Adult ; Critical Care ; Female ; Humans ; Male ; Middle Aged ; Nitrites ; poisoning ; Young Adult

Heat Stroke ; Humans ; Occupational Diseases

Objective To investigate the clinical and pathological features of prostate cancer with low level of serum prostate-specific antigen (PSA) in elderly patients.Methods Data of 328 patients with prostate cancer were retrospectively analyzed.Clinical and pathological data of 4 prostate cancer patients with low serum PSA level were analyzed.Potential risk factors and diagnostic methods of prostate cancer with low serum PSA level were discussed based on the clinical data combined with literatures.Results Mean age of the 4 patients was 71.3 years.Mean PSA value on admission was 1.96 μg/L.2 patients had abnormal digital anal examination results.2 patients were pathologically diagnosed as adenocarcinoma after puncture,among which 1 had duct adenocarcinoma,and the other 2 patients were pathologically diagnosed as neuroendocrine carcinoma after puncture.2 patients with neuroendocrine carcinoma of prostate were treated with endocrine therapy,and the other 2 patients were treated with radical prostatectomy plus auxiliary endocrine therapy.Conclusions Prostate cancer with low serum PSA level has an insidious onset,which is prone to miss the diagnosis.It should be paid sufficient attention for the diagnosis,and monitoring of prostate cancer is independent on PSA.Prostate cancer with low serum PSA level should be diagnosed in combination with some basic examinations such as serum free prostate specific antigen,prostate specific antigen density and digital rectal examination,et al.

T-cell non-Hodgkin lymphoma is a group disease with unique clinical and pathological features. It is more aggressive and has lower chemotherapy sensitivity than B-cell lymphoma. In recent years, to search for effective treatment, novel agents such as gemcitabine, targeted therapy combined with chemotherapy and high-dose chemotherapy combined with hematopoietic stem cell transplantation are applied in the treatmentof T-cell non-Hodgkin lymphoma. And some progresses are achieved.

Objective To analyze the blood pressure,heart rate,the US national institutes of health stroke scale(NIHSS) score,Glasgow coma scale(GCS) score for cerebral infarction patients with cerebral hemorrhage after recombinant human tissue-type plasminogen activator (rt-PA) therapy.Methods From April 2011 to April 2013,48 cases with cerebral infarction after intravenous rt-PA thrombolysis were collected.These cases were divided into two groups:the first group (32 cases):without cerebral hemorrhage after thrombolysis; the second group (16 cases):with cerebral hemorrhage after thrombolysis.The systolic blood pressure,diastolic blood pressure,heart rote,NIHSS score and GCS score were compared between the two groups before and after thrombolysis.Results After thrombolysis,the systolic and diastolic blood pressure were significantly increased in cerebral hemorrhage cases compared with before thrombolysis and patients without cerebral hemorrhage.After thrombolysis,the NIHSS score was significantly reduced in the cases without cerebral hemorrhage compared with that before thrombolysis,while the NIHSS score was significantly higher in the cases with cerebral hemorrhage compared with that before thrombolysis.After thrombolysis,the heart rate and GCS score showed no significant difference between the patients with and without cerebral hemorrhage.Conclusions The rising of systolic blood pressure,diastolic blood pressure and NIHSS score helps us determine the early cerebral hemorrhage after thrombolysis in cerebral infarction patients.

Objective: To study the relationship between endoplasmic reticulum stress (ERS) and adiponectin;to explore the role of ERS for increasing myocardial ischemic vulnerability in type 2 diabetes mellitus (DM) mice.
Methods: Type 2 DM model was established by high fat diet with streptozotocin (STZ) injection. A total of 35 C57BL/6J male type 2 DM mice were divided into 4 groups: ①Control group, n=5. ②Tauroursodeoxycholic acid (TUDCA) group,③Thapsigargin (TG) group and ④Normal saline group. The mice in Groups ②, ③, ④were fed by high fat and high glucose diet by injecting streptozotocin (STZ), in the last 3 weeks and respectively received intraperitoneal injections of TUDCA (250 mg/kg), thapsigargin (TG) (300μg/kg) and normal saline twice a day, n=10 in each group. Then myocardial infarction (MI) model was established in 5 mice from each group. 72 hours later, the MI ranges were measured, serum levels of adiponectin were detected, mRNA expressions of adiponectin and CHOP in myocardial tissue were examined.
Results: The MI range in TUDCA group (21.47 ± 2.85)%and in Normal saline group (39.92 ± 4.28)%were both lower than TG group (66.56 ± 8.15)%, both P<0.01. Before MI occurrence, serum levels of adiponectin in TUDCA group (79.25 ± 6.40) pg/ml and in Normal saline group (70.23 ± 4.15) pg/ml were both higher than TG group (62.64 ± 5.70) pg/ml, both P<0.01;serum levels of adiponectin in each group were higher than they were 72 h after MI. In each group, the mRNA expression and protein content of adiponectin in myocardial tissue were constant to serum adiponectin;while the mRNA expression and protein content of CHOP was opposite to serum adiponectin.
Conclusion: ESR could increase myocardial vulnerability in type 2 DM mice which might be related to down-regulating adiponectin expression.

Objective To evaluate the efficacy of narrow-band ultraviolet B (NB-UVB) for the treatment of early-stage mycosis fungoides (MF).Methods A retrospective study was performed on 98 patients with early-stage MF treated with NB-UVB from January 2003 to December 2013.The rate of and time to recurrence of MF were assessed,and long-term side effects were evaluated in these patients.Results Among 52 patients achieving complete remission,the median number of sessions of NB-UVB radiation was 30 (range,18-87),the median cumulative radiation dose was 24.16 J/cm2 (range,9.11-108.86 J/cm2),and the median follow-up duration was 41 months (range,11-90 months).Relapse occurred in 14 (26.9％) patients with the median time to recurrence being 8.2 months (range,3-60 months).The patients suffering from relapse achieved complete remission after treatment with NB-UVB again.Adverse reactions mainly included skin erythema and itching at the early stage of radiation,as well as temporary pigmentation after radiation.Cutaneous carcinoma occurred in none of these patients during 11-90 months of follow-up.Conclusions NB-UVB phototherapy appeared to be effective for the treatment of early-stage MF,and no cutaneous carcinoma occurred in these patients during the follow-up.Although MF may relapse in some cases,repeated NB-UVB phototherapy is still effective.

Objective To analyze clinical and bacteriological features and therapeutic methods of erysipelas following breast cancer surgery in 12 hospitalized patients. Methods Clinical data on 12 patients with erysipelas following breast cancer surgery were collected from 3 third-grade class-A hospitals in Ningbo. A retrospective study was carried out. Results Of the 12 patients, 8 were treated with modified radical mastectomy and axillary lymph node dissection, 3 with radical mastectomy and axillary lymph node dissection, and 1 with mammectomy only. All of the 12 patients suffered from postoperative lymphedema on the affected side. Erysipelas mostly occurred within 1 - 18 years (mean, 8.0 years)after breast cancer surgery, and on the same side of surgery in all the patients except 2 with multi-site infection. Specifically speaking, erysipelas was located in the upper extremity in 8 patients, in the chest wall in 1 patient, in the lower extremity in 1 patient. Blood culture was performed for 5 patients, of whom, 2 showed positive results, including 1 infected with Streptococcus equisimilis and 1 with Klebsiella pneumonia. Six patients were treated with penicillins, but the primary treatment failed in 2 patients. After replacement of antibiotics, all the 12 patients experienced an improvement of the condition and were discharged from hospital. Conclusions Patients who suffer from lymphedema after breast cancer surgery are prone to erysipelas of the upper limbs and chest wall. Caution should be taken against gram-negative bacterial infections in these pateints. The treatment of lymphedema should be taken into account besides antibiotic therapy.

Objective To explore the value of ultrasonography in the diagnosis and identification of Obstetrics and Gynecology in accident and emergency.Methods A retrospective method was taken to 80 cases of obstetrics and gynecology emergency patients with ultrasound diagnosis data analysis in the hospital from June 2014 to June 2015,and compared to surgical and pathological diagnosis,to observe the ultrasonic diagnosis value.Results The correct rate of the ultrasound diagnosis of ectopic pregnancy,ovarian cyst torsion,inevitable abortion,threatened abortion,corpus luteum rupture,trophoblastic disease,and acute pelvic inflammatory disease was 90.9％,94.1％,100.0％,100.0％,85.7％,75.0％,and 100.0％,and the overall diagnostic accuracy was 93.8％.Conclusions The Emergency Department of obstetrics and gynecology patients used ultrasound has a better diagnosis effect,and high diagnostic accuracy.At the same time,the ultrasound examination is gynecology and obstetrics emergency check the preferred way,strong repeatability,and better observed lesions,high application value.

Objective To establish a HPLC method to detect the propofol concentration of plasma in children undergoing cardiopulmonary bypass. Methods RP-HPLC with fluorescence detector was used in the study. Plasma samples were precipitated by the thymol-methanol solution, and centrifugated. 20?l of supernatant fluid was injected for analysis and separated by Dikma Diamonsil C18 column. The mobile phase was composed of acetonitril:water =56:44(V/V), flo rate was 1.0ml/min. Fluorescence detective wave lengths were ?ex= 276nm, ?em=312nm. HPLC machine was Agilent1100 series. Main column was Diamonsil C18(150?4.6nm,5um),guard column was Phenomenex Security(4mm?3mm). Results There was a good linear relationship within the range of 0.02～8.0mg/L(r=0.9993, n =9),the limit of detection was 5?g/L,average recovery was 96.99%,intra RSD(relative standard deviation )was between0.810% and 5.73%,inter RSD was between 0.932% and 7.337%. Conclusions The method is sensitive, simple, rapid, good linear relationship and precise. The experiment can be used for determination of propofol concentration in child undergoing cardiopulmonary bypass.