Objective:To investigate the comparison of diagnostic value between multi-slice spiral CT (MSCT) and MR pulmonary angiographies in the diagnosis of acute pulmonary embolism.Methods: 86 patients with acute pulmonary embolism who underwent imaging examination were randomly divided into control group (43 cases) and observation group (43 cases) according to random number table method. The patients in the control group were analyzed with MSCT for enhanced scan under pulmonary angiography. The patients in the observation group were analyzed with MR for pulmonary artery imaging and pulmonary embolism. These results were compared depended on above data.Results: The differences of sensitivity and Youden index between control group and observation group were statistically significant (x2=10.052,x2=10.052,P<0.05), and the sensitivity of observation group was higher than that of control group, and both the diagnostic specificity of the two groups were 100%. For embolism of different part, the accuracy of observation group was higher than that of control group. And for the comparison of left multiple between the two groups, the difference were significant (x2=4.168,P<0.05). While for the comparisons of single, bilateral and multiple for right side, the differences between the two groups were no significant (x2=2.355, x2=0.917,x2=2.912,P>0.05). For the diagnosis of various indirect symptom, the accuracy of observation group was higher than control group. For the comparison of diagnostic accuracy of pulmonary segments infarct between the two groups, the difference of them was significant (x2=5.630,P<0.05). While the comparisons of pericardial effusion, pleural effusion and pulmonary artery hypertension, the differences of them between the two groups were no significant (x2=3.214,x2=3.733,x2=3.281;P>0.05).Conclusion: For patients with acute pulmonary embolism, the diagnosis by using MR imaging technology has series advantages, such as convenient operation and higher diagnostic accuracy, and it can accurately determine the severe degree of the disease.

The paper systematically introduces the teaching content and method of Introduction to Modern Clinical Medicine, which is an optional course especially for the non-medical students in those majors like Pharmacy, Medical Trading, Biotechnology, Sanitary Inspection ect. The paper also deeply discusses the problems of designing principle, the depth and extent of the teaching content.

Objective To improve the recognization of long term interval between optic neuropathy and spinal cord injury of neuromyelitis optica. Methods One 51-year old male patient with 37 years'interval between optic neuropathy and spinal cord injury of neuromyelitis optica underwent the examination of plasma and cerebrospinal fluid and head and spinal MRI examinations, who was also followed up. His clinical data were analyzed and related literature was reviewed. Results The myelin basic protein and IgG index in his cerebrospinal fluid was high, his oligoclonal band of cerebrospinal fluid was positive, and abnormal finding in visual evoked potential. Abnormal intramedullary long T2 signals was showed in spinal cord MRI at T1-7 segment. When dignosed as neuromyelitis optica, the clinical symptom and signs was improved with corticosteroid and gamma globulin therapy. The patient was in stable condition at present.Conclusions There could be a long term interval between optic neuritis and myelitis. One should pay attention to clinical features and imaging examination of subclinical lesion in spinal cord and brain and conoide the possibility of developing neuromyelitis optica or multiple sclerosis.

OBJECTIVETo investigate the association between angiotensin-converting enzyme (ACE) gene polymorphism and the reducing urinary protein efficacy of angiotensin-converting enzyme inhibitor (ACEI) in patients with primary chronic glomerulonephritis in Han nationality of southern Sichuan province.

METHODSNinety-nine primary glomerulonephritis patients with urinary protein were enrolled in this study. They were treated with benazepril for at least 3 months. The ACE gene insertion/deletion(I/D) polymorphisms in intron 16 were determined by PCR. A comparison of the reducing urinary protein efficacy of benazepril was made between the patients with different ACE genotypes.

RESULTSUrinary protein excretion was significantly higher in patients with ACE DD genotype than that in patients with II genotype. After benazepril treatment for 3 months, the rates of urinary protein decline were observed. The rates of reduction of proteinuria in patients with DD genotype and ID genotype were obviously higher than that in patients with II genotype(P<0.05).

CONCLUSIONBenazepril could decline the rate of urinary protein excretion in patients with primary chronic glomerulonephritis, and significant relationship was observed between ACE gene polymorphism and the reducing urinary protein efficacy of ACEI.

Adolescent ; Adult ; Angiotensin-Converting Enzyme Inhibitors ; therapeutic use ; Asian Continental Ancestry Group ; genetics ; Benzazepines ; therapeutic use ; China ; Female ; Gene Deletion ; Genotype ; Humans ; Introns ; genetics ; Male ; Middle Aged ; Mutagenesis, Insertional ; Peptidyl-Dipeptidase A ; genetics ; Polymerase Chain Reaction ; Polymorphism, Genetic ; genetics ; Proteinuria ; drug therapy ; ethnology ; genetics ; Young Adult

Objective:To investigate the diagnosis of dual-energy X-ray absorptiometry(DXA)for osteoporosis(OP)of postmenopausal patients with rheumatoid arthritis(RA)in Qinghai region and the risk factors of them.Methods:A total of 200 postmenopausal female RA patients who admitted to Qinghai Hospital of Traditional Chinese Medicine from May 2022 to April 2023 were selected.All patients were tested for bone mineral density(BMD)after admission,and lumbar spines L1-L4,whole lumbar,large trochanter,Ward's triangle area,whole body and whole forearm were measured by DXA.According to the results of BMD test,patients whose BMD T values of all body parts-2.5 SD were less or equal to-2.5 were included in the OP group(121 cases),and patients whose BMD T value of all body parts were larger than-2.5 SD were included in the non-OP group(79 cases).The BMD T value of different body parts between two groups of RA patients were compared and analyzed.The area under curve(AUC)of receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficiency of BMD T value for OP.The logistic regression method was adopted to analyze the risk factors that postmenopausal RA patients of Qinghai region occurred OP.Results:The BMD T values of L1,L2,L3,L4,whole lumbar,large trochanter,Ward's triangular area,whole body and whole forearm of OP group were obviously lower than those of the non-OP group.In analysis of ROC curve,the sensitivities of BMD T values of L1,L2,L3,L4,whole lumbar,large trochanter,Ward's triangle area,whole body and forearm were respectively 96.20%,95.22%,90.16%,96.03%,92.01%,89.36%,99.26%,90.02% and 96.03% in diagnosing OP,and the specificities of them were respectively 81.00%,82.19%,85.22%,83.06%,83.06%,90.22%,80.06%,86.23%,83.09%,and the AUC values of them were respectively 0.908,0.905,0.896,0.906,0.903,0.879,0.918,0.901 and 0.906.The results of the logistic-regression analysis showed that advanced age,long disease course,rheumatic activity scores of 28 joints,erythrocyte sedimentation rate and Calcium supplementation were the risk factors of occurring OP in postmenopausal RA patients in Qinghai region.Conclusion:The DXA method that detects BMD of RA patients who occur OP can be used as gold standard to assess OP,and there are many risk factors that affect the occurrence of OP in postmenopausal RA patients of Qinghai region.The clinical work should combine with relative factors to formulate reasonable measure so as to reduce the incidence of OP.

Emerging SARS-CoV-2 variants have made COVID-19 convalescents susceptible to re-infection and have raised concern about the efficacy of inactivated vaccination in neutralization against emerging variants and antigen-specific B cell response. To this end, a study on a long-term cohort of 208 participants who have recovered from COVID-19 was conducted, and the participants were followed up at 3.3 (Visit 1), 9.2 (Visit 2), and 18.5 (Visit 3) months after SARS-CoV-2 infection. They were classified into three groups (no-vaccination (n = 54), one-dose (n = 62), and two-dose (n = 92) groups) on the basis of the administration of inactivated vaccination. The neutralizing antibody (NAb) titers against the wild-type virus continued to decrease in the no-vaccination group, but they rose significantly in the one-dose and two-dose groups, with the highest NAb titers being observed in the two-dose group at Visit 3. The NAb titers against the Delta variant for the no-vaccination, one-dose, and two-dose groups decreased by 3.3, 1.9, and 2.3 folds relative to the wild-type virus, respectively, and those against the Omicron variant decreased by 7.0, 4.0, and 3.8 folds, respectively. Similarly, the responses of SARS-CoV-2 RBD-specific B cells and memory B cells were boosted by the second vaccine dose. Results showed that the convalescents benefited from the administration of the inactivated vaccine (one or two doses), which enhanced neutralization against highly mutated SARS-CoV-2 variants and memory B cell responses. Two doses of inactivated vaccine among COVID-19 convalescents are therefore recommended for the prevention of the COVID-19 pandemic, and vaccination guidelines and policies need to be updated.