Objective To analyze the value of abdominal CT images combined with serological indicators in predicting the ureteral involvement in idiopathic retroperitoneal fibrosis(IRF). Methods The CT images of 79 IRF patients were analyzed retrospectively,including the involved sites and enhancement characteristics of the lesions.According to the inclusion and exclusion criteria,43 patients with complete serological data were selected and assigned into a ureteral involvement group(n=29)and a non-ureteral involvement group(n=14) according to whether ureters were involved in IRF.Logistic regression analysis was performed to select independent risk factors for ureteral involvement in IRF.The receiver operating characteristic(ROC)curve was plotted to evaluate the predictive value of the CT arterial phase enhancement magnitude and serum cystatin C(CysC)for ureteral involvement in IRF. Results The CT images of IRF usually showed a soft tissue density lesion encompassing the abdominal aorta,iliac arteries,ureters,and retroperitoneal tissue,with a wide range of distribution.The ureteral involvement group and the non-ureteral involvement group showed differences in gender(P=0.031),CT arterial phase enhancement amplitude(P=0.014),CT venous phase enhancement amplitude(P=0.032),and serum CysC(P=0.036).Logistic regression analysis showed that gender(P=0.034),CT arterial phase enhancement amplitude(P=0.046),and serum CysC(P=0.041)were independent risk factors for ureteral involvement in IRF.The area under the curve for CT arterial phase enhancement combined with serum CysC to predict ureteral involvement in IRF was 0.776.Ten patients had lower levels of erythrocyte sedimentation rate(P<0.001),C-reactive protein(P=0.021),and IgG4(P<0.001)in the follow-up period than before treatment. Conclusion The combination of abdominal CT images with serological indicators demonstrates high accuracy in predicting the ureteral involvement in IRF,providing reference for early clinical diagnosis.
Humans ; Male ; Female ; Retroperitoneal Fibrosis/pathology* ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed ; Aged ; Adult ; Ureter/diagnostic imaging* ; Predictive Value of Tests ; Cystatin C/blood*

Objective To summarize the isolation and drug resistance rate of Escherichia coliin The First Hospital of China Medical University over the past 10 years,in order to provide evidence for the efficacies of clinical anti-infection treatments.Methods The data was collected from Escherichia coli isolated from patients treated at The First Hospital of China Medical University between 2013 and 2022.VITEK 2 and VITEK MS were used for bacterial identification,VITEK2 and KB method were used for drug sensi-tivity testing,and WHONET 5.6 software was used for analysis.Results From 2013 to 2022,6 845 strains were isolated,including 80.5%from inpatients and 19.5%from emergency and outpatients.The specimens were most commonly found in the urine(57.8%),blood(15.0%),secretions(9.2%),and drainage fluid(8.1%).The isolation rate of extended-spectrumβ-lactamase(ESBL)producing Escherichia coli was 57.2%(54.3%to 61.5%).The drug resistance rate of Escherichia coli to carbapenems was low,at only 1.2%(0.2%to 2.6%).Conclusion Escherichia coli remains an important pathogen in clinical infections,with varying degrees of resist-ance to multiple antibiotics,and the resistance rate is increasing.Clinical physicians should pay sufficient attention to this issue.

Objective To analyze pathogen distribution and drug resistance in a tertiary hospital in Shenyang in 2022 and provide evi-dence-based guidance for this and other hospitals to formulate antibacterial drug application strategies.Methods In 2022,bacterial iso-lates collected from patients in a tertiary hospital in Shenyang were identified and subjected to drug sensitivity tests based on the require-ments of the national clinical laboratory operation procedures.The data were analyzed using Whonet 5.6 software.Results In total,4968 pathogenic strains were isolated from this hospital in 2022.The top five isolates were Escherichia coli,Klebsiella pneumoniae,Acineto-bacter baumannii,Enterococcus faecalis,and Pseudomonas aeruginosa.The resistance rates of Escherichia coliand Klebsiella pneumo-niaeto carbapenems were 1.9%and 17.7%,respectively.The resistance rates of Enterobacter cloacaeto imipenem and meropenem were 26.7%and 25.0%,respectively.The isolation rate of methicillin-resistant Staphylococcus aureus(MRSA)was 15.6%.The resistance rates of vancomycin-resistant Enterococcusand linezolid-resistant Enterococcus faecaliswere 7.1%and 11.6%,respectively.The resist-ance rates of tropical yeasts to fluconazole was>20%.Conclusion The distribution and drug resistance of pathogens in this hospital differed from those in other regions of China.The drug resistance of strains in this hospital should be closely monitored to understand the distribution and drug resistance of pathogens in a timely manner and to provide guidance for the diagnosis and treatment of infections.

Emerging research suggests a potential association of progression of Alzheimer's disease(AD)with al-terations in synaptic currents and mitochondrial dynamics.However,the specific associations between these pathological changes remain unclear.In this study,we utilized Aβ42-induced AD rats and primary neural cells as in vivo and in vitro models.The investigations included behavioural tests,brain magnetic resonance imaging(MRI),liquid chromatography-tandem mass spectrometry(UPLC-MS/MS)analysis,Nissl staining,thioflavin-S staining,enzyme-linked immunosorbent assay,Golgi-Cox staining,trans-mission electron microscopy(TEM),immunofluorescence staining,proteomics,adenosine triphosphate(ATP)detection,mitochondrial membrane potential(MMP)and reactive oxygen species(ROS)assess-ment,mitochondrial morphology analysis,electrophysiological studies,Western blotting,and molecular docking.The results revealed changes in synaptic currents,mitophagy,and mitochondrial dynamics in the AD models.Remarkably,intervention with Dengzhan Shengmai(DZSM)capsules emerged as a pivotal element in this investigation.Aβ42-induced synaptic dysfunction was significantly mitigated by DZSM intervention,which notably amplified the frequency and amplitude of synaptic transmission.The cognitive impairment observed in AD rats was ameliorated and accompanied by robust protection against structural damage in key brain regions,including the hippocampal CA3,primary cingular cortex,prelimbic system,and dysgranular insular cortex.DZSM intervention led to increased IDE levels,augmented long-term potential(LTP)amplitude,and enhanced dendritic spine density and length.Moreover,DZSM intervention led to favourable changes in mitochondrial parameters,including ROS expression,MMP and ATP contents,and mitochondrial morphology.In conclusion,our findings delved into the realm of altered synaptic currents,mitophagy,and mitochondrial dynamics in AD,concurrently highlighting the therapeutic potential of DZSM intervention.

"Xuanfu",as the microscopic structure in TCM theory of visceral manifestations,spreads all over the human body.The microscopic pathological changes of acute ulcerative colitis are manifested as cryptic abscesses or even structural disorders of the colon.Its damp heat accumulates in the large intestine,and the pathogenic characteristics of the large intestine coincides with the concept of"Xuanfu"that likes opening and avoiding closing.The functions of the mechanical barrier and mucus barrier in the intestinal crypt are very similar to the characteristics of the"Xuanfu",which can provide morphological basis for the"Xuanfu"theory of the intestine.The method of clearing away and opening the"Xuanfu"can inhibit the"Xuanfu closed"state of the intestine caused by the accumulation of damp and heat,and promote the guiding role and theoretical support of the"Xuanfu-crypt"theory in the treatment of early crypt lesions of ulcerative colitis.

Objective:To analyze the long-term cumulative survival and tumor-free survival of hepatocellular carcinoma (HCC) patients after liver transplantation, as well as the influencing factors.Methods:We conducted a retrospective study on 228 HCC patients receiving liver transplantation from May 1, 2000 to May 1, 2012 at the Department of Hepatobiliary Surgery, Peking University People's Hospital. A total of 166 patients met the recruit criteria. The patients' perioperative data and follow-up data were collected. We analyzed the cumulative survival and tumor-free survival of the recipients, as well as the influencing factors.Results:The 1-, 5- and 10-year cumulative survival of the 166 HCC patients were 80.7%, 52.4% and 45.8%, respectively, while the 1-, 5- and 10-year tumor-free survival of these patients were 60.2%, 47.6% and 44.0%, respectively. Among these patients,a total of 96 recipients met the University of California, San Francisco (UCSF) criteria, whose 1-, 5- and 10-year cumulative survival were 83.3%, 66.7%, and 59.4%, respectively, and tumor-free survival were 74.0%, 62.5% and 57.3%, respectively. Multivariate analysis showed that beyond the UCSF criteria, alpha fetoprotein (AFP) ≥ 400 ng/ml before transplantation and poorly differentiated carcinoma were independent factors affecting cumulative survival and tumor-free survival ( P < 0.05). Conclusions:Liver transplantation is an effective treatment of HCC. Besides the size and the number of the tumors, AFP ≥ 400 ng/ml before transplantation and poorly differentiated tumors are independent factors affecting the long-term cumulative survival and tumor-free survival of HCC patients.

Objective:To analyze the clinical characteristics of PHPT in elderly patients, as well as the safety and effectiveness of surgical treatment.Methods:179 patients with PHPT treated from Jan. 2000 to Dec. 2020 were analyzed retrospectively. They were divided into elderly group ( n=51) and non-elderly group ( n=128) according to whether they were over 60 years old at the time of operation. The clinical data of symptoms, complications, preoperative and postoperative blood calcium, phosphorus, ALP, PTH, surgical cure rate and complication rate of the two groups were analyzed retrospectively. T-test was used for measurement data comparison. χ2 test was used for enumeration data comparison and single factor analysis. Logistic regression analysis (forward method) was used for multivariate analysis. Results:The proportion of non-specific symptoms in the elderly group, including fatigue, dizziness, loss of appetite, memory decline, was higher than that in the non-elderly group (21.6% vs 8.6%, P=0.019) . Elderly patients had lower blood ALP level[ (163.4±229.8) U/L vs (325.9±449.2) U/L, P=0.016], higher proportion of preoperative hypertension (47.1% vs 21.1%, P=0.001) , diabetes (31.4% vs 10.9%, P=0.001) , coronary heart disease (13.7% vs 3.1%, P=0.013) and tumor (13.7% vs 3.9%, P=0.025) . High proportion of non-specific symptoms was related to higher blood calcium [ OR=4.936 (95% CI 1.126-21.637) , P=0.034] and lower blood phosphorus[ OR=0.011 (95% CI 0.000-0.650) , P=0.030]. Between the two groups there was no significant difference in cure rate (94.1% vs 96.1%, P=0.564) or complication rate (27.5% vs 44.5%, P=0.127) . Conclusions:The surgical treatment of elderly patients with PHPT also has high effectiveness and safety. More attention should be paid to surgical diagnosis and treatment of elderly patients.

Objective To measure the specificactivity of natural and synthetic radionuclides in the environmental soil of Panjin, China and determine the content of radionuclides in the surface soil, and to conduct a scientific assessment of the radiation health risks of residents in this area. Methods Thirty-one surface soil samples were collected within the jurisdiction of Panjin, and a high-purity germanium detector was used for γ spectrum analysis to obtain the content of radionuclides and the current environmental radioactivity level. The two independent samples mean t-test was used to compare the specific activity data of radionuclides in soil samples between Panjin and Liaoning Province or China. Results The meanspecific activities of natural radionuclides ²³⁸U, ²²⁶Ra, ²³²Th, ⁴⁰K, and synthetic radionuclide ¹³⁷Cs in the surface soil samples of Panjin were 18.7 Bq/kg, 19.6 Bq/kg, 23.5 Bq/kg, 604.6 Bq/kg, and 0.9 Bq/kg, respectively. Conclusion The specific activities of natural and synthetic radionuclides in the surface soil samples of Panjin Area at the background level, causing a very low health risk to the people in this area.

OBJECTIVE: To compare the therapeutic effect between acupuncture combined with ibuprofen sustained-release capsule and simple ibuprofen sustained-release capsule on chronic pelvic pain (CPP) after pelvic inflammatory disease (PID). METHODS: A total of 144 patients were randomized into an observation group (72 cases, 10 cases dropped off) and a control group (72 cases, 9 cases dropped off). Ibuprofen sustained-release capsule was given orally in the control group, one capsule a time. On the basis of the treatment in the control group, acupuncture was applied at Guanyuan (CV 4), Shuidao (ST 28), Guilai (ST 29), Shenshu (BL 23) and Ciliao (BL 32), and Shuidao (ST 28), Guilai (ST 29), Shenshu (BL 23) and Ciliao (BL 32) were connected to electroacupuncture in the observation group. The treatment was given 10 days before menstruation, once a day for 3 menstrual cycles in both groups, and the follow-up was adopted 3 menstrual cycles after treatment. The visual analogue scale (VAS) scores of hypogastrium and lumbosacral region before treatment, after treatment, and at the follow-up, the score of local signs and the score of World Health Organization quality of life questionnaire-brief version (WHOQOL-BREF) before and after treatment were observed in the both groups. RESULTS: After treatment and at the follow-up, the VAS scores of hypogastrium and lumbosacral region were decreased compared before treatment in both groups ( CONCLUSION Acupuncture combined with ibuprofen sustained-release capsule can effectively improve the symptoms, signs and quality of life in patients with CPP after PID, the therapeutic effect is superior to simple ibuprofen sustained-release capsule.
Acupuncture Points ; Acupuncture Therapy ; Female ; Humans ; Pelvic Inflammatory Disease/etiology* ; Pelvic Pain/etiology* ; Quality of Life ; Treatment Outcome

Objective To investigate the computed tomography(CT)imaging features of IgG4-related kidney disease(IgG4-RKD).Methods The clinicopathological and imaging data of 36 IgG4-RKD patients(including 26 cases of renal parenchyma,10 cases of renal pelvis,24 cases of double kidney or multiple lesions,and 12 cases of single focus)were retrospectively analyzed.Results IgG4-RKD had specific clinicopathological and imaging features.Although the kidney or renal pelvis was involved,there were no common clinical manifestations of malignant tumors such as hydronephrosis and hematuria.The boundary was clear and complete,and it had typical characteristics of continuous progressive enhancement.The peak value was mostly in the solid and excretory phase,and there were no imaging manifestations such as liquefaction,necrosis,cystic degeneration,and calcification.Even if the renal pelvis was obviously involved and the focus was large,there was no invasion of the peripheral renal parenchyma,the shape of the renal pelvis still existed,the wall was smooth,and there was no enlarged peripheral lymph nodes.Conclusions CT images of IgG4-RKD are similar to those of renal malignant tumors.Based on clinicopathological features,CT findings,and blood IgG4-related tests,a definite diagnosis can be made and unnecessary operation can be avoided.
Humans ; Immunoglobulin G ; Immunoglobulin G4-Related Disease/pathology* ; Kidney Neoplasms/pathology* ; Retrospective Studies ; Tomography, X-Ray Computed