Objective To evaluate the correlating clinical factors of coronary artery calcification score(CACS).Methods 141 patients suspected of coronary artery disease were included.They underwent multi-slice row computed tomography,pulse wave velocity ( PWV ),UCG and blood biochemistry within a period of 3 months.The subjects were divided into three groups according to CAC score:A(CACS =0-10),B ( CACS = 11-400),C ( CACS > 400).Results CACS was significantly associated with age,history of hypertension and diabetes mellitus.It was also associated with the presence of mitral annular calcification and aortic valve calcification,low ankel brachial pressure index(ABI) and high mean artery pressure(MAP) as well as high values of brachial ankel PWV (baPWV) and Upstroke time (UT).Muhifactorial logistic regression analysis showed that the presence of aortic valve calcification and mitral annular calcification,the history of diabetes mellitus and high value of UT were independently correlated with severe coronary artery calcification.Conclusions Aortic valve calcification,mitral annular calcification,history of diabetes mellitus,high value of UT were independently correlated with severe coronary artery calcification.Measurement of PWV and UCG should be performed before muhi-slicerow computed tomography,because the assessment of coronary artery lumen narrowing with multi-slice row computed tomography can not be carried out accurately in the presence of severe coronary artery calcification.

PACS (Picture Archiving and Communication Systems) is the hot spot of hospital information construction research and DICOM (Digital Imaging and Communication in Medicine) is the international standard about data compression and translation of medical image and relational information. Supporting DICOM standard is the necessary condition for medical image devices to join into PACS net. In making reforms in the old fashioned medical devices in hospitals, it is necessary to add DICOM interface for medical image devices. In this paper, DICOM information model is introduced and software system is implemented with Visual C + + programming, especially the writing, reading and C-STORE service in communication function are introduced in detail.
Computer Communication Networks ; instrumentation ; Data Display ; Diagnostic Imaging ; Humans ; Image Processing, Computer-Assisted ; standards ; Medical Records Systems, Computerized ; Radiology Information Systems ; instrumentation ; standards

Computational fluid dynamics (CFD) was used to numerically investigate the blood flow in 3-D models of human preoperative and posteroperative of cerebral aneurysm clip, and the feasibility of surgical operation was evaluated by the calculated hemodynamics parameters. Mimics software was used to reconstruct the models from CT angiograms, and numerical simulation of blood flow at different time in a cardiac circle was performed. Comparison analysis of blood flow in three models of human preoperative and posteroperative of cerebral aneurysm clip was conducted in terms of blood velocity distribution, wall shear stress (WSS) distribution and pressure distribution. The results demonstrated that blood velocity and WSS were significantly increased, and pressure was obviously decreased.
Blood Flow Velocity ; Cerebrovascular Circulation ; Computer Simulation ; Hemodynamics ; Humans ; Imaging, Three-Dimensional ; Intracranial Aneurysm ; diagnostic imaging ; physiopathology ; surgery ; Models, Cardiovascular ; Stress, Mechanical ; Tomography, X-Ray Computed

Objective To establish a mini-pool nucleic acid testing (NAT) assay using multiplex RT-nested PCR for the detection of HIV RNA, and apply it in screening for acute HIV infection among MSM. Methods Frozen EDTA plasma samples collected between Oct. 2008 and Mar. 2009 from 3 HIV infectors during window-period, a total of 30 HIV chronically infected individuals and 97 healthy subjects were used to develop the NAT assay. Plasma samples from 10 cases were pooled into one tube and centrifuged at high speed for the collection of viruses. HIV RNA was extracted. Two pairs of primers were designed according to two conserved regions of HIV RNA ( HXB2 nt 5783-nt 6228 and nt 1235-nt 2012).Multiplex RT-PCR and nested PCR were performed. Individual NAT-reactive samples were confirmed by commercially available NAT assays. The sensitivity and performance efficacy were also evaluated. The assay was then applied to 1 005 plasma specimens from MSM with negative or uncertain HIV antibody test results.These were collected in the same period as the other samples. Results ( 1 ) Two fragments of HIV were amplified successfully with the low detection limit of 162 copies/ml plasma; (2) Results of the mini-pool HIV NAT validation with samples from 3 HIV infectors during window-period were consistent with the expected values; (3) All 30 plasma samples from MSM with positive HIV antibody, which were tested by multiplex RT nested PCR, were found to be HIV RNA positive; (4) One out of 1 005 plasma samples was found to be HIV RNA positive, for this case acute infection was followed-up and sero-conversion was found. Conclusion Mini-pool NAT has good sensitivity, and may be applied to screening HIV RNA among MSM during window-period.

OBJECTIVETo detect novel mutations in the fibrillin-1(FBN1) gene by screening the gene from 9 patients with Marfan syndrome (MFS).

METHODSDenaturing high-performance liquid chromatography (DHPLC) was used to screen for FBN1 mutation exon by exon. The DNA amplification fragments of which the DHPLC elution profiles showed difference in comparison with the corresponding normal elution profile were sequenced to identify the position and nature of mutation. The detected mutations were further proved by allele specific PCR or restriction fragment length polymorphism.

RESULTSTwo novel FBN1 gene mutations were found and identified in two Marfan patients respectively, one of which was a small insertion in exon 34 at nucleotide 4307-4308 (4307insTCGT) and the other a missense mutation in exon 43 at nucleotide 5309 (5309G>A).

CONCLUSIONThe findings suggested that the frameshift mutation (4307insTCGT) and point mutation (5309G>A) caused the corresponding patients to have MFS.

Adult ; Chromatography, High Pressure Liquid ; methods ; DNA Mutational Analysis ; methods ; Exons ; genetics ; Fibrillin-1 ; Fibrillins ; Frameshift Mutation ; Humans ; Male ; Marfan Syndrome ; genetics ; Microfilament Proteins ; genetics ; Middle Aged ; Point Mutation

Brainstem glioma is a kind of gliomas with focus in the brain stem. At present, surgery is still the preferred treatment for brainstem gliomas. Resection of brainstem gliomas, because of the special anatomical structure and important physiological function, results in extremely high mortality and disability rate, and choosing a reasonable surgical program can significantly improve the prognosis of patients. This article mainly discusses the safe entry zone and surgical approach of brainstem gliomas.

Objective To explore the knowledge and training needs of cardiopulmonary resuscitation (CPR) among a health checkup population, and to provide evidence for promoting cardiopulmonary resuscitation knowledge and skills at physical examination centers. Methods Using physical examination numbers, the random number table method was used to randomly select 1 000 people from a health checkup population, information collected including their basic information, cognitive status of cardiopulmonary resuscitation, and attitudes and behaviors toward cardiopulmonary resuscitation. The statistical analysis was performed using χ2test, a one-way ANOVA, and multivariate logistic regression analysis. Results Questionnaires was acquired from 997 consenting adult subjects. From which, 26% had received CPR training, and they demonstrated a low ratio of cognitive knowledge, scoring only 9.94 ± 6.36 (from a possible score of 30). Additionally, 92.1% had a willingness to learn CPR skills, and the CPR performance score was 23.12±3.27 (the highest score was 28). Unmarried people younger than 25 years old, professional and technical personnel, and military men had higher CPR scores than other groups. The CPR learning efficiency of military men, undergraduates, and people younger than 25 years old was higher than other groups. Older people had a lower willingness to learn cardiopulmonary knowledge and the better the feel-good status, the lower the willingness to learn CPR skills, of which OR values were 0.787 and 0.657, respectively (P<0.05). The rate of people learning CPR skills for relatives was higher than for strangers (P<0.05), and 83.8% were willing to receive medical training. Conclusion The health checkup population had a low cognitive level of CPR knowledge, and the willingness to learn CPR was high. To address this, free CPR training should be conducted at medical examination institutions.

Objective:To investigate the damage and mechanism of artemisia annua pollen on tight junction of human nasal mucosa epithelial cells (HNEpC).Methods:HNEpC were cultured in vitro. Different concentrations of artemisia annua pollen (0, 20, 40, 80, 100, 160, 200 μg/ml) were used to intervene the cells for 24 h, and the cell proliferation activity was detected by the CCK-8 method. The expression and phosphorylation of p38MAPK signaling pathway were detected by Western Blot before and after the intervention of SB203580, a p38MAPK inhibitor in HNEpC. Immunofluorescence chemical staining, Western Blot and quantitative real-time PCR (qPCR) were used to observe the expression and distribution of tight junctions Occludin and Claudin-1. SPSS 21.1 software was used for statistical analysis.Results:CCK-8 results showed that, compared with the control group, the proliferation activity of HNEpC increased after 6 h intervention with different concentrations of artemisia annua pollen (all P<0.05). After 12 h of intervention, the proliferation activity of HNEpC in the 20, 40, 80, 100 and 160 μg/ml groups was not significantly changed (all P>0.05), while that in the 200 μg/ml group was decreased ( P<0.05). After the intervention for 24 h, the proliferation activity of cells in the 20 and 40 μg/ml groups was not significantly changed (all P>0.05), while that in the 80, 100, 160 and 200 μg/ml groups was decreased (all P<0.05). Immunofluorescence staining showed that the Occludin and Claudin-1 proteins in the normal control group were localized on the cell membrane and expressed more and formed a ring structure around the cell membrane. However, under the intervention of high concentration artemisia annua pollen, its expression level decreased, appeared broken, fuzzy, and nonuniform distribution. Western Blot and qPCR results showed that after 24 h of intervention, the expression levels of HNEpC Claudin-1 protein and its mRNA in the pollen groups (40, 80, 100, 160, 200 μg/ml) of artemisia annua decreased compared with those of those of the control group (mRNA expression levels were 0.567±0.214, 0.443±0.109, 0.462±0.160, 0.497±0.134, 0.388±0.076 compared with 1.001±0.067, respectively, all P<0.05). However, the mRNA of Occludin protein and its mRNA only decreased in the 200 μg/ml treatment group (mRNA expression level was 0.631±0.109 compared with 1.016±0.026, P<0.05), while all the other treatment groups increased (mRNA expression levels were 1.258±0.134, 1.827±0.103, 2.429±0.077, 1.707±0.085, 1.477±0.066 compared with 1.016±0.026, respectively, all P<0.05). Western Blot showed that p-p38MAPK expression increased after intervention with 100, 160, 200 μg/ml artemisia annua pollen for 24 h. SB203580 could inhibit the decreasing expression of Occludin caused by artemisinin pollen (mRNA expression was 1.255±0.179 compared with 0.631±0.109, P<0.05), but had no effect on Claudin-1 protein expression. Conclusion:Pollen from artemisia annua may activate p38MAPK signaling pathway and destroy the close connection of HNEpC.

Objective To screen the influencing factors of hepatitis C cirrhosis patients progressing to hepatocellular carcinoma(HCC)using commonly used laboratory testing indicators,establish a prediction model using these indicators and validate them.Methods A total of 231 patients with hepatitis C cirrhosis and 179 patients with hepatitis C HCC hospitalized at the First Affiliated Hospital of Xi'an Jiaotong University between June 2020 and May 2023 were enrolled as the training set,and 105 patients with hepatitis C cirrhosis and 86 patients with hepatitis C HCC hospitalized between June 2023 and February 2024 were enrolled as the validation set.The routine laboratory test indexes of the study subjects in the two groups within the training set were compared,and logistic regression analysis was applied to screen the independent predictors of hepatocellular carcinoma occurrence.Receiver operating characteristic(ROC)curve was used to construct the curve model and validate the model.Results The age,male ratio,ALT,AST,AFP,WBC,NEU,MO,PLT,MPV,PDW,Fbg,NLR and PLR levels of the HCC group were higher than those of the cirrhosis group in the training set(H=-9.07～-2.19),while the levels of INR and LMR were lower than those of the cirrhosis group(H=-4.49,-2.65),and the differences were significant(all P＜0.05).The differences in TP,eGFR,LY and AST/ALT values between the two groups of patients were not significant(H=-1.46～-0.15,all P＞0.05).Multifactorial Logistic regression analysis showed that age(OR=1.048,95％CI:1.023～1.074),Male(OR=1.467,95％CI:1.413～1.765),AST(OR=1.010,95％CI:1.002～1.019),NEU(OR=1.186,95％CI:1.018～1.382)and Fbg(OR=2.245,95％CI:1.639～3.076)were independent risk factors for hepatocellular carcinoma patients(all P＜0.05),and these five independent risk factors were used to construct the HCC column-line graph prediction model,with the AUC for the training set and the validation set AUC(95％Cl)were 0.813(0.771～0.854)and 0.712(0.639～0.784),respectively,and the Hosmer-Lemeshow test showed a good fit of the model with P=0.650 for the training set and P=0.310 for the validation set.Conclusion The prediction model of HCC based on age,gender,AST,NEU and Fbg can have good predictive efficacy and clinical application value.

Objective To investigate the effects of continuous infusion of extremely low-dose dexmedetomidine on the hemodynamic sta-bility and recovery of postoperative cognition of older adult patients undergoing carotid artery stenting(CAS).Methods 106 older adult patients undergoing CAS were randomly divided into the dexmedetomidine(group D,n= 52)and control groups(group C,n= 54).Hemo-dynamic and cerebral perfusion changes were recorded 15 min before anesthesia induction(T0),5 min after anesthesia induction(T1),5 min before stent placement(T2),5 min after stent placement(T3),and 5 min after tracheal extubation(T4).The standard deviations(SD)of mean arterial pressure(MAP),heart rate(HR),and regional cerebral oxygen saturation(rSO2)were calculated as SDMAP,SDHR,and SDrSO2,respectively.The Montreal Cognitive Assessment Scale(MoCA)was used to evaluate and compare changes in pre-and post-operative cognitive function and examine the incidence of postoperative cognitive dysfunction(POCD)in the two groups.Results SDMAP,SDHR,and SDrSO2 in group D were significantly lower than those in group C(P＜0.05).The applied dosages of anesthetics and vasoactive drugs were significantly lower in group D than C(P＜0.05).Extubation time in group D was significantly shorter than that in group C(P＜0.05).MoCA scores in group D were significantly higher one day after CAS than that in group C and POCD incidence was significantly lower in group D one month after CAS(P＜0.05).Conclusion Continuous infusion of low-dose dexmedetomidine has the potential to maintain hemodynamic stability and cerebral perfusion,reduce the dosage of anesthetic drugs,and improve postoperative cognitive performance in older adult patients.