Objective To analyze the pathophysiological variation in patients with penetrating cardiac trauma (PCT) and discuss the classified treatment strategies.Methods A retrospective analysis was conducted on pathogenetic condition,medical interventions and other clinical information of 133 PCT patients.The patients were divided into four groups in accordance with their symptom classification on arrival at emergency department,including sub-clinic type,cardiac tamponade type,hemorrhagic shock type and agonal type.Meanwhile,the patients were classified into three groups according to their pathogenesis phase,including sub-clinical phase,clinical phase and agonal phase.Development characteristic of patients' condition in each group was investigated in each time point by survival analysis.Impacts of medical interventions on prognosis of those patients were analyzed,such as pericardial space exploration,emergency room thoracotomy (ERT),operating room thoracotomy (ORT).Results Some patients at sub-clinical phase were aggravated into clinical phase or agonal phase,as well as some patients at clinical phase were aggravated into agonal phase during in-hospital treatment.There were significance differences of posttraumatic suvival course among the four groups,namely sub-clinical type,cardiac tamponade type,hemorrhagic shock type and agonal type (P ＜ 0.01).The differences of posttraumatic survival course were also significant among the three groups,namely sub-clinical phase,clinical phase and agonal phase (P ＜ 0.01).Conclusion Clinical symptom classification (or pathogenesis phase) of PCT may not be always unchangeable,thus it is recommended that PCT patients should be treated based on their clinical symptom classification or patbogenesis phase at consultation.

Animals ; Lipoproteins, HDL ; blood ; Lipoproteins, LDL ; blood ; Male ; Physical Conditioning, Animal ; physiology ; Random Allocation ; Rats ; Rats, Sprague-Dawley

Objective To investigate the clinical treatment principles of asymptomatic cholecystolithiasis. Methods 136 cases of asymptomatic cholecystolithiasis, found on health check up, were randomly divided into two groups :(1) Preventive cholecystectomy group,66 cases;(2)therapeutic cholecystectomy group,70 cases. The data of postoperative pathologic examination, complications and degree of operative difficulty between the two groups were compared. Results The postoperative pathologic examination, complications and degree of operative difficulty between the two groups were significantly different(P

Objective To evaluate the preoperative localization value of MRI and MRCP for congenital biliary dilatation.Methods 30 cases of congenital biliary dilatition diagnosed by either surgery or pathology were studied.MRI and MRCP findings of all these cases were analyzed.Results MRI and MRCP preoperative examination manifested the place of choledochal cyst and the relation between choledochal cyst and the biliary ductal system around in all 30 patients.Through surgery findings as follow,using Todani's classification,the accuracy of MRI and MRCP in evaluating the site and classification of congenital biliary dilatation was 100%,the accurate visualization rate of pancreatic duct was 73.3% and the junction of pancreaticobiliary duct was 33.3%.Conclusion MRI and MRCP manifestations are very reliable in preoperative localization of congenital biliary dilatation.

The acurate diagnosis of invasive fungal infection(IFI)is the key point for the treatment and proginosis for IFI patients.Pathological diagnosis is still considered as the gold standard for the IFI diagnosis although difficult.The regular procedures for IFI diagnosis including culture and direct examintion are often low yeilding,the discrimination for contamination and infection is hard.Imaging manifestations are nonspecific but have important suggestive values.The detection for molds antigen content is useful,but its sensitivity and specifity need to be improved.The proper diagnosis for IFI relys on the combination of clinical characteristic,imaging manifestion and serial observation.

Objective To explore the cause and epidemiologic characteristics of Keshan disease.Methods The cases observation method,epidemiologic methods,fungus-mycotoxin methods and the analytic chemistry methods were used in our studies.Results From the year 1973-1975,in serious endemic areas,fifteen families and one disease outbreak village were investigated,it was found that all patients and his family members had eaten a vast amount of mould millet or maize 4-12 months before onset of the disease; the millet samples collected from endemic areas were cultured and they werc found to be polluted mainly by fungus(20％ of all),the toxin was citreoviridin(CIT).The cause factor of Keshan disease entered into human body through grain but not drinking water,and the transmitting effect was not different with different grains,millet and maize transmit but wheat did not;according to data of endemic disease inspection,after 1990 no new cases of Keshan disease had been reported in the country,at the same time the CIT content in grain produced in endemic areas did not reduced so quickly.However,after 1983,the reform of agriculture promoted significantly the hygienic quality of grain which was considered to be a specific cause for the decreasing of Keshan disease threatening; Keshan disease was distributed on the narrow-long areas from Yunnan till Heilongjiang.These areas were the connection parts,between the cold west north high lands and the warm-moist east-south flatlands,a narrow-long region.The year mean temperature and humidity in endemic areas might be suitable for growing of fungus and production of its toxin ; of animal experiment,rats were feed with CIT contaminated grain every day 4 mg/kg(body weight) for 4-6 weeks,the necrosis of myocardium and cell mitochondria swelling,proliferation and damage were found,just like what had been seen in died cases of Keshan disease.Conclusions The cause of Keshan disease is CIT toxin,the endemic conditions are geographic climate suitable for growing of fungus and production of its toxin and bad hygienic situation of grain storage.Some discussion about the prevention mcthod was proceeding.

Objective To investigate the effect of extraction of radix isatidis on the expression of transforming growth factor(TGF-β)in lung tissues of rats with radioactive lung injury.Methods 72 female Wistar rats were randomly divided into 3 groups,blank control group(groupA,n=24),simple irradiation group(group B,n=24),irradiation with Chinese medicine group(group C,n=24).Rats in group A and group B were given distilled water 2 mL/200g by gavage for one week,the rats in group C were given extraction of radix isatidis 2 mL/200g(1.6 g/200 g)per day for one week,then the rats received irradiation,during irradiation,the rats' weight was measured once a week,to illuminate the end.After 10-time irradiation(the 30th day), and at 60 days and at 120 days after irradiation,the expression levels of TGF-βin lung tissue were detected;In addition each rat lung tissue morphology was observed.Results The expression levels of TGF-βprotein in group B reached peak at the 30 days after irradiation,which at different time points in group A and group C was significantly lower than that in group B(P<0.01).Rats of group A had no significant change in lung tissue.Rats of group B were observed inflammatory cells in interstitial pulmonary alveolar,alveolar structural damaging,interstitial pulmonary edema,interstitial hemorrhage and inflammatory pulmonary with alveolar cavity;Rats of group C pulmonary interstitial fewer inflammatory cells in alveolar damage were not obvious, with no-pulmonary interstitial edema, hemorrhage and no inflammatory symptoms, comparison between group B and C was not obvious. Conclusion Extraction of radix isatidis could reduce the expression levels of transforming growth factor(TGF-β)in lung tissues of rats with radioactive lung injury ,has better preventive effect on radioactive lung injury,could protect lungtissue from damaging,inhibite alveolar permeability,and present the effect of pulmonary edema.

Bone marrow stromal cells(MSCs) have been shown to be extremely versatile.Recently,it is demonstrated that MSCs differentiate into neurons.Moreover,under the appropriate conditions,MSCs differentiate into special phynotype of neurons,such as 5-hydroxytryptamine-sensitive neurons,and dopaminergic neurons.The mechanism remains to be elucidated,and an overexpression of neuronal specific genes(such as Sox,Pax,Notch gene) may play an important role,especially RB/PBO gene.However,RB triggers cholinergic differentiation.Extrinsic factor such as concentration of cAMP plays certain role in differentiation.MSCs have also been shown to have certain therapeutic effect on neuronal degeneration disease.These cells have great potential because it is easy to isolate,culture,amplify,and no ethics neither immunologic rejection problem was concerned.

Objective To evaluate the changes of reticulated platelets (RP)in diagnosis and treatment of idiopathic thrombocytopenic purpura (ITP). Methods RPs were measured by flow cytometry and the percentage and absolute counts of RPs were calcula- ted in ITP group,non-ITP group and control group.Results Compared with control group,ITP group had a significantly high percentage and low absolute counts of RPs (P