Objective To differentiate between peri-prosthetic infection and aseptic loosening using quantitative analysis of triphasic bone scintigraphy.Methods Twenty-eight patients (9 males,19 females; mean age 67.5 years,range 49-80 years) with recurrent joint pain after arthroplasty were retrospectively assessed.All patients underwent triphasic bone scintigraphy.ROI of each joint was drawn and the ratios of affected to unaffected side were calculated.The ratios of blood flow phase,blood pool phase,static phase,Creactive protein (CRP) and erythrocyte sedimentation (ESR) were quantitatively analyzed by ROC curve.The final diagnosis was based on microbiological and histological examinations.The optimal cut-off value was chosen based on the ideal sensitivity and specificity.Results Nine patients were diagnosed as septic loosening,17 patients aseptic loosening,1 patient bursitis of hip joint and 1 patient suture reaction.Taking the positive results of blood flow phase or blood pool phase as standard for diagnosing septic loosening,the sensitivity,specificity and accuracy of bone scintigraphy were 7/9,78.9％ (15/19) and 78.6％ (22/28),respectively.The AUC of blood pool phase was 0.942,and the sensitivity and specificity were 8/9 and 78.9％(15/19),respectively,with the optimal cut-off value of 1.40.The AUCs of blood flow ratio and CRP were 0.816 and 0.795,with cut-off values of 1.53 and 1.20,respectively.The AUCs of static phase ratio and ESR were 0.474 and 0.722,respectively,both P＞0.05.Conclusions For the diagnosis of septic loosening,quantitative analysis of triphasic 99Tcm-MDP bone scintigraphy,particularly with the ratio of blood pool phase,is more accurate than qualitative analysis.

In this paper, we propose an image-based key frame gating method to reduce motion artifacts in intravascular ultrasound (IVUS) longitudinal cuts. The artifacts are mainly caused by the periodic relative displacement between blood vessels and the IVUS catheter due to cardiac motion. The method is achieved in four steps as following. Firstly, we convert IVUS image sequences to polar coordinates to cut down the amount of calculation. Secondly, we extracted a one-dimensional signal cluster reflecting cardiac motion by spectral analysis and filtering techniques. Thirdly, we designed a Butterworth band-pass filter for filtering the one-dimensional signal clusters. Fourthly, we retrieved the extremes of the filtered signal clusters to seek key frames to compose key-frames gated sequences. Experimental results showed that our algorithm was fast and the average frame processing time was 17ms. Observing the longitudinal viewpictures, we found that comparing to the original ones, the gated sequences had similar trend, less saw tooth shape, and good continuity. We selected 12 groups of clinical IVUS sequences [images (876 +/- 65 frames), coronary segments length (14.61 +/- 1.08 mm)] to calculate vessel volume, lumen volume, mean plaque burden of the original and gated sequences. Statistical results showed that, on one hand, both vessel volume and lumen volume measured of the gated sequences were significantly smaller than those of the original ones, and there was no significant difference on mean plaque burden between original and gated sequences, which met the need of the clinical diagnosis and treatment. On the other hand, variances of vessel area and lumen area of the gated sequences were significantly smaller than those of the original sequences, indicating that the gated sequences would be more stable than the original ones.
Algorithms ; Artifacts ; Heart ; Humans ; Motion ; Ultrasonography, Interventional

Biomarkers, Tumor ; metabolism ; Diagnosis, Differential ; Diagnostic Imaging ; Humans ; Mass Spectrometry ; methods ; Neoplasms ; diagnosis ; drug therapy ; metabolism ; Spectrometry, Mass, Electrospray Ionization ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

OBJECTIVE: To analyze the utilization of traditional Chinese medicine (TCM) injections in our hospital in order to provide reference for clinical rational use of TCM injection. METHODS: The utilization of TCM injection in our hospital from 2006 to 2008 was statistically analyzed in terms of consumption sum, DDDs and its order. RESULTS: The consumption sum and DDDs of TCM injection in our hospital increased year by year, especially stasis-removing agents and antitumor drug. Over the 3 years the proportion of consumption sum of TCM injections in the total consumption sum were 57.3%, 59.4% and 55.9%, respectively. There was poor synchrony between consumption sum order and DDDs order. CONCLUSION: TCM injections are used rationally in our hospital. In addition, safety reevaluation of TCM injection should be improved.

In order to remove the endotoxin from the blood of endotoxemia patients, we prepared a new adsorbent with heparin space arm and polymyxin B (PMB) ligand. The carrier of chloromethyl polystyrene resin was activated and heparin space arm was grafted, and then PMB ligand was immobilized onto adsorbent with glutaraldehyde. We employed in vitro FITC-lipopolysaccharide (FITC-LPS) static adsorption to characterize the adsorption properties on the adsorbent, and conducted in vitro lipopolysaccharide (LPS) static adsorption to measure quantitavely the adsorption capacity and rate, and then evaluated the blood compatibility. The in vitro static adsorption indicated that the adsorbent had the removal rate of LPS above 70% with the adsorption equilibrium time for 2 hours. Blood compatibility experiment showed that the adsorbent had little negative effects on blood cells and plasma protein, and their adsorption rates were less than 10% for hemocytes and 20% for plasma protein respectively. This adsorbent exhibited high selectivity, high adsorption capacity and good biocompatibility, and presented a promising clinical application in the treatment of endotoxemia.
Adsorption ; Endotoxemia ; therapy ; Endotoxins ; isolation & purification ; Hemofiltration ; instrumentation ; methods ; Heparin ; chemistry ; Humans ; Ion Exchange Resins ; chemistry ; Ligands ; Polymyxin B ; chemistry ; Sorption Detoxification ; methods

Objective: To evaluate the clinical characteristics, diagnosis criteria, treatment and prognosis in patients with Bing-Neel Syndrome (BNS) . Methods: The clinical characteristics, lab data, treatment and outcomes of 3 Bing-Neel syndrome patients diagnosed at Peking Union Medical College Hospital were collected. Results: The clinical presentation was heterogeneous without any specific common signs or symptoms. One patient was diagnosed with BNS 42 months after diagnosis of Waldenström macroglobulinemia (WM) by cerebrospinal fluid (CSF) cytology and flow cytometry, but dead of infection during the first course of chemotherapy. BNS was the first manifestation of WM in the other 2 cases. They were diagnosed by flow cytometry and cytology of CSF. The detection of MYD88^L265P mutation in CSF contributed to diagnosis and to sequential monitoring of minimal residual disease. They received systemic chemotherapy of FC (fludarabine + cyclophosphamide) ± rituximab and intrathecal therapy, followed by maintenance therapy of chlorambucil or R2 (rituximab + lenalidomide) . They were followed 17 and 20 months respectively without progression of disease. Conclusion The diagnosis approach of BNS should be based on a combination of CSF cytology, flow cytometry and detection of the MYD88^L265P mutation. The detection of MYD88^L265P mutation may be useful in the monitoring of minimal residual disease.

This paper summarizes the current situation and problems of the research on the theory of "Taibai Seven Medicines" through literature summary and surveys. Although the "Four Beams and Eight Pillars" theory of compounding has a long history, the current research progress of "Taibai Seven Medicines" is mostly focused on plant resources. There lacks researches on the theory of compounding, or development of compounding and large varieties based on "Taibai Seven Medicines". We call for the inheritance and protection of folk experience, and hope that the "Four Beams and Eight Pillars" theory can guide the application and development of the seven Taibai medicines. Therefore, increasing the research on the theory and teaching in undergraduate courses formulary in Chinese medicine are necessary in our province.

Objective:To investigate the prevalence and influencing factors of xerosis in elderly inpatients, to provide basis for effective prevention and management of xerosis.Methods:Using the cross-sectional survey method and the self-designed survey table of the current situation of xerosis and prevention of the elderly, the incidence of xerosis in 1 028 patients hospitalized in Suqian Hospital Affiliated to Xuzhou Medical University, Suqian City Hospital of Traditional Chinese Medicine and Siyang County Hospital of Traditional Chinese Medicine was investigated, and the related factors were analyzed.Results:The incidence of xerofosis was 20.23%(208/1028); the incidence of xerosis was 20.23% (208/1 028), which was mainly found in the lower limbs, with the incidence of 53.37% (111/208), among which the incidence of mild xerosis was the most, with the incidence of 51.44% (107/208). The incidence rate of the elderly patients with xerosis between different age, qualifications, nutritional status, comorbidity, Braden score, drug use, main caregivers, departments, and daily skin care were statistically significant ( χ2 values were 6.91-35.71, all P<0.05). Binary logistic regression analysis showed that age, nutritional status, comorbidity status, Braden score and daily skin care were the independent influencing factors of skin dryness in elderly inpatients. Conclusions:There is a common skin symptom of xerosis in the elderly. It is necessary to establish a standardized management process and take targeted preventive and nursing measures.

OBJECTIVE: To determine the frequencies of deafness gene mutations among patients with non-syndromic hearing loss (NSHL) from northern Jiangsu province. METHODS: A total of 117 patients with NSHL were enrolled. The coding region of GJB2 gene, IVS7-2A>G and 2168A>G mutations of SLC26A4 gene, and 1555A>G and 1494C>T mutations of mitochondrial DNA 12S rRNA were subjected to Sanger sequencing. Patients in whom no mutation was detected were further tested by targeted gene capture and high-throughput sequencing. RESULTS: Among the 117 patients, 86 (73.50%) were found to carry mutations. GJB2 gene mutations were found in 61 patients (52.14%), including 22 (18.80%) with homozygous mutations and 39 (33.33%) with heterozygous mutations. SLC26A4 gene mutations were found in 19 patients (16.24%), including 4 (3.42%) with homozygous mutations and 15 with heterozygous mutations (14.53%). Mitochondrial 12S rRNA gene mutation was found in 6 patients (5.13%). Targeted gene capture and high-throughput sequencing of 8 patients identified 4 further cases, including 1 with RDX gene 129_130del and 76_79del compound heterozygous mutations, 1 with OTOF gene 1274G>C homozygous mutation, 1 with SLC26A4 gene 919-2A>G and IVS16-6G>A compound heterozygous mutation, and 1 with SLC26A4 gene 919-2A>G and A1673T compound heterozygous mutation. CONCLUSION The frequency of mutation among patients with NSHL from north Jiangsu was 73.50%, and GJB2 gene was most commonly mutated.
China ; Connexins ; DNA Mutational Analysis ; DNA, Mitochondrial ; Hearing Loss ; genetics ; Humans ; Membrane Proteins ; Mutation ; Sulfate Transporters

Objective: To explore effects of histone deacetylase inhibitor Belinostat on the immunologic function of dendritic cells (DC) and its possible mechanism. Methods: Cultured mouse bone marrow-derived DC from C57BL/6 mouse in vitro. The experiments were divided into 0, 50, 100 nmol/L Belinostat + immature DC (imDC) group, and 0, 50, 100 nmol/L Belinostat mature DC (mDC). The changes of the ultrastructure of DC were observed by transmission electron microscope (TEM). Immunophenotype and CCR7 expression rate were detected by FCM, and the migration rate was observed by chemotaxis assay. The proliferation of lymphocytes stimulated by different DC was detected by mixed lymphocyte culture reaction. The cytokines in the culture supernatant, including TNF-α, IL-12 and IL-10, were examined by ELISA. RQ-PCR was used to examine the relative expression of mRNA in RelB. Results: Successful cultured and identified the qualified imDC and mDC. Belinostat decreased the expression of CCR7 on imDC [(25.82±7.25)% vs (50.44±5.61)% and (18.71±2.00)% vs (50.44±5.61)%], meanwhile increased the rate on mDC [(71.14±1.96)% vs (64.90±1.47)%]. Chemotaxis assay showed that the migration rate of Belinostat+imDC and Belinostat+mDC group were both decreased, but the difference in imDC was not significant. T lymphocyte proliferation rate stimulated by 100 nmol/L Belinostat+imDC group was lower than imDC group in condition irritation cell∶reaction cell=1∶2 [(227.09±13.49)% vs (309.49±53.69)%]. Belinostat significantly suppressed the secretion of cytokines TNF-α, IL-12 and IL-10 (all P<0.01). The relative expression of mRNA in RelB was slightly decreased in Belinostat+imDC and Belinostat+mDC group (all P<0.05). Conclusion Belinostat could effectly suppress DC maturation and regulate immune tolerance of DC, which may be due to the down-regulation of mRNA level of RelB in DC.