Objective To evaluate the safety and feasibility of injection test which is used to locate esophageal balloon catheter.Methods A prospective study was conducted. The patients undergoing invasive mechanical ventilation (MV) admitted to general intensive care unit (ICU) of Beijing Tiantan Hospital Affiliated to Capital Medical University from May 2015 and March 2017 were enrolled. The commercially available esophageal balloon catheter was modified to perform injection test. The catheter was withdrawn step by step and the injection test was repeated until the presence disturbance wave presented, which indicated that the balloon had just entered the esophagus. The position where disturbance wave appears was named 0 cm. End-expiratory occlusions were performed at the positions of+15,+10,+5, 0, -5, -10 and -15 cm, respectively, and the changes of esophageal pressure (Pes) and airway pressures (Paw) were measured in the spontaneous breathing and passive ventilation, and the ratio between the changes (ΔPes/ΔPaw) was calculated.Results A total of 20 patients were enrolled, of which 15 patients finished both the spontaneous and the passive ventilation parts, and 2 patients finished only the spontaneous part and 3 patients finished only passive part. ① Disturbance waves could be induced by injection test in all patients. The average depth of disturbance wave in spontaneous breathing was deeper than that in passive ventilation (cm: 42.4±3.8 vs. 41.8±3.3), but there was no significant difference between the two ventilation settings (P = 0.132). No adverse events occurred during the study period. ② Pes increased with the stepwise withdraw of esophageal catheter, reached the maximal value at+5 cm, and then decreased when the catheter was further withdrawn, no matter in the spontaneous or the passive ventilation. In spontaneous breathing, the ΔPes/ΔPaw was within the ideal range (0.8-1.2) at the positions of 0, -5 and -10 cm. The ΔPes/ΔPaw was closest to unity at the positions of 0 cm (0.98±0.15). The ΔPes/ΔPaw at -15 cm (0.66±0.26) was significantly lower than that at 0 cm (P < 0.05). For passive ventilation, the ΔPes/ΔPaw was within the ideal range at the positions of -5 cm and -10 cm, and the ΔPes/ΔPaw was closest to unity at the positions of-10 cm (0.94±0.12). The ΔPes/ΔPaw at 0 cm and -5 cm was significantly higher than that at -10 cm (1.43±0.31 and 1.12±0.14, respectively); while the ΔPes/ΔPaw at -15 cm (0.68±0.23) was significantly lower than that at -10 cm (allP < 0.01).Conclusions Ideal position of the esophageal balloon catheter could be determined quickly and easily by using injection test. The method is safe and clinically feasible.Clinical Trial Registration Clinical Trials, NCT02446938.

Objective To discuss the Clinical character of pulmonary tuberculosis combined malignant lymphoma and its Pathogenesis,and to review the literature.Methods Eighteen cases of pulmonary tuberculosis combined malignant lymphoma from 1996 to 2003 were retrospectively analyzed by its clinical manifestations,X-ray features,diagnosis and treatments.Results 18 cases were all infiltrative pulmonary tuberculosis,13 them were calcification focals,5 were active pulmonary tuberculosis;5 of all were Hodgkin’s lymphomas,13 of all were non-Hodgkin′s lymphomas.16 cases were lymphomas after tuberculosis,2 cases tuberculosis after lymphomas,none were co-existent malignant lymphoma and tuberculosis.Tuberculosis may precede or complicate a lymphomatous process during the development of both diseases,This might is linked to immune deficiency and chronic inflammation;Lymphomas might cause pulmonary tuberculosis,it might cause the immune turbulence of an individual,Pulmonary tuberculosis infection occurring during or after the radiotherapy and chemotherapy of lymphoma.Conclusions It may pulmonary tuberculosis combined malignant lymphoma in the patients in the endemic areas of tuberculosis,Appropriate invasive biopsy procedures are necessary for early diagnosis.

Objective To investigate the effect of moderate pain on attentional bias towards emotional pictures among healthy subjects.Methods Thirty-two healthy college students aged from 17 to 26 (21.8±2.2;16 males and 16 females) participated in this study.A tourniquet was tied to each subject's left upper arm 1 to 2cm above the cubits horizontal grain.Pain was inflicted by inflating the tourniquet,and the pressure was maintained at 26.66kPa.While tourniquet was inflated (with pain) or not (no pain),each subject was asked to finish a pictorial dot-probe task with three kinds of pictures-emotionally positive,negative and neutral.In experiment 1,subjects performed the dot-probe tasks with the contralateral hand while the tourniquet was tied on the left upper arm without inflation.In experiment 2 the tourniquet was inflated until the subject completed the dot-probe task (for about 10min).The reaction times (RTs) and the error rates (Ers) in the recognition task were recorded,and the intensity of the subject's pain and discomfort were measured using a verbal rating scale.Results The subjects reported moderate to severe pain with the tourniquet inflated.The RT and ER data were analyzed using two-way analysis of variance (ANOVA) which showed a significant difference between the average RTs of the males (482±73ms without pain and 466±82ms with pain) and those of the females (536±90ms without pain and 519±100 ms with pain).The average ER was significantly different between the pain (2.38±1.49)％ and no pain (1.09±0.82)％ conditions in both groups.Holn-Sidak multiple comparison testing showed significant differences in both groups' average ER between the negative picture (3.81±1.73)％ and the positive picture (1.66±0.97)％,and between the negative and neutral pictures (1.68±0.8) ％ in the pain condition.Mild attentional avoidance was observed with the positive [pain condition (-5.1±4.8) ms and no pain (-4.6±4)ms] and negative pictures [pain condition (-3.43±6) ms and no pain (-0.79±4.1)ms],but no significant difference was found between the pain and no pain conditions.Conclusion The error rate in a pictorial dot-probe task is influenced by pain,especially with negative pictures.

Objective To explore a variety of levels of serum marker test applications in the diagnosis of fatty liver .Methods Data were randomly selected from April 2013 to April 2014 for treatment of patients with fatty liver hospital 45 cases ,set the study group ,choose the same period in healthy volunteers to undergo a medical examination in our hospital 45 cases ,it was set to control group ,two groups of subjects were taking a variety of levels of serum markers tested .Comparison and analysis of two groups of subjects to detect a variety of levels of serum markers and positive case detection rate .Results The study group subjects ALT , AST ,TG ,TC index the average level of detection was higher than the control group ,statistically significant differences (P<0 .01);study group subjects ALT ,AST ,TG ,TC index the positive rates were 77 .78% ,93 .33% ,55 .56% ,46 .67% more than 8 .89% in the control group ,4 .44% ,15 .56% ,11 .11% higher ,statistically significant differences (P<0 .05);United biochemical indicator de‐tection of biochemical indicators of detection rate of fatty liver was obviously higher than that of single detection rate ,the difference was statistically significant (P<0 .05) .Conclusion Multiple levels of serum markers of fatty liver diagnostic test in higher detec‐tion rate .

Objective To explore the value of comprehensive biochemical and serological test in Salmonella clinical test .Methods A total of 95 cases of suspected salmonella infection with enteric fever were selected as subjects in this study from April 2013 to A‐pril 2014 ,and 48 cases randomly divided in research group ,47 cases in control group .Regular inspection was conducted in the con‐trol group ,comprehensive biochemical and serological test were conducted in the control group .Compared the results in the two groups .Results The salmonella detection rate in the research group was 93 .75% ,which was significant higher than 68 .09% in the control group (P< 0 .05) .Conclusion Combined detection of comprehensive biochemical and serology test could detect Salmonella effectively ,it is worthy of application and popularization in clinic .

Recent metabolomics research revealed a new ginseng ginsenoside IH901 that is synthesized by intestinal microbial transformation in oral administration of ginseng. IH901 shows various biological activities, including anti-tumor, anti-inflammatory, anti-diabetic, and anti-aging. In recent years, great effort has been made to prepare IH901 by microbial and enzymatic transformation in a large scale. In this paper, we reviewed the biotransformation pathways both in vivo and in vitro and bioactive properties of rare ginsenoside IH901.
Biotransformation ; Ginsenosides ; metabolism ; pharmacokinetics ; Humans ; Intestines ; metabolism ; microbiology ; Panax ; chemistry ; Sapogenins ; metabolism

The incidence of solitary fibroma of seminal vesicle is low, and the source of seminal vesicle is rare. A 38-year-old patient was admitted to hospital because of intermittent gross hematuria for more than one month. Seminal vesicle space occupying lesions can be seen in pelvic MRI. Laparoscopic resection of right seminal vesicle tumor was performed, and the pathological diagnosis tended to solitary fibroma. During the 5-month follow-up, the symptoms of hematuria disappeared and no recurrence.

Objective To evaluate the effects of different reconstruction algorithms on image quality for Philips GEMINI PET/CT. Methods Jaszczak phantom were scanned on the GEMINI PET/CT system, and the raw data were reconstructed using filtered-back projection with Hanning filter (FBP-Hanning), filtered-back projection with Butterworth filter (FBP-Butterworth), ordered subset expectation maximization (OSEM), row-action maximum likelihood algorithm (RAMLA) and three-dimensional row-action maximum likelihood algorithm (3D-RAMLA), respectively. The resolution, uniformity, contrast of images and the time of different reconstruction algorithms were compared. Results The reconstruction time was 180 s, 130 s, 120 s, 85 s and 80 s for 3D-RAMLA, RAMLA, OSEM, FBP-Hanning and FBP-Butterworth respectively in phantom studies. The smallest rods with diameter of 4.8 mm of the phantom could be observed for FBP- Butterworth and 6.4 mm for other algorithms in case of high counts. The image contrast of 3D-RAMLA were better than that other algorithms, and the image uniformity of 3D-RAMLA and RAMLA were better than those of other algorithms. The resolution, uniformity and contrast of images with all algorithms decreasd in case of low counts, and the image quality of FBP-Butterworth was not good enough for clinical studies. Conclusion Image quality is variable with different reconstruction algorithms. For clinical PET imaging, it is necessary to choose proper algorithms.

Objective To investigate the differences of acquisition protocols from continuous bed motion (CBM) and step-and-shoot (SS) modes and to observe their effects on image quality and standard uptake value (SUV) in 18 F-fluorodeoxyglucose (FDG) PET/CT.Methods A total of 30 patients (13 males,17 females;40-71 years) who underwent 18F-FDG PET/CT from June 2017 to September 2017 were selected.Simulated acquisition protocols for a specific range (upper margin of the skull to the lower edge of sciatic bone) were established with CBM and SS modes.The differences between 2 modes for actual length requiring for a specific acquisition range and the differences in CT radiation dose were compared.Real PET/ CT scans were performed using CBM and SS modes consecutively,and the differences in image quality and SUV were compared.Paired t test andx2 test were used to analyze the data.Results For the specific acquisition range,the average acquisition length of CBM was reduced by 6.65％ ((87.11 ± 3.78) vs (93.32 ±6.02) cm;t=-7.737,P＜0.001) and the CT radiation dose was reduced by 6.88％ ((812±170) vs (872±192) mGy · cm;t=-6.432,P＜0.001) for each patient compared with the results of SS.There were no significant differences in maximum SUV (SUVmax) and mean SUV (SUVmean) between SS and CBM in normal tissues including liver,bone and waist muscles (t values:from-1.895 to 0.132,all P＞0.05).The SUVmax of leg muscles at the end of the image was significantly higher in SS than that in CBM (1.24±0.53 vs 1.06±0.42;t=3.450,P＜0.01).There were no statistically significant differences in SUVmax and SUV between SS and CBM in 40 FDG high uptake lesions (t values:0.420 and-0.260,both P＞0.05).There were 73.33％ (22/30) patients had images with overall high quality during SS and the percentage was 80.00％ (24/30) during CBM (x2 =0.373,P＞0.05).The percentage of patients with images of high quality at the end was 16.67％(5/30) during SS,which was significantly less than that during CBM (63.33％,19/30;x2 =13.611,P＜0.001).Conclusions For the specific acquisition range,CBM can reduce unnecessary CT scan range and radiation dose compared with SS.There is no significant difference in image quality and SUV from normal tissue and lesion except for the end of the image.

Objective This study investigated high fat diet influence on the changes of vitamin D receptor (VDR) expression and endothelial nitric oxide synthase (eNOS) in apolipoprotein E-deficient(apoE-/-) mice.MethodsApoE-/- mice and C57BLP6J mice were divide into two groups (normal control and high fat diet),high fat diet group were feed high fat feedstuff.Plasma 25-(OH)D levels were determined by competitive protein binding radioimmunity,VDR expression were determined by immunofluorescence and reverse transcription-polymerase chain reaction.The levels of NO and eNOS were determined by nitrate reductase.ResultsCompared with normal control group,high fat diet caused more severe dam-age of atherosclerosis in wild type mice and apoE-/- mice.In apoE-/- mice,the levels of plasma 25-(OH)D were significantly decreased [(26.44±1.28) ng/mL,(22.68±2.07)ng/mL,(17.46±2.22)ng/mL,(15.88±0.97)ng/mL,P＜0.01],the expression of VDR protein and mRNA were significantly increased[VDR :0.244±0.088,0.346±0.132,0.547±0.128,0.768±0.162;VDRmRNA:0.228±0.083,0.375±0.103,0.451±0.117,0.597±0.131,P＜0.01],and the levels of NO and eNOS were significantly increased[NO:(39.74±4.81)μmol/L,(48.1±5.24 )μmol/L,(67.34±6.14 )μmol/L,(86.74±8.05)μmol/L;eNOS:(8.6±0.77 )U/L,(12.28±1.42)U/L,(15.96±0.92)U/L,(18.68±1.15)U/L,P＜0.01].These changes were more significantly in high fat diet group(P＜0.01).ConclusionsThere were abnormalities of plasma 25-(OH)D level,VDR expression and the level of NO and eNOS in apoE-/- mice.These changes were more significantly in high fat diet group.