OBJECTIVE To study the clinical characteristics of invasive pulmonary aspergillosis(IPA).METHODS Based on the clinical data from 14 IPA cases identified by pathologic examination in the 454th Hospital,the characteristics of IPA were discussed,including the underlying diseases,symptoms,X-ray,CT,the treatment methods and the curative effect.The related literatures were also reviewed.RESULTS All of the 14 patients had underlying diseases.From them 5 were with pulmonary cancer(35.7%),3 with chronic obstructive pulmonary disease(21.4%),2 with pulmonary abscess(14.3%),2 were after chemotherapy for leukemia(14.3%),1 with pulmonary tuberculosis(7.1%)and 1 with diabetes(7.1%).The common symptoms of the 14 cases were febricity,productive cough and hemoptysis.Some of them also suffered with short of breath,night sweat,fatigue,chest pain and losing weight.The air crescent sign showed on X-ray and CT.Soft tissue masses with halo-sign on the margin,dense shadow of small masses within the alveoli,and multi-nodular shadows were also observed.Among 10 patients treated by antifungal medications,only 4 treated otherwise with operation were cured,4 patients died,and 2 patients did not complete the treatment scheme.CONCLUSIONS The patients with immunodeficiency are susceptible to IPA.The clinical manifestations of IPA are non-specific.The final diagnosis depends on the pathologic examination.The only medication is not sufficient for IPA patients.Pulmonary resection should be considered if the prolonged illness or frequent hemoptysis exist.

This paper briefly reviews the latest progress in the analyses of the technologies for artificial hip joints; and in the researches directed to the features of UHMWPE debris obtained from all kinds of experimental conditions, to the wear process and wear mechanism, and to the factors which influence the wear mechanism. Furthermore, the signification of debris atlas was illustrated. Finally, future directions to be furthered were considered and envisaged. It is suggested that emphases be laid on the relationship between the UHMWPE debris feature and the wear mechanism, and be laid synergistic effects of biochemical environment and loading environment so as to establish the predictive wear models of artificial hip joints.
Arthroplasty, Replacement, Hip ; adverse effects ; Equipment Failure Analysis ; methods ; Foreign Bodies ; etiology ; prevention & control ; Humans ; Particle Size ; Polyethylenes ; adverse effects ; analysis ; Prosthesis Failure

Objective To investigate the clinical efficacy of Dahuang Xiaozhi Suppository combined with tetracycline in treating type Ⅲ prostatitis infected with nano-bacteria. Methods Totally 120 patients of type Ⅲprostatitis infected with nano-bacteria were randomly divided into treatment group and control group, with 60 cases in each group. Both groups were disabled anti-infective drugs and other preparations for diet and life intervention. Both groups received tetracycline, once a tablet, twice a day, orally. The treatment group received Dahuang Xiaozhi Suppository, once a capsule, once a day, placing in the anus 3-4 cm. 10 d was a treatment course, for 3 courses. The clinical efficacy, major symptoms improving time, NIH-CPSI, leukocyte count and ecithin corpuscles in expressed prostatic secretion (EPS), urinary flow rate, and cytokine content of TNF-α, IL-6, IL-8, were evaluated. Results The total effective rate was 100.0% (60/60) in treatment group and 83.3% (50/60) in the control group, and treatment group was higher than the control group (P<0.05). Pelvic pain, urinary symptom, and scrotum wet improvement time of treatment group were lower than the control group (P<0.05). Compared with before the treatment, the NIH-CPSI pain scores, urinary symptom scores, life quality score, leukocyte count and TNF-α, IL-6, IL-8 content of EPS in both groups were significantly lower after treatment (P<0.05), and the cases with lecithin corpuscles +++ - ++++ in both groups significantly increased after treatment (P<0.05). The urinary peak flow rate and mean flow rate in both groups were higher after treatment (P<0.05). There was statistical significance in the scores of NIH-CPSI pain, urinary symptom and life quality, leukocyte count and TNF-α, IL-6, IL-8 content of EPS, and the cases with lecithin corpuscles ++++ between the two groups (P<0.05). Conclusion Dahuang Xiaozhi Suppository can improve the efficacy of treating type Ⅲ prostatitis infected with nano-bacteria. Combining Dahuang Xiaozhi Suppository with tetracycline can reduce prostate inflammation, with obvious efficacy.

BACKGROUND: CT scan and differential modeling are used to analyze the fracture end, which is an effective method to judge the degree of bone healing. To obtain the high precision of differential modeling and simulation, how to select the optimal CT scanning parameters needs further research and analysis. OBJECTIVE: To compare the effects of different CT scanning parameters on modeling accuracy in personalized differential modeling analysis, to verify the accuracy and effectiveness of personalized differential modeling in the reduction of simulated target bone segments, and to explore the research value of this method in judging the degree of bone healing of long canals of lower extremities. METHODS: The model of internal fixation was established with porcine femur. Four groups of 80 kV-300 mA (group A-low dose), 120 kV-335 mA (group B-automatic tube current control system), 140 kV-300 mA (group C-manual setting comparison) and 140 kV-80 mA (group D-high kV and low mA) were used to scan the same object with the same pitch, slice thickness and environment. The scanning data of each group were selected, the same CT value range was used, and the differential modeling analysis method was used to model the target bone segment. The average area and maximum area of metal artifacts in CT scanning images, the average CT value, volume and maximum wall thickness peak after differential modeling analysis, the radiation amount under four groups of scanning conditions were compared to determine the reduction of metal artifacts, modeling accuracy and radiation, so as to select the optimal CT scanning parameters. RESULTS AND CONCLUSION: (1) Artifact measurement method results: In group A, there were many metal artifacts, which obviously obstructed bone tissue, and had a possibility of missed diagnosis. In group D, there were minimal metal artifacts, less occlusion around bone tissue, but poor image contrast and high fog. The difference between group B and group C lay in the clarity of images, and the accuracy of diagnosis was basically the same. Therefore, the order of artifact size was as follows: group A > group B > group C > Group D. (2) Differential modeling analysis results: In group B, because of the smaller artifact and less loss of CT value, the simulated model was more close to the reality. Moreover, group B adopted the automatic tube current control system, which could obviously show that the radiation amount was smaller and more protective for patients. (3) It is confirmed that the CT scan under the condition of group B can effectively reduce the interference caused by metal artifacts, better retain the original information of CT gray value, and retain the density information of the target bone segment to the maximum extent. Therefore, when establishing differential modeling, the CT automatic tube current control system is used as the optimal CT scanning parameter, which not only improves the simulation accuracy of personalized differential modeling, but also increases the accuracy of calculation.

Adenoma ; pathology ; Colonic Neoplasms ; pathology ; Humans ; Intestinal Mucosa ; pathology

Aim To construct the fusion gene of human IgG3 upper hinge region and p53 tetramerization domain and to analyze its space conformation. Methods The fusion gene was obtained by recursive polymerase chain reaction (R-PCR),and was cloned into vector pUC19. The positive clone was selected and sequenced with PE310 auto-sequencer. The space conformation of the fusion gene expression product was predicted by using computer program Antheprot. Results Restriction endonuclease digestion confirmed that the fusion gene has been inserted correctly into the vector. The result of sequencing showed that the fusion gene is identical with designation. Analyzing with antheprot program showed that the fusion gene expression product could auto-assembly into a tetramer with four long and flexible linkers. Conclusion Successful construction of the fusion gene mentioned above laid the foundation for further preparation of multivalent gene engineering antibody.

VP1 gene encoded by the newly identified caprine enterovirus CEV-JL 14 was amplified and cloned to prokaryotic expression vector pGEX-4T-1.Recombinant GST-VP1 fusion protein was expressed,purified,emulsified with Freund's complete adjuvant and used to immunize the BALB/c mice following a standard procedure.The spleen cells from immunized mice were collected and fused with myeloma cells after its antibody titer reached over 104 times detected by indirect ELISA.Hybridoma cell clones secreting monoclonal antibodies against VP1 were screened and their stability and specificity were further determined.The identified hybridoma cells were injected to mice intraperitoneally and ascites were collected at 7 DPI.Isotypes of the monoclonal antibodies against the recombinant VP1 protein were characterized to be either IgG1 or IgG2b,which showed a high specificity for detection of caprine enterovirus antigens by immunoperoxidase monolayer assay,thus laying a solid basis for future study related to viral pathogenesis,detection and diagnostics for caprine enterovirus infection.

Objective: To investigate the clinical application and effect evaluation of failure mode and effect analysis (FMEA) in the optimization of vascular recanalization in patients with ST-segment elevation myocardial infarction (STEMI). Methods: A total of 389 STEMI patients admitted to the emergency department of the Fifth Central Hospital in Tianjin from January 2014 to January 2015 were served as the control group, and 398 STEMI patients admitted to the chest pain center of the Fifth Central Hospital in Tianjin from January 2016 to October 2017 were served as the experimental group. In the control group, routine emergency treatment was used. At the same time, the intervention room was 24-hour prepared for emergency vascular recanalization. The experimental group used FMEA. Through the usage of FMEA, the main factors those caused the delay in revascularization treatment were determined, and the revascularization process was optimized for these influencing factors, thereby shortening the "criminal" blood vessel opening time of patients. The door-to-balloon dilatation time (D-to-B time), troponin testing time, placement time of the catheterization room, initiation of the catheterization room to balloon dilatation time, and preoperative and 1 week postoperative N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, heart function parameters [left ventricular ejection fraction (LVEF), left ventricular short axis shortening rate (FS), left ventricular end-systolic diameter (LVESD), and left ventricular end-diastolic diameter (LVEDD)] within 1 week, 3 months and 6 months after intervention, and the incidence of main cardiovascular adverse events within 1 month after intervention, hospital mortality, the length of hospital stay, and readmission within 1 year in the patients of two groups were recorded. Results: D-to-B time (minutes: 70.6±3.6 vs. 79.4±8.7), troponin testing time (minutes: 17.1±2.3 vs. 65.2±6.5), placement time of the catheterization room (minutes: 28.9±9.8 vs. 52.3±12.2) and activation of the catheterization room to balloon expansion time (minutes: 47.3±9.3 vs. 65.1±7.2) in the experimental group were significantly shorter than those in the control group (all P < 0.01). The NT-proBNP levels at 1 week after intervention in the two groups were lower than the preoperative levels, slightly lower in the experimental group, but the difference was not statistically significant. There was no significant difference in cardiac function at 1 week and 3 months after intervention between the two groups. The LVEF and FS at 6 months after intervention in the experimental group were significantly higher than those in the control group [LVEF: 0.622±0.054 vs. 0.584±0.076, FS: (38.1±4.3)% vs. (35.4±6.2)%, both P < 0.01], and LVESD and LVEDD were decreased significantly [LVESD (mm): 31.2±3.8 vs. 34.7±4.2, LVEDD (mm): 49.2±5.3 vs. 52.4±5.6, all P < 0.01]. The length of hospital stay in the experimental group was significantly shorter than that in the control group (days: 8.3±3.2 vs. 13.2±6.8, P < 0.01), the incidence of major cardiovascular adverse events within 1 month after intervention [13.6% (54/398) vs. 19.8% (77/389)], hospital mortality [1.8% (7/398) vs. 4.9% (19/389)], and readmission rate within 1 year [9.5% (38/398) vs. 14.5% (56/389)] in the experimental group were significantly lower than those in the control group (all P < 0.05). Conclusion The usage of FMEA to optimize the vascular recanalization procedure can shorten the emergency treatment time of STEMI patients, reduce the occurrence of adverse events, and improve the prognosis.

Objective To investigate the efficacy and application of bronchoalveolar lavage in chil-dren with severe pneumonia undergoing mechanical ventilation. Methods Using a prospective randomized controlled clinical study, 202 children with severe pneumonia received mechanical ventilation in Hunan Children′s Hospital from January 2016 to January 2018 were selected as the subjects. According to the digital method,all cases were divided into treatment group (101 cases) and control group (101 cases) randomly. The patients in the control group were given conventional treatment ( anti-infection and symptomatic thera-py) . The treatment group was treated with bronchoalveolar lavage on the basis of conventional treatment. The basic situation,the respiratory function before and after the treatment,the inflammation index,the curative effect and the prognosis of two groups were analyzed. Results There were no significant differences between the two groups in gender,age,course pre-admission,pediatric critical illness score,respiratory function and in-flammation index ( P>0. 05 ) . The respiratory function indexes of the treatment group were obviously im-proved 2 hours after the treatment and the PaO2 ,PaO2/FiO2 and SaO2 were significantly higher than those of the control group[PaO2:(82. 4 ± 6. 4) mmHg(1 mmHg=0. 133 kPa) vs. (74. 0 ± 5. 5) mmHg, PaO2/FiO2:(360. 2 ± 21. 3) mmHg vs. (332. 6 ± 23. 5) mmHg,SaO2:(94. 9 ± 8. 2)％ vs. (88. 6 ± 10. 3)％], while the PaCO2 were significantly lower than the control group [ ( 37. 3 ± 10. 3 ) mmHg vs. ( 45. 8 ± 5. 5 ) mmHg],and the differences were statistically significant (P<0. 05). Five days after treatment,the WBC, PCT and CRP of treatment group were significantly lower than those in the control group[WBC:(8. 5 ± 2. 4) × 109/L vs. (11. 7 ± 3. 5) × 109/L,PCT:(1. 2 ± 0. 7) μg/L vs. (2. 3 ± 0. 9) μg/L,CRP:(9. 1 ± 3. 2) mg/L vs. (16. 5 ± 4. 7) mg/L,P<0. 05,respectively]. The total effective rate in the treatment group was significantly higher than that in the control group[93. 1％(94/101)vs. 81. 2％(82/101)]. Mechanical venti-lation duration and PICU stay in treatment group were significantly shorter than those in the control group [(148. 5 ±30. 6)h vs. (159. 6 ±47. 3)h,(220. 8 ±49. 7)h vs. (330. 7 ±94. 6)h]. The positive rate of patho-genic bacteria was significantly higher than that in the control group [79. 2％(80/101)vs. 62. 4％(63/101), P<0. 05],but there was no significant difference in the 28 days mortality of the two groups[5. 0％(5/101) vs. 5. 9％(6/101),P>0. 05]. Conclusion The bronchoalveolar lavage can improve the respiratory func-tion,reduce the inflammatory reaction,shorten mechanical ventilation duration and PICU stay in children with severe pneumonia undergoing mechanical ventilation obviously. It is worth popularizing in the PICU because of the improvement of curative effect in these children.

Objective To investigate the correlation between serum matrix metalloproteinase-9 (MMP-9) and intracranial pressure after hematoma removal in patients with primary intracerebral hemorrhage (PICH). Methods From January 2015 to June 2017,72 consecutive patients with PICH treated with removal of hematoma + intracranial pressure probe implantation at the Department of Neurosurgery, the Second Affiliated Hospital of Xinjiang Medical University were enrolled retrospectively. They were divided into 3 groups:group A (n=25,intracranial pressure ≤10 mmHg);group B (n=24,intracranial pressure 11-20 mmHg),and group C (n=23,intracranial pressure >20 mmHg) according to the maximum value of monitoring intracranial pressure. The serum MMP-9 levels of all patients were detected using ELISA at 1, 3,5,7 and 14 d after procedure,the volume of cerebral edema was monitored by head CT,and intracranial pressure was continuously observed for 7 d after procedure using the intracranial pressure monitor. Results At 1,3,5,7,and 14 d after removal of the hematomas,the MMP-9 levels in group A were 82 ± 11,117 ± 12,156 ± 14,132 ± 14,and 108 ± 18 mg/L,respectively,and the volumes of brain edema were 15 ± 6,19 ± 7,22 ± 8,19 ± 7,and 17 ± 6 cm3 ,respectively. The MMP-9 levels in group B were 93 ± 14,138 ±13,188 ± 17,153 ± 17,and 134 ± 12 mg/L,respectively,and the volumes of brain edema were 19 ± 7,23 ± 8,30 ± 10,26 ± 8,and 20 ± 7 cm3 ,respectively;the MMP-9 levels in group C were 104 ± 16,199 ± 14,390 ± 22,296 ± 15,and 213 ± 15 mg/L,respectively,and the volume of brain edema were 22 ± 8,30 ± 10,42 ± 12,32 ±19,and 24 ±8 cm3,respectively. There was significant difference between groups (P<0. 05),and there was a moderate positive correlation between the changes of MMP-9 level and the volume of intracranial cerebral edema (r =0. 62,P <0. 01). Conclusion After the removal of the hematomas of primary cerebral hemorrhage, the MMP-9 level in blood serum of the patients was positively correlated with the volume of brain edema,the higher the level of MMP-9,the higher the intracranial pressure.