Objective To evaluate the value of the fusion of 99m Tc-MIBI imaging technology apply in the diagnosis of malignant lung tumor. Methods Thirty - four cases with lung nodules proved by X-ray and/or CT scanning, a total of 48 lung nodular lesions. And the imaging with-99m Tc-MIBI of chest performed at 10 minutes and 2 hours delayed after injection by GE Infinia Hawkeye 4 SPECT-CT. then the regions of interesting ( ROI) were drawn in the tumor and contra lateral position to calculate the radioactivity ratios of tumor to normal ( T/NT) , and fused with the spiral CT scanning image in the same machine, and reading the early and delayed image respectively. Judged the result of the image develops, and statistical analysis of the ratio (T/NT) according to the final pathologic consequence. Results All cases with total of 48 nodular lesions, 21 nodules were positive in early imaging, 16 nodules were positive in delayed imaging (the ratio T/NT over 3. 33). defined the delayed image positive as the final criterion, The(T/NT)ratios of Malignant lung lesions were significantly higher than the benign lesions ( P ＜0. 05). Negative nodes 27, 13 cases of lung cancer lesions were malignant, confirmed by postoperative pathologic examination. The falsepositive nodules 3, false-negative nodules 2. The sensitivity was: 88.88%, the specificity was: 90.9% positive predictive value ( +PV) was: 84. 21% , negative predictive value (-PV) is: 93.75%. Conclusion 99mTc-MIBI as a tumor positive imaging agent is highly sensitivity to lung lesions, but specificity is not so high.

Objective To explore the efficacy of hormone replacement therapy (HRT) for rheumatoid arthritis (RA).Methods The literature about HRT in the treatment of rheumatoid arthritis were searched.Eleven papers were subjected to a Meta-analysis and a heterogeneity test was conducted to evaluate the efficacy of HRT.Results HRT reduced the level of erythrocyte sedimentation rate (ESR) in RA patients (P=0.016),the SMD was-0.22(-0.40,-0.04); improved bone mineral density (BMD) in RA patients (P=0.022),the WMD was 2.83(0.41,5.26); decreased clinical parameters for disease activity evaluations of RA patients (P=0.048),the SMD was-0.19 (-0.38,0.00); decreased the level of C-reactive protein (CRP) in RA patients,the SMD was-0.08 (-0.37,0.21),but the difference was not statistically significant (P=0.591).Conclusion The findings from this Meta-analysis indicate that HRT can reduce the ESR level,improve clinical indexes and improve BMD level of RA patients.HRT may suppress disease activity and osteoporosis of RA patients,so it may be used as an auxiliary therapy in the treatment of RA.

Objective To establish a high performance liquid chromatography method to detect the concentration of lamotrigine in blood dialysate and investigate in vitro recovery of lamotrigine and the factors.Select the microdialysis conditions that apply to the animal experiment and guide the stability study of in vivo recovery.Methods Positive dialysis and retrodialysis were used for the examination of lamotrigine in vitro recovery and the influencing factors such as flow rate, concentration, temperature and time.Filtered out the best conditions that apply to the in vivo experiment.Used the retrodialysis to determine the in vivo recovery and its stability.Results There was no significant difference between relative recovery and relative loss in the same flow rate.The concentration had no obvious effect on relative recovery.At the same condition,relative recovery decreased with the increase of the flow rate and increased with the temperature.The in vivo recovery had a good stability of 6.5 hours when the flow rate and stabilization time were set at 2μL/min and 1.5 h, respectivily.Conclusion Microdialysis technique can be used for the pharmacokinetic study of lamotrigine.Retrodialysis can be used for the determination of the lamotrigine in vivo recovery.

Aged ; Humans ; Lung Diseases, Fungal ; complications ; Silicosis ; complications ; microbiology ; Tuberculosis, Pulmonary ; complications

Objective To investigate the effects of preoperative iv different doses of pantoprazole on acidity of gastric fluid in patients undergoing elective surgery. Methods Sixty ASA Ⅰ -Ⅲ patients aged 38-80 yr,weighing 44-72 kg undergoing elective surgery were randomly allocated into 3 groups (n = 20 each): group Ⅰ control (group C); group Ⅱ pantoprazole 40 mg(group P1) and group Ⅲ pantoprazole 80 mg(group P2). The patients received intravenous normal saline (NS) 100 ml, pantoprazole 40 and 80 mg in NS 100 ml respectively in group C, P1 and P2 at 30 min before surgery. Gastric content was aspirated using a gastric tube on the patients'arrival in the operating room and at 1,2 h and the end of surgery. The pH of the gastric fluid was measured. The adverse effects including dizziness, diarrhea, PONV and incidence of stress ulcer were recorded. Results The pH was significantly increased in group P1 and P2 as compared with control group but there was no significant difference in pH between group P1 and P2 . There were no significant difference in the incidence of stress ulcer and pH of the gastric fluid≤2.5 among the 3 groups. Conclusion Preoperative intravenous pantoprazole 40 mg can effectively increase pH of gastric juice and is helpful in reducing the incidence of stress ulcer and the risk of acid aspiration.

BACKGROUND: It has been proved that interleukin-18 (IL-18) involves in the development of acute cerebral infarction (ACI) and is positively correlated with the time of brain stroke onset, erythrocyte sedimentation rate (ESR), as well as neurological deficit and low-density value of brain CT.OBJECTIVE: To investigate the dynamic changes of serum IL-18 in the course of ACI.DESIGN: Verification analysis with patients as subjects and healthy volunteers as controls.SETTING: Department of neurology of a municipal hospital.PARTICIPANTS: Totally 46 inpatients (29 males and 17 females) with ACI were randomly selected from the Department of Neurology of People's Hospital, Maoming City, between December 2002 and January 2004.Meanwhile, 40 healthy controls (27 males and 13 females) were recruited from those who came to the hospital for routine physical examination. All the participants signed informed consent.METHODS: Fasting peripheral vein blood of 2 mL was collected from the patients on the 1st, 7rh, 14th and 21st days of ACI onset, and from healthy controls on the day of routine examination. The blood samples were centrifuged at 3 000 r/minute for 15 minutes at 4 ℃, and then the supernatant was collected for detecting IL-18 level by ELISA.MAIN OUTCOME MEASURES: The serum IL-18 level of patients on the 1st, 7th 14th and 21st days of ACI onset and that of healthy controls on the day of routine examination.RFSULTS: Totally 46 patients and 40 healthy controls were enrolled in this study and all data were statistically analyzed. The level of serum IL-18 was significantly higher in the patients with ACI than in normal controls on the 1st and 7th days of onset [(178±41) ng/L, (104±34) ng/L, (65±14) ng/L, P ＜ 0.01],but was similar on the 14th and 21st days [(88±36) ng/L, (72±33) ng/L,(65±14) ng/L, P＞ 0.05]. The level of serum IL-18 in ACI patients was significantly higher on the 1st day than on the 7th, 14th and 21 st days of the onset (P ＜ 0.05-0.01); moreover, it was also significantly higher on the 7th day than on the 21st day of the onset (P ＜ 0.05).CONCLUSION: The level of IL-18 increases obviously on the 1st day of ACI onset, and gradually decreases with the extended course of disease and time of treatment.

Objective To analyze the clinical characteristics of severe fever with thrombocytopenia syndrome (SFTS) so as to improve the recognition of the emerging infectious disease.Methods A retrospective analysis was performed upon clinical manifestations,laboratory test results and prognostic features of 169 patients with SFTS admitted to the 154 Hospital,Chinese People's Liberation Army from October 2010 to May 2011.The patients were divided into moderate disease group and severe disease group according to the prognosis.The differences between two groups were compared to explore the prognostic indicator of severe type.Results All patients with SFTS inhabited in hilly ground with history of field work.The main clinical symptoms were severe fever (98.8％,167/169),headache (52.1％,88/169),muscle soreness (95.9％,162/169),nausea (73.4％,124/169),vomiting (67.5％,114/169),coughing (61.5％,104/169),etc.Superficial lymph node enlargement with haphalgesia was observed in 45.0％(76/169) patients.Petechia or ecchymosis was observed in 36.7％ (62/169) patients.Critical patients were mainly aged ＞ 60 years,associated with nerve and circulatory system syndrome,prominent hemoptysis,dyspnea,and nearly 73.3％ (22/30) of severe thrombocytopenia.Serum levels of aspartate aminotransferase,creatinine and urea nitrogen were significantly higher in severe disease group than those in moderate disease group [235 (47-1750) U/L vs 88 (14-2000) U/L,997 (281-2601) U/L vs 399 (26-2633)U/L,101 (62-291) μmol/L vs 70(26-205) μmol/L,7.0(2.2-20.0) mmol/L vs 4.8(1.4-18.5) mmol/L,all P values ＜0.001].Conclusion Nerves system syndrome,transaminase and urea nitrogen are risk factors of prognosis of severe SFTS to whom deserves paying attention.

Objective To compare the effect of L-T4 taken in the morning vs bedtime on serum thyroid hormone in patients with hypothyroidism.Methods Seventeen patients with primary hypothyroidism were prospectively included.They took L-T4 in the morning for 2 months followed by L-T4 taken during the bedtime for 2 months.Thyroid hormone levels and cholesterol,triglyceride,albumin,creatinine and heart rate were measured.Wilcoxon test and paired t test were used to compare the data.The correlation between the changes of TSH and FT3,FT4 was analyzed respectively by Pearson correlation analysis.Results TSH,FT3,FT4 were:(12.10±7.19) vs (3.90±3.47) mU/L,(4.14±0.86) vs (5.24±1.11) pmol/L,(12.72± 4.40) vs (18.48±2.87) pmoL/L for L-T4 taken in the morning and during the bedtime respectively (t value:6.371,-3.166,-5.435,all P＜0.01).There was no correlation between the changes of TSH and FT3,FT4(r=O.12,0.22,both P＞0.05),respectively.The averaged changes were (8.20±5.31) mU/L,(1.09± 1.42) pmol/L and (5.76±4.37) pmol/L.Triglyceride,cholesterol,albumin,creatinine levels and heart rate were not significantly different with L-T4 taken in the morning and during bedtime (t=0.240,0.017;z=0;t=-0.610,1.588,all P＞0.05).Conclusions L-T4 taken during the bedtime by patients with hypothyroidism would reduce TSH and increase FT3,FT4 levels.This method can maintain the stability of TSH level with no need to increase the dose.

Objective To take Ebola virus disease (EVD) as an example and analyze the capability of responding to emerging infectious diseases among medical university students in Chongqing city.Methods Medical university students of 2 094 in Chongqing were selected and investigated by cluster sampling.Questionnaire content includes social demographic information,knowledge,attitude,practice (KAP) and related factors about EVD.The variables of the respondents were described using mean and standard deviation for continuous variables and frequency distributions for categorical variables.Influencing factors were analyzed by using multiple-linear regression model.Results The average scores of KAP regarding EVD were 9.51 ±-3.97,5.93± 1.85,3.35 ±1.43,respectively.Multiple-linear regression analysis showed that the influencing factors of KAP regarding EVD were gender (x2 =0.773,P=0.000),residence (x2 =0.886,P=0.014) and health habits (x2 =0.316,P=0.008);gender (x2 =0.474,P=0.000),grade (x2 =0.118,P=0.024),residence (x2 =0.401,P=0.016) and health habits (x2 =0.307,P=0.000);gender (x2 =0.223,P=0.001),major (x2 =0.152,P=0.000) and health habits (x2 =0.231,P=0.000).Conclusion The capability of responding to emerging infectious diseases is not optimistic among medical university students.Medical universities should perform effective intervention according to the characters of different clusters.