OBJECTIVE To establish a method for detecting adenovirus type 7 by cells culture combined with real-time fluorescent RT-PCR.METHODS After purified adenovirus was dissociated from nasopharyngeal secretion in A549 cells,ADV7 E1A genes were detected by real-time RT-PCR assay and sequence analysis of cells infected with 0.1,0.5,5.0 and 10.0 MOI ADV7 at 3,6,12 and 24 h postinfection.Then the adenovirus in nasopharyngeal secretion was detected with the similar method.RESULTS Early transcription of E1A genes of adenovirus type 7 could be detected by real-time RT-PCR at 3 h postinfection with 0.5MOI virus;or at 6 h postinfection with 0.1MOI virus;Early transcription of E1A genes could be detected at 6 h postinfection in nasopharyngeal secretion.CONCLUSIONS The method by cells culture combined with real-time fluorescent RT-PCR is sensitive,specific and rapid.It can be applied in clinics for diagnosis of adenovirus type 7 infection.

Objective To investigate the clinical value of the duodenum double lumen cannula suction in duodenal rupture repair.Methods According to the operation methods,60 patients with duodenal rupture undergoing duodenal repair were divided into the surgical drainage alone group(26 cases)and double sets attract tube group (34 cases).The surgery effect and complications were observed.Results The difference of traffic flow 7 days after the operation between the two groups was statistically significant(t =7.564,P <0.05).The length of stay and hospital costs of the surgical drainage alone group were more than those of the double sets attract tube group,the differences were statistically significant(t =3.567,4.123,all P <0.05).The fistula,intra -abdominal infections,wound infec-tions,pulmonary infection rates of the surgical drainage alone group were 30.77%,42.31%,46.15%,26.92%, which were higher than 2.94%,11.76%,8.82%,2.94%,5.88% of the double sets attract tube group,the differ-ences were statistically significant(χ2 =8.949,7.330,10.950,2.986,5.116,all P <0.05).Conclusion Applica-tion of the double lumen cannula duodenal suction in duodenal rupture repair can significantly reduce the incidence of postoperative complications,has certain security,it is recommended in clinical practice.

Objective To analysis the effect of stem cell transplantation on serum homocysteine ( Hcy ) , C reactive protein ( CRP ) and brain derived neurotrophic factor( BDNF) in patients with ischemic stroke.Methods 42 patients who were diagnosed with ischemic stroke in Yichang First People's Hospital were collected.All patients were randomly divided into experimental group and control group, 21 cases in each group.The control group was treated with conventional therapy, and the experimental group was treated with autologous bone marrow mesenchymal stem cell transplantation for treatment on the basis of conventional therapy, after treatment, the serum levels of serum homocysteine, CRP, BDNF and clinical curative effect were detected in all patients.Results After treatment, compared with control group, the serum Hcy level was lower in the experimental group(P<0.05);the serum CRP level was lower in the experimental group (P<0.05); the serum BDNF level was higher in the experimental group (P<0.05); the FIM, ADL and Fugl-Meyer score were higher in the experimental group(P <0.05).Conclusions The stem cell transplantation can significantly reduce the serum Hcy and CRP levels in patients with ischemic stroke, increase the content of BDNF in serum, improve the therapeutic effect, and have a guiding significance for clinical.

Objective To explore the levels of serum alkaline phosphatase ( ALP) as well as its impact on the cognitive impairment in patients with subcortical ischemic vascular disease ( SIVD).Methods One hundred and fifty-eight SIVD patients were divided into two subgroups which included 86 patients with mild cognitive impairment ( SVMCI ) and 72 patients with vascular dementia ( SVaD ) according to the severity of cognitive impairment.Sixty-seven old people with normal cognitive function were selected as control qruop.Multiple lacunar infarction ( LI) or leukoaraiosis ( LA) was detected according to their MRI scan appearances and graded LA according to the severity.Serum ALP was measured by an enzymatic method as well as the Mini-Mental State Examination ( MMSE) and the Cambridge Cognitive Examination-Chinese Version (CAMCOG-C) were used in assessments.Serum ALP was divided into 3 groups and the occurrence rate of LI , LA and cognitive impairment were compared with each other.The levels of ALP were compared in different cognitive impairment and Logistic regression was used to explore the relation between ALP and cognitive impairment.Results Both SVaD and SVMCI groups (17.00 (13.00, 20.00), 59.50 (49.00, 68.75);25.00 (25.00, 26.00), 82.50 (76.75, 89.00)) showed significantly lower scores in MMSE and CAMCOG-C than control group (28.00 (28.00, 29.00), 93.00 (89.00, 96.00); Z=187.337, P=0.000; Z=150.480, P=0.000).A positive relationship between the elevated ALP level and the severity of cognitive impairment was found after adjusting for sex , age and other confunding factors ((68.60 ±15.52), (78.76 ±13.39), (86.75 ±18.85) U/L, F=22.587, P=0.000).The occurrence rate of LI, LA and SVaD among the three groups were significantly different (χ2 =8.008, P=0.018;χ2 =17.998, P=0.000;χ2 =12.255, P=0.002).The ALP level was negatively correlated with MMSE and CAMCOG-C scores ( r=-0.350, P=0.000; r=-0.286, P=0.000 ).Logistic regression analysis revealed the relation between ALP and cognitive impairment was positive when we controlled all the vascular risk factors.However , the relation had gone when futher adjusting for the grade of LA.Conclusions The level of ALP is significantly higher in SIVD patients and positively relates with cognitive impairment especially in those whose grade of LA is severe.

Objective To study the imaging finding of the coracoclavicular ligament.Methods 400 cases of normal chest films 200 men and 200 women were collected.The presented rates of pseudoarthrosis of the coracoclavicular joints and the clavicular tuberosities which are the coracoclavicular ligament attachment were evaluated and the distances between the clavicle and coracoid process interval were measured.There were 30 cases of normal shoulder MRI,the displaying rate of coracoclavicular ligament, the length and width of the coracoclavicular ligament were measured at MR imaging.8 case with type Ⅱ(n=5) and type Ⅲ(n=3)of acromioclavicular injury were also included in this study.Results Among 400 cases(800 sides),one pseudoarthrosis(0.25%)and 198 clavicular tuberosities(24.8%)were found.The normal distance between the clavicle and coracoid process interval was (6.92±3.16)mm.On MRI study,30 cases of coracoclavicular ligament were all showed on oblique coronal slices. The acromioclavicular ligament and coracoclavicular ligament tear were found in type Ⅱ and type Ⅲ,of acromioclavicular injury respectively on MRI.The length and width of conoid ligament were(11.48±1.43) mm and (4.82±1.21) mm respectively,and the length and width of trapezoid ligament were(9.09±0.84) mm and (5.10±0.87) mm respectively.Conclusion The normal anatomic measurement standards of the coracoclavicular ligament are established on X-ray and MRI,which is important for diagnosis of coracoclavicular ligament lesions.The coracoclavicular ligament torn is showed in typeⅢ of acromioclavicular dislocation.

Objective To explore the association of smoking and smoking cessation with glycemic control in male patients with type 2 diabetes. Methods From December 2013 to January 2014, a total of 7763 male patients with type 2 diabetes, who received national basic public health service in Changshu county of Suzhou city, Huai'an and Qinghe districts of Huai'an city, Jiangsu province, were recruited by cluster sampling. Questionnaire survey and anthropometric measurements were conducted, and fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) levels were measured. Multiple linear regression model was used to evaluate the association of smoking and smoking cessation with glycemic control. Results The prevalence of current smoking was 45.5%in male patients with type 2 diabetes. The levels of FPG and HbA1c increased with number of cigarettes smoked per day compared with non-smokers (P<0.001). Among patients with drug treatment, the average increase of HbA1c level in current smokers with smoking duration ≥30 years and smoking index ≥40 pack-years were 0.27% (95%CI: 0.05%-0.49%) and 0.38% (95%CI: 0.23%-0.53%),respectively. FPG and HbA1c level decreased obviously with smoking cessation years among former smokers (P<0.05). Among the patients receiving no drug treatment, no dose-response relationships were observed between smoking duration, smoking cessation years and levels of FPG and HbA1c. Conclusion Cigarette smoking was negatively related with glycemic control in male type 2 diabetes patients, especially in patients with drug treatment. Smoking cessation may be beneficial for glycemic control. Smoking cessation should be encouraged for diabetes patients as early as possible.

Objective: To investigate the association between fresh fruit consumption and status of glycemic control, among patients with type 2 diabetes mellitus (T2DM). Methods: Using the stratified cluster sampling method, a cross-sectional study was conducted among 19 473 diabetic patients who were under the Disease Management Program related to the National Basic Public Health Service in Changshu county, Huai’an and Qinghe districts of Huai’an city from December 2013 to January 2014, under the combination of fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c) methods, the glycemic control status in T2DM patients was assessed. Multiple logistic regression method was used to explore the relationship between fresh fruit consumption and status of glycemic control among T2DM patients. Results: 62.4% of the T2DM patients reported their amount of fruits intake in the past year. Both the levels of FPG and HbA1c decreased in T2DM patients, when the frequency and amount of fresh fruit consumption were increasing. Compared with patients who did not take fresh fruits, the risk of poor glycemic control in patients with fresh fruit consumption of 1-4 times/week and ≥5 times/week decreased 20% (OR=0.80, 95%CI: 0.73-0.87) and 30% (OR=0.70, 95%CI: 0.62-0.80), respectively. Patients with fruit consumption of 50-99 g/day and ≥100 g/day had lower risk of poor glycemic control, with ORs (95%CI) as 0.71 (95%CI: 0.62-0.83) and 0.68 (95%CI: 0.59-0.78), respectively. Conclusions The association of fresh fruit intake and glycemic control was statistically significant in patients with type 2 diabetes. With the increase of frequencies and amounts of fresh fruit consumption, the levels of FPG and HbA1c showed a decreasing trend. Our findings suggested that fresh fruit intake seemed helpful for glycemic control.

OBJECTIVE: To analyze the dynamic changes of chest CT images of patients with coronavirus disease 2019 (COVID-19). METHODS: Fifty-two cases of COVID-19 were admitted in the First Affiliated Hospital of Zhejiang University School of Medicine. The consecutive chest CT scans were followed up for all patients with an average of 4 scans performed per patient during the hospitalization. The shortest interval between each scan was 2 days and the longest was 7 days. The shape, number and distribution of lung shadows, as well as the characteristics of the lesions on the CT images were reviewed. RESULTS: The obvious shadows infiltrating the lungs were shown on CT images in 50 cases, for other 2 cases there was no abnormal changes in the lungs during the first CT examination. Ground-glass opacities (GGO) were found in 48 cases (92.3%), and 19 cases (36.5%) had patchy consolidation and sub-consolidation, which were accompanied with air bronchi sign in 17 cases (32.7%). Forty one cases (78.8%) showed a thickened leaflet interval, 4 cases (7.6%) had a small number of fibrous stripes. During hospitalization, GGO lesions in COVID-19 patients gradually became rare,the fibrous strip shadows increased and it became the most common imaging manifestation. The lesions rapidly progressed in 39 cases (75.0%) within 6-9 days after admission. On days 10-14 of admission, the lesions distinctly resolved in 40 cases (76.9%). CONCLUSIONS The chest CT images of patients with COVID-19 have certain characteristics with dynamic changes, which are of value for monitoring disease progress and clinical treatment.
Betacoronavirus ; isolation & purification ; China ; Coronavirus Infections ; diagnostic imaging ; pathology ; Disease Progression ; Humans ; Pandemics ; Pneumonia, Viral ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed

OBJECTIVE: To analyze the dynamic changes of chest CT images of patients with corona virus disease-19 (COVID-19). METHODS: Fifty-two cases of COVID-19 were admitted in the First Affiliated Hospital of Zhejiang University School of Medicine. The consecutive chest CT scans were followed up for all patients with an average of 4 scans performed per patient during the hospitalization. The shortest interval between each scan was 2 days and the longest was 7 days. The shape, number and distribution of lung shadows, as well as the characteristics of the lesions on the CT images were reviewed. RESULTS: The obvious shadows infiltrating the lungs were shown on CT images in 50 cases, for other 2 cases there was no abnormal changes in the lungs during the first CT examination. Ground-glass opacities (GGO) were found in 48 cases (92.3%), and 19 cases (36.5%) had patchy consolidation and sub-consolidation, which were accompanied with air bronchi sign in 17 cases (32.7%). Forty one cases (78.8%) showed a thickened leaflet interval, 4 cases (7.6%) had a small number of fibrous stripes. During hospitalization, GGO lesions in COVID-19 patients gradually became rare, the fibrous strip shadows increased and it became the most common imaging manifestation. The lesions rapidly progressed in 39 cases (75.0%) within 6-9 days after admission. On days 10-14 of admission, the lesions distinctly resolved in 40 cases (76.9%). CONCLUSIONS The chest CT images of patients with COVID-19 have certain characteristics with dynamic changes, which are of value for monitoring disease progress and clinical treatment.