Objective To analyze MRI manifestation of the neonatal purulent meningitis retrospectively,including conventional MRI and diffusion-weighted imaging (DWI),and to evaluate the value of MRI in early assessment of the neonatal purulent meningitis.Methods From Jul 2004 to Jul 2009,20 full-term newborns (14 male,6 female) from Shengjing hospital were included in this study,all of which were diagnosed as purulent meningitis.MRI and DWI examinations were performed within 72h after the diagnosis.Results (1) Among those 20 infants,19 infants (95%) had positive findings,including 7 cases of cerebral infarction,4 cases of subdural effusion,3 cases of encephalomalacia,1 case of hydrocephalus,1 case of ependymitis and 7 cases of intracranial hemorrhage.(2) Among the 7 cases of infarction,5 cases showed hypointensity on T1WI and hyperintensity on DWI and T2WI,but the other 2 cases only showed hyperintensity on DWI.Conclusion MRI can detect infarction and hemorrhage in the early stage of purulent meningitis.So MRI,especially DWI,is very important for the early diagnosis and evaluation of neonatal purulent meningitis.

Objective To investigate dynamic changes of extracellular signal regulated protein kinase (ERK) 1/2 in lung fibroblast of newborn rats with chronic lung disease (CLD) caused by hyperoxia.Methods Full-term newborn rats were randomly divided into two groups:air-exposed group and hyperoxia - exposed with 90％ oxygen group.Rats were sacrificed separately 3 d,7 d and 14 days after exposure to air or 90％ oxygen. Then lung fibroblasts of rats were isolated and primarily cultured. By using Immunocystochemistry,Western-blot and RT-PCR methods,the levels of ERK1/2 protein and expressions of ERK1/2 mRNA were measured. Results The levels of p-ERK1/2 protein in lung fibroblast in the hyperoxia group were significant higher on the 7th day and 14th day after exposure to 90％ oxygen compared with those in the air-exposed group (P ＜0.01 ).And the levels of total ERK1/2 protein and expressions of ERK1/2 mRNA did not change noticeably and were not significantly different between two groups (P ＞0.05 ).Conclusions The activation of phosphorated ERK1/2 may lead to lung fibrosis caused by hyperoxia in newborn rats.

ObjectiveTo study the expression and the role of α-smooth muscle aetin (α-SMA) and collagen Ⅰ ( Col Ⅰ ) in lung fibroblasts of newborn rats with hyperoxia-induced lung injuries.Methods Thirty full-term newborn Wistar rats were randomly assigned to hyperoxia group (90％ oxygen exposure,n =15 ) and air group (room air exposure,n =15) within 12 h after birth.Then lung fibroblasts were isolated and primary cultured from rat lungs on postnatal 3 d,7 d,and 14 d.The distribution of α-SMA protein were measured by immunohistochemistry.The levels of Col Ⅰ were detected by ELISA.ResultsThere were no significant differences in the levels of α-SMA and Col Ⅰ expressions between the two groups at 3 d ( P＞0.05 ).While the expression of α-SMA ( 112.60 ± 4.61 vs 94.69 ± 2.38,200.30 ± 3.97 vs 103.04 ± 1.91,P＜0.01 ) and Col Ⅰ protein [ ( 28.66 ± 1.15 ) μ.g/L vs ( 24.62 ± 3.15 ) μg/L,( 30.60 ± 0.65 ) μg/L vs (27.46 ± 1.68 ) μg/L,P ＜ 0.05 ] in lung fibroblasts caused by hyperoxia were significantly higher than those in air-exposed group on postnatal 7 d and 14 d.There was positive correlation between α-SMA and Col Ⅰ protein ( r =0.72,P＜0.01 ).ConclusionHyperoxia promotes differentiation of lung fibroblasts into myofibroblasts,and synthesis of type Ⅰ collegen in neonatal rats,which leads to lung fibrosis finally.

Objective To determine the prognostic value of standardized uptake value(SUV)of fluorodeoxyglucose(FDG)by positron emission tomography and computed tomography(PET-CT)in nonsmall cell lung cancer(NSCLC).Methods Forty-eight patients(39 male,9 female)with stage ⅢNSCLC were reviewed.All patients had at least two repeated FDG PET-CT scans either before and after therapy and the maximum standardized uptake value(SUVmax)of the primary lung lesion was calculated. Resuits Of the 45 eligible patients,after a median follow-up of 22.5 months(rang,13 to 35 months),24 patients had local and regional recurrenee or metastasis and 21 remain disease-free.The mean SUVmax of patients who had local recurrence or metastasis before and after treatment was 12.30±3.17 and 5.35±2.29,respectively.The mean SUVmax of patients who had no loeal recurrence or metastasis before and after treatment was 8.46±3.00 and 2.82±0.63,respectively.Significant differences(tbefore=4.15,Pbefore＜0.01;Pafter=4.88,Pafter＜0.01)in SUVmax were observed either before and after treatment.However,the percent change of SUVmax between pretreatment and post-treatment were not significiantly different(t=1.99,P＞0.05).Using the SUVbefore of 9.0 yielded 92% sensitivity,62% specificity,73% positive predictive value and 87%negaffve Dredictive value in predicting regional recurrence or metastasis. While using the SUVafter of 4.3 yielded 71% sensitivity,100% specificity,100% positive predictive valne and 72% negative Dredictive value. Conclusions PET-CT may have the potientials to predict response to therapy and the SUVmax is a significant predictor for recurrent or metastasis in patients of NSCLC.

Objective To discuss the value of dual-time-point 18FDG PET-CT imaging on involved field radiotherapy for hilar and mediastinal metastatic lymph nodes in patients with non-small cell lung cancer (NSCLC).Methods Fifty-four patients with NSCLC were included in this analysis,including 34 men and 20 women with mean age of 59(34-76)years.Two sequential PET-CT scans given 3-5 days before surgery were standard single-time-point imaging for the whole body and delayed imaging for the thorax.The pathologic data were used as golden standard to determine the difference between the standard single-time-point and dual-time-point FET-CT imaging in the definition of gross target volume(GTV)of involved-field radiotherapy for metastatic lymph nodes. Results For hilar metastatic lymph nodes,the GTV defined by single-time-point imaging was consistent with pathologic GTV in 21 patients(39%),comparing with 31 patients(57%) by dual-time-point imaging.Using pathologic data as golden standard,GTV alteration defined by single-time-point imaging had statisticaly significant difference comparing with that defined by dual-time-point imaging(u=519.00,P=0.023).For mediastinal metastatic lymph nodes,the GTV defined by single-time-point imaging was consistent with pathologic GTV in 30 patients(56%),comparing with 36 patients(67%)by dual-time-point imaging.Using pathologic data as golden standard.GTV alteration defined by single-time-point imaging had no statisticaly significant difference comparing with that defined by dual-time-point imaging(u=397.50,P=0.616).Conclusions For patients with NSCLC receiving involved-field radiotherapy,GTV definition for hilar and mediastinal metastatic lymph nodes by dual-time-point imaging is more consistent with that by pathologic data.Dual-time-point imaging has a larger value in terms of target delineation for hilar and mediastinal metastatic lymph nodes.

OBJECTIVETo report our experience to embolize the AVM of jaws by direct puncture in conjunction with endovascular treatment.

METHODS5 cases of AVM of mandible and 2 cases of AVM of maxilla comprised this study group. The patients were embolized with coils with wool strands and PVA. The coils were placed directly into the center of the intraosseous lesion. The procedure was under the guidance of DSA machine (PHILIPS V3000).

RESULTSThe acute arterial bleeding of 4 patients was controllable. The chronic oozing bleeding in the other 3 cases disappeared in the 3 - 24 months follow-up and new bone formation was found in the follow-up radiography.

CONCLUSIONSThe embolization of the AVM of jaws by direct puncture in conjunction with endovascular therapy is effective and safe, however the longer follow-up is expected.

Adolescent ; Arteriovenous Malformations ; pathology ; therapy ; Child ; Embolization, Therapeutic ; methods ; Female ; Follow-Up Studies ; Humans ; Jaw ; blood supply ; Male ; Mandible ; blood supply ; Maxilla ; blood supply ; Middle Aged ; Punctures ; Time Factors ; Treatment Outcome

Objective: To know the incidence of heat stroke and explore it's prediction model in Pudong New Area of Shanghai. Methods: An epidemiological investigation was conducted on heat stroke cases in Pudong New Area of Shanghai from 2013 to 2017. Daily temperature data during this period were collected to explore it’s influence. Results: 246 heat stroke cases were reported and investigated, 70.3% (173/246) of them were male. 170 cases are severe heat stroke, accounting for 69.1%. 28 patients died, accounting for 11.4% of all cases of heat stroke, and 16.5% (28/170) of severe heat stroke cases. Thermoplegia (56.5%, 96/170) was the most popular type among severe heat stroke cases. Heat prostration, heat cramps and mixed type account for 17.1% (29/170) , 12.4% (21/170) and 14.0% (24/170) respectively. Scatter plot and linear regression demonstrated that there was a significant linear relation between number of high temperature days and number of heat stroke cases (P<0.01) . And the prediction model is: Predictive number of annual heat stroke cases=β×Number of annual high temperature days+Intercept. Leave-one-out cross validation result shows that the predictive number of annual heat stroke cases from 2013 to 2017 were 85.7%, 90.9%, 83.3%, 91.9 and 84.3% respectively. Conclusion There was a significant linear relation between number of high temperature days and number of heat stroke cases in Pudong New Area. The related work arrangement for heat stroke prevention could be well planed according to the prediction model.

Objective:To investigate the effects of chest pain center construction in basic-level hospitals on treatment time and short-term prognosis in patients with acute ST-elevation myocardial infarction.Methods:A total of 162 patients with acute ST-elevation myocardial infarction who received percutaneous coronary intervention (PCI) in The First People's Hospital of Jiande between November 2014 and November 2018 were included in this study. Among them, 66 patients who received treatment in The First People's Hospital of Jiande between November 2014 and October 2016 were included in the control group. The remaining 96 patients who received treatment between November 2016 and November 2018 were included in the study group. The underlying diseases, PCI success rate, first medical contact-to-balloon time, door-to-balloon time, in-hospital mortality, incidence of heart failure on the next day of PCI, length of hospital stay, hospital medical cost were retrospectively analyzed.Results:There were no significant differences in underlying disease composition ratio and PCI success rate between the two groups (both P > 0.05). There were significant differences in first medical contact-to-balloon time [(185.2 ± 53.7) minutes vs. (108.6 ± 46.4) minutes, t = 6.128], door-to-balloon time [(121.5 ± 23.2) minutes vs. (68.7 ± 14.3) minutes, t = 7.341], length of hospital stay [(10.3 ± 3.5) days vs. (7.2 ± 2.8) days, t = 5.128], hospital medical cost [(43 582.0 ± 7 186.5) yuan vs. (35 479.0 ± 4 213.1) yuan, t = 8.361], in-hospital mortality [6.1% vs. 3.1%, χ2 = 4.784], the incidence of heart failure on the next day of PCI [13.6% vs. 4.2%, χ2 = 8.253] between the control and study groups (all P < 0.05). Conclusion:Establishment of a standardized chest pain center construction in basic-level hospital can greatly shorten the first medical contact-to-balloon time, door-to-balloon time and length of hospital stay, improve the cardiac function and prognosis of patients with myocardial infarction, and reduce medical cost.

OBJECTIVETo observe the impact of mesenchymal stem cells (BMSCs) transplantation on myocardial myocardin-related transcription factor-A (MRTF-A) and bcl-2 expression in rats with experimental myocardial infarction (MI).

METHODSThirty rats were randomly divided into sham, MI and MI + BMSCs (1 × 10(6) injected into 4 infarct points immediately post coronary artery ligation) groups (n = 10 each).One week later, TUNEL was used to detect cardiomyocyte apoptosis, the myocardial expression of MRTF-A and bcl-2 was detected by laser scanning confocal microscope and Western blot. In vitro plasmid of MRTF-A and co-transfection with plasmids of MRTF-A and bcl-2 or mutated bcl-2 transfection into cardiomyocyte was applied to evaluate the relationship between MRTF-A and bcl-2.

RESULTSThe number of apoptotic cardiomyocytes in the sham group, MI group and MI + BMSCs group were (4.05 ± 1.56)%, (62.38 ± 8.41)% and (22.36 ± 6.17)%, respectively (P < 0.05). The protein expression of MRTF-A and bcl-2 in the MI group were significantly lower than those in sham group, while significantly upregulated in MI + BMSCs group (P < 0.05 vs. MI). In cultured neonatal rat cardiomyocyte, the expression of bcl-2 protein was significantly upregulated after transfection with MRTF-A plasmid, and bcl-2-luciferase activity significantly increased after co-transfection with plasmids of MRTF-A and bcl-2-luciferase, however, the positive regulatory effect of MRTF-A was abolished after transfection with mutated bcl-2.

CONCLUSIONMesenchymal stem cells transplantation can effectively reduce cardiomyocyte apoptosis in this rat MI model, and upregulate the expression of MRTF-A. Consequent up-regulated bcl-2 expression might be involved in the beneficial effects of BMSCs transplantation in this model.

Animals ; Apoptosis ; Heart ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells ; Myocardial Infarction ; Myocardium ; Myocytes, Cardiac ; Nuclear Proteins ; Proto-Oncogene Proteins c-bcl-2 ; Rats ; Rats, Sprague-Dawley ; Trans-Activators ; Transcription Factors ; Transfection

Objective To observe the effect of myocardial transcription factor MRTF-A on myocardium inflammation and its mechanism.Methods Totally 30 rats were randomly divided into the sham,ischemia-reperfusion (myocardial ischemia 30 min and reperfusion 2 h),and MRTF-A groups(myocardial ischemia 30 min and reperfusion 2 h & Lentivirus infection MRTF-A) (n=10 each group).Serum myocardial enzyme activity was detected by biochemical analysis,myocardial infarct size detected by TTC,and degree of myocardial injury was measured by HE staining.The TLR4 and TRIF expression was analyzed by immunohistochemistry and qPCR.Results Compared with the sham group,the MRTF-A group significantly increased the activity of serum myocardial enzymes CK-MB and LDH (P＜0.05).The infarct area of myocardial tissue was gray-white,and the infarct area was (54.31±3.07)％ (P ＜ 0.05).Myocardial fibrosis was disorder,myocardial cell was swollen and burst,and inflammatory cell infiltration was obvious.Protein and mRNA expressions of TRL4 and TRIF were significantly up-regulated (P＜0.05).Compared with the ischemia-reperfusion group,the levels of CK-MB and LDH were significantly reduced after myocardial infection with MRTF-A (P＜0.05).The myocardial infarction area was significantly reduced to (16.74±4.26)％ (P＜ 0.05).The myocardial structure was nearly normal with mild edema.Protein and mRNA expression of TRL4 and TRIF decreased significantly (P＜0.05).Conclusions The overexpression of transcription factor MRTF-A in myocardial cells alleviates the myocardial ischemia reperfusion injury by inhibiting the TLR4/TRIF signaling pathway and reducing the serum myocardial enzyme activity and myocardial damage.