The clinical data of 31 patients with delayed hemothorax between August 2003 to November 2010 was retrospectively analyzed. All patients had chest pain, difficult breathing in 14 cases (45％), heart rate increased in 19 patients (61％), fever in 16 cases (52％), abdomen pain in 3 patients (10％), and shock in 1 case (3％).Haemothorax was medium to massive and combined with pneumothorax in 9 cases. Twenty one patients received closed chest drainage, 4 recieved chest puncture to eliminate fluid, 5 were treated conservatively, and 1 had surgery for diaphragmatic hernia and hemorrhage.All patients recovered eventually. The key of diagnosis and treatment for delayed hemothorax is to take chest X-ray for patients with rib fractures in 2 to 9 days after chest trauma, and carefully observing the changes of chest signs, breathing, heart rate and body temperature.

Objective To summary MRI findings and its diagnostic value of Balo's concentric sclerosis .Methods Brain MRI images of 4 cases with Balo's concentric sclerosis were studied with review of the literature in 13 cases.Results MRI showed multiple ring-like lesions within brains in 16 patients and single lesion only in 1.The deep white matters of cerebrum were involved in all patients.The cerebellum and brain stem were invaded in 2 and 4 respectively. Typical concentric sclerosis lesions demonstrated alternate middle and low signal rings on T1WI, middle and high on T2WI. The ring-like lesions were best seen on T1WI. The middle signal rings were enhanced on post-contrast images.The typical multiple sclerosis lesions were seen in 7 patients. Conclusion Balo's concentric sclerosis has characteristic findings on MRI.MRI is a very reliable diagnostic methed for this disease.

ObjectiveTo study preoperative diagnosis and operative route of traumatic diaphragmatic rupture in order to improve postoperative quality of patients' life.MethodsA retrospective analysis was carried out in 63 patients with traumatic diaphragmatic rupture,all that were identified through operation from January 1990 to March 2009.All cases were associated with pneumothorax and/or hemopneumothorax at various degrees.Forty-nine cases complicated with acute peritonitis and 41 cases complicated with hemorrhagic shock.Thirty-seven cases were diagnosed definitely preoperatively,22 cases were found in operations research,4 cases with inefficacious conservation converted to operation.Thoracotomy was performedin 24 cases,laparotomy in 14 cases,combined thoracolaparotomy in 8 cases and thoracotomy plus laparotomy in 17 cases.ResultsFifty-seven cases recovered,6 cases died of hemorrhagic shock (2 cases),pericardial tamponade ( 1 case),acute respiratory failure ( 1 case) and acute renal failure at postoperative 1 week (2 cases).ConclusionDefinite and timely preoperative diagnosis and correct operative approach are striving the rescue time and success and avoiding complication.

Objective To explore the situation of respiratory virus co-infection with EV71 and CA16 in patients with hand,foot and mouse disease(HFMD) ,and analyze the influence of co-infection on clinical aspects.Methods From June to October of 2010,there were 348 patients enrolled in the study,with 248 hospitalization cases and 100 mild outpatients.All the patients were diagnosed as HFMD in Beijing You-an Hospital.The viral RNA from the pharynx swab samples were extracted and reversely transcribed by RT-PCR.All the samples were detected with the EV71 and CA16 by real-time fluorescence quantitative PCR.Twelve kinds of respiratory viruses were detected by a commercial multiplex-PCR method.The PCR products were confirmed by electrophoresis.Chi square test was used in the data analysis.Results Of the 348 HFMD patients,36 subjects were detected as positive for respiratory virus co-infection.In the 248 hospitalization cases,111 cases were positive for EV71 or CA16,with eight cases identified with respiratory virus co-infection(7.2%); the other 137 cases were negative for EV71 and CA16,with eleven cases identified with respiratory virus co-infection(7.4%).There was not significant difference between respiratory virus co-infection and the identification of EV71 /CA16(x2 = 0.059,P ＞ 0.05).In the 100 mild outpatients positive for EV71 or CA16,seventeen cases were identified with respiratory virus co-infection(17%).The rate of respiratory virus co-infection in the mild outpatients was much higher than in the severe hospitalization patients(x2 = 4.830,P＜ 0.05).Among the 111 EV71(+) or CA16(+) inpatients,there were 101 cases diagnosed as severe cases(91.0%); similarly,there were 132 cases diagnosed as severe cases(96.4%) among the 137 EV71(-) CA16(-) cases.There was not difference between the identification of EV71/ CA 16 and illness of HFMD(x2 = 3.099,P ＞ 0.05).The leading respiratory virus being identified were HRV A/B,PIV3 and FLU A in the 348 HFMD patients.Conclusions Co-infection with respiratory virus exists in the HFMD patients. However,the respiratory virus infection has no significant influence to the state of HFMD illness.

Objective To assess the two-dimensional carotid strain as an index of arterial stiffness in patients without carotid atherosclerotic plaques,and its clinic value in cardiovascular risk stratification.Methods All patients were divided into three groups (low risk,intermediate risk,high risk group) by Framingham cardiovascular risk scores,two-dimensional carotid circumferential strain (CS),carotid intimamedia thickness (IMT) were evaluated.CS was adjusted for pulse pressure (CS/PP).Results CS,CS/PP,IMT were significant difference between low risk and intermediate risk groups,low risk and high risk groups (P ＜0.05).IMT and CS were not significant difference between intermediate risk and high risk group (P =0.23,P =0.57).CS/PP was significant difference between three groups (P ＜0.05).Both CS and CS/PP were correlated with IMT (r =-0.30,r =-0.33,P ＜0.05).Conclusions Two dimensional strain could assess the carotid arterial mechanics.IMT and CS could evaluate the structural and functional alternations of carotid stiffness.Combining these two indices allowed more accurate evaluation of the subclinical phase of the atherosclerotic disease.

Objective To assess the myocardial strain in patients with coronary artery disease by two dimensional strain echocardiography.Methods Forty-three patients with coronary artery disease and thirty five healthy subjects were included.High frame rate two-dimensional images were recorded from the left ventricular short-axis views at the levels of mitral annulus,papillary muscle and apex,and the apical four chamber view,two-chamber view and long-axis view of the left ventricle respectively.The longitudinal strain was measured in the apical views,radial strain and circumferential strain were measured in the left ventricular short-axis views using two-dimensional strain software.Results There were 96 segments whose flow was provided by coronary artery with stenosis＜75%,147 segments whose flow was provided by coronary artery with stenosis≥75%.The peak systolic longitudinal strain of different segments in patients with stenosis≥75% significantly reduced when compared with the control group(P＜0.05).The peak systolic radial strain and circumferential strain of different segments in patients with stenosis≥75% had no statistical difference compared with the control group(P＞0.05).When taking peak systolic longitudinal strain≥-16.1% as cut-off value for coronary artery stenosis of≥75%,the sensitivity and specificity were 78.7% and 76.4% respectively.There was no significant difference in systolic longitudinal strain,radial strain and circumferential strain between normal myocardium and stenosis＜75%(P＞0.05).Conclusions Although there are no evident regional wall motion abnormalities by two dimensional echocardiography,in patients with severe coronary artery stenosis,the longitudinal strain which can reflect the subendocardial myocardial function significantly reduced.

Aim To study the synergistic anti-depres-sion effect of 3 , 6-disinapoyl sucrose ( DISS ) and tenuifoliside A ( TFSA ) from Radix Polygalae and the preliminary mechanism . Methods Using the classical behavioral despair and depression model of mouse tail suspension test, 120 mice were divided into control group, positive group, DISS 5 mg·kg-1 group,DISS 10 mg·kg-1 group,TFSA 5 mg·kg-1 group,TFSA 10 mg· kg-1 group, DISS 5 mg · kg-1 +TFSA 5 mg · kg-1 group,DISS 5 mg·kg-1 +TFSA 10 mg·kg-1 group,DISS 10 mg·kg-1 +TFSA 5 mg·kg-1 group and DISS 10 mg · kg-1 +TFSA 10 mg · kg-1 group randomly. They were given intragastric injection for 7 days continuously, to observe the effect of DISS and TFSA monomer and its combination on the time of mouse tail suspension. Expression of BDNF in the hip-pocampus of mice was detected by immunohistochemis-try. The expressions of CREB, pCREB, CRTC1 and BDNF in the hippocampus of mice were detected by Western blot method. Results The administration of DISS and TFSA could shorten the immobility time of mice subjected to the tail. DISS ( 10 mg · kg-1 ) and TFSA( 10 mg · kg-1 ) group were significantly lower than single dose drug group(P<0. 05). DISS and TF-SA and the combination groups could increase the ex-pression of BDNF in hippocampus and cortex by immu-nohistochemistry(P <0. 05). At the same time, the contents of CREB, CRTC1, pCREB and BDNF protein in the hippocampus were increased by DISS and TF-SA, and the combination group was significantly higher than the single drug group ( P<0. 05 ) . Conclusion The administration of DISS and TFSA are used to acti-vate CREB transcription factor CRTC1 , and activate the phosphorylation of CREB in the hippocampus, and then increase the expression of BDNF in the hippocam-pus and plays a synergistic antidepressant effect.

In order to evaluate the left ventricular remodeling in patients with myocardial infarction after revascularization with intravenous real-time myocardial contrast echocardiography (RT-MCE), intravenous RT-MCE was performed on 20 patients with myocardial infarction before coronary revascularization. Follow-up echocardiography was performed 3 months after coronary revascularization. Segmental wall motion was assessed using 18-segment LV model and classified as normal, hypokinesis, akinesis and dyskinesis. Myocardial perfusion was assessed by visual interpretation and divided into 3 conditions: homogeneous opacification=1; partial or reduced opaciflcation or subendocardial contrast defect=2; constrast defect=3. Myocardial perfusion score index (MPSI) was calculated by dividing the total sum of contrast score by the total number of segments with abnormal wall motion. Twenty patients were classified into 2 groups according to the MPSI: MPSI1.5 as poor myocardial perfusion. To assess the left ventricular remodeling, the following comparisons were carried out: (1) Comparisons of left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV) and left ventricular end-diastolic volume (LVEDV) before and 3 months after revascularization in two groups; (2) Comparisons of LVEF, LVESV and LVEDV pre-revascularization between two groups and comparisons of these 3 months post-revascularization between two groups; (3) Comparisons of the differences in LVEF, LVESV and LVEDV between 3 months post-and pre-revascularization (DeltaLVEF, DeltaLVESV and DeltaLVEDV) between two groups; (4) The linear regression analysis between DeltaLVEF, DeltaLVESV, DeltaLVEDV and MPSI. The results showed that the LVEF obtained 3 months after revascularization in patients with MPSI>1.5 was obviously lower than that in those with MPSI1.5 was obviously larger than that in those with MPSI1.5 and those with MPSI Echocardiography/*methods ; Infusions, Intravenous ; Myocardial Infarction/*diagnosis ; Myocardial Infarction/pathology ; Myocardial Infarction/*ultrasonography ; Myocardial Reperfusion ; Myocardium/*pathology ; Perfusion ; Regression Analysis ; Time Factors ; Ventricular Remodeling

Objective:To investigate the expression levels of microRNA-124 (miR-124) and microRNA-494(miR-494) in the serum of elderly patients with Parkinson disease (PD) and its clinical significance.Methods:Ninety PD patients (PD group) who were hospitalized in Zhengzhou Central Hospital Affiliated to Zhengzhou University from March 2018 to April 2020 were selected.At the same time, 100 non-PD elderly people examined in the physical examination center of the same hospital who matched with age and gender of PD patients were selected as the control group.After 12 hours of fasting, 4 ml of venous blood was taken from all subjects.All PD patients were graded by unified Parkinson disease rating scale(UPDRS) from the aspects of mental state, behavior and emotion, quality of life and motor examination, and graded by the Hoehn-Yahr rating scale for Parkinson disease.The expression levels of miR-124 and miR-494 in serum were detected by real-time fluorescent quantitative PCR (qRT-PCR), and the diagnostic values of miR-124 and miR-494 in PD patients were evaluated by ROC curve.Results:Hoehn-Yahr grade of PD patients with UPDRS≤60 points was significantly lower than that of patients with UPDRS >60 points((2.47±0.43) vs (3.42±0.47))( t=9.055, P<0.001), and there was no significant difference in serum miR-124 and miR-494 expression levels((0.72±0.14) vs (0.70±0.12), (1.17±0.19) vs (1.18±0.22)) ( t=0.633, 0.230, P=0.529, 0.819). Compared with that in control group, the expression of miR-124 in PD group was down-regulated ((0.71±0.20) vs (1.05±0.24)), and the expression of miR-494 was up-regulated((1.18±0.26) vs (0.96±0.22)) ( t=10.542, 6.315, P<0.001). The results of ROC showed that the area under curve (AUC) of serum miR-124 and miR-494 in the diagnosis of PD were 0.847 and 0.760 respectively, the cutoff values were 0.901 and 1.126, respectively, the sensitivities were 86.67% and 61.11% respectively, and the specificities were 75.03% and 79.00% respectively. The AUC of the combined diagnosis of PD was 0.898, and the sensitivity and specificity were 85.56% and 85.00% respectively. Conclusions:The expression of miR-124 is low in PD patients, while the expression of miR-494 is high, which suggests that the changes of the two miRNA levels may be related with the occurrence and development of PD.Both of them have a certain diagnostic value for PD, and the value of combined diagnosis is higher.

The myocardial viability after myocardial infarction was evaluated by intravenous myocardial contrast echocardiography. Intravenous real-time myocardial contrast echocardiography was performed on 18 patients with myocardial infarction before coronary revascularization. Follow-up echocardiography was performed 3 months after coronary revascularization. Segmental wall motion was assessed using 18-segment LV model and classified as normal, hypokinesis, akinesis and dyskinesis. Viable myocardium was defined by evident improvement of segmental wall motion 3 months after coronary revascularization. Myocardial perfusion was assessed by visual interpretation and divided into 3 conditions: homogeneous opacification; partial or reduced opaciflcation or subendocardial contrast defect; contrast defect. The former two conditions were used as the standard to define the viable myocardium. The results showed that 109 abnormal wall motion segments were detected among 18 patients with myocardial infarction, including 47 segments of hypokinesis, 56 segments of akinesis and 6 segments of dyskinesis. The wall motion of 2 segments with hypokinesis before coronary revascularization which showed homogeneous opacification, 14 of 24 segments with hypokinese and 20 of 24 segments with akinese before coronary revascularization which showed partial or reduced opaciflcation or subendocardial contrast defect was improved 3 months after coronary revascularization. In our study, the sensitivity and specificity of evaluation of myocardial viability after myocardial infarction by intravenous real-time myocardial contrast echocardiography were 94.7% and 78.9%, respectively. It was concluded that intravenous real-time myocardial contrast echocardiography could accurately evaluate myocardial viability after myocardial infarction.
Angioplasty, Transluminal, Percutaneous Coronary ; Cell Survival ; Coronary Artery Bypass ; Echocardiography/*methods ; Models, Statistical ; Myocardial Infarction/*pathology ; Myocardial Infarction/*ultrasonography ; Myocardial Revascularization ; Myocardium/*pathology ; Perfusion ; Time Factors