Karoshi remains one of the most troublesome issues in forensic identification. It is rather a social medicine than a clinical disease. Japanese scholars pioneered examining the relation between sud- den cardiac death (SCD) and chronic fatigue from long time and/or high-tension work. In the current case, a 55-year-old man, whose job was loading and carrying heavy cement bags, was found dead after 11 days of continuous hard work. His family members sued the cement factory for his death and claimed for compensation. The problem was the difficulty of identifying the causative relation without the precedent or the relevant regulations. However, the forensic problems were finally acknowledged after autopsy and calculation of labor intensity. The lawsuit was won as the first case pertaining to Karoshi in the Chinese court.
Autopsy ; Death, Sudden, Cardiac/etiology* ; Fatigue/mortality* ; Forensic Pathology ; Humans ; Male ; Middle Aged ; Risk Factors ; Workload/legislation & jurisprudence*

To study the anti-tumor metastatic constituents in Rhodiola wallichiana (HK) S H Fu var Cholaensis (Praeg) S H Fu, chemical constituents were isolated and purified by repeated column chromatography (silica gel, Toyopearl HW-40C and preparative HPLC). Their structures were elucidated on the basis of spectral data analysis. The anti-tumor metastasis assay was applied to evaluate the activities of the isolated compounds. Ten compounds (1-10) were isolated and their structures were identified by comparison of their spectral data with literature as follows: syringic acid (1), salidroside (2), tyrosol (3), scaphopetalone (4), berchemol (5), 2,6-dimethoxyacetophenone (6), rhobupcyanoside A (7), miyaginin (8), chavicol-4-O-β-D-apiofuranosyl-(1 --> 6)-O-β-D-glucopyranoside (9), eugenyol-O-β-D-apiofuranosyl-(1 --> 6)-O-β-D-glucopyranoside (10). Compounds 4-6 and 8-10, were isolated from this genus for the first time, while compound 7 was isolated from this plant for the first time. Compounds 2, 6-8 showed positive anti-tumor metastatic activities, and compounds 2 and 8 showed significant anti-tumor metastatic activities.
Antineoplastic Agents, Phytogenic ; isolation & purification ; pharmacology ; Cell Line, Tumor ; Humans ; Neoplasm Metastasis ; prevention & control ; Rhodiola ; chemistry

Objective To explore the effect of different proportions of mixed blood exchange transfusion on blood circulation in neonates with hemolytic disease.Methods Thirty-one newborn infants with hemolytic disease were treated by peripheral arteriovenous synchronization of exchange transfusion with different proportions mixed blood.AB type plasma was mixed with O type red blood cell(RBC) washing.The proportion for the treatment group was 1:1(the O type RBCs 2 U:the AB type plasma 200 mL),by exchange transfusion of haplotypes,in accordance with 80?mL/kg;the proportion for control group was 2:1(the O type RBC 4 U:the AB type plasma 200 mL),by exchange transfusion of double in accordance with 150-180 mL/kg.The indicators were detected,such as the exchange rate of neonatal serum bilirubin,RBC,hemoglobin(Hb),hematocrit(HCT),and the exchange transfusion quantity and days of hospitalization before and after the exchange transfusion were analyzed.Results The exchange rate of serum bilirubin of treatment group and control group was (44.92?3.99)% and (45.69?5.06)%,respectively,there was no significant difference between 2 groups(P=0.639),there was no significant difference of hospitalization days[(8.13?1.13) d vs(8.19?0.91) d]between 2 groups(P=0.884).After exchange transfusion in treatment group,the average level of the RBC,Hb and HCT were increased(P

OBJECTIVETo sum up causes and the prevention of complications after using the radio frequency ablation (RFA) to treat of primary and secondary liver cancers.

METHODSThe clinical courses of 735 patients, undergoing percutaneous RFA treatment for a total of 1780 times were reviewed. The causes of the complications occurring after the RFA treatment, and their prevention and treatment were evaluated.

RESULTSEleven complications after RFA treatment were found. Postoperative fever, sweating, and local pain were common. Serious complications, such as gut perforation, intraabdominal hemorrhage, and cardiovascular accident were found in 4 patients, and the mortality was 75%.

CONCLUSIONSThe RFA treatment is an effective method for the treatment of primary and secondary liver tumor. Careful selection of patients, appropriate preoperative preparations, proper operative procedures, and suitable postoperative care are the key points in preventing the complications.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular ; secondary ; surgery ; Catheter Ablation ; adverse effects ; Female ; Humans ; Liver Neoplasms ; secondary ; surgery ; Male ; Middle Aged

OBJECTIVETo probe into the relationship between hypertension and hemodynamic score of cerebral vascular accumulative function by though studying the history of hypertension and level of blood pressure.

METHODSThe database of blood pressure and cerebral vascular hemodynamic indexes (CVHI) were from baseline data and measurement in a cohort. 18,512 participants who met the included criteria were enlisted in the study. The function scores were estimated using uniform methods according to CVHI. Participants were grouped by age, years of having hypertension and level of blood pressure. Differences of the function score between different groups were compared.

RESULTSThe function score in hypertension group was significantly lower than that of normal tension group, which decreased by 13.3 points. Within 5 years of hypertension history, the function score decreased as course of hypertension prolonged. The same trend was found between the score and level of both systolic and diastolic blood pressure. When systolic blood pressure elevated to 140 mmHg or diastolic blood pressure elevated to 95 mmHg, the function score was below 75 points.

CONCLUSIONThere were significant relationship between decrease of the function scores and medical history, course of hypertension as well as level of blood pressure.

Adult ; Age of Onset ; Aged ; Blood Pressure ; physiology ; Cerebrovascular Circulation ; physiology ; China ; epidemiology ; Cohort Studies ; Female ; Hemodynamics ; physiology ; Humans ; Hypertension ; epidemiology ; physiopathology ; Male ; Middle Aged

Objective:To find out the difference between children with attention-deficit/hyperactivity disorder and normal control,and the difference between boys and girls with ADHD in resting-state.Methods:There were 38 children with ADHD in this study including 31 boys and 7 girls,meanwhile,42 normal controls whose age and gen der were matched with children with ADHD were involved too,including 29 boys and 13 girls.Total scores of ADHD rating scale (ADHD-RS) were used to measure the severity of symptom for both ADHD and normal control.Magnetic resonance imaging was used to collect the resting-state functional magnetic resonance imaging data,and the fractional amplitude of low frequency fluctuation (fALFF) was measured for each child.Analysis of covariance (ANCOVA) was used to find out the difference between the group and the sex.Results:Children with ADHD showed a higher fALFF in the right medial superior frontal gyrus and right supplementary motor area,and a lower fALFF in the left putamen,bilateral cerebellum and bilateral precuneus than controls (all corrected P ＜0.05).ADHD boys showed a lower fALFF in the left cerebellum and a higher fALFF in the bilateral medial superior frontal gyrus than boys without ADHD (all corrected P ＜0.05).ADHD girls showed a higher fALFF in the bilateral cerebellum and in the thalamus than girls without ADHD,and a lower fALFF in the insula than girls without ADHD (all corrected P ＜ 0.05).There was a negative relationship between the fALFF of the left cerebellum of ADHD girls and the scores of inattention symptoms.Conclusion:The fALFF difference exist between ADHD and normal controls,and between boys and girls with ADHD.

OBJECTIVETo present data from a baseline investigation on stroke-related cohort population in rural area of Shanghai.

METHODSA cross-sectional study was carried out in a cluster sampling population aged 40 years and over. General information and data on common risk factors in the population were gathered and cerebral vascular hemodynamic indexes were checked. Hemodynamic score was estimated according to single indexes by unified methods. 5335 persons who had met the inclusion criteria were enlisted in the study. Exposure level of risk factors, prevalence of stroke, and hemodynamic indexes were analyzed and distributional characteristics were described.

RESULTSExposure rate of hypertension, heart disease, diabetes, family history of hypertension, overweight or obesity in males were 31.74%, 6.09%, 1.16%, 3.22%, 17.64%, 29.68% and were 32.76%, 9.22%, 1.55%, 3.84%, 19.22%, 29.44% in female respectively. Standard prevalence of stroke was 1167.3/100000, which in male was significantly higher than that in female (P < 0.05). The change of cerebral vascular hemodynamic indexes was significantly associated with age. Hemodynamic score in 21.3% of the subjects was below 75 points.

CONCLUSIONSAmong population of 40 years old and over in rural areas, hypertension was the principal risk factor regarding the rate of stroke. Prevalence of stroke in males was significantly higher than that in females. Abnormal rate of hemodynamic score was about 20% in this population.

Adult ; Age Factors ; Aged ; Aged, 80 and over ; Brain ; blood supply ; China ; epidemiology ; Cohort Studies ; Cross-Sectional Studies ; Female ; Hemodynamics ; Humans ; Hypertension ; complications ; epidemiology ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Rural Health ; Sampling Studies ; Sex Factors ; Stroke ; epidemiology ; physiopathology

OBJECTIVETo observe the protective effect of ischemic postconditioning on ischemic reperfusion injury of rat liver graft and to investigate the possible mechanism.

METHODSMale Sprague Dawley rats were used as donors and recipients of orthotopic liver transplantation, and the period of cold preservation and anhepatic phase were 100 min and 18 min, respectively. Sixty rats were randomly divided into three groups, twelve rats in control group, twenty-four rats in ischemic reperfusion injury group and ischemic postconditioning group respectively. Control group is sham operation group, only the ligaments around liver were cut off; donor livers in ischemic reperfusion injury group were infused through portal vein with heparinized saline before harvested; ischemic postconditioning group: at very onset of reperfusion after donor liver was implanted, several brief reperfusion-ischemia were given before persistent reperfusion of portal vein. Half recipients of ischemic reperfusion injury group and ischemic postconditioning group were taken blood samples and hepatic tissue samples after 2 hours of reperfusion of liver graft. Rest recipients were taken samples of hepatic tissue after 6 hours of reperfusion. Recipients of control group were taken blood and hepatic tissue samples at corresponding time after abdomen was sutured.

RESULTSCompared with ischemic reperfusion injury group, liver functional parameters, cytokines and peroxidized products contents were lower in ischemic postconditioning group (P < 0.05); meanwhile, the antioxidases contents of hepatic tissue were higher in ischemic postconditioning group than those in ischemic reperfusion injury group (P < 0.05).

CONCLUSIONSIschemic postconditioning could relieve the ischemic reperfusion injury of rat liver graft. Through improving antioxidation capability and cutting down cytokines contents, ischemic postconditioning could apply its protective effect.

Animals ; Glutathione Peroxidase ; metabolism ; Leukocyte Elastase ; blood ; Liver ; blood supply ; metabolism ; Liver Transplantation ; Male ; Malondialdehyde ; metabolism ; Peroxidase ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; metabolism ; prevention & control ; Superoxide Dismutase ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism

OBJECTIVETo explore the effect of hepatitis B virus (HBV) X protein (HBX) on expression of the host gene Wnt induced secreted protein-1 (WISP-1) that is related to the pathogenic process of hepatocellular carcinoma (HCC).

METHODSTumor and paratumor tissues were collected from HCC patients, and normal liver tissues were collected from healthy controls. Immunohistochemistry was used to evaluate the in vivo presence and expression levels of HBX and WISP-1 in the three tissue types. HepG2 cells stably transfected with pc-DNA3.1(+)-HBX or with pc-DNA3.1(+) only (G0, control) were generated and used to examine in vitro the HBX-induced changes in WISP-1 expression at the mRNA and protein levels by reverse transcription polymerase chain reaction and western blotting, respectively.

RESULTSThe HCC tissues showed significantly higher rates of positivity for WISP-1 expression than the non-tumor controls (76.6% vs. paratumor: 23.4% or normal tissues: 0%, x2= 35.967, P less than 0.01). HBX increased WISP-1 expression in HepG2 cells at both the mRNA (1170.33 +/- 41.26 vs. G0: 265.34 +/- 27.47, t = 31.63, P less than 0.01) and protein (240.33 +/- 11.37 vs. G0: 40.33 +/- 7.09, F = 600.57, P less than 0.01) levels.

CONCLUSIONHBV may up-regulate expression of the host gene WISP-1 through its X protein and thus promote the development of HCC.

Carcinoma, Hepatocellular ; Hepatitis B ; Hepatitis B virus ; metabolism ; Humans ; Liver Neoplasms ; Wnt1 Protein

OBJECTIVE To investigate the therapeutic effect and side effect of ibrutinib long-term treatment in systemic lupus erythematosus (SLE) model mice induced by pristane. METHODS Female 6-week old BALB/c mice were ip given pristane 0.5 mL once for SLE induction. Four weeks later, the SLE model mice were divided into three groups based on the body mass and serum level of anti-double-strand DNA (DS-DNA) antibody and treated with 1%methylcellulose (model control group, ig), ibrutinib (30 mg·kg-1, ig) or prednisone (10 mg·kg-1, ig), respectively, once daily for 28 weeks. Every 4 weeks, body mass of each mouse was measured. Autoantibodies against DS-DNA, single-strand DNA (SS-DAN), and histone were tested by ELISA. The incidence of lupus arthritis and clinical score of inflammation and edema were recorded and graded. Biochemical analysis of urea protein, serum urea nitrogen and creatinine was used to evaluate kidney function. Mice were euthanized post 28 weeks of dosing. Inter-leukin-6 (IL-6), interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α) were tested by ELISA. The heart, liver, spleen, lung, and kidney were collected and weighed for organ relative mass calculation. Biochemical analysis of serum glutamic-pyruvic transaminase (GPT), glutamic-oxal(o)acetic transaminase (GOT) and alkaline phosphatase (ALP) was used to evaluate liver function. Hind feet were collected for HE staining and pathological scoring to observe renal injury and inflammation. Immunohistochemical staining was used to study IgG immune complexes deposition in kidneys of lupus. RESULTS Compared with normal control group, autoantibodies (anti-DS-DNA, anti-SS-DNA and anti-histone antibodies), renal function indexes (serum creatinine, urea nitrogen and urine protein), and cytokines (IL-6, IFN-γ and TNF-α) levels in model group were significantly increased (P<0.01). The model group mice had obvious clinical symptoms of arthritis (P<0.01), serious inflammation cell invasion (P<0.01), and the mass of kidneys and spleen increased significantly (P<0.01). Compared with model group, after 28 weeks of treatment, ibrutinib decreased the level of anti-DS-DNA, anti-SS-DNA and anti-histone antibodies (P<0.01), decreased the lupus arthritis score (P<0.01) and the morbidity of arthritis, reduced the level of cyto-kines IL-6, IFN-γand TNF-α(P<0.01), reduced the level of serum creatinine, serum urea nitrogen and urine protein (P<0.01), improved pathological symptoms of hind feet such as inflammation, cartilage destruction, bone resorption and pannus (P<0.01), alleviated renal tissue inflammatory cell invasion and the immune-complex precipitation, and reduced the mass of organs (spleen and kidneys, P<0.01) and the level of liver function (GPT and ALP, P<0.01). CONCLUSION Long-term treatment with ibrutinib has therapeutic effect on the model mice of SLE, and has no obvious side effect.