Objective To investigate the diagnostic value of the T-SPOT.TB test for diagnosing tuberculous meningitis(TBM) by meta-analysis.Methods A systematic retrieval from the databases of PubMed,EMBASE,etc.was performed.The literature on the T-SPOT.TB test for diagnosing TBM was collected.Two reviewers independently screened the literature,extracted the data and judged the quality.The meta analysis was conducted by the Meta-Disc 1.4 software.Results 8 articles were included,involving 425 patients including 232 cases of TBM.In the peripheral blood group,the combined sensitivity was 80%(95%CI:0.74-0.85),the combined specificity was 74%(95%CI:0.67-0.80),the area under the curve(AUC)of summary receiver operating characteristic (SROC)was 0.858 7;the diagnostic odds ratio(DOR)was 15.50.In the CSF group,the combined sensitivity was 76%(95%CI:0.70-0.82),the combined specificity was 83%(95%CI:0.77-0.88),AUC was 0.892 7;DOR was 22.62.Conclusion Adopting the T-SPOT.TB test conduces to increase the diagnostic rate of TBM.The diagnostic accuracy of the T-SPOT.TB test for CSF may be higher than that for peripheral blood.

0. 05]. After sublingual glycerytrinitrate administration,the diameter of the brachial artery dilated significantly [(4.26?0.54) mm vs (4.73?0.43) mm, P 0.05]. Sublingual glycerytrinitrate administration dilated the brachial artery significantly [(4. 37? 0.77) mm vs (4. 82?0. 60) mm, P

Objective To explore the value of RT-PCRin diagnosis of patients with HIV-negative hypoimmunity and pneumocystis pneumonia (PCP).Methods Totally 71 phlegm samples of pulmonary infection patients with suspected PCP and HIV-negative hypoimmunity were selected.ITS-nested PCRand ITS-real-time fluorescence quantitative PCRwere used to detect pneumocystis jiroveci in samples.Results Among the 71 patients,18 cases were diagnosed as PCP.There were 25 cases with positive results by n-PCR,but the false-positive rate was 36.00%,and sensitivity,specificity and positive predictive values of n-PCRwere 88.89%,83.01% and 64.00%,respectively.If the threshold was 103 copies/mL,the specificity and positive predictive value of RT-PCRwere significantly higheRthan n-PCR.In patients with PCP,the the gene load of pneumocystis by RT-PCRwas significantly higheRthan non-PCP patients.Conclusion In patients with HIV-negative hypoimmunity,RT-PCRis more accurate and rapid than nested PCRin the diagnosis of PCP,and it can distinguish the infection and colonization of pneumocystis.

Objective To explore the value of RT-PCRin diagnosis of patients with HIV-negative hypoimmunity and pneumocystis pneumonia (PCP).Methods Totally 71 phlegm samples of pulmonary infection patients with suspected PCP and HIV-negative hypoimmunity were selected.ITS-nested PCRand ITS-real-time fluorescence quantitative PCRwere used to detect pneumocystis jiroveci in samples.Results Among the 71 patients,18 cases were diagnosed as PCP.There were 25 cases with positive results by n-PCR,but the false-positive rate was 36.00%,and sensitivity,specificity and positive predictive values of n-PCRwere 88.89%,83.01% and 64.00%,respectively.If the threshold was 103 copies/mL,the specificity and positive predictive value of RT-PCRwere significantly higheRthan n-PCR.In patients with PCP,the the gene load of pneumocystis by RT-PCRwas significantly higheRthan non-PCP patients.Conclusion In patients with HIV-negative hypoimmunity,RT-PCRis more accurate and rapid than nested PCRin the diagnosis of PCP,and it can distinguish the infection and colonization of pneumocystis.

Objective To establish a quick,economical and reproducible method for high-quality RNA extraction from pancreas.Methods We utilized TRIzol Reagent and liquid nitrogen to isolate total RNA from the rat pancreas.The RNA quality was determined by detection of its content and optic density(A) at 260/280nm,and electrophoresis in 1% non-denatured agarose gel.Then reverse transcription-polymerase chain reaction(RT-PCR) was performed to detect expression of the pancreas-specific genes.Results The content of the total RNA extracted from the rat pancreas reached 3-6?g/mg pancreatic tissues,and A260/280 ratio was 1.75-1.89.Electrophoresis of the total RNA showed 28S and 18S rRNA bands with clear smear between them.The RT-PCR products of pancreas-specific genes including insulin 1,glucagon,?-amylase and housekeeping gene ?-actin all exhibited clear bands on 1% agarose gel,which were located in the expected positions,respectively.Conclusion These results suggest that we have successfully isolated the high-quality and intact RNA from the rat pancreas with TRIzol Reagent and liquid nitrogen.The extracted total RNA can be used in RT-PCR for pancreatic gene expression.

Background and Objective:The mechanism of tumor tissues selectively uptaking the photosensitizer in photodynamic therapy(PDT)is still unclear.This study was to investigate the affinity of tumor cells to the photosensitizer photofrin-Ⅱ. Methods: Ultraviolet spectrophotometer was applied to measure the absorption spectra of various cell culture media.The fluorescence spectrum of photofrin-Ⅱ was determined by spectrofluorometer.The absorption and eIimination condition of photofrin-Ⅱ were detected in immortalized human esophageal epithelial cell line SHEE and its malignant transformation cell line SHEEC.Results:The maximum excitation wavelength of fluorescence for photofrin-Ⅱ was(395.0±0.5) nm, and the maximum emission wavelength of that was (634.1±0.5) nm.The laser at the wavelength of 630 nm used in this experiment could permeate various types of cell culture media.There was no significant difference in the absorption and elimination of photofrin-Ⅱ between SHEE and SHEEC at the same concentration and time.The absorption of photofrin-Ⅱ in SHEE and SHEEC increased with the increase in photofrin-Ⅱ concentration and duration. and reached the platform at the concentration of 30 μg/mL and a time point of 150 min.respectively.The photofrin-Ⅱ contents of SHEE and SHEEC showed a slight change after 15-30 min, and diminished rapidly after 30 min.Conclusion:High photosensitizer concentration in tumor tissues may be not correlated with the affinity of tumor cells.

Objective:To establish an acute kidney injury (AKI) prediction model in patients after cardiac surgery by extreme gradient boosting (XGBoost) machine learning model, and to explore the risk and protective factors for AKI in patients after cardiac surgery.Methods:All patients who underwent cardiac surgery in Medical Information Mart for Intensive Care-Ⅲ (MIMIC-Ⅲ) database were enrolled, and they were divided into AKI group and non-AKI group according to whether AKI developed within 14 days after cardiac surgery. Their clinical characteristics were compared. Based on five-fold cross-validation, XGBoost and Logistic regression were used to establish the prediction model of AKI after cardiac surgery. And the area under the receiver operator characteristic curve (AUC) of the models was compared. The output model of XGBoost was interpreted by Shapley additive explanations (SHAP).Results:A total of 6 912 patients were included, of which 5 681 (82.2%) developed AKI within 14 days after the operation, and 1 231 (17.8%) did not. Compared with the non-AKI group, the main characteristics of AKI group included older age [years: 68.0 (59.0, 76.0) vs. 62.0 (52.0, 71.0)], higher incidence of emergency admission and complicated with obesity and diabetes (52.4% vs. 47.8%, 9.0% vs. 4.0%, 32.0% vs. 22.2%), lower respiratory rate [RR; bpm: times/min: 17.0 (14.0, 20.0) vs. 19.0 (15.0, 22.0)], lower heart rate [HR; bpm: 80.0 (67.0, 89.0) vs. 82.0 (71.5, 93.0)], higher blood pressure [mmHg (1 mmHg ≈ 0.133 kPa): 80.0 (70.7, 90.0) vs. 78.0 (70.0, 88.0)], higher hemoglobin (Hb), blood glucose, blood K + level and serum creatinine [SCr; Hb (g/L): 122.0 (109.0, 136.0) vs. 120.0 (106.0, 135.0), blood glucose (mmol/L): 7.3 (6.1, 8.9) vs. 6.8 (5.7, 8.5), blood K + level (mmol/L): 4.2 (3.9, 4.7) vs. 4.2 (3.8, 4.6), SCr (μmol/L): 88.4 (70.7, 106.1) vs. 79.6 (70.7, 97.2)], lower albumin (ALB) and triacylglycerol [TG; ALB (g/L): 38.0 (35.0, 41.0) vs. 39.0 (37.0, 42.0), TG (mmol/L): 1.4 (1.0, 2.0) vs. 1.5 (1.0, 2.2)] as well as higher incidence of multiple organ dysfunction syndrome (MODS) and sepsis (30.6% vs. 16.2%, 3.3% vs. 1.9%), with significant differences (all P < 0.05). In the output model of Logistic regression, important predictors were lactic acid [Lac; odds ratio ( OR) = 1.062, 95% confidence interval (95% CI) was 1.030-1.100, P = 0.005], obesity ( OR = 2.234, 95% CI was 1.900-2.640, P < 0.001), male ( OR = 0.858, 95% CI was 0.794-0.928, P = 0.049), diabetes ( OR = 1.820, 95% CI was 1.680-1.980, P < 0.001) and emergency admission ( OR = 1.278, 95% CI was 1.190-1.380, P < 0.001). Receiver operator characteristic curve (ROC curve) analysis showed that the AUC of the Logistic regression model for predicting AKI after cardiac surgery was 0.62 (95% CI was 0.61-0.67). After optimizing the XGBoost model parameters by grid search combined with five-fold cross-validation, the model was trained well with no overfitting or overfitting. ROC analysis showed that the AUC of XGBoost model for predicting AKI after cardiac surgery was 0.77 (95% CI was 0.75-0.80), which was significantly higher than that of Logistic regression model ( P < 0.01). After SHAP treatment, in the output model of XGBoost, age and ALB were the most important predictors of the final outcome, where age was the risk factor (average |SHAP value| was 0.434), and ALB was the protective factor (average |SHAP value| was 0.221). Conclusions:Age is an important risk factor for AKI after cardiac surgery, and ALB is a protective factor. The performance of machine learning in predicting cardiac and vascular surgery-associated AKI is better than the traditional Logistic regression. XGBoost can analyze the more complex relationship between variables and outcomes, and can predict the risk of postoperative AKI more accurately and individually.

Objective To study the course setting of the core competencies training for obstetrics nurse specialists (OBNS).Methods A total of 40 nursing experts were selected by Delphi method for two turns of questionnaires.Results Two turns of questionnaires had a 92％ and 97％ valid return.The Coordination coefficient was 0.423 (P ＜ 0.001).The CR,Cs and Ca was 0.858,0.900,and 0.817.The overall scale reliability had a Cronbach' sα of 0.802 and a overall interrater agreementof 0.782.The final course setting for OBNS was confirmed,consisting of 4 items (basic nursing of obstetrics,core nursing technique and knowledge,obstetrics nursing administration,Legal/ethical practice) in the first dimension and 20 items in the second dimension.Conclusions It is necessary and feasible to provide professional training for obstetrics nurses.The course setting for OBNS will underlie core competencies training and continuing education.

Objective To investigate the feasibility of translocation of pedicled buccal fat pad in the treatment of the temporomandibular joint ankylosis(TMJA)by measuring the diameter of buccal fat pad and related anatomical structures of the transverse blood vessels,nerves and temporomandibular joint.Methods A total of 40 adult head and neck specimens were randomly divided into group A and group B,with 20 cases in each group.The morphology of the buccal fat pad in group A was observed,and its size and compression diameter through blood vessels and nerves were measured.The anatomical structures of the temporomandibular joint in group B were observed and measured.Results The volume of buccal fat pad in group A was(10.10±1.10)mL on the left side and(9.70±1.50)mL on the right side.The longitudinal axis length of buccal fat pad was(28.18±1.35)mm on the left side and(29.47±1.12)mm on the right side;Transverse axis length of buccal fat pad was(18.56±1.67)mm on the left side and(18.97±1.73)mm on the right side;There are facial artery,facial vein,maxillary artery branch,facial nerve buccal branch and so on through the buccal fat pad.In group B,the sagittal section of the temporomandibular joint disc presented S-type in 15 cases(75.0%),L-type in 3 cases(15.0%),and transitional type in 2 cases(10.0%).Anterior and posterior diameter of the articular disc was(14.42±1.94)mm on the left side and(15.34±1.37)mm on the right side;inside and outside diameter of the articular disc was(20.18±1.77)mm on the left side and(19.57±1.32)mm on the right side.Branches of maxillary artery and superficial temporal artery were respectively distributed within and outside the joint.Conclusion The pedicled buccal fat pad has a constant anatomical position,abundant blood supply,strong tissue repair,anti-infection ability and"buffer pad"function,which can reduce the formation of scar after surgery for TMJA,reduce the postoperative recurrence rate,and contribute to the recovery of joint function after surgery.

OBJECTIVE: To investigate the influence of cuspal-coverage thickness on the stress distribution of all-ceramic onlay-restored premolars by using 3D finite element (FE) analysis and to provide references for the design of all-ceramic onlays for clinical application. METHODS: 3D FE models of all-ceramic onlays with three cuspal-coverage thicknesses (2, 3, and 4 mm) of endodontically treated maxillary premolar were constructed based on micro-CT images. Stress distributions in the onlay, adhesive resin cement layer, and dentin of models were analyzed under vertical load (600 N) and oblique load (200 N). RESULTS: When the cuspal-coverage thickness increased, the peak maximum principal stress value decreased inside the onlay but increased in the margin of the adhesive resin cement layer. In addition, stress concentration areas increased in the coronal residual dentin on the palatal side under oblique load. CONCLUSIONS An increase in the cuspal-coverage thickness of all-ceramic onlays may reduce the risk of rupture of the restoration but may deteriorate the restoration and cause palatal dentin fracture.
Bicuspid ; Ceramics ; Composite Resins ; Dental Porcelain ; Dental Stress Analysis ; Finite Element Analysis ; Inlays