The astrocyte reaction to cerebral trauma was reviewed in this paper,which included the study model,detection technique,as well as the astrocyte changes in the morphology and metabolism.It was also prospected to their significance in medicolegal expertise.

0.05). Conclusions Peroperative transcatheter arterial infusion chemotherapy resulting in apoptosis of adenocarnoma, can raise the radical operation rate, and prolong survival rate for colprectal carcinoma patients.

The patient is a 75 years old man complaining of ear plug and hearing loss for about three days. Physical examination shows liquid in two tympanic cavities. Chronic congestion occurs to nasal mucosa. Bilateral inferior turbinates are a little bigger than normal. Both inferior meatus are unblocked and pharyngeal recess is smooth. This patient is fat. Bilateral eye lids are swollen. A tumour could be touched in bilateral parotids with good movement and no tenderness. Its size is as big as an egg. Several lymph nodes could be touched under the jaw. The blood test is normal and IgG, IgA, IgM, ANA, anti-ENA, C3, C4, CRP and ESR is normal but RF is high. The function of liver and kidney is normal. B-mode ultrasonography result shows bilateral parotids are diffusely swollen and several swollen lymph nodes in cervix. Pathology examination of lower mandibular lymph node and parotid shows follicular lymphaticus hyperplasia with several plasmacytes and eosinophil granulocytes. The diagnosis accords with Kimura disease.
Aged ; Angiolymphoid Hyperplasia with Eosinophilia ; complications ; Humans ; Male ; Otitis Media with Effusion ; complications

Objective: To investigate the relationship between C-reactive protein(CRP)and its-717MG polymorphismin atrial fibrillation(AD of the population of the city of Nantong.Methods:The relationships between AF and AF risk factors were analyzed by comparing genders,ages and body nlagS index(BWI)in 92 AF patients and 60 non-AF control subjects.The serum CRP levels were detected by immunoturbidimetry in of the two groups.The CRP-717MG polymorphism wa8 detected by polymerage chain reaction-restriction fragment-length polymorphism in patients and control subjects.Results:The sel3utm CRP level wag positively correlated with the left atrium internal diameter(LAD)in AF patient group(r=0.58,P＜0.01).The level of CRP Wag significantly higher in AF patient group compared with that of control group(P＜0.01).The serum CRP level Wag higher in patients with non-paroxysmal atrial fibrillation than that of patients with paroxysmal atrial fibrillation(P＜0.05).There Wag no significant difference in the frequency of CRP genotype between AF and control groups(P＞0.05).But the alleles frequency of the G Wag lower in AF group than that of control group(P＜0.05).Conclusion:The semm CRP level is associated with AF and its subgroups.The serum CRP level is positively correlated with LAD.The results suggest that the inflammation influences the AF though atrium reconstruction.The relationship between CRP-7 17A/G and AF stir needs further large-scale perspective studies.

Objective To investigate the special cases of distally based sural neurofasciocutaneous flap with muscle repairing the soft tissue defect of foot and ankle. Methods Since February 2004,distally based sural neurofasciocutaneous flap with muscle was applied for repairing the soft tissue defect of foot and ankle in 7 cases, the soft tissue defeat simultaneous chronic osteomylitis of tibia lower section 1 case, the soft tissue defeat simultaneous dead space of foot heel 3 cases, the soft tissue defeat of sole of foot simultaneous bone loss of calcaneus epicarp (5～8 mm) 3 cases, the scope of the flap was 16 cm?12 cm～10 cm?7 cm, the thickness of gastrocnemius flap was 1～4 cm, the muscle flap was smaller than the skin flap. Results Viewing 15 to 20 minutes during operation, muscle side of the muscle flap was errhysising actively, blood circulation fine, all flap were lively. All cases were followed up from 2 to 6 months, osteomyelitis cured, muscle flap outline satisfied, feels recoveried almost, and walk well. Conclusion Distally based sural neurofasciocutaneous flap with muscle can live, the operation is easy, and it is an good donner area in repairing the soft tissue defect of foot and ankle in special cases.

Objective To explore the law and distribution characteristics of malaria prevalence in Pingguo County,Guangxi Zhuang Autonomous Region,so as to provide the evidence for formulating the targeted control strategy and measures after malar?ia elimination. Methods The data of malaria epidemic situation in Pingguo County from 1951 to 2014 were collected and ana?lyzed with the retrospective epidemiological method. Results From 1951 to 2014,there were 71 365 malaria cases reported in the county. The malaria incidence dropped from 429.43/10 000 in 1960 to 0 in 1993. Since 2002,there was no local endogenous infection case reported. In 1993,this county achieved the standard of malaria elimination basically,and in 2014,passed the ex?amination and evaluation of malaria elimination. Conclusions In Pingguo County,the comprehensive malarial control strategy is effective in different stages. In the future,the monitoring of mobile population and dealing with imported malaria cases timely is the key of consolidation of malaria control achievements.

Objective To investigate the clinical features of urothelial carcinoma in a single center.Methods The clinical data of 2 115 urothelial carcinoma patients admitted to Peking Union Medical College Hospital from January 2003 to December 2012 were reviewed retrospectively.Of the 2 115 patients,1414 cases were bladder carcinoma,329 cases were ureter carcinoma and 372 cases were renal pelvic carcinoma.Statistical method was used to analyze the differences of distribution and pathological grading and staging of bladder,ureter and renal pelvic carcinoma among different ages,genders,and urban and rural patients.Results The proportion of low-grade carcinoma was 83.5％ for bladder,68.7％ for ureter and 46.5％ for renal pelvic carcinoma,and the proportion of non-muscle invasive carcinoma was 84.9％,74.8％ and 59.7％ respectively,and significant difference was found in pathological grading and staging among the three groups (P =0.000).In bladder and renal pelvic carcinoma patients,males were common,while females were more common in ureter carcinoma patients.There was significant difference in gender among the three groups (P =0.000),while there was no significant difference in pathological grading and staging between male and female patients(P＞0.05).89.7％ (1 898 cases) were concentrated in the 41-80 years old.The grading and staging of urothelial carcinoma in young,middle-aged and elderly groups showed significant difference (P＜ 0.05).The proportions of high-grade and muscle invasive urothelial carcinoma patients in rural areas were both higher than that in urban areas,the difference in pathological grading and staging between urban and rural patients was significant (P＜0.05).Of the 129 cases (6.1％) with multifocal urothelial carcinoma,there were 89 cases (70.0％) with high grade and 62 cases (48.1％) with muscle invasive carcinoma.Significant difference was found in pathological grading and staging between multifocal and single urothelial carcinoma (P=0.000).Conclusions In the uretholial carcinoma of Peking Union Medical College Hospital in the past ten years,the proportion of bladder carcinoma is the highest,while ureter and renal pelvic carcinoma have higher proportion of high grade and stage.The proportion of patients in the 41-80 years old is higher.The pathological grading and staging of urothelial carcinoma is positively correlated with age,but there is no significant correlation in gender.The patients with high grade and stage carcinoma in rural areas are more than that in urban areas.Multifocal urothelial carcinoma has higher malignancy.

Objective To discuss and evaluate the clinical efficacy and safety of sunitinib for patients with advanced renal cell carcinoma and further to analyze the associated prognostic factors.Methods A retrospective analysis was performed in 78 cases with advanced renal cell carcinoma, receiving sunitinib therapy from April 2009 to December 2014.Patients consisted of 53 males and 25 females, with median age of 54 years old, ranged from 25-85 years old.Therapeutic regimen was described as following: 52 cases receiving sunitinib 50.0 mg/d 4 weeks on and 2 weeks off (4/2 regimen), 26 cases receiving 50.0 mg/d 2 weeks on and 1 weeks off (2/1 regimen).The dosage and regimen were adjusted according to the severity of side effects.Efficacy evaluation and drug-related toxicity were based on RECIST version 1.1 and CTCAE version 3.0.Progression-free survival (PFS) and overall survival (OS) were evaluated using the KaplanMeier method.Univariate and multivariate Cox proportional hazards model were used to assess the risk factors of PFS and OS.Results Nineteen cases switched from 4/2 to 2/1 regimen.Attenuated dosage was allowed in 49 cases to ameliorate drug-related toxicities.The most common drug-related toxicities were handfoot syndrome (HFS) in 63 cases (80.8％), diarrhea in 59 cases (75.6％), fatigue in 59 cases (75.6％) and thrombocytopenia in 6 cases (71.8％).The most common grade Ⅲ-Ⅳ toxicities were HFS in 9 cases (11.5％), thrombocytopenia in 6 cases (7.7％) and hypertension in 5 cases (6.4％).In RECIST evaluation, complete response (CR) was not recorded.8 cases (10.3％) achieved partial response (PR) , 59 cases (75.6％) kept stable disease (SD) and 11 cases (14.1％) suffered progressive disease (PD).The objective response rate (ORR) was 10.3％ and the disease control rate (DCR) was 85.9％.The median PFS was 11.0 months and median OS was 21.8 months.Multivariate Cox proportional hazards model showed two independent risk factors for PFS, including number of metastasis organs ≥ 2 and a high ECOG score.One independent risk factor for OS was number of metastasis organs ≥ 2.Conclusions Sunitinib shows encouraging efficacy and safety for patients with advanced renal cell carcinoma.Patients with multiple metastatic organs and poor performance status seems to be high risky of poor prognosis.

Objective To investigate the prognostic related factors in patients with renal cell carcinoma(RCC) and bone metastases,treated by targeted therapy.Methods Forty-five patients with RCC and osseous metastases were treated by targeted therapy between June 2006 and April 2013.The mean age was 59 years (range 32-81 years) with 33 male cases and 12 female cases.Twenty-seven cases were diagnosed as RCC accompanied with bone metastases initially,and the median time between the diagnosis of RCC and that of osseous metastasis for the other 18 cases was 12.5 months.All the cases underwent target therapy with sorafenib in 38 cases and sunitinib in 7 cases.Data was retrospectively analyzed and the relationship between several clinical features and overall survival (OS) was examined univariately.The Cox proportional hazards model was then performed multivariately to identify the independent risk factors.According to the independent risk factors,RCC patients with osseous metastases were categorized into high risk group (≤ 1 favorable factors) and low risk group (＞ 1 favorable factors).The median OS in those groups was compared.Results The median OS from the diagnosis of bone metastasis was 19 months,and overall survival was 74.7％ at 1 year,and 32.7％ at 2 year.Clinical features correlated with longer survival in the multivariate analysis were the absence of osseous metastases when initially diagnosed as RCC (HR:2.401,95％CI:1.210-5.699),the resection of primary renal tumor (HR:2.635,95％CI:1.021-6.307) and the absence of extraosseous metastases (HR:2.323,95％CI:1.003-6.221).The median OS of high risk group in 23 patients was 16months.On the other hand,22 patients in the low risk group had a longer median OS with 22 months.There was a significant difference in median OS between the two groups (P＜0.05).Conclusions The three prognostic factors including the absence of osseous metastases when initially diagnosed as RCC,the resection of primary renal tumor and the absence of extraosseous metastases could be favorable factors for RCC patients with bone metastasis treated with target therapy.

Objective To explore clinicopathologic features,diagnosis,treatment and prognosis of von Hippel-Lindau (VHL) type 2B mixed cutaneous leukocytoclastic vasculitis. Methods A 22-Year-Old Man who presented with constitutional symptoms,severe hypertension,and purpuric lesions over the knees.Clinical features,histopathological,IHC and anti-angiogenesis therapy of this case with VHL syndrome-2B mixed cutaneous leukocytoclastic vasculitis was studied based on the available follow-up data.He underwent laparoscopic adrenalectomy and nephron sparing nephrectomy.Clinical evaluation included ophthalmologic examination as well as imaging exams and endocrinal hormone test for tumors markers ; molecular analysis consisted of PCR amplification of the complete VHL gene coding sequence (three exons) and automated nucleotide sequencing. Results 24 h urine Norepinephrine was 295.84 μg and octreotide scan was positive.The VHL-2B patient suffered from leukocytoclastic vasculitis,a retinal hole,pancroatic tumors (endocrine tumor and microcystic cystadenoma),bilateral pheochromocyoma,clear renal cell carcinoma,renal cysts,hepatic hemangioma and epididymal cyst.The patient developed 5 different tumors related to VHL within a period of 6 years.The cutaneous vasculitis persisted despite treatment with high-dose systemic corticosteroids,but rapidly resolved after treatment with phenoxybenzamine and removal of bilateral pheochromocytomas.Tumor cells of resected PHEO samples stained positive for CgA and S-100,but negative for Melan-A.,and with less than 1％ Ki-67. Conclusions Cutaneous leukocytoclastic vasculitis is one of paraneoplastic syndrome of pheochromocytoma.Because new lesions may develop during the patient's lifetime,regular clinical inspection is recommended in order to check up the development of any new lesions.