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Wang M.,Jining No. 1 Peoples Hospital | Li W.,Jining No. 1 Peoples Hospital | Lun-Hou D.,Shandong Chest Hospital | Li J.,Jining No. 1 Peoples Hospital | Zhai R.,Jining No. 1 Peoples Hospital
European Radiology | Year: 2015

Objectives: CT pulmonary angiography (CTPA) aims to provide pulmonary arterial opacification in the absence of significant pulmonary venous filling. This requires accurate timing of the imaging acquisition to ensure synchronization with the peak pulmonary artery contrast concentration. This study was designed to test the utility of right atrium (RA) monitoring in ensuring optimal timing of CTPA acquisition. Methods: Sixty patients referred for CTPA were divided into two groups. Group A (n = 30): CTPA was performed using bolus triggering from the pulmonary trunk, suspended respiration and 70 ml of contrast agent (CA). Group B (n = 30): CTPA image acquisition was triggered using RA monitoring with spontaneous respiration and 40 ml of CA. Image quality was compared. Results: Subjective image quality, average CT values of pulmonary arteries and density difference between artery and vein pairs were significantly higher whereas CT values of pulmonary veins were significantly lower in group B (all P < 0.05). There was no significant difference between the groups in the proportion of subjects where sixth grade pulmonary arteries were opacified (P > 0.05). Conclusions: RA monitoring combined with spontaneous respiration to trigger image acquisition in CTPA produces optimal contrast enhancement in pulmonary arterial structures with minimal venous filling even with reduced doses of CA. Key Points: • Bolus tracking (BT) with pulmonary trunk monitoring is widely used in CTPA. • Pulmonary venous contamination is a disadvantage of BT due to transition delay time. • Right atrium monitoring with spontaneous respiration can optimize CTPA. • It produces optimal contrast enhancement in pulmonary arteries with minimal venous filling. • The contrast dose was significantly reduced. © 2015, European Society of Radiology.

Lv Y.,Shandong University | Guo S.,Shandong Chest Hospital | Li X.-G.,Internal Medicine Tuberculosis | Chi J.-Y.,Internal Medicine Tuberculosis | And 2 more authors.
International Journal of Infectious Diseases | Year: 2016

Objective: To measure the expression levels of sputum and serum microRNA-144 (miR-144) before and after the treatment of patients with tuberculosis (TB). Methods: Details of the cases of a total of 124 TB patients were collected at Qilu Hospital of Shandong University between April 2014 and April 2015. Fifty-three of these patients had sputum positive for bacteria and a cavity on imaging (group A), 20 patients had sputum negative for bacteria and a cavity on imaging (group B), and 51 patients had sputum negative for bacteria and no cavity on imaging (group C). One hundred seventeen healthy people who attended the hospital for a physical examination were recruited as controls. Quantitative real-time PCR (qRT-PCR) was used to measure the levels of sputum and serum miR-144 before anti-TB treatment and at 1 month after treatment. Results: Before treatment, sputum and serum miR-144 expression levels in the TB patients were both higher than those of the controls (both p< 0.05). After treatment, sputum and serum miR-144 levels in the TB patients were significantly lower than those measured before treatment (both p< 0.05). The levels of sputum and serum miR-144 in the improved TB patients decreased significantly after treatment compared to those measured before treatment (both p<. 0.001). Significant differences were found in sputum and serum miR-144 levels in the TB patients, with or without improvement, compared with the healthy controls (all p< 0.05). Conclusion: Sputum and serum miR-144 levels were significantly upregulated in the TB patients, but were found to decrease significantly after anti-TB treatment. © 2016 The Authors.

Li L.,Clinical Center on Tuberculosis | Lin Y.,China Office | Mi F.,Clinical Center on Tuberculosis | Tan S.,Guangzhou Chest Hospital | And 12 more authors.
Tropical Medicine and International Health | Year: 2012

Objective There is a high burden of both diabetes (DM) and tuberculosis (TB) in China, and this study aimed to assess feasibility and results of screening patients with TB for DM within the routine healthcare setting of six health facilities. Method Agreement on how to screen, monitor and record was reached in May 2011 at a stakeholders' meeting, and training was carried out for staff in the six facilities in July 2011. Implementation started in September 2011, and we report on 7months of activities up to 31 March 2012. Results There were 8886 registered patients with TB. They were first asked whether they had DM. If the answer was no, they were screened with a random blood glucose (RBG) followed by fasting blood glucose (FBG) in those with RBG≥6.1mm (one facility) or with an initial FBG (five facilities). Those with FBG≥7.0mm were referred to DM clinics for diagnostic confirmation with a second FBG. Altogether, 1090 (12.4%) patients with DM were identified, of whom 863 (9.7%) had a known diagnosis of DM. Of 8023 patients who needed screening for DM, 7947 (99%) were screened. This resulted in a new diagnosis of DM in 227 patients (2.9% of screened patients), and of these, 226 were enrolled to DM care. In addition, 575 (7.8%) persons had impaired fasting glucose (FBG 6.1 to <7.0mm). Prevalence of DM was significantly higher in patients in health facilities serving urban populations (14.0%) than rural populations (10.6%) and higher in hospital patients (13.5%) than those attending TB clinics (8.5%). Conclusion This pilot project shows that it is feasible to screen patients with TB for DM in the routine setting, resulting in a high yield of patients with known and newly diagnosed disease. Free blood tests for glucose measurement and integration of TB and DM services may improve the diagnosis and management of dually affected patients. © 2012 Blackwell Publishing Ltd.

Li W.,Shandong University | Gao J.,Shandong Chest Hospital | Wei S.,Shandong University | Wang D.,Shandong University
Experimental and Therapeutic Medicine | Year: 2016

Acute cerebral hemorrhage accounts for approximately 25% of strokes for elderly patients. Consequently, treatments to improve prognosis should be identified. The aim of the present study was to examine the clinical values of the application of clinical nursing pathway for patients with acute cerebral hemorrhage. Between January 2013 and January 2015, 92 patients diagnosed with acute intracerebral hemorrhage were enrolled in the study based on the guidelines recommended for providing appropriate surgical or conservative treatment and the sequence of admission. The 92 patients were randomly divided into the control and observation groups. Patients in the control group underwent routine nursing mode prior to and after admission, and underwent clinical nursing path model (hierarchical partitioning prior to admission to hospital plus general professional program of nursing in hospital) was applied to the observation group. Barthel index scores for the observation group were significantly higher than that of the control group. The length of hospital stay for patients in the observation group was significantly lower while the average score for patients' satisfaction on nursing care while in hospital was significantly higher than that of the control group, with statistically significant differences (P<0.05). The incidence of complications such as fever, infection, bedsore, gastrointestinal function, electrolyte disturbances, and malnutrition, in the observation group was significantly lower, with statistically significant differences (P<0.05). The functional independence measure (FIM) and Fugl-Meyer scores after 6 months for the observation group were significantly higher, with statistically significant differences (P<0.05). In conclusion, application of the clinical nursing pathway for patients with acute cerebral hemorrhage significantly improved the clinical effects and nursing satisfaction, reduced adverse reactions, and had a greater clinical application value. © 2016, Spandidos Publications. All rights reserved.

Zhang S.,Fudan University | Shao L.,Fudan University | Mo L.,Fudan University | Chen J.,Fudan University | And 7 more authors.
Clinical and Vaccine Immunology | Year: 2010

T-cell-based gamma interferon (IFN-γ) release assays (IGRAs) using Mycobacterium tuberculosis-specific antigens have shown higher sensitivity and specificity than the routine tuberculin skin test (TST). However, the effects of Mycobacterium bovis BCG vaccination and anti-tuberculosis (TB) treatment on dynamic T-cell responses to M. tuberculosis-specific antigens in active TB cases have rarely been investigated in regions where TB is endemic. Eighty-nine patients with active pulmonary TB (ATB) and 57 healthy controls (HC) from China were recruited and tested by sputum smear and culture, TSTs, and IGRAs with M. tuberculosis-specific antigens ESAT-6 and CFP-10 (T-SPOT.TB) as well as purified protein derivative (PPD) stimulation. All 146 participants were screened by the T-SPOT.TB assay at recruitment. T-SPOT.TB-positive rates in ATB and HC groups were 87.6% (78/89) and 21.1% (12/57), respectively. Of 38 ATB patients who were both TST and T-SPOT.TB tested, the positive rates were 73.7% (28/38) and 94.7% (36/38), respectively (P = 0.0215), and those in the HC group were 62.3% (33/53) and 18.9% (10/53), respectively (P < 0.0001). The T-SPOT.TB-positive rates declined during TB treatment and were 94.4% (51/54), 86.4% (19/22), and 61.5% (8/13) for ATB patients receiving 0- to 1-month, 1- to 3-month, and 3- to 6-month anti-TB treatment, respectively. The IGRA is a most promising test for both active TB and latent TB infection (LTBI) diagnosis due to the improvement of its specificity and convenience, especially in the Mycobacterium bovis BCG-vaccinated population. Furthermore, the T-SPOT.TB assay using ESAT-6 and CFP-10 in ATB patients during anti-TB treatment could serve as a potential predictor of therapeutic efficacy. Copyright © 2010, American Society for Microbiology. All Rights Reserved.

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