Objective To determine the feasibility of human routine blood tests as a surrogate for CD4+ T cell count through studying the correlation of CD4+ T cell count with total lymphocyte count(TLC),hemoglobin(Hb),blood platelet(PLT),and white cell count(WBC)in HIV/AIDS patients.Methods 1 038 person-time blood tests among 778 HIV/AIDS patients were performed and Spearman correlation analysis was used.Predictive power and the cut-off for potential predictors of CD4+ T cell count were assessed through receiver operating characteristic(ROC)curves.Combination test was used to assess the capability of multipie indexes to serve as surrogate markers for CD4+ T cell counL Results Significant correlations with CD4+ T cell count were observed for TLC,Hb,PLT and WBC.The Spearman correlation coefficients were r=0.64,P=0.000;r=0.36,P=0.000;r=0.24,P=0,000;r=0.09,P=0.000,respectively.No correlation between TLC and CD4+ T cell count was found when,TLC was more than 2 000 × 106/L(r=0.12,P=0.15).The areas under ROC curve of TLC and Hb for predicting CD4+ T cell count were between 0.82 to 0.84,and 0.66 to 0.70,respectively.When CD4+ T cell count were less than 50,200,350 cells/μl respectively,the optional cut-off value was TLC＜1 100 × 106/L,1 200 × 106/L and 1 400 × 106/L.When the study combined TLC＜1 200 × 106/L and Hb＜120 g/L for prediction of CD4+ T cell count＜200/μl,the sensitivity was 45.3% and specificity was 82.8%.Conclusion There is no significant application value for combination of TLC＜1 200×106/L and Hb＜120 g/L as a surrogate for prediction of CD4+ T cell count＜200/μl.

Since mid-December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has outbroken in Wuhan, Hubei Province, China, and spread rapidly to other provinces in China and dozens of countries and regions around the world, becoming the Public Health Emergency of International Concern (Public Health Emergency of International Concern). SARS-CoV-2 can mainly transmit by droplets or close contact, and is generally susceptible in the crowd. Tumor patients are at high risk of this pathogen because of their impaired immune function. Identifying tumor patients with 2019 novel coronavirus disease (COVID-19) early, and understanding its distribution characteristics can help to improve the cure rate of patients, and better control the epidemic and development of SARS-CoV-2 much better. With comprehensive analysis of relevant literature, this paper reviews the clinical characteristics of neoplastic patients with COVID-19, and puts forward some suggestions on how to deal with this epidemic.
Betacoronavirus ; Coronavirus Infections ; complications ; epidemiology ; prevention & control ; transmission ; Epidemics ; Humans ; Neoplasms ; complications ; Pandemics ; prevention & control ; Pneumonia, Viral ; complications ; epidemiology ; prevention & control ; transmission

Objective:To observe the effect of fluid therapy on volume and coagulation function in patients with severe postpartum hemorrhage during cesarean section of placenta accreta under the guidance of inferior vena cava diameter (IVCD) and inferior vena cava collapse index (IVC-CI).Methods:A prospective randomized controlled study was conducted in 60 pregnant women with severe postpartum hemorrhage (blood loss ≥ 1 000 mL) who were hospitalized for delivery or referred for delivery in the Peking University Third Hospital from December 2018 to July 2019. The patients were divided into routine fluid replacement group and goal-oriented fluid resuscitation group (goal-oriented fluid replacement therapy was given) according to the different ways of fluid replacement. The hemodynamics, blood gas analysis, coagulation function, total fluid replacement, urine volume, prognosis, intraoperative vasoactive drugs utilization rate and postoperative adverse events were recorded before skin incision, after the fetus delivered, postpartum hemorrhage and at the end of operation, and the differences of these indices between the two groups were compared.Results:① Hemodynamics: the heart rate (HR) of the two groups were reached the peak during postpartum hemorrhage, but there was no significant difference in HR at each time point between the two groups. The mean arterial pressure (MAP) was decreased at first and then increased in both groups, and reached the trough at postpartum hemorrhage, but the MAP in the goal-oriented fluid resuscitation group was significantly higher than that in the routine fluid replacement group [mmHg (1 mmHg = 0.133 kPa): 75.6±10.7 vs. 69.2±8.9, P < 0.05]. In the goal-oriented fluid resuscitation group, the central venous pressure (CVP) was increased slightly after the fetus delivered and then stabilized, while in the routine fluid replacement group, the CVP was increased at first and then decreased, and reached the peak in postpartum hemorrhage. During postpartum hemorrhage, CVP in the goal-oriented fluid resuscitation group was significantly lower than that in the routine fluid replacement group [cmH 2O (1 cmH 2O = 0.098 kPa): 9.5±3.9 vs. 11.4±3.4, P < 0.05]. ② Arterial blood gas: partial pressure of oxygen (PaO 2) and partial pressure of carbon dioxide (PaCO 2) in arterial blood at the end of operation in both groups were higher than those in postpartum hemorrhage. There was no significant difference in PaO 2 at the end of operation between the goal-oriented fluid resuscitation group and routine fluid replacement group (mmHg: 189.3±100.5 vs. 240.2±126.3, P > 0.05). The PaCO 2 in the goal-oriented fluid resuscitation group was significantly lower than that in the routine fluid replacement group (mmHg: 34.6±4.6 vs. 36.8±4.1, P < 0.05). The lactic acid (Lac) at the end of operation of the goal-oriented fluid resuscitation group was significantly lower than that of the routine fluid replacement group (mmol/L: 2.2±0.6 vs. 2.6±1.1, P < 0.05). ③ Liquidintake and output volume: the total infusion volume, crystal fluid infusion volume and suspended red blood cell infusionvolume in the goal-oriented fluid resuscitation group were significantly less than those in the routine fluid replacement group [total infusion volume (mL): 3 385.9±1 144.1 vs. 4 448.3±1 194.4, crystal infusion volume (mL): 2 635.6±789.7 vs. 3 160.0±860.3, suspended red blood cell input volume (mL): 695.6±366.2 vs. 911.1±284.7, all P < 0.05], and the utilization rate of vasoactive drugs in the goal-oriented fluid resuscitation group was decreased significantly during operation [13.3% (4/30) vs. 60.0% (18/30), P < 0.05]. The amount of bleeding in the goal-oriented fluid resuscitation group was also significantly less than that in the routine fluid replacement group (mL: 1 451.7±373.8 vs. 1 725.9±372.8, P < 0.05), but there was no significant difference in urine volume between the goal-oriented fluid resuscitation group and the routine fluid replacement group (mL: 369.0±262.7 vs. 485.0±286.8, P > 0.05). ④ Coagulation function: at the end of operation, the prothrombin time (PT) in the goal-oriented fluid resuscitation group was significantly shorter than that in the routine fluid replacement group (s: 10.9±0.6 vs. 11.2±0.6), and the fibrinogen (Fib) in the goal-oriented fluid resuscitation group was significantly higher than that in the routine fluid replacement group (g/L: 3.7±0.5 vs. 2.9±0.8), and the differences were statistically significant (both P < 0.05).⑤ Prognostic index: compared withthe routine fluid replacement group, the proportion of patients transferred to intensive care unit (ICU) at the end of operation in the goal-oriented fluid resuscitation group was significantly lower [16.7% (5/30) vs. 66.7% (20/30), P < 0.05], and ICU length-of-stay was significantly shorter [hours: 0 (0, 24) vs. 24 (0, 24), P < 0.05], but there was no significant difference in the incidence of disseminated intravascular coagulation (DIC), acute renal injury (AKI) or hysterectomy between the goal-oriented fluid resuscitation group and the routine fluid replacement group [the incidence of DIC: 0% (0/30) vs. 6.7% (2/30), the incidence of AKI: 0% (0/30) vs. 3.3% (1/30), the hysterectomy rate: 10.0% (3/30) vs. 26.7% (8/30), all P > 0.05]. Conclusion:Fluid resuscitation guided by IVC-CI can effectively reduce the volume of blood and fluid transfusion and blood loss in patients with severe postpartum hemorrhage and improve their blood coagulation function.

Blood-brain barrier (BBB) is a kind of important barrier system in the body. It can have a choice to prevent certain substances from entering the brain, in order to maintain the relative stability of internal environment of the central nervous system (CNS). However, it also became an important restriction factor for the treatment of CNS diseases. Traditional Chinese medicine (TCM) had good curative effects on several kinds of CNS diseases, which illustrated that effective composition of TCM can pass through or influence the function of BBB. This paper summarized the research progress of literatures on current pharmacological and clinical trials for the effect of TCM on BBB.

OBJECTIVE: The prior functional MRI studies have demonstrated significantly abnormal activity in the bilateral superior temporal gyrus (STG) of anxiety patients. The purpose of the current investigation was to determine whether the abnormal activity in these regions was related to a loss of functional connectivity between these regions. MATERIALS AND METHODS: Ten healthy controls and 10 anxiety patients underwent noninvasive fMRI while actively listening to emotionally neutral words alternated by silence (Task 1) or threat-related words (Task 2). The participants were instructed to silently make a judgment of each word's valence (i.e., unpleasant, pleasant, or neutral). A coherence analysis was applied to the functional MRI data to examine the functional connectivity between the left and the right STG, which was selected as the primary region of interest on the basis of our prior results. RESULTS: The data demonstrated that the anxiety patients exhibited significantly increased activation in the bilateral STG than the normal controls. The functional connectivity analysis indicated that the patient group showed significantly decreased degree of connectivity between the bilateral STG during processing Task 2 compared to Task 1 (t = 2.588, p = 0.029). In addition, a significantly decreased connectivity was also observed in the patient group compared to the control group during processing Task 2 (t = 2.810, p = 0.012). CONCLUSION: Anxiety patients may exhibit increased activity of the STG but decreased functional connectivity between the left and right STG, which may reflect the underlying neural abnormality of anxiety disorder, and this will provide new insights into this disease.
Adult ; Anxiety Disorders/pathology/*physiopathology ; Case-Control Studies ; Emotions/physiology ; Female ; Humans ; Magnetic Resonance Imaging/*methods ; Male ; Middle Aged ; Temporal Lobe/pathology/*physiopathology

The spinal manipulation in traditional Chinese medicine (TCM) has a prominent clinical advantage in the treatment of chronic lumbar pain,such as low back pain,but the insufficient basic research on manipulation is a serious obstacle to its development.Using finite element analysis (FEA) can preferably simulate the mechanics under various kinds of spinal manipulation,analyze its action mechanism,test the hypothesis,standardize the operating practices,make quantitative,qualitative and optimal treatment plans,so as to provide an effective method for the basic research on manipulation therapy.This paper reviews the FEA studies of spinal manipulation in recent years,discusses the influence of different spinal manipulation on intervertebral disc,lumbar accessory structures,spinal loads and mechanical stability of the vertebral body.The results show that current FEA studies on spinal manipulation need to make the simulation method standardized and precise.Meanwhile,the research ideas of finite element method should be developed to guide the clinical application of spinal manipulation.

A method of medical image segmentation based on support vector machine (SVM) for density estimation is presented. We used this estimator to construct a prior model of the image intensity and curvature profile of the structure from training images. When segmenting a novel image similar to the training images, the technique of narrow level set method is used. The higher dimensional surface evolution metric is defined by the prior model instead of by energy minimization function. This method offers several advantages. First, SVM for density estimation is consistent and its solution is sparse. Second, compared to the traditional level set methods, this method incorporates shape information on the object to be segmented into the segmentation process. Segmentation results are demonstrated on synthetic images, MR images and ultrasonic images.
Humans ; Image Interpretation, Computer-Assisted ; methods ; Magnetic Resonance Imaging

OBJECTIVETo analyze and optimize the gene rearrangement primers of different frame regions (FR) of immunoglobulin heavy chain (IgH) genes by bioinformatic methods and explore the application of these primers in the detection of paraffin-embedded lymphoma tissues.

METHODSThree pairs of primers from IgH FR1, FR2 and FR3 regions (P1c, P2A and P31, respectively) were selected as the B cell gene rearrangement primers after comparison of the gene fragments in 44 IgH variable and 6 joining regions. Using one pair of T cell receptor (TCR) gamma primer as the T cell gene rearrangement primer, 101 histopathologically confirmed lymphoproliferative samples including 80 B cell lymphomas, 14 T cell lymphomas, and 7 reactive proliferative lymph nodes were examined by PCR for gene arrangement. The DNAs from DG75 and Jurkat cell lines were used as the positive controls for B and T cell lymphoma, respectively, with those from reactive proliferative lymph nodes as the negative control.

RESULTSThe positivity rates of IgH primers (P1c, P2A and P31) in the 80 B cell lymphomas were 37.5% (30/80), 52.5% (42/80) and 70.0% (56/80), respectively, and only one of the 14 T cell lymphoma cases was positive for the primers, suggesting significant differences in the detection rates of B cell lymphomas by the 3 primers. The detection rate was increased to 83.9% by combining the results by P31 and P2A primers. No positivity was found in the proliferative reaction tissues.

CONCLUSIONPrimers from IgH FR3 region genes are more sensitive than that from the FR1 and FR2 regions in the detection of gene rearrangement in paraffin-embedded lymphoma tissues. The detection rates can be increased by combining the results with the primers for IgH FR3 with that of FR2.

DNA Primers ; Gene Rearrangement, B-Lymphocyte, Heavy Chain ; genetics ; Humans ; Immunoglobulin Heavy Chains ; genetics ; Lymphoma, B-Cell ; diagnosis ; genetics ; pathology ; Lymphoma, Non-Hodgkin ; diagnosis ; genetics ; pathology ; Lymphoma, T-Cell ; diagnosis ; genetics ; pathology ; Male ; Paraffin Embedding

OBJECTIVETo investigate the effect of education on self-evaluation and control level in patients with bronchial asthma.

METHODSSeventy-five asthmatic patients with the initial diagnosis in line with the American Thoracic Society criteria, including 46 with junior high school education or below (group A) and 29 with senior high school education or above (group B), were asked to complete a survey to assess their symptoms and asthma attacks. Asthma control test (ACT) and peak expiratory flow rate (PEFR) evaluation were performed 8, 12 and 24 weeks after salmeterol/fluticasone therapy. Step-down treatment was administered according to GINA guidelines. The self-evaluation of the patients was assessed according to ACT score, physical signs and pulmonary function. An ACT score over 19 indicate well controlled condition. The effect of education on the self-evaluation and control level of bronchial asthma was assessed.

RESULTSThe two groups had similar basal level of pulmonary function (FEV1). Eight weeks after the therapy, 29 patients in group A had ACT score over 19, including 11 with high control level; in group B, 17 had ACT score over 19, of whom 4 showed high control level. There was no significant difference between the two groups in control levels and self-evaluation (P>0.05). At 12 weeks, 37 patients in group A had ACT score over 19, with 17 having high control level; 22 patients in group B had ACT score over 19, 4 showing high control level; the two groups were similar in the control levels (P>0.05) but showed significant difference in self-evaluation (P<0.05). At the time of 24 weeks, 42 and 26 patients had ACT score over 19 in the two groups, with 19 and 5 having high control level, respectively. The two groups differed significantly in the control levels (P<0.05) and self-evaluation (P<0.05).

CONCLUSIONThe patients' education level may play a role in self-evaluation and control level of bronchial asthma, but its impact differs in the course of the treatment.

Adolescent ; Adult ; Aged ; Albuterol ; analogs & derivatives ; therapeutic use ; Androstadienes ; therapeutic use ; Anti-Asthmatic Agents ; therapeutic use ; Asthma ; therapy ; Educational Status ; Female ; Fluticasone ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Middle Aged ; Patient Education as Topic ; methods ; standards ; Salmeterol Xinafoate ; Self Care ; methods ; Young Adult

OBJECTIVETo investigate the expression of HMGB1 and RAGE mRNA in the lungs of asthmatic mice and the effect of N-acetylcysteine (NAC) on their expression.

METHODSTwenty-one female BALB/c mice were randomly divided into control group, asthma group and NAC group (n=7). The expressions of HMGB1 and RAGE mRNA and their distributions in the lungs were detected by RT-PCR and immunohistochemical method.

RESULTSThe expression levels of HMGB1 and RAGE mRNA were not significantly different between the control group (0.88-/+0.02 and 1.20-/+0.20, respectively) and the asthma model group (0.86-/+0.05 and 1.21-/+0.08, P>0.05). After NAC treatment, both of HMGB1 and RAGE mRNA levels (0.98-/+0.05 and 1.58-/+0.21) were significantly higher than those in the other two groups (P<0.05). HMGB1 was found in the nuclei and membrane of the bronchial and alveolar epithelial cells, and RAGE was located on the membrane of the alveolar epithelial cells.

CONCLUSIONHMGB1 and RAGE may play a role in the oxidative stress during asthma, but the exact mechanism needs further investigation.

Acetylcysteine ; pharmacology ; Animals ; Asthma ; physiopathology ; Female ; Free Radical Scavengers ; pharmacology ; Gene Expression ; drug effects ; HMGB1 Protein ; biosynthesis ; genetics ; Immunohistochemistry ; Lung ; drug effects ; metabolism ; pathology ; Mice ; Mice, Inbred BALB C ; Mitogen-Activated Protein Kinases ; biosynthesis ; genetics ; RNA, Messenger ; biosynthesis ; genetics ; Random Allocation ; Reverse Transcriptase Polymerase Chain Reaction