Objective To evaluate Alberta stroke programme early CT score on diffusion-weighted imaging (DWI-ASPECTS)and clot burden score on MR angiography (MRA-CBS)in predicting hemorrhagic transformation(HT) in acute anterior circulation cerebral infarction after thrombolysis in diffusion-weighted imaging Alberta stroke program.Methods A total of 37 consecutive patients with acute anterior circulation cerebral infarction were treated with thrombolysis.The clinical information , score of DWI-ASPECTS before thrombolysis , score of MRA-CBS before thrombolysis and images of enhanced gradient echo T 2*-weighted angiographywithin ( ESWAN) 24 hours before and after thrombolysis were all collected.The interval between onset and the two MRI scans were recorded respectively.We identified HT according to the images of ESWAN scanned after thrombolysis , and divided patients into 2 groups:with HT(14 cases) and without HT (23 cases).Differences of clinical data and imaging indicators between the two groups were compared by using Fisher′s exact test and Wilcoxon rank sum test.Logistic regression analysis was performed by taking HT as the dependent variable , and the scores of NIHSS , DWI-ASPECTS and MRA-CBS at admission were taken as independent variables.The variables which were statistically significant in logistic regression analysis were enrolled in receiver operating characteristic analysis.Results In HT group, the scores of NIHSS, DWI-ASPECTS and MRA-CBS were 15.00 ±5.30, 6.00(4.75,7.00) and 7.00(0.75,8.50) respectively.In the other group without HT, these scores were 7.00 ±4.80, 9.00(8.00,10.00)and 10.00(6.00,10.00) respectively.Compared with patients without HT , patients with HT had a higher baseline NIHSS score ( Z=-3.72,P<0.01), a lower DWI-ASPECTS (Z=-4.13,P<0.01) and a lower MRA-CBS (Z=-2.00, P<0.05).Logistic regression analysis showed that the scores of DWI-ASPECTS ( OR 0.42,95%CI 0.21-0.87,P <0.05 ) and NIHSS ( OR 1.22, 95%CI 1.00-1.48, P <0.05 ) at baseline predicted HT development independently.Receiver operating characteristic analysis showed that the optimal cut -off point of DWI-ASPECTS to predict the development of HT was≤7.Its sensitivity, specificity and area under ROC curve were 92.9%, 78.3% and 0.902 respectively ( P<0.01 ).Conclusions ASPECTS on DWI is of great value in predicting HT after thrombolysis in acute cerebral infarction.CBS on MRA can provide additional information for predicting HT.

Objective To evaluate the diagnostic value of galactomannan(GM) detection for invasive aspergillosis infections in pediatric patients, a Meta-analysis was performed.Methods According to selection criteria, studies indexed by PubMed,EMBASE,Medline,CNKI and Wanfang Data on GM testing in pediatric aspergillosis were included from January 2001 to November 2012. The methodological quality was assessed by QUADAS, sources of heterogeneity investigated, pooled effect quantities evaluated, and summary receiver operative curves(ROC) and subgroup analysis performed.Stata12.0 was used to analyze diagnostic parameters, such as, sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and area under the curve(AUC). Results Thirteen articles with 16 sets of data were included.The weighted sensitivity and specificity with 95% confidence interval were 0.71(0.60-0.79)and 0.94(0.89-0.96), respectively.Under different cut-off values, sensitivities of GM assay in diagnosis of pediatric aspergillosis were 0.71(0.54-0.84) for 0.5, 0.77(0.64-0.87) for 0.8, 0.72(0.58-0.84) for 1.0 and 0.59(0.39-0.76) for 1.5, and its responding specificities were 0.94(0.89-0.97), 0.89(0.82-0.93), 0.89(0.81-0.94) and 0.91(0.88-0.94).Conclusion Under the cut-off value of 0.8, the GM assay is a useful method in the detection of pediatric invasive aspergillosis.

Objective: To analyze the correlation of miR-625 expression with clinicopathological characteristics in esophageal squa-mous cell carcinoma (ESCC) and to explore the effect of miR-625 on the migration and proliferation of ESCC cells. Methods:The expres-sion level of miR-625 was determined through real-time PCR in 86 paired human ESCC tissue specimens and tumor-adjacent normal esophageal tissue specimens, ESCC cell lines, and esophageal epithelial cell line. The associations of miR-625 expression with clinico-pathological characteristics and survival in ESCC patients were analyzed. Transwell and CCK-8 assays were performed to examine the effect of miR-625 expression on migration and proliferation of ESCC cells. Results:Compared with tumor-adjacent normal specimens, miR-625 was significantly downregulated in ESCC tissue specimens (P<0.05). MiR-625 expression was decreased in ESCC cell lines com-pared with human esophageal epithelial cell lines (P<0.05). Lower miR-625 expression was associated with poorer prognosis and sur-vival. The migration and proliferation abilities of ESCC cells were inhibited by miR-625 overexpression (P<0.05). Conclusion:MiR-625 acts as a tumor suppressor gene in the development and progression of ESCC, suggesting that miR-625 may serve as an efficient prog-nosis biomarker and a potential therapeutic target for ESCC.

Objective To obtain the effective characteristic information for the standardization of diagnosis of traditional Chinese medical(TCM) syndrome in rheumatoid arthritis(RA).Methods Fifty-four items of symptoms and signs in RA patients were input into the computer,and Mahalanobis distance discriminant analysis(DDA) was used for the selection of effective indexes.Results According to the weight value and the result of T test,17 items from 54 had the highest rate of discrimination accuracy,up to 96.5%.Conclusion The results of computerized pattern recognition for the syndrome diagnosis of RA are consistent with the clinical diagnosis,which indicates that computerized pattern recognition can be used for the standardization of syndrome diagnosis of RA.

Objective: To investigate the prevalence and influencing factors of comorbidity of chronic diseases among hypertensive patients with uncontrolled blood pressure in Huzhou City, so as to provide insights into community hypertension control. Methods: Hypertensive patients with uncontrolled blood pressure at ages of 35 to 74 years were sampled using a cluster random sampling method from 5 districts (counties) of Huzhou City. Participants' demographics, living behaviors, and development of chronic diseases were collected using questionnaires, and the height, body weight, waist circumference and blood pressure were measured. Blood glucose, blood lipid and other biochemical parameters were detected, and the number and combination of comorbidity of chronic diseases were descriptively analyzed. Factors affecting the comorbidity of chronic diseases were identified using a multivariable ordinal logistic regression model. Results: A total of 1 215 respondents were included, with a mean age of (60.83±7.76) years, and including 652 men (53.66%) and 563 women (46.34%). The prevalence of dyslipidemia, diabetes, hyperuricemia and cardiac encephalopathy was 45.10%, 30.95%, 23.05% and 5.10%, respectively. The prevalence of comorbidity of chronic diseases was 69.22% among respondents, and there were 497 respondents with one comorbidity (40.91%), 272 with two comorbidities (22.39%) and 72 with three and more comorbidities (5.93%). Hypertension+dyslipidemia (20.74%), hypertension+diabetes+dyslipidemia (9.96%) and hypertension+diabetes+dyslipidemia+hyperuricemia (4.36%) were predominant comorbid combinations. Multivariable ordinal logistic regression analysis showed that participants with overweight (OR=1.782, 95%CI: 1.390-2.286), obesity (OR=2.411, 95%CI: 1.802-3.222), grade 2 hypertension (OR=1.438, 95%CI: 1.077-1.919) had a higher risk of multiple comorbidities than those with normal body mass index and controlled blood pressure, and women (OR=0.563, 95%CI: 0.456-0.696) had a lower risk of multiple comorbidities than men. Conclusions The prevalence of comorbidity of chronic diseases was 69.22% among community hypertensive patients with uncontrolled blood pressure in Huzhou City, and the comorbidity of chronic diseases mainly included dyslipidemia and diabetes. Men, overweight, obesity and hypertension resulted in a high risk of comorbidity of chronic diseases.

Objective To explore the computed tomography (CT)manifestations of adrenocortical oncocytoma (ACO)for better understanding the disease and improving its diagnosis accuracy.Methods The CT manifestations of 9 cases with adrenocortical onco-cytomas confirmed by surgery were retrospectively reviewed and compared with pathological results.Results Five of cases were lo-cated in left side while 4 cases were in right side.Well defined and round or oval border could be found in all the cases.Of all the ca-ses,3 cases were solid lesions with equal density,< 3 cm in diameter,and mild consistent intensification after enhancement.Cystic lesion was detectd in 6 cases with > 3 cm in diameter.The mixed cystic and solid components with polycystic changes could be found on CT image,and remarkable intensification on solid lesion while no intensification on cystic lesion after the enhancement. Moreover,patchy or cotton-like shape could be found on solid lesion in 4 cases and 1 case with island like intensification;reticular pattern could be found in the central of lesion in 3 cases and 1 case with stellate shape.Pathological observation showed that the on-cotytomas were comprised of cells with abundant eosinophilic cytoplasm and necrotic and fibrous capsule without pathological mitosis could be found in some of lesion.Conclusion The characteristic CT features of adrenocortical oncotytoma has a worse specificity,its diagnosis was dependent on pathologic examination.

Objective To investigate the effect of rhubarb and ephedra prescription on the pulmonary function and blood pressure circadian rhythm in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods One hundred and enghty six patients with AECOPD admitted to Department of Integrated Medicine of Harrison International Peace Hospital from December 2013 to Auguest 2016 were enrolled, and they were divided into a control group 90 cases and an experimental group 96 cases by random number talbe method. The patients in control group were treated with conventional therapy, while those in the experimental group were treated with the conventional therapy and additionally rhubarb and ephedra prescription (including rhubarb 6 g, ephedra 5 g, agrimony 15 g, licorice 15 g), taken orally 2 times a day, the therapeutic course in the two groups being 2 weeks. The diference of blood gas analysis, pulmonary function indexes, dyspnea score (mMRC) and ambulatory blood pressure monitoring were compared before and after treatment in the two groups.Results Compared with before treatment, the pH value, arterial partial pressure of oxygen (PaO2), forced vital capacity (FVC), one second forced expiratory volume (FEV1), FEV1/FVC of the two groups were significantly increased after treatment, while the arterial partial pressure of carbon dioxide (PaCO2) and mMRC score were significantly lowered, and the changes in the experimental group were more significant than those in the control group [pH: 7.40±0.04 vs. 7.37±0.03, PaO2 (mmHg, 1 mmHg = 0.133 kPa): 81.09±12.54 vs. 76.27±12.20, PaCO2 (mmHg): 48.01±8.27 vs. 51.91±8.37, FVC (L): 2.37±0.39 vs. 2.13±0.45, FEV1 (L): 2.08±0.38 vs. 1.87±0.41, FEV1/FVC: (69.01±12.04)% vs. (64.02±11.81)%, mMRC: 2.02±0.76 vs. 2.40±0.87, allP < 0.05 orP < 0.01]. Based on the percentage of blood pressure circadian value difference, the blood pressure circadian rhythm was divided into dipper type, non dipper type, super dipper type and anti dipper type, 24.2% patients were of dipper type and 75.8% patients were of non dipper, super dipper and anti dipper types. There was no significant difference in daytime systolic blood pressure (dSBP) between patients with super dipper and dipper types (P > 0.05),and the dSBP (mmHg) in patients with non dipper type was significantly higher than that in patients with dipper, super dipper and anti dipper types (131.55±5.08 vs. 117.78±4.47, 118.26±4.24, 113.37±3.97, allP < 0.05); the daytime diastolic blood pressure [dDBP (mmHg)] of anti dipper, non dipper type, dipper type, super dipper type increased in turn (respectively, 63.27±2.80, 70.24±3.82, 73.98±2.61, 82.96±4.52, allP < 0.05); the night SBP (nSBP) of anti dipper type was the highest (127.38±4.98) mmHg, and the nSBP of super dipper type was the lowest (89.07±3.81) mmHg; the night DBP (nDBP) of dipper type was lower than that of non dipper, anti dipper and super dipper types (mmHg: 63.57±1.37 vs. 68.86±2.12, 67.15±1.56, 67.89±2.04, allP < 0.05). After treatment, the proportion of patients with dipper type [66.7% (64/96) vs. 54.4% (49/90)], no dipper type [11.5% (11/96) vs. 8.9% (8/90)], and super dipper type [5.2% (5/96) vs. 2.2% (2/90)] in experimental group was significantly higher than that in the control group, the proportion of patients with anti dipper type [16.7% (16/96) vs. 34.4% (31/90)] in experimental group were significantly lower than those in the control group (allP< 0.05).Conclusion The Rhubarb and ephedra prescription can obviously improve the blood gas analysis indexes, pulmonary function and blood pressure rhythm in patients with AECOPD.

Objective To observe the clinical efficacy of Tanreqing combined with cefoperazone sulbactam for treatment of patients with chronic obstructive pulmonary disease (COPD) and explore its mechanism. Methods One hundred and twenty eligible COPD patients admitted to the Harrison International Peace Hospital in Hengshui of Hebei Province from June 2015 to August 2017 were selected, their diagnostic criteria were in accordance with the diagnostic guidelines for COPD (in 2007 revision edition) and they were divided into an experimental group and a control group according to the random number table method, with 60 patients in each group. Both groups had the same routine treatment, such as continuous nasal catheter low flow oxygen inhalation, expel phlegm and relieve asthma, and electrolyte disturbance correction. In the control group, cefoperazone sulbactam intravenous drip was given on the basis of conventional treatment; and the experimental group was additionally given Tanreqing intravenous drip on the basis of treatment in the control group. Both groups received 1 course of treatment for 7 days. According to the clinical symptoms, imagelogy, laboratory indexes, the therapeutic effect was evaluated, and the levels of interleukin-2 (IL-2) and tumor necrosis factor-α (TNF-α) in serum were detected by enzyme linked immunosorbent assay (ELISA). Results After treatment, the levels of IL-2 in serum were significantly higher than those before treatment in both groups (μg/L: control group was 15.5±2.8 vs. 12.7±1.5, experimental group was 18.2±3.2 vs. 11.6±1.3, both P < 0.05), while the levels of TNF-α in serum were decreased compared with those before treatment in both groups (μg/L: control group was 23.8±2.1 vs. 26.9±6.2, experimental group was 20.1±4.3, 27.6±3.7, both P < 0.05). After treatment, the concentration of IL-2 in the serum of the experimental group was significantly higher than that of the control group (μg/L: 18.2±3.2 vs. 15.5±2.8, P < 0.05), and TNF-α level was significantly lower than that of the control group (μg/L: 20.1±4.3 vs. 23.8±2.1, P < 0.05). After 1 course of treatment, the clinical efficacy in the experimental group was significant, and its total effective rate was higher than that in the control group [93.3% (56/60) vs. 86.7% (52/60), P < 0.05], and no adverse reactions were observed during the course of treatment in both groups. Conclusion The therapeutic effect of Tanreqing combined with cefoperazone sulbactam for treatment of patients with COPD is obvious, and it can increase the concentration of IL-2 and reduce the concentration of TNF-α in serum.

OBJECTIVETo determine the level of genetic variation of human parainfluenza virus type 3 (HPIV-3), and to describe infection and co-infection characteristics of HPIV-3 in children.

METHODSSingle respiratory samples from 856 pediatric patients with acute respiratory tract infection (ARI) in Hangzhou were collected from December 2009 to March 2013. All samples were screened for HPIV-3 by real-time RT-PCR and followed by HN sequencing and phylogenetic analysis. In all RSV positive specimens, we screened for the other pathogens, and co-infection characteristics were evaluated.

RESULTSA total of 9.6% of 856 samples were positive for HPIV-3, the nucleotide among the strains ranged from 96.9% to 100%. All Hangzhou strains were placed in C3 subgroup based on HN gene analysis. 49% (n=41) of all HPIV-3-positive children with ARI were found to be co-infected with at least one of the other pathogen. The highest co-infection rate of HPIV-3 was with HRV (n=17). Children in the younger groups (≤12 months old) were significantly more prone to be co-infected with other pathogen (χ(2)=4.78, P=0.029). Pneumonia infection rate was significantly higher in the mono-infection group than the co-infection group (χ(2)=3.92, P=0.048).

CONCLUSIONHPIV-3 was an important pathogen in children with ARI in Hangzhou. HN gene variation rate was low, but showed a more local pattern. The co-infections with other respiratory viruses were popular. Except for pneumonia, no significant differences in other clinical presentation between the HPIV-3 mono-infection and co-infection groups were observed.

Child ; China ; epidemiology ; Genetic Variation ; Humans ; Parainfluenza Virus 3, Human ; Phylogeny ; Real-Time Polymerase Chain Reaction ; Respiratory Tract Infections ; epidemiology ; virology ; Respirovirus Infections ; epidemiology

OBJECTIVETo explore the appropriate early warning method for influenza epidemic in Gansu province.

METHODSBy using simple control chart, moving percentile method, exponential smoothing method and cumulative sum control chart method, the annual incidence data of influenza-like illness in Gansu province during 2014-2015 were analyzed, and the sensitivities, specificities, positive predictive values, Jorden indexes and Kappa values of the 4 methods were evaluated and compared.

RESULTSThe 2014-2015 seasonal influenza epidemic occurred in the fiftieth week of 2014 in Gansu, and the epidemic peak lasted for 6 weeks. Cumulative sum control chart method had the best early warning effect with the sensitivity of 66.67% and specificity of 93.48%.

CONCLUSIONIt is feasible to use cumulative sum control chart method to give early warning of influenza epidemic in Gansu.

China ; epidemiology ; Disease Notification ; methods ; Epidemics ; Feasibility Studies ; Humans ; Influenza, Human ; epidemiology ; Seasons