database (CBM) combined with a manual search of Jinan University library journal database. Literature inclusion and exclusion criteria were established to extract data and the qualities of the included studies were assessed using a Jadad rating scale. A meta-analysis was made using the software ReviewManager 5.2.ResultA total of 17 articles were included with 1158 patients. The results of meta-analysis showed that there were statistically significant differences in the total efficacy rate [OR=3.99, 95%CI(2.83, 5.63),P<0.00001] and the cure rate[OR=2.67, 95%CI(2.03, 3.53),P<0.00001] between the nape acupuncture and control groups.ConclusionNape acupuncture has clinically a good therapeutic effect on post-stroke dysphagia. Multi-center, large-sample and high-quality studies are still needed for validation because the qualities of the included articles are lower, which is one of the factors influencing the assessment.

BACKGROUND: More and more patients with small pulmonary nodules (SPN) can be found along with the developing of chest low-dose computed tomography (LDCT). With current examinations not all the SPN can be diagnosed to be benign or malignant and not all the malignant nodules can be diagnosed to be lymphatic metastasis. We need to study the correlation between plasma D-dimer count of patients before surgery with pathology features of non-small cell lung cancer (NSCLC). METHODS: The study comprised 567 highly suspected lung cancer patients. Preoperative plasma D-dimer were qualified, and the relationship between plasma D-dimer with pathology features including benign or malignant nodules, tumor size and involvement of lymph nodes was examined using Kruskal-Wallis test and Spearman correlation coefficients. RESULTS: The median plasma D-dimer values were statistically higher in NSCLC patients than in those who suffered from benign lung nodules (P<0.001). The median plasma D-dimer values in NSCLC patients with malignant lymph nodes were statistically higher than in those without malignant lymph nodes (P<0.001). An obvious relationship was observed between elevated D-dimer with number of malignant lymph nodes involvement and tumer size. An obvious relationship was observed between elevated D-dimer (>112.5 ng/mL) and malignant lymph node involvement in stage T1 lung cancer. CONCLUSIONS The plasma D-dimer maybe useful for early diagnosis, staging and prognosis of the patients with NSCLC. The plasma D-dimer can be one of the indicator to identify what kind of patients need mediastinal lymph node cleaning.
Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; blood ; pathology ; Female ; Fibrin Fibrinogen Degradation Products ; metabolism ; Humans ; Lung Neoplasms ; blood ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Retrospective Studies

Tocilizumab has been reported to attenuate the "cytokine storm" in COVID-19 patients. We attempted to verify the effectiveness and safety of tocilizumab therapy in COVID-19 and identify patients most likely to benefit from this treatment. We conducted a randomized, controlled, open-label multicenter trial among COVID-19 patients. The patients were randomly assigned in a 1:1 ratio to receive either tocilizumab in addition to standard care or standard care alone. The cure rate, changes of oxygen saturation and interference, and inflammation biomarkers were observed. Thirty-three patients were randomized to the tocilizumab group, and 32 patients to the control group. The cure rate in the tocilizumab group was higher than that in the control group, but the difference was not statistically significant (94.12% vs. 87.10%, rate difference 95% CI-7.19%-21.23%, P = 0.4133). The improvement in hypoxia for the tocilizumab group was higher from day 4 onward and statistically significant from day 12 (P = 0.0359). In moderate disease patients with bilateral pulmonary lesions, the hypoxia ameliorated earlier after tocilizumab treatment, and less patients (1/12, 8.33%) needed an increase of inhaled oxygen concentration compared with the controls (4/6, 66.67%; rate difference 95% CI-99.17% to-17.50%, P = 0.0217). No severe adverse events occurred. More mild temporary adverse events were recorded in tocilizumab recipients (20/34, 58.82%) than the controls (4/31, 12.90%). Tocilizumab can improve hypoxia without unacceptable side effect profile and significant influences on the time virus load becomes negative. For patients with bilateral pulmonary lesions and elevated IL-6 levels, tocilizumab could be recommended to improve outcome.
Antibodies, Monoclonal, Humanized ; COVID-19/drug therapy* ; Humans ; SARS-CoV-2 ; Treatment Outcome