Objective To compare the value of the 2018 Chinese guideline prognostic score with that of the 2019 European Society of Cardiology(ESC)in the predicting efficiency for acute pulmonary embolism(APE)in 30-day all-cause mortality.Methods The data of the hospitalized patients with confirmed APE from January 2015 to December 2019 were retrospectively collected.According to death within 30 days,the patients were divided into a death group and a survival group.Subgroup analysis was performed according to gender,oxygen saturation and infection.The SPSS software was used to establish the receiver operating characteristic curve(ROC)for the two scores and calculated the area under the curve(AUC).The Delong's test was applied to compare the AUC differences.The net reclassification index(NRI)and integrated discrimination improvement(IDI)were calculated using the R software packages of survival,survIDINRI,and PredictABEL.Results 626 APE patients were enrolled,and 30-day death was predicted in those patients using two scores.In terms of overall discrimination,the 2018 Chinese guideline prognostic score was better than the 2019 ESC guideline prognostic score,with an AUC of 0.782 and 0.749,respectively;but there were no statistical differences between the two AUC(P＞0.05).In terms of prediction accuracy,the NRI of the 2019 ESC guideline prognostic score was 44.4%(95%CI:0.091～0.753),higher than that of the 2018 Chinese guidelines prognostic score,which increased by 58.6%(95%CI:0.161～0.917)in the correct reclassification to death group,while decreased by 14.2%(95%CI:-0.249～0.08)in the correct reclassification to survival group.IDI increased by 3.38%(P＜0.05).Subgroup analysis showed the prognostic scores of the 2018 Chinese guidelines and the 2019 ESC guidelines prognostic scores had predictive ability for patients with different gender and different oxygen saturation(P＜0.05),and the prognostic scores for co-infected population(AUC:0.749,0.772)(P＞0.05),non-coinfected population(AUC:0.652,0.833).Conclusions Both the 2018 Chinese guideline prognostic score and the 2019 ESC guideline prognostic score can predict 30-day mortality in APE patients,and have a better predictive ability for the co-infected population.However,the predictive accuracy of the former is higher than that of the latter in the survival group,and the score is more rapid and convenient for clinical application,while the latter has improved the prediction ability in the death group.

Objective To compare the diagnostic efficiency of the thyroid imaging reporting and data system (TIRADS), the Bethesda system for reporting thyroid cytopathology(BSRTC) and BRAFV600E detection, and their combined use in the differentiation between benign and malignant thyroid nodules. Methods One hundred and twenty eight patients with 128 thyroid nodules who were scheduled for ultrasound-guided fine-needle aspiration biopsy (FNAB) were recruited for the study. All of them underwent ultrasound, fine-needle aspiration cytology(FNAC) examination, and BRAFV600E detection. TIRADS and BSRTC systems were adopted to judge the ultrasound and FNAC results. The receiver operating characteristic curve was established to assess the diagnostic value of each method. Results The sensitivity, specificity, and AUC of TIRADS were 74. 3%, 84. 5%, and 0. 794, respectively. BSRTC had higher specificity(98. 3%) and equal sensitivity compared to TIRADS. The sensitivity, specificity, and AUC of BRAFV600E detection were the highest ones among the three methods. Combinations of different methods could increase the diagnostic sensitivity and accuracy. The combination of FNAC and BRAFV600E detection significantly increased the diagnostic efficiency(AUC=0. 984), with sensitivity 98. 6% and specificity 98. 3%. Conclusions The diagnostic value of BRAFV600E detection in the differentiation of benign and malignant thyroid nodules is better than both TIRADS and BSRTC, and the combination of FNAC and BRAFV600E detection reaches the best diagnostic efficiency.

Objective:To compare the effect of pressure‐controlled ventilation‐volume guarantee(PCV‐VG) with that of vol‐ume‐controlled ventilation(VCV) in patients undergoing spinal surgery in prone position .Methods:A total of 60 patients under‐going selective spinal surgery in prone position ,who were classified as GradeⅠto GradeⅡby American Society of Anesthesiolo‐gists(ASA) criteria and weighed 43‐80 kg ,were randomly divided into VCV group and PCV‐VG group with 30 cases in each . In VCV group ,the ventilation mode was VCV with tidal volume of 8 mL/kg and Inspiration/Expiration ratio of 1∶2 ,respira‐tory rate of 12 breaths/min and pressure limit of 30 cmH2 O .In PCV‐VG group ,the ventilation mode was set as PCV‐VG and the other settings were same as those in VCV group .Heart rate ,mean artery pressure ,tidal volume ,minute volume ,mean air‐way pressure ,airway peak pressure ,end‐tidal pressure of carbon dioxide were recorded immediately after tracheal intubation (T1) ,immediately before the patients were turned to prone position(T2) ,30 min after the patients were turned to prone posi‐tion(T3) ,immediately after the end of surgery(T4) and immediately after the patients were turned to supine position(T5) ,and dynamic lung compliance was calculated .Results:Compared with those in VCV group ,mean airway pressure and airway peak pressure in PCV‐VG group significantly decreased at T2 ,T3 and T4 ,while dynamic lung compliance increased(P< 0 .05) . Conclusions:Compared with VCV ,PCV‐VG can guarantee the effect of mechanical ventilation ,reduce the risk of airway pres‐sure injury ,and impact less on respiratory function ,in patients undergoing spinal surgery in prone position .

MED1 is a key transcription co-activator subunit of the Mediator complex that is essential for RNA polymerase II-dependent transcription. MED1 functions as a co-activator for PPARs and other nuclear receptors and transcription factors, and plays an important role in lipid metabolism. To examine how MED1 might affect plasma lipids, plasma triglyceride, cholesterol levels, and lipoprotein profiles, were measured in MED1(deltaLiv) mice fasted for 24, 48 and 72 hours. Histological changes in liver sections from MED1(deltaLiv) mice after 72 hours of fasting were also examined using H&E staining. There was no fat accumulation in livers of MED1(deltaLiv) mice compared to MED1(fl/fl) and PPARalpha -/- control mice after 72 hours of fasting. Compared with MEDl(fl/fl) mice, plasma triglycerides in MED1(deltaLiv) mice were significantly increased after 24, 48 and 72 hours of fasting, and plasma cholesterol was significantly increased after 48 and 72 hours of fasting. Lipoprotein profiles were similar in fed MED1(fl/fl) and MED1(deltaLiv) mice. However, very low density lipoprotein (VLDL) was significantly increased in MED1(deltaLiv) mice after 24 hours of fasting. We conclude that, hyperlipidemia in MED1(deltaLiv) mice in response to fasting is due to the accumulation of VLDL, which suggests that MED1 plays a pivotal role in the regulation of plasma triglyceride and cholesterol levels.
Animals ; Cholesterol ; blood ; Fasting ; Hyperlipidemias ; blood ; Lipoproteins, VLDL ; blood ; Liver ; chemistry ; Mediator Complex Subunit 1 ; genetics ; physiology ; Mice ; Mice, Knockout ; Triglycerides ; blood

Objective:To explore the effect of revision endoscopic sinus surgery (RESS) on quality of life in the patients with chronic rhinosinusitis with nasal polypsis (CRSwNP).Method:To survey and evaluate 60 cases of RESS patiens (treatment group) and 120 normal ones with physical examination (Control group) through the medical outcomes survey short form questions (MOS SF-36) and the Sino-Nasal Outcome Test-20 (SNOT-20), and comparison and analysis of the two groups results which we got were carried out.Result:With SF-36 scales for evaluation of quality of life, the results show that: the scores of CRSwNP patients (treatment group) without surgical treatments with RESS were significantly lower than that of the control group(P<0.05); while use of SNOT-20 scales in evaluation of the properative treatment group patients, the results were significantly higher than that of the control group(P<0.05). While the CRSwNP patients with surgical treatments with RESS for 6 monthes, not only with SF-36 scales but also with SNOT-20 scales,there was no significant difference between the two groups(P>0.05 ).Conclusion:RESS may obviously improve the clinical symptom of CRSNP patients. The SF-36 and SNOT-20 assessment scales could reflect the patient's QoL change.

OBJECTIVE: To explore the effect of revision endoscopic sinus surgery (RESS) on quality of life in the patients with chronic rhinosinusitis with nasal polyposis (CRSwNP). METHOD: To survey and evaluate 60 cases of RESS patients (treatment group) and 120 normal ones with physical examination (Control group) through the medical outcomes survey short form questions (MOS SF-36) and the Sino-Nasal Outcome Test-20 (SNOT-20), and comparison and analysis of the two groups results which we got were carried out. RESULT: With SF-36 scales for evaluation of quality of life, the results show that: the scores of CRSwNP patients (treatment group) without surgical treatments with RESS were significantly lower than that of the control group(P < 0.05); while use of SNOT-20 scales in evaluation of the preoperative treatment group patients, the results were significantly higher than that of the control group (P < 0.05). While the CRSwNP patients with surgical treatments with RESS for 6 months, not only with SF-36 scales but also with SNOT-20 scales, there was no significant difference between the two groups (P > 0.05). CONCLUSION RESS may obviously improve the clinical symptom of CRSNP patients. The SF-36 and SNOT-20 assessment scales could reflect the patient's QoL change.
Adolescent ; Adult ; Case-Control Studies ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Nasal Polyps ; surgery ; Otorhinolaryngologic Surgical Procedures ; methods ; Paranasal Sinuses ; surgery ; Quality of Life ; Reoperation ; Sinusitis ; surgery ; Young Adult

Objective To analyze MRI appearance after augmentation mammoplasty,and to assess the clinical value.Methods Sixty-three cases with augmentation mammoplasty were imaged by MR scanner.MR imaging features of silicone implant and injected implant were analyzed respectively.Results(80 breasts) in 40 patients were with polyacrylamide hydrogel injection.In 50 breasts,the implants were shown as irregular gel in mammary gland,pectoralis muscle,and subcutaneous tissue.Auto-fat injection in both side of breast was performed in 7 cases.Among them,fibrofatty mass was detected in 12 breasts,fat-fluid interface was seen in 6 breasts,and fat in pectoralis major was revealed in 6 breasts.Silicone implant in both side of breast was performed in 16 cases.2 breasts in 2 case were detected as saline-filled implants with intracapsular rupture.14 cases were with silicone gel-filled implants,among them,4 breasts were found to have extracapsular rupture and 10 breasts intracapsular rupture.Conclusion MRI is a perfect method in accessing the patients with augmentation mammoplasty.