To explore the relationship between pathological findings and clinical manifestation, pathological and clinical data were collected and analyzed in 22 cases died from infantial pneumonia, and inference study were undertaken based on the theory of airway hydrokinetics (AHK).The results showed that all 22 cases suffered from airway obstruction. 2 of 5 cases with aspiration pneumonia were confirmed to have inhaled meconium, other 3 cases were probably correlated to gastro-esophageal reflux (GER).Among 17 cases with primary pneumonia, myocardial damage was observed in 14 cases, cerebral neural degeneration in 10,hepatic damage in 13 and renal damage in 9, respectively. Pathological changes were significantly correlated with the results of X-rays and blood-gas analysis.It is concluded that big changes of AHK can be induced by pneumonia, and should be pay attention to the features of the laminar flow and the eddy flow in the airway during the clinical treatment of infantial pneumonia.

Objective To study whether focal mild hypothermia can prolong the therapeutic time window in ischemic stroke, and inquire into the protection mechanisms of focal mild hypothermia on cerebral ischemia. Methods The focal cerebral ischemia and reperfusion model of rats was achieved by intraluminal middle cerebral artery occlusion (MCAO). The adult rats were randomly divided into sham-operation group, normothermia ischemia and reperfusion group and hypothermia ischemia and reperfusion group. The two ischemic groups were respectively further divided into 5 subgroups (subjected ischemia for 2, 3, 6, 8 and 12 h respectively and then all reperfused for 4 h, n=14 per time point). Brain mild hypothermia was achieved 30 minutes after ischemia and maintained to reperfusion period. The neurological deficit scores were assessed. The infarct volumes were evaluated by TTC staining and measured with a computerized image analysis system. TUNEL method was used to observe the neuron apoptosis. The expressions of NF-?Bp65 and NF-?BP65mRNA were detected by immunohistochemistry and hybridation in situ. Results The infarct volumes of hypothermia group were respectively (57.39?37.62) mm~3, (74.09?61.00) mm~3, (81.26?25.46) mm~3, (87.43?54.81) mm~3 and (111.10?43.67) mm~3, which saw significant reductions of 63%, 55%, 56%, 70% and 63% as compared with the normothermia group. In comparison with the normothermia group, focal mild hypothermia also greatly reduced the neurological deficit scores (P

Objective:To research the curative effect of moxifloxacin solution atomization inhalation in the treatment of chronic obstructive pulmonary disease (COPD) combined with respiratory failure.Methods:94 cases of COPD patients combined with respiratory failure from May 2014 to May 2016 were selected and divided into the control group(n=47) and the research group (n=47) acording to the lottery method,the control group received routine treatment,while the research group was treated based on the control group with moxifloxacin solution inhalation treatment.The curative effect,serum tumor necrosis factor-α(TNF-α),c-reactive protein (CRP) and interleukin 10 (IL-10),creatine phosphokinase (CK),aspertate aminotransferase (AST) levels,the blood oxygen partial pressure (PaO2),CO2 partial pressure (PaCO2),APACHE Ⅱ score and occurrence of adverse reactions were compared between two groups.Results:After treatment,the total effective rate of research group was higher than that of the control group (P＜0.05).The serum levels of TNF alpha,CRP,PaCO2,CK,AST,APACHE Ⅱ score of research group were evidently lower than those of the control group (P＜0.05).The serum levels ofIL-10,PaO2 of research group were evident higher than those of the control group (P＜0.05).The occurrence of adverse reactions showed no differences between the two groups (P＞0.05).Conclusion:Moxifloxacin solution atomization inhalation was effective in the treatment of COPD combined with respiratory failure,which might be related to the inhibition of inflammatory response,and improvment of breath.

Objective To explore the variations and prognostic factors of hyperhomocysteinaemia in ischemic cerebral apoplexy for the youth who administrated vitamin B6,vitamin B12 and folic acid at pretherapy and post-treatment.Methods One hundred and twenty cases of young patients with ischemic cerebral apoplexy in the Pinggu Hospital of Capital University from January 2003 to December 2013 as case group(intervention group,60 cases and 60 cases of non-intervention group),while 120 youth volunteers with the same period and age without neurological diseases as a control group.Both groups patients were detected for hyperhomocysteinaemia,folic acid and vitamin B12.The non-intervention group was administrated basic treatment,while the intervention group administrated vitamin B6,vitamin B12 and folic acid on this basis.The hyperhomocysteinaemia,folic acid and vitamin B12 were detected repetitively after four weeks.Results Compared with control group,the hyperhomocysteinaemia in ischemic cerebral apoplexy group for the youth had increased significantly ((10.2 ± 3.1) μmmol/L vs.(21.3 ± 4.5) μmmol/L,P ＜ 0.05).The hyperhomocysteinaemia,folic acid and vitamin B12 had no significant differences between intervention group and non-intervention group (P ＞ 0.05).After replenished vitamin B6,vitamin B12 and folic acid,the hyperhomocysteinaemia had decreased significantly ((10.5 ± 3.0) μmnol/L) in intervention group.Folic acid ((6.5±2.8)μg/L) and vitamin B12(450.2±155.6) ng/L) had increased significantly(P＜0.05).Conclusion The hyperhomocysteinaemia increased in ischemic cerebral apoplexy for the youth.It is that hyperhomocysteinaemia decreased by replenished vitamin B6,vitamin B12 and folic acid which make for prognosis in ischemic cerebral apoplexy for the youth.

Objective To investigate the optimal methods of detecting micrometastasis of sentinel lymph node(SLN) in papillary thyroid carcinoma(PTC).Methods Data of 51 consecutive PTC patients without clinical evidence of cervical lymph node metastasis were analyzed.They were conducted with SLN localization with blue dye,technetium-labeled sulfur colloid or the combination of them from Aug.2007 to Sep.2010.55 SLNs from 18 cases were selected.No metastasis was found to these 55 SLNs by routine pathological section.The 55 SLNs were serially sectioned at a 50 μm interval and stained by both HE and immunohistochemistry for detecting micrometastasis.Results SLN was successfully identified in all the 51 cases,with SLN identification rate of 100％.Among the 18 cases without metastasis to SLN by routine pathological section,5 cases were found micrometastasis by step sectioning plus immunohistochemically stains.The false negative rate was reduced from 15.4％ by routine pathological section to 2.6％ by step sectioning plus immunohistochemically stains.Conclusion Cytokeratin immunohistochemistry on series sections is a reliable method in detecting SLN micrometastasis in PTC.

ObjectiveTo explore the value of virtual touch tissue quantification (VTQ) in evaluating Lauren classification of advanced gastric carcinoma.MethodsForty-one patients with gastric cancer proved by endoscopic biopsy performed preoperative VTQ examination,and the findings were compared with postoperative pathologic results via hematoxylin -eosin and Alcian Blue-Periodic Acid Schiff (AB-PAS) staining.ResultsIn 41 patients,26 cases were diagnosed as diffuse type and 15 cases as intestinal type by pathology after operation.The shear wave velocity(SWV) of diffuse type was higher than that of intestinal type [(1.72± 0.83)m/s vs (1.05± 0.66)m/s,t =2.819,P=0.008] measured by virtual touch tissue quantification (VTQ).According to the area under the ROC curve,the cut- off value of SWV in gastric cancer tissues for assessing the diffuse type was 1.045 m/s with a sensitivity of 80.8％ and specificity of 73.3 ％ respectively.ConclusionsVTQ could be considered as a promising method to distinguish the Lauren classification in patients with advanced gastric carcinoma.

Objective:To determine the compositions of Pingwei microemulsion through the formula screening and optimization, and carry out the pharmacodynamic validation. Methods:Three levels of mixed volatile oil,dregs water extract and glycyrrhizin were determined by single factor investigation. With the ulcer inhibition rate as an indicator,the orthogonal test was carried out to determine the amount of each component in the formula,and the pharmacodynamic validation was performed on the mouse model of gastric ulcer induced by indomethacin and the rat model of ulcer induced by ethanol hydrochloride.Results:The amount of each component in the formula was determined as follows:SFE-CO2mixed volatile oil of Atractylodes Lancea (Thunb.) DC., Magnolia officinalis Rehd. Et Wils. and Pericarpium Citri Reticulatae was 0.8 ml,glycyrrhizin was 60 mg,and the water extract after SFE-CO2extraction of Atrac-tylodes Lancea (Thunb.) DC.,Magnolia officinalis Rehd. Et Wils. and Pericarpium Citri Reticulatae was 2.0 g. Conclusion: The preparation process of Pingwei microemulsion is feasible,and Pingwei microemulsion has a good anti-ulcer effect,equalling to the posi-tive control Sanjiuweitai.

ObjectiveTo evaluate combined radioisotope and methylene blue dye method for identifying sentinel lymph node (SLN) for modified radical neck dissection of papillary thyroid carcinoma (PTC). MethodFifty-one consecutive PTC patients without clinical evidence of locoregional lymph node involvement were enrolled in the study between August 2007 and September 2010.5 h ( rangel.5 - 8 h) before the surgery,one single intratumoral injection of 74 MBq in a volume of 0.4 ml 99mTc -Dextran was administered under ultrasound guidance and 1％ methylene blue dye was injected into the parenchyma surrounding the primary tumor intraoperatively.Preoperative lymphoscintigraphy,intra-operative hand-held gamma probe detecting and blue dyed lymph node were used to identify the SLN.All SLNs were sent for frozen-section and the specimens of routine selective neck dissection were stained with haematoxylin and eosin (H&E). ResultsSLNs were identified in 48 of 51 cases (94.1％ ) with combination method.SLN identification rate were 66.7％by methylene blue dye method and 90.2％by radioisotope method respectively.Final pathologic examination revealed that 30 cases ( 58.8％ ),including 3 cases who had negative SLNs,had lateral neck occult lymph node metastasis.The rate of occult lymph node metastasis in level Ⅱ,level Ⅲ,level Ⅳ and level Ⅴ were 17.6％,52.9％,29.4％ and 0％.Thus,the sensitivity,specificity,accuracy, and positive and negative predictive values of SLN biopsy were 90％, 100％,94.1％,100％ and 87.5％,respectively. ConclusionsSLNB is feasible and safe,the findings correlate with lateral lymph node status.Therefore,SLN biopsy is a good method for estimating the status of lateral lymph node in patients with clinical negative lymph node papillary thyroid carcinoma.

Objective:To investigate the clinicopathological characteristics, treatments, and survival of patients with esophageal adeno-squamous carcinoma (EASC). Methods:A total of 494 patients with EASC were selected from the clinical information databases of 500, 000 cases with esophageal and gastric cardiac carcinomas in the Henan Key Laboratory for Esophageal Cancer Research. Among the 494 EASC cases, 361 were males with an average age of 61.47 ± 8.32 years, and 133 were females with an average age of 65.56 ± 8.06 years. SPSS 21.0 software was applied to determine the statistical differences among the different groups. A life-table method was also used to calculate the five-year survival rate. A linear regression model was used to analyze the correlation of changes at different peri-ods. Results:The incidence of EASC in our database was 0.196%(494/251707). EASC occurred predominantly in male patients (male:female=2.71:1.00). The peak age was within 60-69 years in both males and females (39.6%vs. 40.6%). Notably, the incidence of male patients showed a downward trend (R2=0.063), whereas that of female patients showed an upward trend (R2=0.004). The prevalence of EASC was obviously higher in low-incidence areas for esophageal cancer than in high-incidence areas (53.1%vs. 46.9%, P<0.001). Ac-cording to the TNM staging criteria for esophageal cancer, phases II and III patients comprised the majority of cases, which accounted for 40.8%(173/424). The positive lymph node metastasis rate was 47.0%(206/438), and the number of positive lymph node metasta-ses ranged within 1-2 (48.5%, 100/206). In addition, preoperative biopsy was performed in 467 cases, and more than half of the pa-tients (53.96%, 252/467) were diagnosed before the operation. Surgical resection was the predominant treatment method for EASC (88.8%, 419/472). Only 1.9%patients (9/472) underwent radiotherapy and chemotherapy. The five-year survival rate of male patients who were neither smoking nor drinking of alcohol was higher than that of male smokers (26.5%vs. 12.1%). In patients with stagesⅠ,Ⅱ, andⅢ+Ⅳcarcinomas with surgery as lone treatment, the three-year survival rates were 64.7%, 50.9%, and 48.5%, respectively. Correspondingly, these rates were 51.7%, 47.8%, and 33.1%after adjuvant radiotherapy and chemotherapy. Conclusion:EASC is a rare type of esophageal malignant tumor. The preoperative biopsy pathological diagnosis has high misdiagnosis rate. Smoking and drinking of alcohol can influence the prognosis of patients. In EASC patients, lymph node metastasis easily occurs, and a simple surgery is bet-ter than other cancer treatments.

Objective:To elucidate the factors influencing the differences in the survival rates of esophageal squamous cell carcinoma (ESCC) patients between the rural and urban regions in China. Methods:A total of 36,723 ESCC patients derived from the clinical data-bases containing 500,000 esophageal and gastric cardia carcinoma cases (1973-2015) of the Henan Key Laboratory for Esophageal Can-cer Research of the First Affiliated Hospital, Zhengzhou University, were analyzed. Of these patients, 33,625 were from the rural re-gions (91.6%), comprising 20,906 male patients with an average age of 58.98 ± 8.71 years and 12,719 females with an average age of 59.59 ± 8.53 years. The remaining 3,098 were from the urban regions and composed of 2,089 male patients with an average age of 60.84±9.10 years and 1,009 females with an average age of 62.46 ± 9.14 years. All the patients underwent radical esophagectomy, de-tailed histopathological diagnosis, and TNM staging. Chi square test, Kaplan-Meier, Log-rank, and Cox proportional hazards regression model were used to analyze the differences between ESCC patients from rural regions and those from urban regions and among the risk factors in prognosis. Results:Kaplan-Meier and Log-rank analysis results showed that the ESCC patients from the rural regions had significantly higher overall survival than the urban patients (χ2=12.971, P=0.000). Further analysis showed that rural patients≥50 years old and diagnosed with stage IIa and IIb (middle stage) ESCC had higher survival rates than urban patients in males and females (male:χ2=16.188, P<0.001;female:χ2=5.019, P=0.025). However, the survival rates of rural and urban patients with stage 0,Ⅰa,Ⅰb (early stage) and Ⅲa, Ⅲc, and Ⅳ (late stage) were similar (P>0.05). The results of Cox proportional hazards regression model analysis showed that age, gender, and TNM stages were independent risk factors for rural and urban ESCC patients. When the rural and urban ESCC patients were both considered, the Cox proportional hazards regression model analysis results showed that male ESCC patients≥50 years old, urban residence, and TNM stages were independent risk factors. Conclusion:Rural ESCC patients have significantly high-er overall survival than urban patients. Male, age of≥50 years old, urban residence, and TNM stages were independent risk factors for ESCC patient survival.