Objective To observe the value of immediate CT-guided small negative pressure thoracic drainage for pneumothorax after percutaneous lung biopsy(PTLB).Methods Totally 172 patients of unilateral pneumothorax after PTLB were retrospectively enrolled,including 83 patients underwent immediate CT-guided small negative pressure(about 30 mmHg)thoracic drainage after PTLB(group A)and 89 patients underwent bedside closed thoracic drainage after PTLB(group B).Clinical data before treamtent,degree of pneumothorax,the duration of catheterization,pain degree during catheterization(visual analogue scale[VAS]),blood oxygen saturation after treatment,the ratio of immediate relief of clinical symptoms,duration of drainage retention,duration of hospitalization after treatment and the occurrence of pleural reaction were compared between groups.Results Drainage went smoothly in both groups.No significant difference of clinical data before treatment nor pneumothorax degree was found between groups(all P＞0.05).Compared with those in group B,the duration of catheterization was shorter,and pain degree was lower during drainage in group A(both P＜0.001).After drainage,blood oxygen saturation and the proportion of immediate relief of clinical symptoms in group A were both higher than those in group B,while the duration of drainage retention and hospitalization were both shorter in group A than those in group B(all P＜0.001).Pleural reaction occurred in 2 patients in group A and 1 patient in group B,and no significant difference of pleural reaction was detected between groups(P=0.520).Conclusion Immediate CT-guided small negative pressure thoracic drainage was effective and safe for pneumothorax after PTLB.

Objective To investigate the correlation between the combined assessment of preoperative 5-factor modified frailty index(mFI-5)and Naples prognostic score(NPS)with overall survival in patients with unresectable hepatocellular carcinoma(uHCC)following interventional therapy.Methods A retrospective cohort study enrolled 292 patients with uHCC who underwent interventional therapy at the Department of Hepatobiliary Pancreatic Surgery of the Second Affiliated Hospital in Army Medical University from October 2017 to December 2021.Patients were stratified into high-risk and low-risk groups based on mFI-5(≥1),NPS(≥3),and CONUT(≥4)scores.Propensity score matching(PSM)was performed to balance baseline characteristics(post-matching n=186).The primary endpoint was overall survival(OS),analyzed using Kaplan-Meier curves with log-rank tests.The predictive performance of combined indicators was evaluated by receiver operating characteristic(ROC)curves,and prognostic factors were assessed via Cox regression analysis.Results After PSM,baseline characteristics(including age,tumor markers,and treatment-related parameters)showed no significant differences between the two groups.Survival analysis demonstrated a 2.252-fold higher risk of death in the mFI-5 plus NPS high-risk group(95%CI:1.60～3.18,P<0.001).The combination of mFI-5 and NPS scores yielded an area under curve(AUC)of 0.718 for predicting 3-year overall survival,significantly outperforming either index alone(P=0.007).Multivariable Cox regression analysis identified that dual positivity for mFI-5 and NPS(HR=1.46;95%CI:1.01～2.11,P=0.044),portal vein tumor thrombosis(HR=1.49;95%CI:1.03～2.16,P=0.035),tumor diameter>5 cm(HR=2.01;95%CI:1.27～3.17,P=0.003),Barcelona clinic liver cancer(BCLC)stage C disease(HR=2.05;95%CI:1.37～3.07,P<0.001)were independent predictors of poor prognosis.Postoperative combination targeted therapy and immunotherapy was associated with significantly reduced mortality risk(HR=0.57;95%CI:0.39～0.81,P=0.002).Conclusion The combination of mFI-5 and NPS scores is significantly associated with overall survival in patients with unresectable hepatocellular carcinoma(uHCC)undergoing locoregional therapy,providing a validated tool for clinical risk stratification and personalized treatment planning.

Objective To observe the value of immediate CT-guided small negative pressure thoracic drainage for pneumothorax after percutaneous lung biopsy(PTLB).Methods Totally 172 patients of unilateral pneumothorax after PTLB were retrospectively enrolled,including 83 patients underwent immediate CT-guided small negative pressure(about 30 mmHg)thoracic drainage after PTLB(group A)and 89 patients underwent bedside closed thoracic drainage after PTLB(group B).Clinical data before treamtent,degree of pneumothorax,the duration of catheterization,pain degree during catheterization(visual analogue scale[VAS]),blood oxygen saturation after treatment,the ratio of immediate relief of clinical symptoms,duration of drainage retention,duration of hospitalization after treatment and the occurrence of pleural reaction were compared between groups.Results Drainage went smoothly in both groups.No significant difference of clinical data before treatment nor pneumothorax degree was found between groups(all P＞0.05).Compared with those in group B,the duration of catheterization was shorter,and pain degree was lower during drainage in group A(both P＜0.001).After drainage,blood oxygen saturation and the proportion of immediate relief of clinical symptoms in group A were both higher than those in group B,while the duration of drainage retention and hospitalization were both shorter in group A than those in group B(all P＜0.001).Pleural reaction occurred in 2 patients in group A and 1 patient in group B,and no significant difference of pleural reaction was detected between groups(P=0.520).Conclusion Immediate CT-guided small negative pressure thoracic drainage was effective and safe for pneumothorax after PTLB.

Following the principles of evidence-based medicine,in accordance with the structure and drafting rules of standardized documents,based on literature research,according to the characteristics of chronic cough in children and issues that need to form a consensus,the TCM Guidelines for Diagnosis and Treatment of Chronic Cough in Children was formulated based on the Delphi method,expert discussion meetings,and public solicitation of opinions.The guideline includes scope of application,terms and definitions,eti-ology and diagnosis,auxiliary examination,treatment,prevention and care.The aim is to clarify the optimal treatment plan of Chinese medicine in the diagnosis and treatment of this disease,and to provide guidance for improving the clinical diagnosis and treatment of chronic cough in children with Chinese medicine.

Cardiomyopathy, Dilated/metabolism* ; Humans ; Microfilament Proteins/metabolism* ; Models, Cardiovascular ; Mutation ; Myocytes, Cardiac ; Pluripotent Stem Cells/metabolism* ; Transcription Factors/metabolism* ; Troponin T/metabolism*

Objective:To investigate the predicting value of cardiac serum troponin I (cTnI) levels for the clinical outcome of patients with aneurismal subarachnoid hemorrhage (aSAH) after endovascular coil embolization.Methods:Patients with aSAH treated with endovascular coil embolization in the Department of Neurology, Fujian Provincial Hospital from January 2017 to December 2019 were enrolled retrospectively. The baseline data, clinical grade, serum cTnI and N-terminal-pro B-type natriuretic peptide (NT-proBNP) levels, electrocardiogram, aneurysm characteristics, endovascular treatment status, and complications of the patents were collected. The outcomes were evaluated by the modified Rankin Scale (mRS) at 90 d after onset. Poor outcome was defined as >2 points. Multivariate logistic regression analysis was used to identify the independent risk factors for poor outcomes. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of serum cTnI levels for poor outcomes. Results:A total of 316 patients were enrolled, among them, 256 had good outcomes (81.01%), 60 had poor outcomes (18.99%) and 13 died (4.11%). Forty-seven patients (14.87%) had elevated serum cTnI levels. The proportion of patients with elevated serum cTnI levels in the poor outcome group was significantly higher than that in the good outcome group (45% vs. 7.81%; P<0.001). Compared with the good outcome group, the Glasgow Coma Scale score of the poor outcome group was lower, and the Hunt-Hess grades and Fisher grades were higher ( P<0.001). The proportion of patients with elevated NT-proBNP levels and abnormal electrocardiogram in the poor outcome group (all P<0.001) were also significantly higher than those in the good outcome group. The proportion of receiving stent-assisted coil embolization, cerebrospinal fluid replacement and ventricular drainage, as well as the incidence of complicated with cerebral infarction, hydrocephalus, seizure and rebleeding in the poor outcome group were significantly higher than those in the good outcome group (all P<0.01). Multivariate logistic regression analysis showed that after adjusting for other confounding factors, Hunt-Hess grading 3-5 (odds ratio [ OR] 6.615, 95% confidence interval [ CI]2.158-20.278; P=0.001), Fisher grading 3-4 ( OR 3.719, 95% CI 1.479-9.352; P=0.005), cerebral infarction ( OR 15.814, 95% CI 4.978-50.235; P<0.001), rebleeding ( OR 13.324, 95% CI 2.092-84.881, P=0.006) and elevated serum cTnI levels ( OR 3.874, 95% CI 1.406-10.672; P=0.009) were significantly and independently associated with the poor outcomes, which could independently predict the poor outcomes after the onset of aSAH at 90 d. The area under the ROC curve for serum cTnI levels predicting poor outcomes was 0.747 (95% CI 0.666-0.828; P<0.001). The best cut-off value was 0.025 μg/L, the sensitivity and specificity were 60.0% and 87.9%, respectively. Conclusion:The elevated serum cTnI levels have certain predictive value for the poor outcomes of patients with aSAH after endovascular coil embolization.

Rift Valley fever (RVF) is an acute, febrile zoonotic disease that is caused by the RVF virus (RVFV). RVF is mainly prevalent on the Arabian Peninsula, the African continent, and several islands in the Indian Ocean near southeast Africa. RVFV has been classified by the World Organisation for Animal Health (OIE) as a category A pathogen. To avoid biological safety concerns associated with use of the pathogen in RVFV neutralization assays, the present study investigated and established an RVFV pseudovirus-based neutralization assay. This study used the human immunodeficiency virus (HIV) lentiviral packaging system and RVFV structural proteins to successfully construct RVFV pseudoviruses. Electron microscopy observation and western blotting indicated that the size, structure, and shape of the packaged pseudoviruses were notably similar to those of HIV lentiviral vectors. Infection inhibition assay results showed that an antibody against RVFV inhibited the infective ability of the RVFV pseudoviruses, and an antibody neutralization assay for RVFV detection was then established. This study has successfully established a neutralization assay based on RVFV pseudoviruses and demonstrated that this method can be used to effectively evaluate antibody neutralization.
Africa ; Animals ; Blotting, Western ; HIV ; Indian Ocean ; Islands ; Methods ; Microscopy, Electron ; Product Packaging ; Rift Valley fever virus ; Rift Valley Fever ; Zoonoses

Objective To investigate the correlation between the location of ruptured intracranial vertebral artery dissecting aneurysm (VADA)and the outcome after endovascular treatment. Methods Thirty-six patients with ruptured intracranial VADA undergoing endovascular treatment were enrolled retrospectively. According to the relationship between VADA and the location of the opening of posterior inferior cerebellar artery(PICA),they were divided into 3 groups:proximal to PICA group (n=13), distal to PICA group (n=13),and PICA involvement group (n=10). The demographic data, vascular risk factors, clinical features, imaging features, endovascular treatment mode, postoperative complications, and differece of the good outcome rate(defined as the modified Rankin scale 0-2)after 6 months of treatment were compared.Results Seven patients in the proximal to PICA group received reconstructive endovascular treatment (RET), and 6 received endovascular internal trapping(EIT);the good outcome rate was 100%(13/13).Seven patients in the distal to PICA group received RET,6 were treated with EIT;the good outcome rate was 84.6%(11/13).Four patients in the PICA involvement group received RET,and 6 received EIT,and 2 of them received contralateral vertebral artery retrograde PICA stenting combined with VADA segment and proximal vertebral artery coil embolization;the good outcome rate was 60.0%(6/10). There were significant differences in the overall outcome good rate among the 3 groups (P<0.05). The good outcome rate in the PICA involvement group was significant lower than that in the proximal to PICA group,and significantly lower than that in the proximal to PICA combined with distal to PICA group(P<0.05).Multivariate logistic regression analysis showed that only Fisher grade 3-4 was the independent risk factor for poor outcome (odds ratio 28.0, 95% confidence interval 1.71-458.82; P=0.020). Conclusions The surgical options of endovascular treatment for ruptured intracranial VADA needs to evaluate the relationship between the location of dissecting aneurysms and the PICA origin. The risk of endovascular treatment in patients with intracranial VADA involving the origin of PICA is higher and it may affect the outcome.

Objective To summarize the clinical experience of endovascular intervention for intra-cranial aneurysms, especially in the respect of the technique and management of intra-operative complications. Method The clinical data of 60 patients with intra-cranial aneurysms treated with endovascular intervention in the past 3 years were analyzed. The relevant literature especially with regard to the practical technique described was reviewed so as to potentiall minimize and properly manage the intra-operative complications. Results A total of 69 sacciform aneurysms and one dissecting aneurysm located at left vertebral artery (VA) were detected by using digital subtraction angiography (DSA) in 60 patients. There were 65 saccular aneurysms obliterated with constructive approach, and five of them treated with stent-assisted technique and four of them treated with ballon-assisted technique. The VA dissecting aneurysm was obliterated with coils by deconstructive approach with complete occlusion of its parent vessel. There were a total of 53 complete occlusions of aneurysms accounted for 76.81% of 69 sacciform aneurysms in 51 patients ( 85 % ) and eight subtotal occlusion of aneurysms (95 % ～ 99 % occlusion) accounted for 13.56% of total sacciform aneurysms in five patients (8.47%) and four incomplete occlusion of aneurysms ( ＜ 95% occlusion) accounted for 6.78% of total sacciform aneurysms in three patients (5.08%), and one was failure in operation. The rupture of aneurysms occurred during operation in4 patients (6.78%). Two senile patients suffered from intra-opeartive symptomatic thromboembolisn. One patient had stent shifting and spring coil dislocated and moved into the M3 segment of the ipsilateral MCA. Vasospasm occurred in 15 patients during operation, and most of them received endovascular intervention 3 days after the initial ictus. The rate of good recovery was 93.3% at discharge from hospital (the modified Rankin Scales, mRS＜ 2). There were 55 patients followed up for up 24 months after discharge, and excellent recovery rate was found in 51 patients ( mRS ＜ 2), and 3 died.During the follow-up period, no aneurismal recanalization or rupture was noticed in all patients. Conclusions The endovascular intervention is a safe and effective approach to the intra = cranial aneurysms. Advances in the skill of technique and proper management will decrease the complications during operation and improve the prognosis of patients.

Objective　To investigate the influence of γ-interferon (γ-IFN) on liver cancer cell line (Hep-G2). Methods　Observing the expression of Fas and Bcl-2 by γ-IFN-pretreated Hep-G2 cells via immunohistochemical stain; subsequently treating these cells with adrimysin, and observing the cell death rate and apoptosis of these cell by MTT and electroscopy. Results　(1) γ-IFN up-regulating the expression of Fas protein and down-regulating Bcl-2 protein (P<0.05), and the sensitivity of pretreated hep-G2 cell to adrimysin was increased. Conclusions　γ-IFN can rise the sensitivity of Hep-G2 to adrimysin via regulating the expression of Fas and Bcl-2.