OBJECTIVETo explore the features of various mediastinal lymphadenopathies using computed tomography perfusion (CTP).

METHODSCTP parameters (CTPs) of the selected mediastinal nodes from 59 patients with pathology-proven malignant lymph nodes and of those from 29 patients with clinically diagnosed or pathology-proven inflammatory lymphadenopathies were collected. Patients were divided into subgroups by etiology and phase of primary disease, including different pathological malignant nodes and diverse inflammatory nodes. CTPs were defined as blood flow (BF), blood volume (BV), mean transit time (MTT), permeability (PMB), and time to peak (TTP). Differences of CTPs were compared between malignant and benign nodes, and among subgroups, respectively.

RESULTSIn the mediastinum, no significant differences of CTPs were found between malignant and benign groups (all P>0.05), the same for subgroups of malignant nodes (all P>0.05). Acute lymphadenitis had higher BF and BV than chronic inflammatory, lymphoid tuberculosis, sarcoidosis and malignant nodes. The BF of malignant nodes was markedly slower than that of acute lymphadenitis (P=0.01), but faster than chronic inflammatory nodes (P=0.04) and sarcoidosis (P=0.03), with no significant difference compared with lymphoid tuberculosis. Pneumonia-complicated lymphoid tuberculosis showed the longest MTT while sarcoidosis displayed the shortest MTT, and inflammatory nodes, lymphoid tuberculosis without complicated pneumonia and malignant nodes had moderate MTT.

CONCLUSIONCTPs show promising potential in distinguishing various lymphadenopathies in the mediastinum, but more studies are needed to improve their specificity.

Adult ; Female ; Humans ; Lymph Nodes ; diagnostic imaging ; Lymphatic Diseases ; diagnostic imaging ; Male ; Mediastinal Diseases ; diagnostic imaging ; Perfusion ; Retrospective Studies ; Tomography, X-Ray Computed ; methods

Distribution channel of Chinese herbal medicines has been changing. From Han to Ming Dynasty, Chinese herbal medicine were mainly trafficked to urban by dealers or farmers; From the Ming Dynasty to the foundation of new China, distribution channels are primarily intermediated with township "bazaar" and national distribution center with fixed place and regularly trading hours. In the planned economy period, the state-owned herbal medicine company was the sole medium with monopoly nature. From the mid1980s to the end of last century, planned economy and market economy have been co-existing. Stepping into 21st century, producing area highlighted in the distribution channels. Presence or absence and rise or fall of different types of distribution market went throughout the changing process of distribution channels, which became an important clue. Changes were motivated by economical consideration of channel subject, which originated from commodity characteristic and social environment changes.
Cities ; Drugs, Chinese Herbal ; economics ; supply & distribution ; Economic Development ; Marketing

Objective:To investigate the risk factors of rotator cuff tears combined with long head of bicep tendon (LHBT) lesion and its effects on preoperative function.Methods:From January 2016 to January 2020, there were 680 patients with rotator cuff tears, including 260 males and 420 females, were included. The average age was 56.1±8.7 (range 27-74 years). There were 250 cases on the left side and 430 cases on the right side. There were 436 cases on the main side, while 274 cases had definite trauma before operation. The following were the Post rotator cuff tears classification, 133 cases in partial injury, 473 cases in small and medium size of rotator cuff tears, 74 cases in large and massive size of rotator cuff tears. The Habermayer-Walch classification of LHBT lesions was as following, 302 cases in type 0 (normal), 216 cases in type 1 (tendonitis), 29 cases in type 2 (dislocation and subluxation), 104 cases in type 3 (partial tear), 20 cases in type 4 (complete tear) and 9 cases in type 5 (SLAP injury above type II). The patient with rotator cuff tears were divided into partial tears group, medium and small tears group, large and massive tears group according to the classification of Post. The visual analogue scale (VAS), simple shoulder test (SST), Constant-Murley function score and the score of the University of California Los Angeles (UCLA) were recorded. The differences in age, sex, main side, trauma and LHBT lesion in patients with three types of rotator cuff tears were analyzed. The preoperative pain and function scores of patients with or without LHBT lesions in various rotator cuff tears were compared among the groups by t-test. The age, sex, main side, with trauma or not, and the classification of rotator cuff tears were analyzed by Logistic regression to investigate the risk factors of patients with rotator cuff tears with LHBT lesions. Results:There were 378 cases (55.6%) with LHBT lesions in 680 patients with rotator cuff tears, including 216 cases of tendinitis (57.1%), 104 cases of partial tear (27.5%), 29 cases of dislocation and subluxation (7.7%), 20 cases of complete tear (5.3%) and 9 cases of SLAP injury (2.4%). The incidence of partial injury, small and medium injury, large and massive rotator cuff injury combined with LHBT lesions were 35.3% (47/133), 57.5% (272/473) and 79.7% (59/74) respectively. The preoperative VAS score, UCLA score, Constant-Murley score and SST score were 5.20±1.52, 14.81±4.12, 41.45±4.93 and 4.56±1.96 respectively in rotator cuff tears group and 5.29±1.65, 14.34±4.01, 41.60±5.88, 4.47±1.97 in LHBT group ( P>0.05). In the partial rotator cuff tears group, the VAS score was 5.16±1.41 in patients with simple rotator cuff tears and 5.68±1.46 in patients with LHBT lesion ( t=2.004, P=0.047). Regression analysis showed that age ≥60 years and rotator cuff tears degree were the risk factors for rotator cuff tears with LHBT ( P<0.001). Conclusion:It is common for patients to have rotator cuff tears with LHBT lesions. The more severe the rotator cuff tears are, the higher the incidence of LHBT lesions will be. Patients with rotator cuff tears aged 60 and above are more likely to have LHBT lesions. However, the complications of LHBT could not affect the preoperative pain and functional scores of patients with rotator cuff tears.

Traditional Chinese medicine market is a typical market with information asymmetry, which may lead to "lemons" problem. Third-Party Certification is efficient path to solve the problem of information asymmetry. For this reason geo-authentic and commodity classes certification seems to be very important. But as we know, information asymmetry happen in the stages of traditional Chinese patent medicines market. So a signaling transfer mechanism, which can deliver the quality signal, is badly needed in TCM market. This paper analysis and design of signaling transfer mechanism based on Third-Party Certification, which called quality prestige index of TCM enterprises (QPITCM). QPITCM can display quality information as a signal run through the TCM market.
Certification ; Drugs, Chinese Herbal ; economics ; standards ; Medicine, Chinese Traditional ; economics ; standards ; Quality Control

Objective To investigate the application of quantitative parameters associated with iodine concentration derived from iodine overlay image by dual-source dual-energy computed tomographic (CT) in differentiating benign and malignant thyroid nodules. Methods Seventy-eight patients (total 112 nodules, including 64 benign and 48 malignant nodules) with thyroid nodules who underwent plain scan (PS), arterial phase (AP) and venous phase (VP) enhanced scan by DSCT (80 kVp/ Sn140 kVp) were analyzed retrospectively. Iodine overlay images were obtained by the dual energy post-processing software. The mean iodine concentrations in the normal thyroid parenchyma (ICThy), the lesion (ICLes), and the carotid artery(ICCar) of PS, AP and VP were measured from iodine overlay images. The iodine concentration difference (ICD), the iodine concentration difference-to-normal parenchyma ratio (ICDNR) and the normalized iodine concentration ratio (NIC) were calculated. The two-sample t test was performed to compare quantitative parameters between the benign and malignant nodules. ROC curve with quantitative parameters of three phases was used to analyze the diagnostic efficiency of ICD, ICDNR, NIC and ICles. Results During
PS, mean ICDNR, ICD and ICLes of malignant nodules were respectively 1.04 ± 0.95, (2.20 ± 1.82) mg/ml, (-0.04 ± 1.65) mg/ml, ICDNR, ICD and ICLes of benign nodules were respectively 0.04 ± 0.41, (0.35 ± 0.97) mg/ml, (2.19 ± 0.55) mg/ml. ICDNR and ICD of malignant nodules were higher than benign nodules (t'=6.63, 6.39, P<0.05), while ICles of malignant nodules were lower than benign nodules (t=10.13, P<0.05). During AP , mean ICDNR, ICD, ICLes of malignant nodules were 0.39 ± 0.29, (2.23 ± 1.77) mg/ml, (3.81 ± 1.50) mg/ml, and benign nodules were 0.49 ± 0.22, (2.97 ± 1.91) mg/ml, (3.17 ± 1.64) mg/ml, respectively. ICDNR, ICD of malignant nodules were lower than benign nodules (t'=2.08, t=2.12;P<0.05),while ICles of malignant nodules were higher than benign nodules (t=2.12, P< 0.05). During VP, mean NIC of the malignant and benign nodules were 0.45 ± 0.21, 0.58 ± 0.37, respectively. NIC of malignant nodules were lower than benign nodules (t'=2.35, P< 0.05). AUC of ICDNR during PS was 0.892, the sensitivity was 83.3% and the specificity were 90.5%. Conclusion Quantitative parameters associated with iodine concentration by dual-source dual-energy CT may increase the efficiency and accuracy in differentiating benign and malignant thyroid nodules.

Objective To study the effect of implanted stent or selected operation in patients with acute occlusion of right coronary artery during the emergency coronary arteriongraphy. Methods Forty-three patients with acute occlusion of right coronary artery who underwent the emergency coronary arteriongraphy were divided into two groups: the implanted stent group ( n = 23) during the emergency coronary arteriongraphy and the selected operation group (n =20) during the emergency coronary arteriongraphy . Then we observed the general data, the coronary artery pathological changes, preoperative and postoperative thrombus, the blood flow, remained stenosis and the prognosis. Results The implanted stent group was similar to the control group in general condition, but implanted stent group was significantly different from the control group in the near, intermediate and distal coronary artery pathological changes ( <0.05) . The control group was significantly different from the implanted stent group in the thrombus and slowly blood flow ( <0.05) . After three months, we reviewed coronary arteriongraphy and selected operation, The implanted stent group was significantly different from the control in the remained stenosis and slowly blood flow (<0.05) . But the implanted stent group was similar to the control groug in the thrombus and new proceeding cardiovascular events. Conclusion When thrombus appears in acute occlusion of right coronary artery, we can implant stent during the emergency coronary arteriongraphy if the thrombus is little, or we can select operation after PTCA on the contrary.

0.05),and the antifebric time of group A was shorter than that of group B.No significant difference was found in the incidence rate of side reaction between two groups. CONCLUSIONS Ceftazidime and vancomycin combination is more effective than ceftazidime alone.

Partial immunoactivities of peptidoglycan(PG)isolated from lactic acid bacteria were investigated.PG isolated from strain Z8 and Z17 of lactic acid bacteria respectively,had similar immunoactivities.The phagocytic function of M?(macrophage)increased markedly and serum lysozyme activity was significantly enhanced by injection of PG-extracts on mice.Investigation of immuno-enhancing effects of PG on vaccine of Newcastle disease in chickens showed that the hemagglutination inhibition levels of PG were higher than that of the control and the level was maintained for a longer time as compared to the control.

OBJECTIVETo evaluate the efficacy and safety of three antithrombotic agents on venous thromboembolism (VTE) after unilateral total knee arthroplasty.

METHODSFrom November 2011 to March 2014, 149 patients undergoing unilateral total knee arthroplasty for knee osteoarthritis were reviewed. Among them, there were 66 males and 83 females, ranging in age from 48 to 76 years old. All the cases were randomly divided into three groups including Aspirin group, low-molecular-weight heparin (LMWH) group, and rivaroxaban group, according to antithrombotic agents. Deep vein thrombosis (DVT), pulmonary embolism (PE) and bleeding complication (including wound ecchymosis, hematoma and other local complications, gastrointestinal, cardiovascular, urinary hemorrhage and other major bleeding events) of antithrombotic agents were observed and analyzed statistically at the 6 week, 8 week, and 12 week after operation.

RESULTSAmong patients who received Aspirin (48 cases), 4 patients had DVT, in 1 patient had PE, and 2 patients had bleeding complication. Among 54 patients in low-molecular-weight heparin group, 3 patients had DVT, 1 patient had PE, and 3 patients had bleeding complication. While among those patients received the rivaroxaban (47 cases), 3 patients had DVT, 0 patient had PE, and 11 patients had bleeding complication. There were no statistically differences among three groups on DVT, and PE (P>0.05). The incidence of bleeding complication in rivaroxaban group was higher than the other two antithrombotic agents, and the difference among the three groups was statistically significant (P<0.05).

CONCLUSIONAspirin, low-molecular-weight heparin, and rivaroxaban could effectively reduce the incidence of VTE after total knee arthroplasty, and their efficacy was similar. Rivaroxaban has a higher incidence of bleeding complication and further clinical trials are required to be conducted to assess the safety of rivaroxaban in clinical.

Aged ; Arthroplasty, Replacement, Knee ; adverse effects ; Aspirin ; therapeutic use ; Case-Control Studies ; Female ; Fibrinolytic Agents ; therapeutic use ; Heparin, Low-Molecular-Weight ; therapeutic use ; Humans ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Rivaroxaban ; therapeutic use ; Venous Thromboembolism ; prevention & control

Objective To investigate the effect of the side of cerebral lesion on the outcome in patients with ischemic stroke.Methods A total of 407 consecutive anterior circulation ischemic stroke patients within 14 days after symptom onset were recruited prospectively.The basic data ofthe e,~ISes were collected,such as the National Institutes ofHealth Stroke Scale (NU-ISS)and the side ofcerebral lesion.The modified Rankin Scale(mRS)was used to evaluate the prognosis of the patients at 6 raomhs.Results Of the 407 patients recruited,230 patients (56.5%)Were left hemisphere stroke,177(43.5%)were fight hemisphere stroke.After multivariable logistic recession analysis,the age(odds ratio[OR]1.022,95% confidence interval[CI]1.001-1.043,P=0.040),the side of lesion(OR 1.999.95%CI1.179.3.389.P=0.010),the time from onset to admission(OR1.006,95%(7/1.002-1.010,P=0.007),the outcome of the anterior circulation ischcmic stroke at 6 months aftel"onset.The outcome of the right hemisphere stroke Was significantly worse than that of the left hemisphere stroke.The onset-admission time in patients with right hemisphere stroke(median 12 h,median 39.61 h)was significantly delayed compared to the patients with left hemisphere stroke(median 12 h,median 22.72 h;Z=-2.962,P=0.003).Condusions The outcome of the left hemisphere stroke at 6 months after onset is superior to the right hemisphere stroke,and it mau be associated with the delayed admission.