BACKGROUND:Severe acute respiratory syndrome (SARS),an acute infection with a mutant coronavirus,is characterized by acute pulmonary inflammatory injury accompanied by possible multiple organ injuries. Besides somatic symptoms,affective disorder constitutes an obvious neuropsychiatric symptom in SARS patients.OBJECTIVE:To analyze the clinical features of SARS with neuropsychiatric involvement.DESIGN:A retrospective case analysis.SETTING:Department of Neurology,Department of Respiratory Diseases and Department of Radiology of Affiliated Hospital of Sun Yat-sen University.PARTICIPANTS:Totally 325 SARS patients treated in the Second Affiliated Hospital of Sun Yat-sen University and the 8th People's Hospital of Guangzhou from February 2003 to May 2003 were involved,including 173cases who developed neuropsychiatric symptoms.METHODS:The clinical data of 325 of SARS including 173 cases with neuropsychiatric symptoms were retrospectively analyzed.MAIN OUTCOME MEASURES:Clinical neuropsychiatric symptoms,ophthalmoscopic examination,and pathological findings in autopsy.RESULTS: ①The incidence of neuropsychiatric involvement was about 53.2% in SARS patients. The manifestations consisted mostly of headache (67.1%),dizziness(28.9%),conscious-ness disturbance(10.4%),mental disorder(4.6%), local orientational disorder(0.6%),seizures(1.2%),and affective disorders (30.6%);anxiety occurred in 20.2%,depression in 6.4%,suicidal tendency in 1.2%,and phobia in 7.5% of the patients with neuropsychiatric involvement. ②Among the 325 patients,56 were in critical condition of whom 47 had accompanying neuropsychiatric impairment,with significantly greater incidence than that in mild cases (P＜0.01). ③Ophthalmoscopic examination performed in 4 patients showed blurred margin of the optic disc with retinal venous congestion. ④Autopsy in 2 cases identified edema of the perivascular tissue and vascular wall of the small veins with mononuclear cell and lymphocyte infiltration,neuron degeneration and demyelination in focal brain tissues.CONCLUSION:The manifestations of neuropsychiatric involement can vary in association with the severity of SARS,and the typical pathological changes include edema,neuronal demyelination etc.in the brain.

The aim of the research is to study the prevalence and antimicrobial resistance of Campylabocter jejuni isolated from poultry in Jiangsu Province.A total of 753 samples from poultry meat and cloacal swabs were investigated,after the pure culture and the polymerase chain reaction of the mapA gene,207 isolates were examined for antimicrobial resistance by using K-B method according to World Health Organization.Results showed that all isolates performed different degree of antimicrobial resistance except meropenem,gentamycin,kanamycin,florfenicol and fosfomycin,the resistance rates of 194 strains to trimethoprim,norfloxacin,ceftriaxone and tetracycline were 100％,84.02％,80.9％ and 79.4％ respectively,1 strain isolated from Xuzhou was resistant to 92.6 ％ antibiotics.The multi-drug resistance appeared and the advantage of drug-resistant spectrum was LIN/CTX/CRO/NOR/CIP/T/TE,the resistant type focused on 40％-60％.The research provided evidence for surveillance of the antimicrobial resistance of C.jejuni and highlighted the need to employ more prudent use of critically important antimicrobial.

This study was aimed to observe influence on clinical symptoms of Qing-Fei Pei-Yuan Wei-Wan (QFPY-WW) for pulmonary infection HIV/AIDS cases with the syndrome of phlegm-heat obstructing the lung. A total of 141 pulmonary infection HIV/AIDS cases with the syndrome of phlegm-heat obstructing the lung were randomly divided into the treatment group (94 cases) and the control group (47 cases). The treatment group was given basic western medication combined with QFPYWW. The control group was given basic western medication. After 4 weeks treat-ment, observation was made on changes of main symptoms. The results showed that on the 28th day, compared with the control group, there was improvement on symptoms such as cough, breathing and chest tightness (P< 0.05). Com-parison on coughing up phlegm degree showed that the treatment group was significantly better than the control group (P< 0.05). On the 7th day treatment, the treatment group had better effect on lowering body temperature than the control group (P< 0.05). It was concluded that QFPYWW can improve symptoms such as cough, breathing, chest tightness and cough up phlegm among pulmonary infection HIV/AIDS patients.

BACKGROUND: Memory loss is the main presentation during the earlier stage of radiative eneephalopathy, and it was reported that ganglioside (GM1) played important role in neural rehabilitation, particular in the improvement of memory.OBJECTIVE: To study the improving effect of GM1 on spatial learning and memory retardation in rats following radiative encepholopathy. DESIGN: Randomized control and comparative observing study based on the experimental animals.SETTING: Department of Neurology and Department of Radiation of Second Affiliated Hospital of Sun Yat-sen University.MATERIALS: This study was carried out at the Laboratory of the Second Hospital Affiliated to Sun Yat-sen University between March 2001 and May 2002. Tctally 80 SD rats were randomly selected and divided into control group, GM1 treatment group, physiological saline group and non-intervention group with 20 rats in each group.INTERVENTIONS: Rats in GM1 group, physiological saline group and non-intervention group subjected to head 60Coγ irradiation of 7Gy each time after anesthesia, once a day for consecutive 6 days, and the total dosage was 42Gy while rats in control group did not receive irradiation after anesthesia. Rats in GM1 and physiological saline(PS) group were given intraperitoneal injection of GM1 and physiological saline of 30 mg/kg respectively at 1 hour after each time of radiation, once a day for consecutive 6 days but not in control group and non-intervention group. Evaluation: ①After irradiation, morris water labyrinth navigation test was used to assess the capability of learning and memory of rats by the time for reaching platform (latency); ② Spatial searching test was used to detect their spatial memory after learning how to reach the platform by recording the way of rats searching the platform in 120 s and calculating the percentage of swimming distance in platform quadrant in the total distance; ③ After labyrinth test, brains were taken out of the rats in GM1 group, PS group and non-intervention group for observing the histological and pathological changes in rat brains.RESULTS: ① The latency become stable form onset of the 4th day in each group. On the 5th day, the searching platform latency in GM1 group was(13.6±1.4) s, shorter than(17.1±2.9) s of PS group and [(15.8±2.2) s, (P＜0.05)] of non-intervention group; ② Rats in GM 1 and control group were found capable of searching platform according to their spatial memory, presented by swimming trail most located in platform quadrant while rats in PS and non-intervention groups were found mostly swimming around the pool with moving trails distributed randomly. The percentage of swimming distance in platform quadrant was found higher in GM 1 treatment group than in the PS group and non-intervention group, but lower than that in the control group; ③ Histological examination revealed slight neuronal degeneration in PS group, part of which was changes of vacuolar degeneration with cell shrank, chromosome concentrated and nuclei gathered aside, and the number of astrocytes also decreased; the pathological changes in non-intervention group and PS group were similar; in GM1 group, part neurons became smaller with peripalsm turning red but the pathological changes, such as the number of cells,neuclei shrank and gathered aside, and vacuolar changes were less than those of the former two groups.ONCLUSION: Radiative encephalopathy would result in obvious learning nd memory impairments in rats but histological and pathological changes due o brain radiation injury can be attenuated with the treatment of GM1, implying that GM1 may play important role in the improvement of radiation-induced spatial learning and memory loss.

BACKGROUND: At present, the researches on murine model of acute radiation encephalopathy are still in investigation, and mature model making method is not clear.OBJECTIVE: To establish a murine model of acute radiation encephalopathy in order to provide a good foundation for further researches of radiation encephalopathy(REP) mechanism and therapy.DESIGN: Randomized controlled study based on the experimental animals.SETTING: Animal laboratory in a university hospital. The Second Affiliated Hospital of Sun Yat-sen University.MATERIALS: The experiment was completed in the Laboratory of the Second Affiliated Hospital of Sun Yat-sen University from June 2001 to August 2002. Totally 30 female and 30 male SD rats, weighted(300 ± 30) g, were selected from the Animal Experiment Center of Sun Yat-sen University, and randomly divided into blank control group with 20 rats and experimental group with 40 rats.METHODS: Fourty rats' brain received 60Co γ-ray irradiation with the dosage of 7 Gy/time per day for 6 consecutive days with the total dosage of 42 Gy. The amount of ingestion and drinking, general activities, central nervous system(CNS) symptoms and signs were recorded every day. The hairs and skin of irradiated field and weight were checked and recorded weekly. On the 3rd, 7th, 14th, 30th days after radiation, the brain tissue was collected and the histopathologic changes were examined.Histopathologic changes after radiation.RESULTS: Since the third day, the ingestion and drinking amount of irradiated rats were decreased. The general activities were increased for the first two days, but decreased without abnormal nervous signs on the 3rd day. The rats in experimental group had a slower weight gain than those of control group, and the difference between them was of no statistical significance. All rats had slight alopecia and neuronal necrosis 2 weeks after irradiation.CONCLUSION: The irradiation method is reliable, practical and good for modeling REP process, which can be used in preventing or reducing the harm effect of radiation therapy on brain tissue.

OBJECTIVEThe present study aimed to test whether exposure to benzo(a)pyrene [B(a)P] affects spatial learning and short-term memory by modulating the expression of the Gria1 and Grin2a glutamate receptor subunit genes in the hippocampus.

METHODSThirty-six 21-24-day-old, male rats were randomly assigned into high-, medium-, and low-dose toxin exposure groups (6.25, 2.5, and 1 mg/kg, respectively) and a control group, each containing nine rats. The behavioral performance of adult rats exposed to sub-chronic administration of B(a)P was monitored by learning and memory tests (Morris water maze). Real-time PCR assays were used to quantify Gria1 and Grin2a gene expression in the hippocampus.

RESULTSAt medium and high doses, B(a)P impaired spatial learning performance. The crossing-platform-location frequency and the time spent swimming in the platform area, which both relate to short-term memory, were significantly decreased in B(a)P-treated rats compared with controls. The level of Gria1 mRNA increased 2.6-5.9-fold, and the level of Grin2a mRNA increased 10-14.5-fold, with a greater fold increase associated with higher doses of B(a)P.

CONCLUSIONWe demonstrated that sub-chronic administration of B(a)P inhibits spatial learning and short-term memory, and increases Gria1 and Grin2a expression in the hippocampus. This suggests a relationship of B(a)P exposure levels with Gria1 and Grin2a expression and impairment of short-term and spatial memory.

Animals ; Behavior, Animal ; drug effects ; Benzo(a)pyrene ; administration & dosage ; toxicity ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Gene Expression Regulation ; drug effects ; Hippocampus ; metabolism ; Learning ; drug effects ; Male ; RNA, Messenger ; genetics ; metabolism ; Rats ; Receptors, AMPA ; genetics ; metabolism ; Receptors, N-Methyl-D-Aspartate ; genetics ; metabolism

Ewing sarcoma is a member of the Ewing sarcoma family tumor(ESFT), which is commonly from bones and soft tissues, while it is rare for penis. In this thesis, a case of 21-year-old Ewing sarcomas on the left side of the penis was reported. After the penis mass excision, the pathological diagnosis was Ewing sarcoma and positive margin, then he underwent penis total hysterectomy. After the surgery, he received chemotherapy for 14 cycles without radiation. With 8 months’ reexamination and follow-up, there was no local recurrence or metastasis.

Objective:To investigate the surgical efficacy and prognosis influencing factors of hilar cholangiocarcinoma based on multidisciplinary diagnosis and treatment.Methods:The retrospective cohort study was conducted. The clinicopathological data of 91 patients with hilar cholangiocarcinoma who underwent surgery in Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from April 2004 to April 2021 were collected. There were 59 males and 32 females, aged (61±10)years. Patients who were admitted from April 2004 to March 2014 underwent traditional surgical diagnosis and treatment, and patients who were admitted from April 2014 to April 2021 underwent multidisciplinary diagnosis and treatment. Observation indica-tors: (1) surgical situations; (2) postoperative situations; (3) postoperative pathological examina-tions; (4) postoperative prognosis analysis; (5) influencing factors of postoperative prognosis. Follow-up was conducted using telephone interview and outpatient examination. Patients were followed up once every 6 months after surgery to detect survival. The follow-up was up to April 2023. Measure-ment data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Comparison of ordinal data was conducted using the rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test or Fisher exact probability. The Kaplan-Meier method was used to draw survival curve and calculate survival rate. The Log-Rank test was used for survival analysis. Univariate and multivariate analyses were conducted using the COX proportional hazard model. Results:(1) Surgical situations. Of the 91 patients, there were 65 cases receiving hemi- or expanded hemi-hepatectomy, 13 cases receiving tri-hepatectomy, 9 cases receiving partial hepatectomy, 4 cases receiving extrahepatic bile duct resection. There were 24 cases receiving combined vein resection and reconstruction, 8 cases receiving combined pancreaticoduodenectomy, 6 cases receiving com-bined hepatic artery resection and reconstruction, including 24 cases receiving extended radical surgery (tri-hepatectomy, hepatic artery resection and reconstruction, hepatopancreaticoduodenec-tomy). The operation time, volume of intraoperative blood loss and intraoperative blood transfusion rate of 91 patients was (590±124)minutes, 800(range, 500?1 200)mL and 75.8%(69/91), respectively. Of the 91 patients, cases receiving extended radical surgery, the volume of intraoperative blood loss were 4, 650(range, 300?1 000)mL in the 31 patients who were admitted from April 2004 to March 2014, versus 20, 875 (range, 500?1 375)mL in the 60 patients who were admitted from April 2014 to April 2021, showing significant differences between them ( χ2=4.39, Z=0.31, P<0.05). (2) Post-operative situations. The postoperative duration of hospital stay and cases with postoperative infectious complications were (27±17)days and 50 in the 91 patients. Cases with abdominal infection, cases with infection of incision, cases with bacteremia and cases with pulmonary infection were 43, 7, 5, 8 in the 91 patients. One patient might have multiple infectious complications. Cases with bile leakage, cases with delayed gastric emptying, cases with chylous leakage, cases with liver failure, cases with pancreatic fistula, cases with intraperitoneal hemorrhage, cases with reoperation, cases dead during the postoperative 90 days were 30, 9, 9, 6, 5, 3, 6, 3 in the 91 patients. Cases with abdominal infection was 10 in the 31 patients who were admitted from April 2004 to March 2014, versus 33 in the 60 patients who were admitted from April 2014 to April 2021, showing a significant difference between them ( χ2=4.24, P<0.05). Cases dead during the postoperative 90 days was 3 in the 31 patients who were admitted from April 2004 to March 2014, versus 0 in the 60 patients who were admitted from April 2014 to April 2021, showing a significant difference between them ( P<0.05). (3) Post-operative pathological examinations. Of the 91 patients, cases with Bismuth type as type Ⅰ?Ⅱ, type Ⅲ, type Ⅳ, cases with T staging as Tis stage, T1 stage, T2a?2b stage, T3 stage, T4 stage, cases with N staging as N0 stage, N1 stage, N2 stage, cases with M staging as M0 stage, M1 stage, cases with TNM staging as 0 stage, Ⅰ stage, Ⅱ stage, Ⅲ stage, ⅣA stage, ⅣB stage, cases with R 0 radical resection, cases with R 1 or R 2 resection were 15, 46, 30, 1, 9, 25, 30, 26, 49, 36, 6, 85, 6, 1, 7, 13, 58, 6, 6, 63, 28. Cases with R 0 radical resection, cases with R 1 or R 2 resection were 15, 16 in the 31 patients who were admitted from April 2004 to March 2014, versus 48, 12 in the 60 patients who were admitted from April 2014 to April 2021, showing a significant difference between them ( χ2=9.59, P<0.05). (4) Postoperative prognosis analysis. Of the 91 patients, 3 cases who died within 90 days after surgery were excluded, and the 5-year overall survival rate and median overall survival time of the rest of 88 cases were 44.7% and 55 months. The 5-year overall survival rate was 33.5% in the 28 patients who were admitted from April 2004 to March 2014, versus 50.4% in the 60 patients who were admitted from April 2014 to April 2021, showing a significant difference between them ( χ2=5.31, P<0.05). Results of further analysis showed that the corresponding 5-year overall survival rate of cases without lymph node metastasis was 43.8% in the 16 patients who were admitted from April 2004 to March 2014, versus 61.6% in the 31 patients who were admitted from April 2014 to April 2021. There was a significant difference in the 5-year overall survival rate between these patients without lymph node metastasis ( χ2=3.98, P<0.05). The corresponding 5-year overall survival rate of cases with lymph node metastasis was 18.5% in the 12 patients who were admitted from April 2004 to March 2014, versus 37.7% in the 29 patients who were admitted from April 2014 to April 2021. There was no significant difference in the 5-year overall survival rate between these patients with lymph node metastasis ( χ2=2.25, P>0.05). (5) Influencing factors of postoperative prognosis. Results of multivariate analysis showed that poorly differentiated tumor and R 1 or R 2 resection were inde-pendent risk factors influencing prognosis after surgical treatment of hilar cholangiocarcinoma ( hazard ratio=2.62, 2.71, 95% confidence interval as 1.30?5.29, 1.30?5.69, P<0.05). Conclusions:Compared with traditional surgical diagnosis and treatment, treatment of hilar cholangiocarcinoma based on multidisciplinary diagnosis and treatment can expand surgical indications, reduce proportion of dead patients within 90 days after surgery, improve proportation of radical resection and long-term survival rate. Poorly differentiated tumor and R 1 or R 2 resection are independent risk factors influencing prognosis after surgical treatment of hilar cholangiocarcinoma.