Objective: To study the curative effect of Shengmai injection(生脉注射液) and composite Danshen injection(复方丹参注射液) on acute septic cardiomyopathy(ASC).Methods: Sixty patients(clinically) diagnosed as ASC were randomly divided into two groups: treatment group and control group.All the patients received western routine treatment,and Shengmai injection and composite Danshen injection were added to the patients in the treatment group once per day for 14 days.Cardiac troponin(cTn),electrocardiogram(ECG),clinical synthetic curative effect and amelioration rate of traditional Chinese medicine syndrome scores as well as inflammatory indexes including C-reactive protein(CRP),procalcitonin(PCT) and white blood cell count(WBC) were observed after treatment.Results: The levels of cTn,ECG,clinical synthetic curative effect and amelioration rate of traditional Chinese medicine syndrome scores were more improved in the treatment group than those of the control group(all P

Purpose To investigate the clinicopathlogic characteristic, diagnosis and histogenesis of pancreatic solid-pseudopapillary tumors ( SPPT) . Methods Combined with relevant literature, the clinical history, histopathological features and immunohistochemi-cal characteristics were analyzed in 11 cases of SPPT. Results There were 10 female patients and only 1 male in total 11 cases, aged from1 7 to 60 years (mean 33). The sizes of tumors were from 3. 2 to 10. 0 cm. Histologically, they were composed of papillary and microcysticsolid structures. Pseudopapillary with a fibrovascular core was remarkable. Immunohistochemically, the tumors expressed EMA (1/11), vimentin (10/11), NSE (11/11), Syn (7/11), CgA (1/11), CD56 (11/11), CD10 (11/11), PR (9/11), CD99 (9/11),α-AT (11/11),β-catenin (11/11), E-cadherin (11/11), Cyclin D1 (11/11), c-Myc (11/11). 6 patients were followed up for a period of 20 to 112 months, and they were all alive and had no recurrence and metastasis. Conclusions SPPT is a tumor with low malignancy of the pancreas that most frequently affect young females. SPPT may be derived from multipotent stem cells and closely related withβ-catenin signaling pathway. Pathological morphology and immunohistochemistry are very important to the diag-nosis and differential diagnosis of SPPT.

Objective: To investigate the relationship between prognosis and alteration of oxygen(utilization) coefficient(O_2UC) in patients with sepsis.Methods: Sixty critically ill patients were divided into(sepsis)(n=30) and nonsepsis(n=30) groups,and 30 healthy controls were selected as normal control group.Gas analysis of arterial blood and central venous blood and calculation of O_2UC(O_2UC=arterial oxygen(saturation-venous) oxygen saturation/arterial oxygen saturation) were carried out at 8 o′clock in sepsis and(non-sepsis) groups on admission and 1,2,3,5,7 and 10 days after admission,and gas analysis of arterial blood and central venous blood was carried out only once in the controls.Results: On admission and 1 day(after) admission,O_2UCs in sepsis and non-sepsis groups were significantly higher than that of control group(both P0.05)).When O_2UC in critically ill patients persisted higher than 55% for 12-24 hours,the prognosis of the patients was poor and had a tendency to die in a short time.From the 2 nd day after admission,O_2UCs in sepsis and non-sepsis groups were lower than that in control group,and O_2UC in sepsis group was obviously lower than that in non-sepsis group(all P0.05),but from the 2 nd day after admission,O_2UC in sepsis group remained at a lower level compared with that in control group(all P

Objective To identify the specific genotype and analyze clinical features of spinocerebellar ataxias (SCAs) pedigree in the region of Yunnan Province.Methods Fourteen SCAs pedigrees and 183 blood samples of the family members were collected between January 2011 and July 2014 from Department of Neurology,First Affiliated Hospital of Kunming Medical College.Polymerase chain reaction (PCR) amplification,agarose gel electrophoresis and DNA sequencing technologies were utilized to identify the specific genotype of SCAs pedigree.Presymptomatic tests were carried out and the clinical features and genetic test results of patients were carefully analyzed.Results SCA3 was the most common subtype of SCAs in the Han nationality of Yunnan region.Nine of the 14 families were SCA3,only one family was SCA2.Additionally,there were four SCAs families that remained indeterminate.The patients with di-allele mutations (46/77) of SCA3 gene had early onset,rapid progression and serious clinical symptoms.Hereditary SCA3 and autonomic dominant polycystic kidney disease can happen simultaneously in a family.The proband SCA3 gene' s CAG repeat number is 28/76,and repetitions of the mutation allele are in all range.The PKD1 gene exon 23 is found to be in abnormal sequence.Conclusions SCA3 is the most common subtype of SCAs in the Han population of Yunnan region.There are 15/46 incomplete penetrance nutation and 46/77 di-allele mutations.It is possible that di-allele mutations make the disease worse and accelerate clinical course progression.SCA3 and polycystic kidney disease can uncommonly happen simultaneously in a family,which perhaps suggests there are interactions between the two disease-virulence genes.

Purpose To discuss the clinical pathological features, diagnosis and differential diagnosis, treatment and prognosis of pri-mary breast diffuse large B-cell lymphoma ( DLBCL) . Methods 7 cases of primary breast DLBCL were collected, their clinical path-ological characteristics and immunophenotypes were also observed, and the treatment and prognostic factors were discussed. Results All of the 7 patients were women, aged 28~75 years, with the median 51 years. 5 cases involved left breast, 2 cases were located in the right breast. Painless mammary mass and ipsilateral axillary lymphadenopathy were the commonest clinical manifestations. On mi-croscopic observation, tumor cells were large to medium-sized which characterized as diffuse infiltration between the lobules of mamma-ry gland, around the duct, interstitial and fat tissue, some were single file cord pattern. 1 case was ALK-1 positive DLBCL, 6 cases were DLBCL of the non special type. The immunophenotype showed 5 cases were of non-GCB, 2 cases were of GCB type. Ki-67 index were from 60% to 95%. According to Ann Arbor staging, 2 cases were stage I EA, 5 cases were stage II EA. IPI score:4 cases with 0 score, 3 cases with 1 score. Of 7 patients, one case was modified radical mastectomy, 4 cases were lumpectomy, 2 cases were diag-nosed by core needle biopsy. 2 patients died without chemotherapy, 5 patients were chemotherapy or radiotherapy for 4 to 6 cycles ( CHOP/R-CHOP) , 4 patients received complete response, one died. Patients were followed up from 1 to 114 months, the median fol-low-up time was 18 months. The 1 year OS rate was 57. 1%, 5 years OS rate was 14. 3%. Conclusion The diagnosis of primary breast DLBCL is confirmed by pathological biopsy and immunohistochemical markers. The immunophenotype was mainly non-GCB type. Comprehensive treatment including chemotherapy and radiotherapy is appropriate. The prognosis should be comprehensively eval-uated by multiple factors.

Objective To explore the set-up errors of position fixation with simple perforated foam pad in colorectal cancer radiotherapy and their causes as well as the improvement measures.Methods Sixty cases of color-ectal cancer patients undergoing radiotherapy were collected.Prone position was adopted with the position fixed by perforated foam pad and membrane.CBCT imaging was taken weekly before treatment,setup errors were corrected if necessary.Errors throughout the course of treatment for each patient were recorded and compared between patients, followed by analyzing the reasons of errors.Results Before calibration,the maximum errors on the direction of left and right (X-axis),front and back (Z),upside and downside (Y)in these 60 patients were 0.5cm,0.9cm and 0.7cm respectively with the average errors of (0.22 ±0.03)cm,(0.38 ±0.03)cm and (0.27 ±0.04)cm respec-tively.Conclusion The method of applying perforated foam pad and thermoplastic mask in colorectal cancer radio-therapy is currently the most commonly used in the clinical position fixation techniques,by which the small intestine, bladder and other pelvic tissues can be well protected.Due to poor comfort prone position,it is necessary to further improve perforated foam pad through improving the quality of the foam pad,thus improving patients comfort and posi-tioning repeatability and reducing position fixation errors.

Objective To investigate the effect of different treatment regimens guided by magnetic resonance angiography (MRA) and diffusion weighted imaging (DWI) mismatch on the outcomes of patients with mild ischemic stroke caused by acute middle cerebral artery (MCA) M1 segment occlusion. Methods From January 2013 to February 2018, the clinical data of patients with mild ischemic stroke caused by acute MCA M1 segment occlusion and admitted to the Department of Neurology, the Affiliated Hospital of Yangzhou University were analyzed retrospectively. Mild stroke was defined as the National Institutes of Health Stroke Scale (NIHSS) score ≤5, and the MRA-DWI mismatch was defined as MCA M1 segment occlusion confirmed by MRA and the DWI-Alberta Stroke Program Early Computed Tomography Score ≥6. According to the clinical decision, they were divided into endovascular treatment group and intravenous thrombolytic therapy group. The primary outcome measure was the modified Rankin Scale score at 90 days after onset, ≤2 was defined as good outcome. The secondary outcome measure was the incidence of symptomatic intracranial hemorrhage (sICH) within 7 days after treatment and the mortality rate at 90 d. Multivariate logistic regression analysis was used to determine the independent effects of different treatment regimens on outcomes. Results A total of 38 patients were enrolled, 19 (50. 00％) in the intravenous thrombolytic therapy group, and 19 in the endovascular treatment group (50. 00％, including 5 patients with intratracheal thrombectomy after intravenous thrombolysis); 27 patients had good outcomes (71. 05％) and 11 had poor outcomes (28. 95％). Except for total cholesterol level, there were no significant differences in demography, vascular risk factors, and all baseline clinical data between the endovascular treatment group and the intravenous thrombolytic therapy group. The rate of good outcome in the endovascular treatment group was significantly higher than that in the intravenous thrombolytic therapy group (89. 47％ vs. 2. 63％; P = 0. 029), and there was no significant difference between the incidence of sICH within 7 days (15. 79％ vs. 5. 26％; P = 0. 604) and 90-day mortality (0％ vs. 10. 53％; P = 0. 486). The proportion of patients who underwent endovascular treatment in the good outcome group was significantly higher than that in the poor outcome group (62. 96％ vs. 18. 18％; P = 0. 029). Multivariate logistic regression analysis showed that endovascular treatment was an independent predictor of good outcome (odds ratio 0. 103, 95％ confidence interval 0. 015-0. 714; P = 0. 021). Conclusion Endovascular treatment is an independent predictor of good outcome in patients with mild ischemic stroke caused by acute MCA M1 segment occlusion.

Objective To study the Hainan Utstein templates used for cardiac arrest and resuscitation registries to evaluate the epidemiological characteristics and outcomes of the patients with CPR by multi-center study. Methodsccording to the Utstein templates for cardiac arrest and CPR set by International Liaison Committee on resuscitation in 2004, a Hainan Utstein CPR registry chart was designed and a prospective descriptive study was carried out to evaluate the epidemiological characteristics, impact factors and outcomes of the patients with resuscitation attempt in emergency departments of thirteen hospitals in Hainan Island between January 2007 and December 2010.Results Of 1125 patients with cardiac arrest, male accounted for 73. 8％ and female was 26. 2％. The mean ( ± S. D) age of the cardiac arrest patients was 53.9 ± 13. 1 years old.Coronary heart diseases and hypertension were the most common preexisting chronic diseases in the studied patients. The ROSC rate and discharge rates after survival in 1125 patients with CPR were 23. 8％ and 7.4％ respectively. The ROSC rate and discharge rates after survival were 36. 3％ and 11.6％ in the in-hospital cardiac arrest (IHCA) group, respectively whereas 11.5％ and 3. 3％ in out-hospital cardiac arrest (OHCA) group. Of 188 patients with ventricular fibrillation/Pulseless ventricular tachycardia, the ROSC rate and discharge rate after survival were 58.0％and 21.8％,respectively. Of them, 448 (39. 8％ ) of the cardiac arrest patients had underlying cardiac causes, and the ROSC rate and discharge rate after survival were 36. 3％ and 11.5％ respectively in IHCA group whereas 11.6％ and 3. 3％ in OHCA group. The ROSC rate and discharge rate after survival were 69. 8％ and 7. 4％respectively in the tertiary hospitals whereas 30. 2％ and 7. 3％ in the secondary hospitals. Conclusions Patients experienced cardiac arrest were predominantly male. Coronary heart disease and hypertension were the two most common preexisting chronic diseases. The ROSC rate and discharge rate of patients with IHCA were higher than those with OHCA. ROSC rate and discharge rate after survival were higher in the ventriculat fibrillation/Pulseless ventricular tachycardia group than the other cardiac rhythms first witnessed groups. The time delayed of starting CPR after onset of cardiac arrest had a critical impact on survival and discharge rate in both IHCA and OHCA groups.

OBJECTIVETo investigate clinical features and genetic mutations of a family affected with spinocerebellar ataxia 3 and polycystic kidney disease.

METHODSPolymerase chain reaction and DNA sequencing were employed to analyze exon 10 of the SCA3 gene, in addition with all exons and flanking sequences of PKD1 and PKD2 genes. The clinical features were also carefully analyzed.

RESULTSThe numbers of CAG repeat in the proband's SCA3 gene were 28/76, with the number of repeats in the mutant allele being in the full range. The sequence of exon 23 of the PKD1 gene was also found to be abnormal. Clinical symptoms of the proband were very serious, which were characterized by obvious ataxia, pyramidal signs, Meige syndrome, depression and high blood pressure.

CONCLUSIONHereditary spinocerebellar ataxia 3 and autonomic dominant polycystic kidney disease may co-occur, and genetic testing is the primary means of diagnosis.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Polycystic Kidney Diseases ; genetics ; Polymerase Chain Reaction ; Sequence Analysis, DNA ; Spinocerebellar Ataxias ; genetics

Objective:To investigate the effect of decarbromodiphenyl ether(BDE-209)exposure on the migration ability of triple-negative breast cancer(TNBC)cells and to explore the underlying mechanism.Methods:Human TNBC MDA-MB-231 cells were divided into blank control group and BDE-209 exposure groups(treated with 0.02,0.20,2.00,20.00 and 200.00 ng/mL BDE-209 in high glucose DMEM).Extracellular vehicles(EVs)secreted by MDA-MB-231 cells were isolated by differential ultracentrifugation.Transmission electron microscopy(SEM),nanoparticle tracking analysis(NTA)and Western blotting were performed to characterize the EVs.The effect of the EVs induced by BDE-209 exposure(EVs-BDE-209)on the migration and invasion of MDA-MB-231 cells was detected by wound-healing assay and Transwell test.qRT-PCR was used to measure the miR-221 level in EVs-BDE-209.The expression of MMP9 in MDA-MB-231 cells was determined by Western blotting.Results:Compared with the blank control,BDE-209 exposure increased the tumor cell-derived EVs in dose-dependent manner.The MDA-MB-231 cells co-cultured with EVs released by 200.00 ng/mL BDE-209 exposure showed an 86%increase in cell migration rate,a 1.32-fold higher number of membrane-penetrating cells,a 2.71-fold higher expression level of miR-221,and a 1.62-fold higher expression level of MMP9 compared with the blank control group(all P<0.05).While transfection with anti-miR-221 antibody to decrease miR-221 level in EVs significantly reversed the increased invasion ability of the MDA-MB-231 cells treated with EVs-BDE-209.Conclusion:BDE-209 exposure may promote metastasis potential of MDA-MB-231 cells via EVs-BDE-209 transmitted miR-221.