Objective To improve the diagnosis and treatment of acute exacerbation in idiopathic pulmonary fibrosis(IPF)Methods A case with clinical proven acute exacerbation in IPF and treated with corticosteroid was described and the foreign literature was reviewed.Results Most patients with idiopathic pulmonary fibrosis(IPF)show slowly progressive deterioration.However,accelerated deterioration also occurs without any definite factors on infection,heart failure,et al in a few of patients with IPF who have previously shown slowly progressive deterioration,and for part of patients corticosteroid treatment is effective.Conclusion Some acute exacerbation in idiopatic pulmonary fibrosis can be idiopathic.

Autoantibodies ; Child ; Complement Factor H ; immunology ; Female ; Hemolytic-Uremic Syndrome ; immunology ; Humans

Objective To observe and analyze the reasons of intra-abdominal hypertension,and to discuss the influence of intra-abdominal hypertension (IAH) on recipients' respiratory function and its changes after disposition.Method During January to June in 2012,50 patients who had performed orthotopic liver transplantation were involved in this study.Intra-abdominal pressure was measured by AbViser Intra-Abdominal Pressure Monitoring Kit.According to the value of intra-abdominal pressure,the patients were divided into two groups (IAH group and control group).The reasons of IAH were observed and analyzed.Respiratory rate,oxygenation index,and the arterial partial pressure of carbon dioxide between IAH and control groups were compared.IAH was dealt with restricting oral input,inserting nasogastric tube,administering enema,inserting ilues tube or placing percutaneous catheter drainage according to reasons.Intra-abdominal pressure,respiratory rate,oxygenation index,and arterial partial pressure of carbon dioxide were also observed after disposition.Result The incidence of IAH was 44％ (22/50).The respiratory rate of patients in IAH group was quicker than that in control group.The oxygenation index in IAH group was lower than that in control group.The arterial partial pressure of carbon dioxide in IAH grade I group was not higher than in control group.However,the arterial partial pressure of carbon dioxide in IAH grade Ⅱ and Ⅲ groups was higher than in control group.After disposition,the intra-abdominal pressure,respiratory rate and arterial partial pressure of carbon dioxide in IAH groups were decreased from 16.4 ± 3.1 mmHg,33.0 ± 5.2 L/min and 47.6 ± 9.4 mmHg to 10.5 ± 1.8 mrnHg,19.7 ± 4.1 L/min and 39.9 ± 2.9 mmHg respectively,while the oxygenation index was increased from 202.7 ± 72.9 mmHg to 350.5 ± 98.5 mmHg.Conclusion The incidence of IAH after orthotopic liver transplantation was high.The influence of IAH on patients' respiratory function was serious.After timely and proper disposition,the respiratory function of patients with IAH could be improved.

Scientific researchers , medical and nursing staff in Academy of Military Medical Sciences and Chinese PLA General Hospital are the main readers of Medical Library of Chinese PLA.The papers they published in CMCI-covered journals from 2010 to 2012 and their citations were analyzed by citation analysis in order to find the de-mand of users and the use of literature in militarymedical journals , and discover the demand for biological literature information in scientific researchers and nursing staff in Academy of Military Medical Sciences and Chinese PLA General Hospital.The authors proposed that library holding journals should be evaluated with the support rate of highly cited journals and zero citation rate of library holding journals to guide the development of journal resources , provide evidence for the adjustment of resource acquisition , and perfect the library holding resources ofuser-ori-ented demand.

ObjectiveTo implement two typical algorithms, Marching Cubes and Ray-casting, of medical image 3-D visualization using Visualization Toolkit (VTK) with VC++.MethodsSkull and scarfskin of brain were reconstructed based on CT data. Results and ConclusionVTK is a powerful tool with many advantages, such as easy to use, fast, good interaction ability, good results for image reconstruction and so on.

Purpose To explore the role of cell blocks combined with immunohistochemical examination in the diagnosis and differential diagnosis of malignant pleural effusion,and to explore the role of pleural effusion cell blocks in lung adenocarcinoma molecular pathology examination.Methods 142 cases of malignant pleural effusion based cytology,cell blocks of HE staining and immunohistochemical staining by EnVision twostep were retrospectively analysed,the tumor classification was made through analyzing the characteristics of the cells combined with antibody expression.The detection of epidermal growth factor receptor (EGFR) gene mutation of 40 cases of lung adenocarcinoma diagnosed after immunohistochemical staining were used by ARMS-PCR method.Results Among 142 cases of malignant pleural effusion,there were 99 cases caused by lung adenocarcinoma,4 cases of lung small cell carcinoma,3 cases of lung squamous cell carcinoma,13 cases of breast carcinoma,9 cases of ovarian carcinoma,2 cases of gastric carcinoma,1 case of thyroid carcinoma,1 case of endometrial carcinoma,5 cases of mesothelioma,3 cases of lymphoma,1 case of malignant melanoma,1 case of synovial sarcoma.In 40 cases of lung adenocarcinoma pleural effusion cell block,there were 20 cases with EGFR mutations,9 cases of 19del mutations and 11 cases L858R mutations.Conclusion The pleural effusion cell blocks combined immunohistochemistry are useful to improve the accuracy of diagnosis of patients with pleural effusion,and helpful for the determination of classification and the primary site of tumor,assessment of prognosis.Pleural dffusion cell block may used to detect EGFR mutations of lung adenocarcinoma,which provide new source of specimen for the gene detection of lung adenocarcinoma.

Objective To study the construction of the lentiviral-mediated RNA interference(RNAi) vector targering rat suppressors of cytokine signaling 3(SOCS3) gene.Methods Three target sequences were selected by on-line designer software on Ambion according to rat SOCS3 mRNA sequence(NM053565),the complementary DNA contained both sense and antisense oligonucleotides were designed and synthesized.After annealing,these double strands DNA were cloned to pRNA-Lenti-green fluorescent protein(GFP),which contained U6 promoter and GFP.The resulting Lentiviral vector containing SOCS3 shRNA was named pRNA-Lenti-SOCS3-GFP.After the rat glioma cells(C6)were transduced with the constructed 1entiviral vectors,real-time polymerase chain reaction was used to evaluate the level of SOCS3 expression(including siRNA1 group,siRNA2 group,siRNA3 group,vacuity group and siRNA-Negative group).The pRNA-Lenti-SOCS3-GFP and Lentivector Pakaging plasmid mix were cotransfected into 293T to package Lentivirus particles.Culture supematant was harvested,then the virus titer was determined by serial dilution assay.Results The SOCS3 mRNA sequence was successfully cloned to pRNA-Lenti-GFP,which was proved by PCR and DNA sequence.Compared with control group,the SOCS3 mRNA expressions were obviously suppressed in all 3 experimental groups,especially the expression rate in siRNA1 group was reduced by 80%.The Lentiviral particle titer was determined by serial dilution assay with 1.0?1010 TU?L-1.Conclusion The lentiviral-mediated RNAi vector of rat SOCS3 gene has been constructed successfully,this may provide a potential tool for studying and treating SOCS3-related diseases.

Objective: To investigate the changing trends in the burden of cardiovascular diseases (CVD) in Zhejiang Province from 1990 to 2019, so as to provide insights into CVD control in the province. Methods: Based on the data of the Global Burden of Disease Study (GBD) 2019 (GBD 2019), the years lived with disability (YLD), years of life lost (YLL), disability-adjusted life years (DALY), YLD rate, YLL rate and DALY rate due to CVD were estimated to assess the burden of CVD in Zhejiang Province from 1990 to 2019. The changing trends in the burden of CVD were using annual percent change (APC) in Zhejiang Province from 1990 to 2019, and compared to China and global regions with different socio-demographic indexes (SDI). Results: The YLL rate (APC=-0.50%, F=22.366, P<0.001) and DALY rate due to CVD (APC=-0.20%, F=5.212, P=0.030) appeared a tendency towards a decline in Zhejiang Province from 1990 to 2019, while the YLD rate showed a tendency towards a rise (APC=1.92%, F=1 117.891, P<0.001). The YLL rate (APC=-1.09%, F=56.871, P<0.001), YLD rate (APC=1.92%, F=922.541, P<0.001) and DALY rate (APC=-0.60%, F=28.974, P<0.001) appeared the same tendency among women relative to among the whole populations, while only the YLD rate showed a clear-cut change among men, appearing a tendency towards a rise (APC=1.82%, F=1 238.423, P<0.001). Both the YLL rate and DALY rate appeared a tendency towards a decline among subjects at all age groups, with the most significant reduction among subjects at ages of 50 to 69 years (YLL rate: APC=-4.40%, F=1 443.608, P<0.001; DALY rate: APC=-3.82%, F=1 519.452, P<0.001). Among all types of CVD, the highest burden was measured in cerebrovascular diseases, with a standardized DALY rate of 1 359.7/105, and the most remarkable reduction in the standardized DALY rate was seen in rheumatic heart diseases. The burden of CVD in Zhejiang Province was lower than that in China and the majority of the world, with consistent changing trends with that in China and global regions with different SDI. Conclusions The overall burden of CVD appeared a tendency towards a decline in Zhejiang Province from 1990 to 2019, which was in agreement with that in China and global regions with different SDI. A remarkable reduction in the burden of CVD was seen among women, residents at ages of 50 to 69 years and cases with rheumatic heart diseases.

Purpose:To investigate fMRI and DTI in the assessment of cortical visual impairment in children with periventricular leukom-alacia ( PVL).Materials and Methods: Twenty-four children with PVL were enrolled.Meanwhile,24 age-matched normal controls were recruited for comparison.fMRI scan was performed using a 3.0T MR scanner.Data analysis was performed by statistical parametric mapping software (SPM2).Activated voxels were identified in both groups,t test was used for statistical analysis.DTI was performed by MedlNRIA software and DTI color maps were created from fractional anisotropy (FA) values and the three vector elements,FA values on diffusion tensor color maps were compared between the patients and the controls.AH the FA values of these WM fibers were analyzed by paired t test.The correlation was calculated between FA values and activated voxels of visual cortex for PVL children using SPSS10.0.Results: In all 24 normal children,the maximum response of blood oxygen level-dependent (BOLD) signal was located in the primary visual cortex ( PVC).However,some of the 24 cases of PVL had deviated activation.The active voxels of patients in visual cortex were less than that of controls.All 24 cases of PVL showed a significant mean FA reduction in ICPL and PTR in comparison to the ipsilateral regions of healthy controls.The significantly positive correlation was shown between FA values and activated voxels of visual cortex for PVL children.Conclusion:fMRI and DTI play an important role in the assessment of cortical visual impairment in children with PVL.

Objective To evaluate the effect of heparin and argatroban on the coagulating function and the vascular thrombosis in the early period after pediatric living related liver transplantation (LRLT).Method Eighty-four congenital biliary atresia pediatric patients who had performed LRLT were involved in this study.According to the method of anticoagulation,the patients were divided into two groups (heparin group and argatroban group).Antithrombin Ⅲ (AT-Ⅲ) activity,activated partial thromboplastin time (APTT) and international normalized ratio (INR) of two groups were measured in the first 5 days after LRLT.In order to determine whether vascular thrombosis existed,Doppler ultrasound was performed daily.Result There were no significant differences in gender,age,body weight,graft-recipient weight ratio and whether to accept Kassi procedure between two groups.The AT-Ⅲ activity of two groups was low and increased gradually after operation.There was no significant difference between two groups.There were no significant differences in APTT and INR between two groups immediate and at first day after operation.After anticoagulation,the differences in APTT and INR between two groups were significant.The incidence of vascular thrombosis was 4.76％ (3/63) and 0(0/21) respectively in heparin and argatroban groups.There was no significant difference between two groups.During treatment,there were no severe complications in two groups,such as active hemorrhage and allergy.Conclusion Argatroban is a direct anticoagulant.It is independent on the level of AT-Ⅲ activity.It may play an important role for preventing vascular thrombosis after pediatric LRLT.