Neurosyphilis is a group of clinical syndromes caused by treponema pallidum invading the central nervous system and causing varying degrees of damage to the brain parenchyma, brain (spinal) membrane or spinal cord. Cerebral syphilitic gumma is the rarest form of neurosyphilis, and its clinical manifestations lack specificity, which is easily confused with other intracranial space occupying lesions on imaging. In this article, a patient with cognitive dysfunction, intracranial hypertension, and imaging findings similar to multicentric glioma was diagnosed as cerebral syphilitic gumma by serology, cerebrospinal fluid test and brain histopathology. The symptoms basically disappeared after treatment with standard penicillin. This report aims to raise awareness of cerebral syphilitic gumma in order to reduce missed diagnosis and misdiagnosis.

Neurosyphilis is a group of clinical syndromes caused by treponema pallidum invading the central nervous system and causing varying degrees of damage to the brain parenchyma, brain (spinal) membrane or spinal cord. Cerebral syphilitic gumma is the rarest form of neurosyphilis, and its clinical manifestations lack specificity, which is easily confused with other intracranial space occupying lesions on imaging. In this article, a patient with cognitive dysfunction, intracranial hypertension, and imaging findings similar to multicentric glioma was diagnosed as cerebral syphilitic gumma by serology, cerebrospinal fluid test and brain histopathology. The symptoms basically disappeared after treatment with standard penicillin. This report aims to raise awareness of cerebral syphilitic gumma in order to reduce missed diagnosis and misdiagnosis.

Percutaneous pulmonary puncture guided by computed tomography (CT) is one of the most effective tools for obtaining lung tissue and diagnosing lung cancer. Path planning is an important procedure to avoid puncture complications and reduce patient pain and puncture mortality. In this work, a path planning method for lung puncture is proposed based on multi-level constraints. A digital model of the chest is firstly established using patient's CT image. A Fibonacci lattice sampling is secondly conducted on an ideal sphere centered on the tumor lesion in order to obtain a set of candidate paths. Finally, by considering clinical puncture guidelines, an optimal path can be obtained by a proposed multi-level constraint strategy, which is combined with oriented bounding box tree (OBBTree) algorithm and Pareto optimization algorithm. Results of simulation experiments demonstrated the effectiveness of the proposed method, which has good performance for avoiding physical and physiological barriers. Hence, the method could be used as an aid for physicians to select the puncture path.
Humans ; Lung/diagnostic imaging* ; Lung Neoplasms/diagnostic imaging* ; Punctures ; Thorax ; Tomography, X-Ray Computed

Objective:To study the molecular biological characteristics of isolates from the infection site and isolates colonizing in anterior nares of children with invasive Staphylococcus aureus (SA) infection, and to analyze the concordance between the two types of strains from different sources. Methods:A total of 45 strains were collected from children with invasive SA infection treated in the Pediatric Ward of Sichuan Provincial Maternal and Child Health Care Hospital from January 2019 to August 2019, and 28 colonization isolates were obtained from the anterior nares of these patients.The susceptibility test was carried out by broth dilution method.The drug resistance genes mecA and blaZ and the virulence gene panton-valentine leucocidin( pvl) were detected by PCR.The homology of infective and colonizing isolates was detected by pulsed-field gel electrophoresis(PFGE)typing technique. Results:Colonization of SA was found in the nasal vestibule of 62.2% (28/45 cases) of patients with invasive SA infection.A total of 40.0% (18/45 strains) of the infective isolates and 32.1% (9/28 strains) of the colonizing isolates were Methicillin-resistant SA (MRSA), and the difference was not statistically significant( P>0.05). The resistance of infective isolates to Clindamycin, Azithromycin and Erythromycin was stronger than that of colonizing isolates, the difference of drug resistance rate was statistically significant( χ2=7.114, 7.820, 5.359, all P<0.05). There were no differences in the carrying rates of the drug resistance gene blaZ and the virulence gene pvl between the infective and colonizing bacteria( P>0.05). Phenotypically, Methicillin-susceptible SA (MSSA)was more susceptible to concordant colonization than MRSA[16.7%(3/18 cases) vs.48.1%(13/27 cases), χ2=4.671, P<0.05]. PFGE indicated that patients with invasive MSSA infection were significantly more likely to have a concordant MSSA colonization isolate in their anterior nares, compared with patients with invasive MRSA infection[59.3%(16/27 strains) vs.27.8%(5/18 strains), χ2=4.301, P<0.05]. Conclusions:The infective and colonizing strains of invasive SA show no difference in their resistance to some anti-biotics, but they carry almost the same number of drug resistance and virulence genes.Compared with those with MRSA infection, patients with MSSA infection are more likely to have concordant colonizing isolates.It is of potential clinical significance to screen the colonizing SA strains in patients with invasive SA infection.

Objective To explore the effect of pulmonary rehabilitation training on the respiratory function,motor function,life quality,survival and complications of patients with non-operative lung cancer.Methods A group of 88 patients with non-operative lung cancer was randomly divided into a training group (n=45) and a control group (n=43).Both groups were given anti-tumor therapy,while the training group was additionally provided with systematic respiratory training,including breathing pattern training,cough and expectoration training,respiratory gymnastics and walking training.Forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) were measured at the outset and after 8,16 and 24 weeks of the training.The 6-minute walk test (6MWT) was administered along with the QLQ-C30 assessment of the European Organization for Research and Treatment of Cancer.Complications in both groups were also recorded and analyzed.The progression-free survival (PFS) and overall survival (OS) were followed up after the treatment.Results After 8,16 and 24 weeks of the treatment,the average FVC and FEV1 volumes and the 6MWT times of the training group were significantly better than those before treatment and significantly better than the control group averages.Indeed,no significant improvement was observed in the control group's average FVC,FEV1 or 6MWT results.After 24 weeks the treatment group's average scores on the physical function,social function,emotional function,fatigue,nausea and vomiting,pain,dyspnea,insomnia,appetite,constipation,and overall quality of life sub-scales of the QLQ-C30 had all improved significantly more than in the control group.The incidence of pulmonary complications in the control group (26％) was significantly higher than that in the training group.(11％).The median PFS and OS of the training group (14.3 and 27.3 months) were not significantly better than those of the control group,however.Conclusion Respiratory exercise training and aerobic exercise training combined with the anti-tumor therapy,while not prolonging survival,can effectively improve the life quality of patients with non-operative lung cancer,reducing the incidence of complications and promoting the recovery of respiratory function.The combination is worthy of popularization in clinical practice.

Objective To explore the effect of short-term intensive rehabilitation training on respiratory function, motor function and the life quality of patients with obstructive sleep apnea combined with chronic obstruc-tive pulmonary disease ( OSA-COPD) . Methods Fifty-seven patients with OSA-COPD were randomly divided in-to an observation group and a control group. Both groups were treated with non-invasive positive pressure ventilation ( NPPV) , oxygen therapy and a bronchodilator, while the observation group was additionally provided with 8 weeks of intensive lung rehabilitation training, including respiratory function training and limb exercise training. Polysom-nography was used to monitor the apnea hyponea index ( AHI) , the lowest oxygen saturation level during the night ( LowSpO2 ) and the nocturnal oxygen saturation ratio for ＜ 90% of total sleep time ( tst90) . Arterial blood gases, forced vital capacity ( FVC) and forced expiratory volume in one second ( FEV1 ) were measured. The 6-minute walk test (6MWT) and St. George's respiratory questionnaire ( SGRQ) were used to evaluate all the patients before and after the intervention. Results After 8 weeks of treatment, the average AHI, LowSpO2 , TST90 and PaO2 had improved significantly in both groups. There was no significant difference between them. After the treatment the average FVC, FEV1 and 6MWT time of the observation group were significantly better than before the treatment and the significantly better than the control group's averages. After treatment, the average SGRQ score and activity abili-ty score of the observation group were also significantly improved and significantly better than the control group's av-erages. Conclusions NPPV can effectively improve OSA-COPD patients'tolerance of short-term intensive pulmo-nary rehabilitation training. With that assistance, short-term intensive rehabilitation training can promote the recov-ery of respiratory function and motor function, and improve the life quality of patients. Therefore, such therapy is worthy of clinical promotion and application.

Objective To Analyze the urodynamic features in the patients with benign prostatic hyperplasia (BPH) complicated with diabetes mellitus (DM) and its diagnostic value.Methods One hundred and twenty patients with BPH who were hospitalized from January,2014 to August 2016 were recruited as study subjects,of whom 60 patients with BPH complicated with MD were designated as the observation group,and the other 60 patients with simple BPH were designated as the control group.Then,analysis was made on the urodynamic test results in the two groups.Results The scores of detrusor dysfunction for the observation group and the control group were respectively 46.67％ and 21.67％,and the percentages of high compliance bladder were respectively 40％ and 18.33％,while the scores of detrusor damage for the 2 groups were respectively 56.67％ and 33.33％.Statistical significance could be seen when comparisons were made between the 2 groups (x2 =18.865,P =0.037;x2 =19.458,P =0.043;x2 =18.382,P =0.041).The percentages of urinary bladder outlet obstruction were respectively 75.00％ and 48.33％,and the percentages of detrusor instability were respectively 51.67％ and 41.67％,also with statistical significance (x2 =5.253,P =0.031;x2 =4.963,P =0.026).Initial precipitant urination volumes for the observation group and the control group were respectively (242 + 15.46) ml and (146 + 22.34) ml,maximum bladder capacity for the 2 groups were respectively (306 +44.52) ml and (226 + 22.73) ml,residual urine volumes were respectively (166.18 + 23.35) and ml (56 ± 12.31) ml,precipitant urination pressures at maximum urinary flow were respectively (26.46 + 9.64) cmil20(1 cmil20 =0.098 kPa) and (61.73 + 11.75) cmH20,the scores of bladder compliance for the 2 group were respectively (47.36 +4.68) ml/cmH20 and (23.26 + 5.37) mL/cmH2O,and maximum urinary flow rate (Qmax) for the 2 groups were respectively (4.12 + 2.12) ml/s and (8.78 +2.36) mL/s.Statistical significance could also be seen when comparisons were made between the 2 groups (t =2.235,P=0.016;t=2.183;P =0.045;t =2.275;P=0.038;t =2.258;P =0.042;t =2.465;P=0.033;t =2.472;P =0.032).Conclusions In the patients with BPH complicated with DM,bladder detrusor dysfunction was severer as compared with those with simple BPH.Early urodynamic detection should be performed for those patients with BPH complicated DM,so as to provide clinical evidence for the selection of treatment methods.

Objective To Analyze the urodynamic features in the patients with benign prostatic hyperplasia (BPH) complicated with diabetes mellitus (DM) and its diagnostic value.Methods One hundred and twenty patients with BPH who were hospitalized from January,2014 to August 2016 were recruited as study subjects,of whom 60 patients with BPH complicated with MD were designated as the observation group,and the other 60 patients with simple BPH were designated as the control group.Then,analysis was made on the urodynamic test results in the two groups.Results The scores of detrusor dysfunction for the observation group and the control group were respectively 46.67％ and 21.67％,and the percentages of high compliance bladder were respectively 40％ and 18.33％,while the scores of detrusor damage for the 2 groups were respectively 56.67％ and 33.33％.Statistical significance could be seen when comparisons were made between the 2 groups (x2 =18.865,P =0.037;x2 =19.458,P =0.043;x2 =18.382,P =0.041).The percentages of urinary bladder outlet obstruction were respectively 75.00％ and 48.33％,and the percentages of detrusor instability were respectively 51.67％ and 41.67％,also with statistical significance (x2 =5.253,P =0.031;x2 =4.963,P =0.026).Initial precipitant urination volumes for the observation group and the control group were respectively (242 + 15.46) ml and (146 + 22.34) ml,maximum bladder capacity for the 2 groups were respectively (306 +44.52) ml and (226 + 22.73) ml,residual urine volumes were respectively (166.18 + 23.35) and ml (56 ± 12.31) ml,precipitant urination pressures at maximum urinary flow were respectively (26.46 + 9.64) cmil20(1 cmil20 =0.098 kPa) and (61.73 + 11.75) cmH20,the scores of bladder compliance for the 2 group were respectively (47.36 +4.68) ml/cmH20 and (23.26 + 5.37) mL/cmH2O,and maximum urinary flow rate (Qmax) for the 2 groups were respectively (4.12 + 2.12) ml/s and (8.78 +2.36) mL/s.Statistical significance could also be seen when comparisons were made between the 2 groups (t =2.235,P=0.016;t=2.183;P =0.045;t =2.275;P=0.038;t =2.258;P =0.042;t =2.465;P=0.033;t =2.472;P =0.032).Conclusions In the patients with BPH complicated with DM,bladder detrusor dysfunction was severer as compared with those with simple BPH.Early urodynamic detection should be performed for those patients with BPH complicated DM,so as to provide clinical evidence for the selection of treatment methods.

Nitric oxide (NO), which is involved in the regulation of the cardiovascular system, nervous system, immune system, reproductive system, digestive system and other physiological activities, is an important biological substance with activity. Under normal physiological conditions, neuronal nitric oxide synthase (nNOS) can precisely regulate the nervous system NO production, release, diffusion and inactivation processes. But an excess of NO associates with the development of cerebral ischemia, Alzheimer's and Parkinson's psychosis nervous system diseases, while inhibition of nNOS activity can regulate the content of NO in vivo, and produce a therapeutic effect on some of the nervous system diseases. This review mainly describes the structure and regulation of nNOS and recent developments of small molecule inhibitors of nNOS.

The pharmacodynamics of compound Guhuanzhixue granule(CGH- ZX)was studied.The results showed that CGHZX inhibited the contraction of rat's uterine smooth muscle and antagonized the vigorous contraction induced by oxytoxin in vitro,It exerted an anti-inflammatory effect in rats and miee with uteritis caused by various foreign bodies,This preseription also shertened the bleeding and coagulation times in mice.It is suggested that CGHZX is applicable to metrorrhagia,pain and uteritis occurring after setting of contra- ceptive ring.