Esophageal Neoplasms ; drug therapy ; pathology ; Humans ; Induction Chemotherapy ; Neoplasm Staging ; Preoperative Period

Objective To investigate the value of CARE Dose 4D technique in decreasing radiation dose and improving image quality of multi-slice spiral CT in adult chest scanning.Methods 100patients of chest CT scanning were equally divided into study group and control group randomly.CARE Dose 4D Technique was used in study group.Effective mAs value,volume CT dose index (CTDIvol) and dose length product (DLP) were displayed automatically in machine while chest scanning; those values and actual mAs value of every image were recorded respectively.The image quality at apex of lung,lower edge of aorta arch,middle area of left atrium and base of lung on every image of 400 images was judged and classified as three level (excellent,good,poor) by two deputy chief physicians with double blind method,the image noise at corresponding parts was measured.Results While setting 80 mAs for quality reference mAs,the effective mAs value in study group most decreased 44 mAs than control group with an average decrease of 9.60( 12.0% ) ,CTDIvol with 4.75 mGy with an average decrease of 0.95 mC y( 11.0% ) ,DLP 99.50% in study group,with 98.0% in control group.But it was higher at apex of lung and base of lung,lower at middle area of left atrium,and similar at lower edge of aorta arch in study group than contrast group.The image noise were lower at apex of lung and base of lung in study group than control group (t =6.299 and 2.332,all P ＜ 0.05 ) ,higher at middle area of left atrium in study group than control group (t=3.078,P ＜0.05) and similar at lower edge of aorta arch in study group than control group (t =1.191,P ＞0.05).Conclusions CARE Dose 4D technique provides a function regulated mAs real-time on line,it not only raises utilization rate of radiation and decreases radiation dose,but also promises and increases image quality in chest CT scanning,and has some clinical significance.

Objective To compare the difference in cardiac injuries between asphyxia and ventricular fibrillation modes in different periods after cardiac arrest (CA).Methods The model was established in Cardiopulmonary Resuscitation Lab,Sun Yat-sen University.A total of 35 male SD rats were used to produce the asphyxia or ventricular fibrillation (VF) cardiac arrest models randomly.Both of the two modes were induced 8 minutes cardiac arrest.The myocardial HE stains,mitochondrial respiratory control ratio (RCR),and echocardiography were observed at 4 h,24 h and 72 h after ROSC (restoration of spontaneous circulation).The results were expressed as (-x ± s),t test was performed to compare between two groups,and one way analysis of variance was used to compare multiple groups.P ＜ 0.05 was considered as significant difference.Results HE stains showed damages were more serious in the VF mode than in asphyxia mode at 4 h,and both of them had a disorderly-arranged myocardium at 72 h.RCR in VF mode became worse at 4 h,and RCR resumed at 24 h in both modes without significant difference compared with the sham operated rats.The echocardiography showed VF mode had a lower left ventricular ejection fraction (LVEF) than asphyxia mode at 4 h (29.68％ vs.42.16％,P =0.03),and there was no difference in LVEF between VF mode and the sham operated rats at 24 h,however no difference in LVEF between the asphyxia and sham operated rats at 72 h.Both of them had a thicker left ventricular anterior wall than the sham operated rats at 72 h (2.41 mm vs.1.72 mm,P=0.013; 2.61 mmvs.1.72 mm,P=0.007),and there was no significant difference between them.Conclusions The ventricular fibrillation mode has a more severe injuries in early period,but it recovers sooner than asphyxia one.Both of two groups get compensatory left ventricular hypertrophy in later period of ROSC.

Immunologic classification of acute lymphocytic leukemia (ALL) was carried out by using 11 - 13 kinds of monoclonal antibodies against human leucocyte differentiation antigens in 19 cases. The results showed that of these 19 cases, there were T-ALL in 4, B-ALL in 4, C-ALL in 7, AUL in 2 and hybrid type of ALL (H-ALL) in 2. The 5 types mentioned above could also be classified, according to the immunologic criteria described by Foon in 1986, into 3 major groups: T-ALL, non-T-ALL and H-ALL. The Foon's classification method is useful for judgement of malignant cell source and differentiated stage, and for further understanding the nature of ALL cells.

Objective:To investigate the clinical characteristics and prognosis of secondary hemophagocytic syndrome (HPS) in adults.Methods:The clinical data of 43 adult patients with primary secondary HPS in Mianyang Central Hospital of Sichuan Province from January 2014 to June 2020 were retrospectively analyzed. The patient's clinical manifestations and biochemical indicators were summarized. The clinical characteristics of patients between high-level ferritin (≥5 000 μg/L) group and low-level ferritin (<5 000 μg/L) group, lymphoma-related HPS group and infection-related HPS group were compared. Logistic regression model was used for multivariate survival analysis.Results:All patients had fever as the main complaint, and infections were manifested at the onset or during treatment. In all patients, 88.4% (38/43) had hemophagocytosis in the bone marrow; 88.4% (38/43) had varying degrees of cytopenia; 36.6% (15/41) had reduced fibrinogen [median value 0.93 g/L (0.50-1.35 g/L)]; 76.7% (33/43) had elevated aminotransferase. Compared with the low-level ferritin group (19 cases), the high-level group (21 cases) had a lower proportion of monocytes (0.081±0.040 vs. 0.163±0.076, P = 0.016), the incidence of fibrinogen reduction and the incidence of aminotransferase elevation were high [60.0% (12/20) vs. 11.1% (2/18), P = 0.002; 95.2% (20/21) vs. 52.6% (10/19), P = 0.006]. Compared with infection-related HPS patients, lymphoma-related HPS patients had a higher incidence of lymphadenopathy [72.7% (16/22) vs. 27.8% (5/18), χ2 = 8.021, P = 0.005] and a lower incidence of aminotransferase elevation [59.1% (13/22) vs. 94.4% (17/18), χ2 = 4.848, P = 0.028]. Multivariate analysis showed that the high proportion of neutrophils ( OR = 0.886, 95% CI 0.786-0.998, P = 0.046) and high-level albumin ( OR = 0.376, 95% CI 0.156-0.907, P = 0.030) after treatment were protective factors for survival of patients. Conclusions:Among adult patients with primary secondary HPS, the proportion of monocytes in patients with ferritin ≥5 000 μg/L is low, and liver damage and fibrinogen reduction are more likely to occur. Lymphoma-related HPS patients are more likely to have lymphadenopathy, and infection-related HPS patients are more likely to have liver damage. After treatment, a low proportion of neutrophils and hypoproteinemia indicate a poor prognosis in adult patients with secondary HPS.

OBJECTIVE:To establish the quality standard of Liyan mixture. METHODS:TLC was conducted to identify the Scrophularia ningpoensis,Terminalia chebula and Glycyrrhiza uralensis;HPLC was conducted to determine the content of chloro-genic acid. The column was Agilent Eclipse Plus C18 with mobile phase of methanol-0.2% phosphoric acid (18:82,V/V) at flow rate of 1.0 ml/min,the detection wavelength was 327 nm,column temperature was 30 ℃ and the injection volume was 20 μl. RE-SULTS:TLC showed S. ningpoensis,T. chebula and G. uralensis had clear spots and good separation. There was no interference for negative control. The linear range of chlorogenic acid was 0.16-1.6 μg(r=0.999 9);RSDs of precision,stability and reproduc-ibility tests were lower than 1.0%,recovery was 96.9%-101.4%(RSD=1.17%,n=9). CONCLUSIONS:The method is simple and reproducible,and can be used for the quality control of Liyan mixture.

Objective To observe the effect and safety of the human glucagon-like peptide-1 analogue,liraglutide,versus insulin glargine in patients with type 2 diabetes mellitus inadequately controlled with metformin alone.Method Ninty patients with type 2 diabetes mellitus(aged 18-79 years,HbA1C 7.5％-10.0％,body mass index＜40 kg/m2) who had inadequate glycaemic control on metformin were allocated for the research with an open,randomized,parallel controlled clinical research method.The patients kept the original dose of metformin unchanged and were randomly assigned to the liraglutide group or the insulin glargine group according to a proportion of 1 ∶ 1.Liraglutide group started with a dose of 0.6 mg subcutaneous injection qd,changed to 1.2 mg subcutaneous injection qd after one week and kept unchanged until the end of the research.Insulin glargine group started with a dose of 0.1-0.2 U/kg according to the fingertips peripheral blood glucose level before breakfast on the continuous 3 d before every follow-up.At the baseline,after 4 weeks,12 weeks,20 weeks,and 26 weeks of treatment,HbA1C,blood glucose,lipids weight,blood pressure were arranged to measured.86 patients finally completed the study.Results Mean HbA1C and the success rate of HbA1C ＜7％ were similar between liraglutide group and insulin glargine group [(7.06 ± 0.87) ％ vs (7.25 ± 1.20) ％,47.73 ％ vs 45.23 ％,P＞0.05],while the percentage of subjects reaching the composite endpoint of HbA1C＜7％ with no hypoglycemia and no weight gain was significantly higher in liraglutide group than insulin group(P＜0.05) ; Fasting plasma glucose decreased more markedly in insulin glargine group,2 h postprandial plasma glucose was decreased more markedly in liraglutide group(P＜0.05 or P＜0.01).Liraglutide significantly reduced mean body weight by (3.21 ± 1.18) kg,waist circumference by (3.82 ± 1.21) cm,and body mass index by (1.95 ± 0.61) kg/m2 (P＜0.01 or P＜0.05),while in the insulin glargine group there sere rise of respective figure of(2.86 ± 0.43) kg,(1.52 ± 0.56) cm,and (0.61 ± 0.25) kg/m2 (P＜0.05),systolic blood pressure and serum triglyceride declined.There was no serious adverse affect in both groups,the incidence of mild hypoglycemia was significantly less in liraglutide group and has a statistically significant difference (4.55％ vs 21.43％,P＜0.05).Conclusions Liraglutide showed a good effect on reducing weight,systolic blood pressure,blood lipid and in addition to blood glucose control which is comparable to insulin glargine.What is more,liraglutide had good safety and tolerability,which can be regarded as a good choice for patients with type 2 diabetes mellitus inadequately controlled with metformin alone.

A questionnaire was used to survey the perspective of the 22 mentors,24 students, 27 graduate students and 27 public health units on the competence of MPH student. The result showed that the practice skill,analyzing skill,program plan and practice skill,and emergency reaction abil-ity got more attention. This suggested that to the training of MPH,the training objective should focus on the ability to resolve problems; the curriculum should focus on the characters of public health and on the practice training.

OBJECTIVETo explore the effect of Qiling Decoction (QD) combined highly active antiretroviral treatment (HAART) on expression levels of peripheral blood Th17 and Treg cells in HIV/AIDS patients.

METHODSTotally 55 HIV/AIDS patients were randomly assigned to the treatment group (28 cases) and the combination group (27 cases). Besides, 21 HIV negative patients were recruited as the healthy control group. Those in the treatment group received HARRT alone, while those in the combination group received HAART combined QD. The observation lasted for 24 weeks. Meanwhile, according to peripheral blood CD4+ T cell counts before treatment, HIV/AIDS patients were assigned to three subgroups. For patients in subgroup 1, 1 cells/microL < CD4+ T cell counts < or = 100 cells/microL; For patients in subgroup 2, 101 cells/microL < CD4+ T cell counts < or = 200 cells/lL; For patients in subgroup 3, 201 cells/microL < CD4+ T cell counts < or = 350 cells/microL. Expression of peripheral blood Th17 and Treg cells, and number of CD4+ T cell counts were detected using flow cytometry (FCM)in HIV/AIDS patients at the pre-treatment baseline, week 4, 12, and 24, as well as those in the healthy control group.

RESULTSCompared with the healthy control group, CD4+ T cell counts and the baseline expression level of Th17 cells in the peripheral blood of HIV/AIDS patients significantly decreased, the expression level of Treg cells significantly increased P < 0.01). Compared with before treatment in the same group, CD4+ T cell counts all increased at week 4, 12, and 24 in the two treatment groups, showing statistical difference (P < 0.05, P < 0.01). There was no statistical difference in the effective rate at various CD4+ T cell levels between the two groups (P > 0.05). There was no statistical difference in expression levels of Th17 and Treg cells between the combination group and the treatment group at any time point (all P >0.05). The Th17/Treg ration significantly increased in the combination group after 24 weeks of treatment, showing statistical difference when compared with the treatment group (U = 2.135, P = 0.038).

CONCLUSIONQD could improve the immune balance of Th17/Treg cells, which might be one of its mechanisms for improving HIV/AIDS patients' immunity.

Acquired Immunodeficiency Syndrome ; drug therapy ; immunology ; Adult ; Antiretroviral Therapy, Highly Active ; CD4 Lymphocyte Count ; Case-Control Studies ; Drugs, Chinese Herbal ; therapeutic use ; Female ; HIV Infections ; drug therapy ; immunology ; Humans ; Male ; Middle Aged ; Phytotherapy ; T-Lymphocytes, Regulatory ; cytology ; Th17 Cells ; cytology

Notopterygium incisum is the important medicinal materials of the Tibetan-Qiang medical system in China, also one of the rare and endangered medicinal materials in the Plateau areas in the meantime. Taking the planting of in Sichuan province as an example, research on the N. incisum in Sichuan utilize remote sensing and GIS techniques, bind growth environment factor, including height factor, average annual precipitation, average annual temperature, forest information, were chosen according to habitat conditions. And combine field measurement to verify. The results indicate that N. incisum resources in Sichuan province were mainly distributed in the alpine valley and the northwest of the plateau, which suitability distribution areas of 4145 km2 approximately and accounting for 2% of the total area. Suitability areas accounting for more than 2% of the respective total area in Heishui county, Lixian county, Xiaojin county, Kangding county, ect. According to the field investigation and the related document information record, drawn that the suitability distribution based on RS and GIS were corresponded with the actual distribution areas of N. incisum resources. It's feasible to divide the suitability distribution area of N. incisum using RS and GIS, which will provide a scientific basis for a comprehensive investigation of the distribution as well as its rational exploitation and protection.
Apiaceae ; China ; Conservation of Natural Resources ; Geographic Information Systems ; Telemetry