Objective To evaluate the value of 64-slice spiral CT angiography in diagnosing diabetic leg arteriosclerosis obliterans(DLASO).Methods 64-slice spiral CT angiography was done in 90 patients with diabete and suspected vascular disorders of lower limb.Images were analyzed on the basis of the transverse CT source data including the maximum intensity projection(MIP),volume rendering(VR),multiplanar reconstruction(MPR) and curved planar reconstruction(CPR).Results 64-slice spiral CT angiography could exactly show the space relationship and anatomical detail of aortoiliac and lower extremity arteries.Arteriosclerostic obliterans was found in variant degree in 67 cases(67/90),of them,49(56.3%) were slight to medium arteriostenosis,18(20.7%) were obvious arteriostenosis and 7 were complete obstructed with collateral circulation.Conclusion 64-slice spiral CT angiography is of significant value in the assessment of arteriosclerosis obliterans of lower extremity arteries in the patients with diabetes.

Animals ; Female ; Hydrocarbons ; toxicity ; Kidney ; drug effects ; ultrastructure ; Liver ; drug effects ; ultrastructure ; Male ; Mice

Response surface methodology (RSM) based on a three-level three-factor Box-Behnken design of experiments was used to optimize the extracellular polysaccharide content and the mycelium biomass by submerged cultivation using Pholiota squarrosa AS 5.245. The critical factors selected for the investigation were temperature, time of cultivation and volume of medium, based on the results of our previous Plackett-Burman design. The objectives of this present work were to locate optimum levels of these process parameters, and to find out interactions among them for enhancement of the yield of extracellular polysaccharide and mycelium biomass. By solving the regression equation and also by analyzing the response surface contour plots, the optimal process conditions were determined: under conditions of temperature, 28.07℃; cultivation time, 8.79 d and volume of medium, 68.51 mL, the prediction of extracellular polysaccharide content (EPC) by Pholiota squarrosa AS 5.245 was 1062.69 ?g per milliliter of fermentation liquor. While cultivation temperature, time and volume of medium were 27.60℃, 9.42 d and 54.20 mL respectively, the mycelium biomass expressed as dry cell weight (DCW) was 11.32 mg?mL -1. In order to simultaneously obtain the maximum yield of EPC and DCW, the above conditions would be located at 27.62℃, 9.19 d and 64.10 mL. In these conditions, the maximum predicted yield of EPC and DCW were found to be 1050.64 ?g?mL -1 and 11.10 mg?mL -1, respectively. These predicted values were also verified by validation experiment.

Objective To assess the efficacy of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) of the breast in the detection of residual lesions of early stage breast carcinoma after lumpectomy. Methods 53 patients with breast masses confirmed to be malignant tumors by pathology after lumpectomy underwent the dynamic contrast-enhanced breast MR imaging and then further surgical treatment by lumpectomy. The DCE MRI-based diagnoses were compared to the results of pathological analyses after the second lumpectomy. Results 17 (32%) cases were detected with abnormal enhancement. 8 cases presented mass-like enhancements , and 6 of them showed tumorous residuals (P < 0.01). 6 presented focal enhancements, taking up 35% and one of them was confirmed pathologically to have tumorous residuals (P < 0.01). 3 cases presented mass-like enhancement, taking up 18% and 2 of them were confirmed with cancerous residuals . MR dynamic enhancement showed 68% of the them presented no abnormal enhancements in the breast and 33 of themhad no residual cancer , taking up 92%. 3 of them were confirmed with tumorous residuals , taking up 8%. The The positive predictive value and negative predictive value of DCE MR imaging for diagnosing residual malignant lesion were 52% and 92%, respectively . Conclusion The dynamic contrast-enhanced MRI of breast is helpful for evaluating residual malignant lesion after lumpectomy and affects positively subsequent treatment.

Objective:To investigate the changes of plasma ghrelin levels and insulin(INS) sensitivity of full-term infants small for gestational age (SGA) and the effects of breast feeding on it.Methods:Full-term SGA hospitalised in the Department of Neonatology, Wuhan Children′s Hospital from October 2014 to April 2019 were re-cruited as the SGA group (120 cases), with full-term infants appropriate for gestational age (AGA) born in the same period as the AGA group (96 cases) in this study with recorded birth weight and length.The levels of fasting blood glucose (FG), triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), INS and ghrelin were measured 7 days after birth.Homeostasis model assessment-insulin resistance (HOMA-IR) was calculated.The SGA group was subdivided into breast feeding group and formula feeding group.The above indexes were tracked and mea-sured in the 3 rd and 6 th month, respectively, and their growth parameters were recorded. Results:There were no diffe-rences in serum FG, TG, LDL and HDL levels between the SGA and the AGA group (all P>0.05). Compared with the AGA group, the serum INS[(4.21±0.83) mIU/L vs.(3.54±1.10) mIU/L], ghrelin levels[(0.80±0.23) μg/L vs.(0.69±0.19) μg/L] and HOMA-IR (0.85±0.25 vs.0.72±0.25) increased in the SGA group, the differences were statistically significant (all P<0.05). Serum INS, HOMA-IR and ghrelin levels changed with the duration of breast feeding, the differences were statistically significant( F=12.394, 9.810, 5.531, all P<0.05). Conclusions:The serum ghrelin levels of SGA infants increased and INS sensitivity decreased.Breastfeeding can decrease levels of serum INS, HOMA-IR and ghrelin, and can improve INS sensitivity of SGA infants.

Adolescent ; Adult ; Blood Donors ; Child ; Child, Preschool ; Female ; Gastrointestinal Diseases ; drug therapy ; etiology ; Graft vs Host Disease ; drug therapy ; etiology ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Hormones ; administration & dosage ; therapeutic use ; Humans ; Male ; Middle Aged ; Transplantation, Homologous ; Young Adult

Objective To observe the influence of ATP protection after brachial plexus injuries. Methods A total of 80 female Wistar rats,weighting 280～300 g,were randomly divided into ATP and con- trol groups.The right C_5～T_1 nerve roots were transected and then the intraperitoneal injection of 4m[ of ATP or normal saline was given immediately and once daily to the rats,respectively.The rats were sacrificed on postoperative days 14,28 and 42 respectively.The C_5-T_1 segments of the spinal cord were harvested.NT-3 activity was measured by enzymo-histochemistry method.Four weeks and 6 weeks postoperatively,ultrastruc- ture of the denervated skeletal muscles was observed.Results Compared to the control group,the expres- sions of NT-3 was increased in the treated groups with ATP injection (P

Objective To investigate the effect of combined Metformin and esomeprazole therapy on plasma levels of gastrin,blood glucose,glycosylated hemoglobin(HbA1c) and insulin in elderly patients with type 2 diabetes.Methods A randomized,double-blind,placebo-controlled study of 41 elderly patients with type 2 diabetes was conducted.Patients were randomly assigned into treatment group(combination therapy with Metformin 0.5 g,bid or tid and Esomeprazole 20 mg,qd,for 12 weeks)and placebo group(Metformin monotherapy 0.5 g,bid or tid,for 12 weeks).Fasting blood samples were taken from vein before and after treatment.Fasting serum levels of gastrin,glucose,HbA1c,insulin,lipids,liver and renal functions were compared between the two groups.The homeostasis model of assessment for insulin resistance index(HOMA-IR) and insulin secretion index (HOMA-β)were calculated,and complications were recorded.Results There were no significant differences in body mass index and waist circumference between the two groups.Serum gastrin level was slightly increased in the treatment group 12 weeks after treatment,but without statistically significance [(127.20±9.21)ng/L vs.(131.53±7.84)ng/L,P＞0.05],and serum gastrin level had no significant differences in the placebo group before and after treatment [(128.42±4.58)ng/L vs.(127.51±3.47)ng/L,P＞0.05].However,there were no significant differences in the changes of blood glucose,HbA1c,insulin,HOMA-β and HOMA-IR before versus after therapy,and between the two group(all P＞0.05).Conclusions Combined Metformin and insulin therapy cannot increase serum gastrin and insulin levels and has no significant effect on reducing blood glucose and HbA1c levels in elderly patients with type 2 diabetes.

ObjectiveTo investigate the incidence and risk factors of antibiotic-associated diarrhea (AAD) of pediatric patients with severe bacterial pneumonia.MethodsClinical data of 1086 pediatric patients with severe bacterial pneumonia from January 2010 through January 2014 were recruited. The incidence and risk factors of AAD were retrospectively analyzed. ResultsThe incidence of AAD in 1086 pediatric patients with severe bacterial pneumonia was 36.74%. The incidence of AAD in patients younger than 2 years old were higher than that in those older than 2 years, once or more times of mechanical venti-lation history were higher than that with no arrangements of this treatment, administering of combined antibiotics therapy were higher than that with single antibiotics, and the incidence of AAD due to amoxicillin/clavulanate, piperacillin/tazobactam, cefo- perazone/sulbactam in pediatric patients were 43.55%, 43.75%, and 45.03%, respectively. Three β-lactam/β-lactamase inhibitors above were risk factors of AAD through multivariate Logistic regression analysis.ConclusionThe high incidence of AAD in pediatric patients with severe bacterial pneumonia was associated with some risk factors, including younger than 2 years old, me-chanical ventilation, combined antibiotics therapy and administration of β-lactam/β-lactamase inhibitor (amoxicillin/clavulanate, piperacillin/tazobactam, cefoperazone/sulbactam).

Objective To investigate the expression of IgG4 in liver tissues of patients with type Ⅰ autoimmune hepatitis (AIH) and to analyze the clinical manifestation,biochemical indexes,immunological genetic features,pathological characteristics and the effects of immunosuppressive therapy.Methods From March 2012 to July 2013,45 patients diagnosed as type Ⅰ AIH were enrolled.Immunostaining of CD38,IgG and IgG4 in liver tissue slices was performed,inflammation grade G and fibrosis stage S were determined.At the same time,serological indexes (alanine aminotransferase (ALT),aspartate transaminase (AST),alkaline phosphatase (ALP),IgG,antinuclear antibody (ANA) titer,antibodies to asialoglycoprotein receptor (ASGPRAb)) of the patients were collected,serum IgG4 was tested and the response to immunosuppressive therapy was observed.Wilcoxon rank sum test and t test were performed for quantitative data comparison.Spearman correlation coefficient was used for correlation analysis.Results Among 45 patients with type Ⅰ AIH,five patients (11.1％) were IgG4 associated AIH (IgG4-AIH group).There were no significant differences in age,gender,biochemical indexes (serum levels of ALT,AST,ALP),immunity indexes (serum levels of IgG,ANA titer,ASGPRAb) and degree of liver fibrosis between patients with IgG4-associated AIH and classical AIH (40 cases) (all P＞ 0.05).Compared with classical AIH group (18.3(6.7) mg/L).The serum level of IgG4 of IgG4 AIH group was 25.8(9.2) mg/L,which significantly increased (Z=-2.041,P＜0.05).However,there was no significant difference in serum level of IgG4 between the two groups (P＞0.05).There was no correlation between the number of infiltrated IgG4 positive plasma cells and the serum level of IgG4 (r=0.311,P=0.279).The inflammation in the liver tissues of IgG4-AIH group was more significant compared with that of classic AIH group (H=4.120,P＜0.05).The number of CD38' or IgG+ plasma cells was larger compared with that of classical AIH (CD38(39.3(13.5)/high power field (HPF) vs (21.3(8.8))/HPF,IgG(39.3 (14.0))/HPFvs (18.5(8.9))/HPF;Z ＝-3.561 and-3.584,both P＜0.01).The number of IgG4+ plasma cells in liver tissues was positively correlated with the number of CD38+ or IgG+ plasma cells (r=0.884 and 0.791,both P＜0.01).Conclusions Among patients with type Ⅰ AIH,the incidence of IgG4-associated AIH was not high.The serum level of IgG4 did not significantly increase in these patients.However,the histological inflammation activity was significant along with many CD38+ or IgG+ plasma cells infiltration.