Objective To promote the understanding of X-ray examination in the diagnosis of solitary globular lesion of lung.Methods Of 402 cases with solitary globular lung lesion, 398 were proved by operation,pathology and 4 cases of lung abscess were proved by clinical therapy. Anteroposterior radiogrphs were taken in all cases;lateral radiogrphs were taken in 368 cases.Results Of these cases ,there were peripheral lung cancer 96,tuberculoma 33,lung echinococcosis 253, lung abscess 9, pulmonary metastatic carcinoma 3.There were no characteristic signs in the rare diseases. Therefore , it's difficult to diagnose these lesions. The rare diseases include inflammatory pseudotumor 2, pulmonary hamartoma 2 , lung sarcoma 2 , pneumoblastoma 1 and lung fibroma 1. Conclusion X-ray examination is important in the diagnosis of solitary globular lung lesion.

BACKGROUND:Biomechanical compatibility is the necessary condition to ensure the stable osseointegration with implants that then can function over a long period; therefore, it is especialy important to get knowledge about distribution of stress and strain between the maxilary central incisor and its surrounding bone tissue. OBJECTIVE: Based on five different anatomical types of natural teeth, to study the regularity of stress distribution between the maxilary central incisor root and implant.METHODS: According to the five different anatomical types of natural maxilary central incisors, UGNX and ANSYS were used to set up three-dimensional finite element models (B1, B2, M1, M2, P1) for the implant and surrounding structures, which were under 100 N static load at angles of 0o, 30o, 45o, 60o, 90o with the long axis of teeth. Then, the stress distribution between the five kinds of maxilary central incisor roots and implants was analyzed. RESULTS AND CONCLUSION:Among the five different anatomical types, the equivalent stress for both the natural central incisor and implant were increased with the increasing of angles, and the implant had a higher raising trend. The equivalent stress for the natural tooth concentrated upon B1 for the maximum value and M1 for the minimum value; while the equivalent stress for the implant focused on the maximum value at M1 and the minimum value at M2. There was a gap of 2%-31% between the equivalent stresses for the natural tooth roots and a gap of 4%-21% for the implants. The stress distribution range for the implant was just smaler than that for the natural tooth roots. It implies that the bit force of implant and natural tooth is in positive proportion to the bite angles, and the bite force that implant can burden is smaler than that the central incisor can.

Objective To analyze the dermoscopic features and patterns of onychomycosis.Methods From February to July in 2017,hospitalized patients from the Department of Endocrine Dermatology of the People's Hospital of Xuancheng City was enrolled and subjected to direct microscopic examination of fungi in nails,and the patients with positive results for fungi were diagnosed with onychomycosis.And then,dermoscopic photographs of infected nails were taken to analyze the dermoscopic characteristics and patterns of onychomycosis.Results A total of 205 patients with 634 infected nails were investigated.The dermoscopic characteristics on the nail plates included marble-like turbid areas (47.3％,300/634),pigmentation (30.9％,196/634),splinter hemorrhages (18.3％,116/634) and onycholysis (13.2％,84/634).The prevalence rates of marble-like turbid areas,pigmentation and onycholysis all significantly differed between distal and lateral subungual onychomycosis (DLSO) group and total dystrophic onychomycosis (TDO) group (X2 =42.09,31.23,18.19,respectively,all P ＜ 0.01).The dermoscopic characteristics at the free edge of the nails included nail thickening (33.1％,210/634) and subungual deposition of keratin and debris (26.5％,168/634).The TDO group showed significantly higher prevalence rates of nail thickening and subungual deposition of keratin and detritus compared with the DLSO group (x2 =44.3,18.52,respectively,both P ＜ 0.01).Periungual skin dryness and desquamation occurred more frequently in the TDO group than in the DLSO group (X2 =16.07,P ＜ 0.01).Of the 634lesional nails,141 (22.2％) showed a short spiked pattern,210 (33.1％) showed a longitudinal striated pattern,202 (31.9％) showed a linear edge pattern,and 193 (30.4％) showed a distal irregular termination pattern.Conclusion The main characteristic dermoscopic manifestations of onychomycosis are marblelike turbid areas,subungual deposition of keratin and debris,periungual skin dryness and desquamation,and characteristic dermoscopic patterns of onychomycosis are short spiked pattern,longitudinal striated pattern,linear edge pattern and distal irregular termination pattern.

Objective To investigate the effects of matrine on proliferation and apoptosis of human Tenon capsule fibroblasts (HTFs) in.vitro.Methods After treated with 0,0.3,0.6 and 0.9 g/L matrine in vitro,cell counting kit-8 (CCK-8) method was used to assay the proliferation of HTFs at 24,48 and 72 hours,Western blot and PCR were performed to evaluate the expression of apoptosis-associated factor caspase-3 on both protein and RNA levels.Results The activity of human Tenon capsule fibroblast at 48 hours and 72 hours after treated with 0.3,0.6,0.9 g/L matrine was significantly inhibited when compared with the 0 g/L matrine group,and the inhibitory effect was dose-dependent and time-dependent (F ion =1 019.51,P =0.00;Ftime =5 848.66,P =0.00;Fi ion =147.45,P=0.00).After treated with 0,0.3,0.6 and 0.9 g/L matrine,the early apoptosis rate of HTFs was (2.68±0.30)％,(5.08±0.47)％,(6.97±0.69)％ and (10.30±1.20)％,the grey value ofcaspase-3 protein was 1.00±0.13,1.90±0.19,2.50±0.30 and 2.67±0.30,the relative expression of caspase-3 mRNA was 0.98 ±0.12,2.01 ±0.34,6.15 ± 0.60 and 11.40 ± 1.12,respectively,with significant differences among them (F =55.74,66.01,154.50;all at P＜0.01),the early apoptosis rate of HTFs,the grey value of caspase-3 protein and the relative expression of caspase-3 mRNA were all increased significantly as the concentration of matrine increased,with significant differences between any two groups (all at P＜0.05).Conclusions Matrine can inhibit the proliferation of HTFs and induce the apoptosis of HTFs in a time-and dose-depended manner.

Objective:To investigate the diagnostic performance of Xpert Mycobacterium tuberculosis/rifampin (Xpert MTB/RIF) assay for pulmonary tuberculosis (TB) in patients with acquired immunodeficiency syndrome (AIDS). Methods:Clinical data of 226 patients with AIDS and suspected pulmonary TB in Shanghai Public Health Clinical Center, Fudan University from July 2017 to November 2019 were retrospectively analyzed. Fluorescence staining microscopy of sputum smear, BACTEC MGIT 960 liquid culture (or Roche solid culture) and Xpert MTB/RIF assay were implemented respectively. The sensitivity and specificity of Xpert MTB/RIF in the diagnosis of Mycobacterium tuberculosis (MTB) infection and rifampin resistance were analyzed. Results:Totally 226 patients of suspected pulmonary TB were enrolled. There were 94(41.6%) patients had positive mycobacterium culture, in which 51 (54.3%) were MTB and 43 (45.7%) were nontuberculous mycobacteria (NTM). Using the positive MTB culture of sputum and mycobacterial protein from BCG of Rm 0.64 in electrophoresis (MPB64) as reference standard, the sensitivity and specificity of Xpert MTB/RIF assay for MTB diagnosis were 72.6%(95% confidence interval ( CI) 66.7%-78.4%) and 97.1% (95% CI 95.0%-99.3%), respectively. The sensitivity and specificity of Xpert MTB/RIF assay for MTB diagnosis in patients with positive sputum smear were 76.7%(95% CI 67.7%-85.8%) and 90.0(95% CI 83.6%-96.5%), respectively. The sensitivity and specificity of Xpert MTB/RIF assay for MTB diagnosis in patients with negative sputum smear were 50.0%(95% CI 41.8%-58.2%)and 99.3%(95% CI 97.9%-100.0%), respectively. With phenotypic resistance as reference standard, the sensitivity and specificity of Xpert MTB/RIF assay for rifampicin resistance were 75.0% and 100.0%, respectively. Conclusion:Among AIDS patients, the performance of Xpert MTB/RIF assay for pulmonary TB diagnosis is pretty good and could differentiate MTB from NTM rapidly, which has good application value.

Objective To explore the compliance , success rate of puncture of pediatric intravenous infusion and satisfaction of family .Methods One thousand and eight hundred children with pediatric intravenous infusion from June 2012 to July 2012 were chosen and divided into the control group and the intervention group according to the random number table , each with 900 cases.The control group received the routine nursing , and the observation group received the nursing work of improving pediatric intravenous infusion and the improved the nursing intervention technique .The compliance , puncture success rate and satisfaction of pediatric intravenous infusion were compared between the two groups .Results The rate of compliance was 90.00%in the observation group, and was significantly higher than 62.22% in the control group, and the difference was statistically significant (χ2 =190.99, P<0.05).The success rate of puncture was 93.33% in the observation group , and was significantly higher than 67.78% in the control group, and the difference was statistically significant (χ2 =187.54, P<0.05).The satisfaction of family was 98.89%in the observation group, and was significantly higher than 67.78% in the control group, and the difference was statistically significant (χ2 =194.61, P<0.05).Conclusions The active nursing intervention can effectively improve the compliance , success rate of puncture of pediatric intravenous infusion and satisfaction of family .

Humans ; COVID-19 ; HIV Infections/drug therapy* ; Risk Factors

Objective:To analyze the pathological patterns, clinical features, and prognosis in patients with human immunodeficiency virus (HIV) infection complicated with kidney disease.Methods:A retrospective analysis of 21 renal damage cases in HIV-infected patients undergoing renal biopsy from June 2016 to November 2019 in Shanghai Public Health Clinical Center, Fudan University was conducted. The clinical features, renal pathological patterns, therapies and outcomes were summarized and analyzed.Results:The age of 21 patients was (45.4±11.0) years. There were 19 men and two women. The CD4 + T lymphocyte count was (473.7±218.4) cells/μL. The HIV RNA levels were measured in 20 patients, and 13 cases (65.0%) were less than 40 copies/mL. A total of 18 cases (85.7%) had initiated antiretroviral therapy before renal biopsy, and the treatment time was 12 (1, 47) months. As for the clinical diagnosis, 14 cases (66.7%) were nephrotic syndrome and seven cases (33.3%) were nephritic syndrome. Renal pathology reports showed that HIV immune-complex kidney disease was the most common pathology pattern, accounting for 42.9% (9/21), followed by podocytopathy and diabetic nephropathy, both accounting for 23.8% (5/21), respectively. The IgA nephropathy (23.8%, 5/21) was the most common subtype of HIV immune-complex kidney disease, while minimal change disease (19.0%, 4/21) was the most common one of podocytopathy. However, classic HIV-associated nephropathy was not found in the study. The follow-up period was (12.5±9.2) months. During this period, the nephropathy conditions of nine patients were improved, eight were stable, two deteriorated, and two died. Conclusions:IgA nephropathy, minimal change disease and diabetic nephropathy are the top three patterns of renal pathology in patients with HIV infection. Most cases have good prognosis after treatments. For HIV-infected patients with serious renal damage, timely kidney biopsy is vital to determine pathological pattern, and to subsequently guide the clinical treatment and evaluate the prognosis.

Objective:To investigate the clinical manifestations, imaging findings, characteristics of cerebrospinal fluid, treatment and prognosis in patients with acquired immune deficiency syndrome (AIDS)-related progressive multifocal leukoencephalopathy (PML) diagnosed by second generation sequencing techniques with cerebrospinal fluid.Methods:From October, 2017 to January, 2019, ten patients with AIDS-related PML were diagnosed by second generation sequencing techniques with cerebrospinal fluid, and their clinical data were retrospectively reviewed. Descriptive analysis was used.Results:Among the ten patients with AIDS-related PML, eight were males and two were females. The age was (38.7±8.2) years. The median CD4 + T lymphocyte count was 46/μL. The median human immunodeficiency virus (HIV) RNA was 5.99×10 4copies/mL. The main clinical manifestations included dyskinesia in four patients, dizziness in three patients, cognitive decline in two patients, and speech disorder in one patient. Three patients developed convulsion throughout the course of the disease. Image findings indicated that lesions could appear in any part, including lesions located under the tentorium of cerebellum in three cases, and above the cerebellum in seven cases. Mild increase of total protein was observed in the cerebrospinal fluid of four cases, while white blood cell count ((0-10)×10 6/L), sugar and chloride were normal in all cases. The reads of JC virus sequence in the cerebrospinal fluid ranged from 3-12 531 reads (median 67 reads). All the patients received antiviral therapy containing integrase inhibitors. Among the 10 patients, two died in hospital and eight survived, and two of them had survived for more than one year. The symptoms were improved in five patients and unchanged in three patients. Conclusions:PML is less common in patients with HIV/AIDS. The second generation sequencing techniques with cerebrospinal fluid can help to diagnose the disease together with clinical manifestations, routine detection of cerebrospinal fluid and imaging. Potent antiretroviral treatment may improve the prognosis of the patients.

Objective: To observe the effect of electroacupuncture on the volume of cerebral infarction, apoptosis of cerebral cells and the expression of protein kinase A (PKA) in the cerebral cortex of rats after ischemia and reperfusion so as to explore how electroacupuncture stimulates brain protection. Methods: One hundred and twenty healthy, adult, male Sprague-Dawley rats were randomly divided into a sham operation group, a model group, an electroacupuncture group and an electroacupuncture with pre-stimulation group. All except the rats in the sham operation group received occulusion of the left middle cerebral artery using the intraluminal thread method for 2h and then reperfusion. Before the operation, the rats in the electroacupuncture with pre-stimulation group were given 30 minutes of electroacupuncture at the baihui, dazhui and right neiguan points every day for 5 days. After the operation both the electroacupuncture group and the pre-stimulated group were given that same electroacupuncture regimen. The other two groups received no special treatment. Garcia scoring was used to evaluate the neurological deficits of all of the rats 5 and 10 days after the intervention. Meanwhile, the ischemic volume, apoptosis of cortical cells and PKA-positive cells were determined using flow cytometry and immunohistochemistry after triphenyltetrazolium chloride (TTC) staining. Results: The neurological function of the injured rats was severely impaired, while no neurological deficit was found in the sham operation group. The average Garcia score, cerebral infarction volume, cerebral apoptosis rate and PKA-positive cell expression rate of the electroacupuncture and electroacupuncture with pre-stimulation groups were all significantly better than those of the model group at the same time points. The averages of the electroacupuncture with pre-stimulation group were all significantly superior to those of the electroacupuncture group at the same time points. Conclusions Pre-stimulation using electroacupuncture can promote the recovery of injured nerves after cerebral ischemia and reperfusion, at least in rats. Electroacupuncture′s protective mechanism may be related to its reducing the infarcted volume, inhibiting apoptosis of brain cells and promoting PKA expression.