Objective:To evaluate the clinical efficacy of Huzhang Polou Decoction combined with acupoint application in the treatment of children with mycoplasma pneumoniae pneumonia (MPP) complicated with atelectasis.Methods:A total of 105 MPP children with atelectasis and phlegm-heat obstructing lung syndrome in our hospital from August 2019 to March 2022, who met the inclusion criteria, were divided into control group (53 cases) and observation group (52 cases), by random number table method. The control group was given azithromycin sequential therapy on the basis of conventional western medicine treatment, and the observation group was given Huzhang Polou Decoction and acupoint application on the basis of the control group. Both groups were treated for 19 days. TCM syndromes were scored before and after treatment. The FEV1 and peak expiratory flow rate (PEF) were measured by pulmonary function measurement instrument. The CRP was measured by immunoturbidimetry and procalcitonin (PCT) was measured by ELISA. The recovery time of fever, disappearance time of cough and sputum, disappearance time of lung rales, lung recruitment time, and adverse reactions during treatment were recorded, and the clinical efficacy was evaluated.Results:The total effective rate was 96.15% (50/52) in the observation group and 84.91% (45/53) in the control group, and the difference between the two groups was statistically significant ( χ2=3.85, P=0.050). After treatment, the TCM syndrome score of the observation group was significantly lower than that of the control group ( t=22.78, P<0.01). FEV1 [(1.87±0.29) L vs. (1.54±0.28) L, t=5.93] and PEF [(79.82±6.29) L/min vs. (74.32±6.30) L/min, t=4.48] were significantly higher than those in the control group ( P<0.01). The levels of serum CRP [(9.18±2.98) mg/L vs. (12.34±3.00) mg/L, t=5.42] and PCT [(0.60±0.15) ng/L vs. (0.96±0.21) ng/L, t=9.93] were significantly lower than those in the control group ( P<0.01). The recovery time of fever, disappearance time of cough and sputum, disappearance time of lung rale and lung recruitment time in the observation group were significantly earlier than those in the control group ( t=7.27, 6.84, 3.76, 5.87, all Ps<0.01). During treatment, the incidence of adverse reactions was 3.77% (2/53) in the control group and 1.92% (1/52) in the observation group, and there was no significant difference between the two groups ( χ2=0.32, P=0.569). Conclusion:The Huzhang Polou Decoction combined with acupoint application can improve the pulmonary function of children with MPP complicated with atelectasis, reduce the level of serum inflammatory cytokines, improve the clinical efficacy safely.

PURPOSE: This study aims to investigate the feasibility of contouring target volume according to residual tumor and decreasing the dose to the tumor regression field after induction chemotherapy (IC) in locoregionally advanced nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS: From August 2009 to August 2013, patients with stage III–IVB NPC were treated with IC and concurrent chemoradiotherapy. Gross tumor volume of nasopharynx (GTVnx)–residual and gross tumor volume of cervical lymph node (GTVnd)–residual were contoured according to post-IC residual primary tumor and any N+ disease, respectively. The tumor regression field was included in CTVnx1/CTVnd1 and prescribed a dose of 60 Gy. Outcomes and toxicities of all patients were evaluated. RESULTS: A total of 57 patients were enrolled. At a median follow-up of 68 months, three cases displayed locoregional recurrence and one case showed both distant metastasis and locoregional recurrence. All locoregional recurrences were in the GTVnx-residual/GTVnd-residual and in-field. The 5-year overall, locoregional relapse-free, distant metastasis-free, and progression-free survival rates were 82.2%, 87.7%, 85.8% and 80.3%, respectively. CONCLUSION: After IC, contouring of GTVnx-residual/GTVnd-residual as residual tumor volume and distribution 60 Gy ofradiation dose to the tumorregression field may be feasible and need further investigation.
Chemoradiotherapy ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Induction Chemotherapy ; Lymph Nodes ; Nasopharynx ; Neoplasm Metastasis ; Neoplasm, Residual ; Radiotherapy, Intensity-Modulated ; Recurrence ; Tumor Burden

Objective? To explore effects of CoughAssist on sputum excretion efficacy among patients with intensive care unit-acquired weakness (ICU-AW). Methods? From January 2016 to December 2017, we selected 84 ICU-AW patients with mechanical ventilation of ICU in Hu'nan Provincial People's Hospital by convenience sampling. All of the patients were divided into control group and observation group with the random number table, 42 cases in each group. Two groups all received routine treatment and nursing. On this basis, observation group carried out CoughAssist therapy. We compared the sputum excretion effects, results of sputum smear/sputum culture, arterial blood gas indexes, respiratory mechanics indexes, the incidence of ventilator-associated pneumonia (VAP), time of mechanical ventilation, hospital days in ICU and the score of Medical Research Council (MRC) of patients between two groups. Results? There were no statistical difference in the volume of sputum excretion of patients in two groups before dividing groups (P＞0.05). One to three days after treatment, the volume of sputum excretion and number of effective sputum excretion patients in observation group were more than those in control group; the positive rate of sputum culture of patients in observation group was lower than that in control group; the differences were all statistical (P＜ 0.05). The partial pressure of oxygen (PaO2) of observation group was higher than that of control group; the partial pressure of carbon dioxide (PaCO2) of observation group was lower than that of control group; the differences were all statistical (P＜0.05). The pressure support/pressure control (PS/PC) and airway resistance of observation group were lower than those of control group;and the compliance and cough peak flow (PCF) were higher than those of control group with statistical differences (P＜ 0.01). The incidence of VAP, time of mechanical ventilation and hospital days in ICU of observation group were lower than those of control group (P＜0.05). There was no statistical difference in the scores of MRC between two groups (P＞0.05). Conclusions? The application of CoughAssist in ICU-AW patients with mechanical ventilation can improve the sputum excretion effects as well as respiratory function and shorten the time of mechanical ventilation and hospital days in ICU, and improve the clinical effects.

Objective:To provide scentific evidence for determining the harvest period of Cortex Abizziae by studying the dynamic variation of the content of lignan glycoside I in Cortex Abizziae.Methods:Chromatography was performed on a Boston Green ODS C18 (250 mm×4.6 mm,5 μm) column,the mobile phase was acetonitrile-0.04% phosphate (18∶82),the flow rate was 1.0 ml·min-1,the detection wavelength was 204 nm,and the column temperature was at 25℃.Results:There were differences in the contents of lignan glycoside I in Cortex Abizziae at different harvest periods.The content of lignan glycoside I reached the highest level in January,decreased quickly from January to March,and gradually increased from April to December.Conclusion:The content of lignan glycoside I in Cortex Abizziae at different harvest periods is different,and the optimum harvest time of Cortex Abizziae is determined from November to January of the following year.

Objective To investigated the protective ways of intensity modulated radiotherapy (IMRT)for submandibular gland function in patients with nasopharyngeal carcinoma.Methods From March 2010 to November 2012,101 patients with nasopharyngeal carcinoma were enrolled into study.They were treated with IMRT and evaluated by face to face dry mouth questionnaire during the follow-up of 3,6,12,18,24 and more than 24 months,meanwhile,their dose volume histogram of submandibular gland were taken into consideration.Results The average contralateral median dose and that of ipsilateral submandibular gland were (45.69±7.22) Gy and (51.64±8.20) Gy,respectively,and the V35,V40,V45,V50 were 95.82 ％,69.99 ％,46.90 ％,25.50 ％,and 100 ％,96.50 ％,82.24 ％,60.98 ％,respectively.There were positive relationship between the xerostomia grading of 3,6,and 12 months after radiotherapy and the average dose of submandibular gland or the V35,V40,V45,V50.After 6 month,the xerostomia in 77.2 ％ (78/101) was significantly improved,and after 12 months,less than 5 ％ of patient complained about G3 or more grade of xerostomia.Conclusions When using IMRT in nasopharyngeal carcinoma,it' s necessary to reduce the irradiated volume and the dose of submandibular gland.It is confined that the median dose of contralateral submandibular gland should be less than 40-45 Gy,and V40 or V45 ≤66.7 ％ or ≤50 ％,which can effectively protect the function of salivary gland.

Objective To explore the value of gemstone spectral imaging (GSI) in the detection and differential diagnosis of benign and malignant thyroid nodules.Methods The spectral CT images in 88 patients with thyroid nodules were analyzed retrospectively.All the patients underwent spectral CT scanning,including 33 patients undergoing biphase enhanced CT imaging.Nodules were divided into benign and malignant ones according to histopathologic results.The iodine concentration,slope of spectral curve,effective atomic number in non-enhanced and enhanced scanning were compared between benign and malignant group by the Wilcoxon rank sum test,respectively.The optimal iodine concentration threshold to predict malignancy was obtained by receiver operating characteristic curve (ROC),sensitivity and specificity were achieved.Results A total of 106 nodules were detected,including 76 benign and 30 malignant nodules.In non-contrast CT imaging,the average iodine concentration,slope of spectral curve,effective atomic number of were 2.35 × 100 μg/ml,0.29 and 7.71 for benign group:-0.51 × 100 μg/ml,-0.06 and 7.52 for malignant group (Z value were-3.072,-3.107 and-3.055,respectively ; P ＜ 0.05).In the arterial phase,the average iodine concentration,slope of spectral curve,effective atomic number of the two group were 27.22 × 100 μg/ml,3.23 and 9.10 for benign group; 18.81 × 100 μg/ml,2.24 and 8.69 for malignant group (Z value were-2.582,-2.582 and-2.564,respectively; P ＜ 0.05).In venous phase,no significant difference was found for each parameter between the two groups (P ＞ 0.05).The optimal iodine concentration to predict malignancy was-0.35 × 100 μg/ml in non-enhanced phase with 56.7％ sensitivity and 73.7％ specificity.The optimal iodine concentration was 22.91 × 100 μg/ml in arterial phase,with 76.2％ sensitivity and 75.0％ specificity.Using iodine concentration to predict malignancy in both noncontrast phase and arterial phase,the sensitivity and specificity were 81.2％ and 73.3％,while the accuracy was 81.6％.Conclusion Gemstone spectral CT imaging can quantitatively evaluate the iodine content of thyroid nodules,having a potential value in differential diagnosis of thyroid nodules.

Objective:To investigate the protective effect of intensity-modulated radiotherapy (IMRT) on salivary gland function in nasopharyngeal carcinoma (NPC) patients. Methods:In total, 101 NPC patients who were admitted from March 2010 to November 2012 were enrolled in this study. The parotid gland, the submandibular gland, and the oral cavity were sketched as the organs at risk (OARs). The patients were treated with IMRT and were evaluated through a face-to-face interview using a dry mouth assessment ques-tionnaire during the follow-up visits at 3, 6, 12, 18, and 24 months. The dose volume histogram of the salivary gland of the patients was also considered. Results:The mean doses (MDs) in the parotid gland were 37.4 and 33.8 Gy in the affected and uninjured sides, respec-tively. Meanwhile, the MDs in the submandibular glands were 51.6 and 45.7 Gy in the affected and uninjured sides, respectively. The MD of the oral cavity was 38.2 Gy. At 6 months after the treatment, the symptom of xerostomia was significantly improved in 77.2%of the patients (78/101). One year later, only less than 5%of the patients complained of having G3 or higher-grade xerostomia. Conclu-sion:With time, xerostomia significantly improved after the radiotherapy. At least one of the V30 to V35 of the parotid gland was≤50.0%, whereas at least one of the V40 to V45 of the submandibular glands was≤66.7%~50.0%. The MD for the oral cavity should be<40 Gy to effectively protect salivary gland function.

Gastrointestinal duplication cyst is a rare congenital disease which can occur in any part of the digestive tract between the root of tongue and the anus,and it is commonly seen in the ileum.About 45％ of the gastrointestinal duplication cyst occurs in the ileocecus and the epityphlon.Multiple gastric duplication cyst is a rare type of the gastrointestinal duplication cyst,which accounted for 3.8％-5.0％.Gastric duplication cyst mostly occurs in the greater curvature of the stomach,and it connects with the stomach wall.Multiple gastric duplication cysts in the mediastina is rarely seen.In this article,the imaging presentations of 1 patient with multiple gastric duplication cysts inside the mediastina were analyzed.

ObjectiveTo evaluate the feasibility of determining the chemical composition of kidney stones using gemstone spectral imaging ( GSI ).Methods One hundred and sixty eight extracted human kidney stones immersed in a 10 cm deep water tank underwent CT (Discovery CT750 HD) scans with GSI mode and conventional polychromatic imaging ( CPI,120 kVp) mode.All GSI data were transferred to Workstation AW 4.4 to acquire monochromatic images of 50 keY,effective atomic number (Zeff) mapping images,water (calcium)-based images and calcium (Water)-based images with GSI Viewer.CT numbers of stones were measured and compared at 50 keV monochromatic images and 120 kVp polychromatic images,the mean Zeff,calcium density and water density were measured at Zeff mapping images,Calcium (Water) -based images and Water (Calcium)-based images,respectively.The mean Zeff,spectral HU curve slope and calcium water ratio (CWR) were compared with ANOVA and Wilcoxon test.The composition of kidney stones was determined by infrared spectrometer after CT examination.According to the result of stone composition determined by infrared spectroscopy,108 pure kidney stones were divided into five groups:Uric acid stones ( UA,n = 13 ),struvite stones ( STR,n = 24),cystine stones ( CYS,n = 14),calcium phosphate stones ( CaP,n = 18),and calcium oxalate stones ( COX,n = 39).ResultsThe mean Zeff,CWR,the mean CT numbers at 50 keV images,120 kVp images and spectral HU curve slope of each group were listed as the following:UA [ 7.4 ± 0.4,0.0085 ± 0.0021,( 503 ± 168 ) HU,(495 ± 106 ) HU and - 0.77 ] ; STR [ 11.8 ± 0.9,0.1743 ± 0.0677,( 1056 ± 290 ) HU,( 799 ± 165 ) HU and 18.72 ] ; CYS [ 11.2 ± 0.6,0.1253 ± 0.0297,( 740 ± 172 ) HU,( 565 ± 129 ) HU and 12.79 ] ; CaP [ 16.0 ± 0.4,0.6781 ± 0.0952,( 2567 ±178 ) HU,( 1602 ± 200 ) HU and 37.14 ] ; COX [ 15.4 ± 0.4,0.5683 ± 0.0759,( 2267 ± 385 ) HU,( 1489 ±284) HU and 36.36 ],there were significant differences among groups ( P ＜ 0.01 ).The differences in the mean Zeff,CRW,spectral HU curve slope were statistically significant among the five groups ( P ＜ 0.05 ).Conclusion Spectral CT imaging provides a new method to characterize the kidney stones with the information orovided by mean Zeff,CRW and the CT numbers at 50 keV.

Objective To investigate the effect of soluble Tie2 fusion protein(sTie2/Fc)on the angiogenesis of peritoneal vessels in uremic peritoneal dialysis (PD) rats.Methods Rats were randomly divided into 6 groups:normal rats as control group (group1),rats with sham operation (group2),uremic rats without PD (group3),uremic rats dialyzed with 4:25％ PD solution (group4),uremic rats dialyzed with 4.25％ PD solution and treated by subcutaneous injection of 2.5 μg/kg sTie2/Fc (group5),uremic rats dialyzed with 4.25％ PD solution and treated by subcutaneous injection of 5.0 μg/kg sTie2/Fc (group6).sTie2/Fc was given every other day during peritoneal dialysis period,total 14 doses.After regular PD for 28 days,RT-PCR and tissue immunohistochemical staining were used to detect the mRNA and protein expressions of Angpt-2 in peritoneal tissues in each group of rats.Microvessel density (MVD) of peritoneum was detected and quantified with immunohistochemical staining by using anti-CD34 antibody.Results The expression of Angpt-2 mRNA and protein was found in each group.There was no significant difference of.Angpt-2 expression both in mRNA and protein level between group1 and group2.Compared with group1,the mRNA and protein expression of Angpt-2 were significantly increased in group3 and group4 (all P＜0.05).Compared with group3,the mRNA and protein expression of Angpt-2 were significantly increased in group4 (all P＜0.05).Compared with group 4,the mRNA and protein expression of Angpt-2 were significantly decreased in group5 and group6 (all P＜0.05).Compared with group5,the mRNA and protein expression of Angpt-2 were significantly decreased in group6 (all P＜0.05).Only few new microvessel was found in group1 and group2.Compared with group1,MVD was significantly up-regulated in group3 and group4 (all P＜0.05).Compared with group4,MVD was significantly down-regulated in group5 and group6 (all P＜0.05).Conclusions Peritoneum neoangiogensis can be effectively inhibited by sTie2/Fc in uremic rat treated with PD.Blocking of signal transduction may be involved in the mechanism of sTie2/Fc inhibiting peritoneal angiogenesis.