Objective To explore the application of multi-slice CT angiography(MSCTA)in the diagnosis of cerebral aneurysm(CA),and to analyze its imaging characteristics.Methods A total of 180 patients with suspected CA in the First Affiliated Hospital of Nanjing Medical University were enrolled,and all these patients underwent digital subtraction angiography(DSA)and MSCTA.Taking DSA results as the golden standard,the consistency of MSCTA in the diagnosis of CA was evaluated.The diagnostic coincidence rate of CA distribution,the maximum diameter of tumors and maximum width of tumor neck by the two methods were compared.Results In the 180 patients with suspected CA,DSA showed that there were 174 confirmed cases,including 240 aneurysms,while MSCTA showed that there were 168 confirmed cases,including 207 aneurysms.Taking DSA results as the golden standard,the sensitivity,specificity,accuracy and Kappa value of MSCTA in the diagnosis of CA were 96.55%,100%,96.67%and 0.651 respectively,showing good diagnostic consistency.The diagnostic coincidence rates of CA distributed in the internal carotid artery,vertebrobasilar artery,middle cerebral artery,clinoid process of internal carotid artery,cavernous sinus segment of internal carotid artery,anterior communicating artery and posterior communicating artery diagnosed by MSCTA were 81.82%,83.33%,85.71%,87.50%,86.67%,90.00%and 90.00%,and the overall diagnostic coincidence rate was 86.25%.There was no significant difference in the maximum diameter of tumors or maximum width of tumor neck between MSCTA and DSA(P>0.05).Conclusion The diagnostic value of MSCTA for CA is good,whihc has high diagnostic consistency with DSA and can be widely used in clinic.

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Objective To explore the application of multi-slice CT angiography(MSCTA)in the diagnosis of cerebral aneurysm(CA),and to analyze its imaging characteristics.Methods A total of 180 patients with suspected CA in the First Affiliated Hospital of Nanjing Medical University were enrolled,and all these patients underwent digital subtraction angiography(DSA)and MSCTA.Taking DSA results as the golden standard,the consistency of MSCTA in the diagnosis of CA was evaluated.The diagnostic coincidence rate of CA distribution,the maximum diameter of tumors and maximum width of tumor neck by the two methods were compared.Results In the 180 patients with suspected CA,DSA showed that there were 174 confirmed cases,including 240 aneurysms,while MSCTA showed that there were 168 confirmed cases,including 207 aneurysms.Taking DSA results as the golden standard,the sensitivity,specificity,accuracy and Kappa value of MSCTA in the diagnosis of CA were 96.55%,100%,96.67%and 0.651 respectively,showing good diagnostic consistency.The diagnostic coincidence rates of CA distributed in the internal carotid artery,vertebrobasilar artery,middle cerebral artery,clinoid process of internal carotid artery,cavernous sinus segment of internal carotid artery,anterior communicating artery and posterior communicating artery diagnosed by MSCTA were 81.82%,83.33%,85.71%,87.50%,86.67%,90.00%and 90.00%,and the overall diagnostic coincidence rate was 86.25%.There was no significant difference in the maximum diameter of tumors or maximum width of tumor neck between MSCTA and DSA(P>0.05).Conclusion The diagnostic value of MSCTA for CA is good,whihc has high diagnostic consistency with DSA and can be widely used in clinic.

Objective To investigate the causes of abnormal decrease in maximum amplitude(MA)of thromboelastog-raphy(TEG)and its effect on prognosis by monitoring the changes of coagulation-related indexes in emergency trauma pa-tients.Methods A total of 319 cases of trauma patients admitted to our hospital from September 2020 to September 2023 were retrospectively analyzed,and the coagulation-related indexes of 0 h and 24 h after admission were observed.According to the MA results,they were divided into normal MA group(>50 mm)and reduced MA group(≤50 mm)to compare the hemoglobin(Hb),platelets count(Plt),activated partial thromboplastin time(APTT),prothrombin time(PT),fibrinogen(Fib),thrombin time(TT),D-dimer(D-D),coagulation reaction time(R),clot formation kinetics(Angle),30 min clot dissolution rate(Ly30),MA,thrombine-antithrombin complex(TAT)and plasminase-α2 plasminase inhibitor complex(PIC).The correlation between MA and fibrinolysis indexes in 319 trauma patients was analyzed.According to whether tranexamic acid(TXA)was used,the reduced MA group was divided into a TXA group and a non-drug group.The differ-ences in the change of the above coagulation-related indexes,mortality rate and changes in blood product dosage were com-pared between the two groups.Results Compared with the normal MA group,Hb,Plt,Fib,diastolic blood pressure and GCS scores decreased,while heart rate,ISS score and mortality increased significantly in the reduced MA group(P<0.05).The R,PT and TT were prolonged significantly(P<0.05),and PIC and D-D increased significantly(P<0.05)in the re-duced MA group.Correlation analysis found that MA had no correlation with Ly30,TAT and APTT,but was correlated with Angle(r=0.803),Plt(r=0.544),Fib(r=0.581),PIC(r=-0.443)and D-D(r=-0.343).Compared with the non-drug group,the change of Angle,MA and FIB in the TXA group increased significantly(P<0.05),while the change of PIC de-creased(P<0.05).Cryoprecipitate and platelet transfusion in the TXA group reduced significantly(P<0.05),and red blood cell transfusion had a decreasing trend,but the difference was not significant(P>0.05).The mortality rate in the TXA group was reduced significantly(P<0.05).Conclusion Hyperfibrinolysis may be an important factor in the abnormal decrease of MA in emergency trauma patients.Treatment with TXA can improve its effect on MA,and reduce the transfusion of blood products and the patient mortality.

This study was aimed at investigating the distribution of Bartonella in rodents,and analyzing the prevalence of the virus in Inner Mongolia.Rodent liver,spleen,and kidney tissue samples were collected from Hohhot,Baotou,Chifeng,Tongliao,Ordos,Bayannur,Ulanqab,Xingan League,Xilin Gol League,and Hulun Buir in the Inner Mongolia Autonomous Region from 2022 to 2023.Bartonella pathogens were detected with TaqMan probe fluorescence quantitative PCR(qPCR).The samples that tested positive by qPCR were amplified by PCR;those with positive results were sequenced,and genetic evo-lution analysis was performed.A total of 799 rodents were captured,including 271 mice(33.92％,271/799),188 Rattus nor-vegicus(23.53％,188/799),and 188 long-claw gerbils(23.53％,188/799).Tissue test results indicated 49 qPCR positive samples,with a positivity rate of 6.13％(49/799),29 of which subsequently had positive PCR findings.Sequence analysis and genetic evolution analysis indicated detection of four Bartonella species,B.Krasnovii(55.17％,16/29),unnamed Bartonella(34.48％,10/29),B.ribocorum(6.90％,2/29),and B.rochalimae(3.45％,1/29),in rodents from Inner Mongolia.Bar-tonella infection in rodents was widespread in many cities of Inner Mongolia,and showed genotype and host diversity.The surveil-lance of pathogens carried by rodents should be strengthened,and the prevention and control of rodent borne diseases should be opti-mized to decrease the risk of human infection.

This study was aimed at investigating the distribution of Bartonella in rodents,and analyzing the prevalence of the virus in Inner Mongolia.Rodent liver,spleen,and kidney tissue samples were collected from Hohhot,Baotou,Chifeng,Tongliao,Ordos,Bayannur,Ulanqab,Xingan League,Xilin Gol League,and Hulun Buir in the Inner Mongolia Autonomous Region from 2022 to 2023.Bartonella pathogens were detected with TaqMan probe fluorescence quantitative PCR(qPCR).The samples that tested positive by qPCR were amplified by PCR;those with positive results were sequenced,and genetic evo-lution analysis was performed.A total of 799 rodents were captured,including 271 mice(33.92％,271/799),188 Rattus nor-vegicus(23.53％,188/799),and 188 long-claw gerbils(23.53％,188/799).Tissue test results indicated 49 qPCR positive samples,with a positivity rate of 6.13％(49/799),29 of which subsequently had positive PCR findings.Sequence analysis and genetic evolution analysis indicated detection of four Bartonella species,B.Krasnovii(55.17％,16/29),unnamed Bartonella(34.48％,10/29),B.ribocorum(6.90％,2/29),and B.rochalimae(3.45％,1/29),in rodents from Inner Mongolia.Bar-tonella infection in rodents was widespread in many cities of Inner Mongolia,and showed genotype and host diversity.The surveil-lance of pathogens carried by rodents should be strengthened,and the prevention and control of rodent borne diseases should be opti-mized to decrease the risk of human infection.

OBJECTIVE: To observe the impacts of acupuncture on depressive mood and sleep quality in patients with comorbid mild-to-moderate depressive disorder and insomnia, and explore its effect mechanism. METHODS: A total of 60 patients with comorbid mild-to-moderate depressive disorder and insomnia were randomly divided into an observation group (30 cases, 1 case dropped off) and a control group (30 cases, 2 cases dropped off). In the observation group, acupuncture and low frequency repeated transcranial magnetic stimulation (rTMS) were combined for the intervention. Acupuncture was applied to Baihui (GV 20), Yintang (GV 24⁺), Neiguan (PC 6) and Yanglingquan (GB 34), etc., the needles were retained for 30 min; and the intradermal needles were embedded at Xinshu (BL 15) and Danshu (BL 19) for 2 days. After acupuncture, the rTMS was delivered at the right dorsolateral prefrontal cortex (R-DLPFC), with 1 Hz and 80% of movement threshold, lasting 30 min in each treatment. In the control group, the sham-acupuncture was adopted, combined with low frequency rTMS. The acupoint selection and manipulation were the same as the observation group. In the two groups, acupuncture was given once every two days, 3 times weekly; while, rTMS was operated once daily, for consecutive 5 days a week. The duration of treatment consisted of 4 weeks. Hamilton depression scale-17 (HAMD-17) and Pittsburgh sleep quality index (PSQI) scores were observed before and after treatment, as well as 1 month after the treatment completion (follow-up period) separately. Besides, the levels of nerve growth factor (BDNF) and γ-aminobutyric acid (GABA) in the serum were detected before and after treatment in the two groups. RESULTS: After treatment and in follow-up, the HAMD-17 scores were lower than those before treatment in the two groups (P<0.05), and the scores in the observation group were lower than the control group (P<0.05). After treatment, the total scores and the scores of each factor of PSQI were reduced in the two groups in comparison with those before treatment except for the score of sleep efficiency in the control group (P<0.05); the total PSQI score and the scores for sleep quality, sleep latency, sleep efficiency and daytime dysfunction in the observation group were all lower than those in the control group (P<0.05). In the follow-up, except for the scores of sleep duration and sleep efficiency in the control group, the total PSQI score and the scores of all the other factors were reduced compared with those before treatment in the two groups (P<0.05); the total PSQI score and the scores of sleep quality, sleep latency, sleep duration, sleep efficiency and daytime dysfunction in the observation group were lower than the control group (P<0.05). After treatment, the levels of serum BDNF and GABA were increased in comparison with those before treatment in the observation group (P<0.05), and the level of serum BDNF was higher than that in the control group (P<0.05). CONCLUSION Acupuncture relieves depressive mood and improves sleep quality in patients with comorbid mild-to-moderate depressive disorder and insomnia. The effect mechanism may be related to the regulation of BDNF and GABA levels and the promotion of brain neurological function recovery.
Humans ; Sleep Initiation and Maintenance Disorders/therapy* ; Transcranial Magnetic Stimulation ; Brain-Derived Neurotrophic Factor ; Treatment Outcome ; Acupuncture Therapy ; Acupuncture Points ; gamma-Aminobutyric Acid ; Depressive Disorder

This paper reported 3 cases of poisoning caused by chlorfenagyr. Chlorfenapyr poisoning has gradually increased in clinical practice. The early stage after poisoning is digestive tract symptoms, followed by sweating, high fever, changes in consciousness, changes in myocardial enzymology, etc. Its main mechanism of intoxication is uncoupling oxidative phosphorylation. Since there is no specific antidote after poisoning, the fatality rate of chlorfenapyr poisoning remains high. The therapeutic measures are early gastrointestinal decontamination, symptomatic and supportive treatments, and early blood purification may be an effective treatment.
Humans ; Pyrethrins ; Gastrointestinal Tract ; Insecticides ; Poisoning/diagnosis*

Aim To investigate the antibacterial activity and anti-resistant mutation ability of Qiguiyin decoction (a traditional Chinese herbal formula) combined with levofloxacin against pseudomonas aeruginosa byantibacterial experiment in vitro and serum pharmacology. Methods The minimal inhibitory concentrations (MICs) of levofloxacin and Qiguiyin decoction were detected respectively by the broth dilution technique.The MIC of the combination of two drugs was determined by the micro chessboard dilution method. The effects of combined drugs on enhancing the antibacterial activity of different strains were evaluated respectively by calculating the fractional inhibitory concentration index (FICI). The drug-containing serum of levofloxa-cin group, Qiguiyin decoction group, Qiguiyin decoction combined with levofloxacin group and control group was prepared. The antibacterial rate, MIC and MBC of 10% ~ 90% serum against the two strains were determined. Results Combined with Qiguiyin decoction, MIC of levofloxacin against pseudomonas aeruginosa (standard/resistant) decreased significantly, 0. 5 < FICI ^ 1. With the increase of the proportion of serum, the inhibitory rate of 10% ~ 90% drug-containing serum to pseudomonas aeruginosa (standard/resistant) increased gradually.compared with the control group, the inhibitory effect of the Qiguiyin group on bacteria was significantly enhanced. The MIC

This study explores the effects of enhancing the definitive hematopoiesis(DH)signals during the differentiation of human embryonic stem cells(hESCs)into hematopoietic stem/progenitor cells on the generation efficiency and effector function of natural killer(NK)cells generated from hESCs(also known as hESC-NK cells).The hESC(H1)were transformed into embryoid bodies(Ebs)by centrifugation,and during the induction of K562,were used to analyze the efficiency of hematopoietic differentiation,the efficiency of NK cell generation from hESC,the in vitro effector functions,and the expression of effector function related surface receptors.Compared to the control group,the DH group had a significant increase in the number of arterial hematopoietic endothelial cells(CD34+DLL4+)and a significant decrease in primitive hematopoietic related cells(CD34-CD43+)on day 8 of hematopoietic differentiation(P<0.05).On day 28 of NK cell differentiation,the DH group demonstrated a significant increase in the number of NK cells(CD45+CD56+),while a slight increase in the expression of effector function-related molecules such as IFN-γ,Granzyme B,Perforin and CD107a without statistical significance.Furthermore,the activation receptors CD16a and CD69 were significantly increased,NKP46 was significantly decreased,the inhibitory receptor NKG2A was significantly increased,while CD96 was significantly decreased on hESC-NK cells of DH groups(P<0.05).Conclusively,enhancing the signals for definitive hematopoiesis during hESC differentiation into hematopoietic stem/progenitor cells significantly improves the yield of NK cells and the expression of CD16a without affecting their in vitro effector functions.Our study provides a new approach to improving the efficiency of hESC-NK cell or iPSC-NK cell generation.