OBJECTIVE: To explore the forensic pathological features of death caused by anaphylactic shock. METHODS: One hundred and forty-two death cases of anaphylactic shock were retrospectively analyzed. The IgE level in the serum of anaphylactic shock cases were statistically compared with that of 62 non-anaphylactic shock cases. RESULTS: Most cases (77.46%) of anaphylactic shock death occurred in the medical institutes, with intravenous drug administration accounting for 53.53% of anaphylactic shock death. β-Lactam antibiotics, glucocorticoid and herbal medications were responsible for a significant proportion of such cases. Although characteristic histopathological changes were absent in vast majority of these anaphylactic shock cases, the differences of IgE levels in the serum between anaphylactic shock group and non-anaphylactic shock group were statistically significant (P<0.05). CONCLUSION Combined information including clinical data, autopsy results, IgE level, and other specific test results should be evaluated together in the forensic pathological diagnosis of anaphylactic shock.
Anaphylaxis ; Autopsy ; Cause of Death ; Forensic Pathology ; Humans ; Infusions, Intravenous ; Retrospective Studies ; Serum

Objeetive To investigate the relationship among social avoidance and acceptance of disability in burn patients.Methods Totally 127 patients were investigated using Social Avoidance and Distress Scale (SADS),Acceptance of Disability Scale (AODS),demographic information questionnaire and disease related information sheet.Results The points of burn patients' SADS was (21.38±6.75),One-way ANOVA showed that gender,marital status,special parts burns,amputation affected social avoidance significantly.The total score and factors scores of acceptance of disability were all negatively related to the score of social avoidance.Regression analysis showed that acceptance of disability,head burns,gender were the independent risk factors of depression.Conclusions Acceptance of disability were negatively related to social avoidance; Nurse can help them accept the reality of disability,develop the confidence to partici-pate in social communication,and improve the social adaptability.

Yunnan sudden death syndrome (YSDS) is an abruptly fatal disease of unknown etiology, found mostly in central or northwestern mountain area (with altitude between 1,815 and 2,225 meters) of Yunnan province from June to September every year. It occurs mostly in young female adults, with high incidences in Lisu, Yi and Miao ethnics and high familial aggregation. The clinical manifestation of YSDS is changeful and the pathological characteristic is lack of specificity. The pathogenesis may be attributed to several factors including poor hygiene and lower socioeconomic conditions, lack of Selenium or Chromium, infection of Coxsackie B virus, mushroom consumption and special geological conditions. This article reviews the epidemiologic features, clinical manifestations, pathological features, etiology and hypothesis in order to provide clues for the research of YSDS.
Adult ; China ; Death, Sudden/pathology* ; Female ; Humans ; Syndrome

OBJECTIVETo assess the association of the A260G and A386G single nucleotide polymorphisms (SNP) of the DAZL gene with male infertility in the Chinese population of Zhejiang Province.

METHODSWe collected the peripheral blood samples from 317 idiopathic infertile males with azoospermia or oligozoospermia and 246 normal fertile men, and genotyped the polymorphic loci of the A260G and A386G polymorphisms of the DAZL gene using the SNaPshot technique.

RESULTSThe DAZL gene A260G was found genetically polymorphic in the Chinese population of Zhejiang Province, with the gene frequencies and their distribution consistent to the Hardy-Weinberg equilibrium. The frequencies of the AA, AG and GG genotypes of the A260G polymorphism were 92.3%, 7.3%, and 0.4% respectively in the normal controls and 94.3%, 5.7%, and 0% in the infertile patients, with no statistically significant differences between the two groups (P = 0.43, OR = 0.78, 95% CI 0.413-1.46). Heterozygosis (AG) of A386G was found in 1 of the control males but not in the infertile patients, while homozygosis (GG) of A386G was not observed in either group (P = 0.259, OR = 0.698, 59% CI: 0.374-1.306).

CONCLUSIONA260G and A386G SNPs of the DAZL gene are not associated with spermatogenic failure and neither represents a molecular marker for the genetic diagnosis of male infertility in the Chinese population of Zhejiang Province.

Asian Continental Ancestry Group ; Azoospermia ; genetics ; China ; Gene Frequency ; Genetic Markers ; Genotype ; Humans ; Infertility, Male ; genetics ; Male ; Oligospermia ; genetics ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide ; RNA-Binding Proteins ; genetics

OBJECTIVE: To evaluate the spontaneous brain activity alterations in liver transplantation (LT) recipients using resting-state functional MRI. MATERIALS AND METHODS: Twenty cirrhotic patients as transplant candidates and 25 healthy controls (HCs) were included in this study. All patients repeated the MRI study one month after LT. Amplitude of low-frequency fluctuation (ALFF) values were compared between cirrhotic patients (both pre- and post-LT) and HCs as well as between the pre- and post-LT groups. The relationship between ALFF changes and venous blood ammonia levels and neuropsychological tests were investigated using Pearson's correlation analysis. RESULTS: In the cirrhotic patients, decreased ALFF in the vision-related regions (left lingual gyrus and calcarine), sensorimotor-related regions (left postcentral gyrus and middle cingulate cortex), and the default-mode network (bilateral precuneus and left inferior parietal lobule) were restored, and the increased ALFF in the temporal and frontal lobe improved in the early period after LT. The ALFF decreases persisted in the right supplementary motor area, inferior parietal lobule, and calcarine. The ALFF changes in the right precuneus were negatively correlated with changes in number connection test-A scores (r = 0.507, p < 0.05). CONCLUSION: LT improved spontaneous brain activity and the results for associated cognition tests. However, decreased ALFF in some areas persisted, and new-onset abnormal ALFF were possible, indicating that complete cognitive function recovery may need more time.
Ammonia ; Brain* ; Cognition ; Fibrosis ; Frontal Lobe ; Hepatic Encephalopathy ; Humans ; Liver Transplantation* ; Liver* ; Magnetic Resonance Imaging ; Motor Cortex ; Neuropsychological Tests ; Occipital Lobe ; Parietal Lobe ; Rabeprazole ; Somatosensory Cortex

OBJECTIVETo study the factors related to repeated abortions among unmarried young people, and to standardize the services as informed choice counseling and post abortion, and to reduce the repeated abortion rate.

METHODSA cross-sectional survey using anonymous questionnaire was conducted among unmarried young women who requested termination of early pregnancy in 10 hospitals in Shanghai.

RESULTS2343 subjects responded to the questionnaires. Results showed that the repeated abortion rate was 38.5%, repeated abortion rate within 1 year was 23.5%, and the high risk factors of abortion accounted for 40.2% . Subjects who were older than 19, unemployed, with poor education background, cohabitating and boyfriends being elder were more likely to have repeated abortions (OR > 1). Subjects who did not change boyfriend or use no contraception were more likely to have repeated abortions 1 year after abortion (OR > 1).

CONCLUSIONNo reliable contraception used after abortion seemed to be the main reason for repeated unwanted pregnancy. Being socially disadvantaged women such as unemployed or with poor education background, meanwhile cohabitating with boyfriends or boyfriends being elder etc. they should be viewed as the key population for intervention. Male involvement and reliable contraceptive methods use among young people should be emphasized as key steps for intervention. 1 year after abortion fell into the key period for intervention. Reinforcement on factors including: training for service providers to improve their skills, setting up standard technical process and monitoring systems to carry out the basic principle of 'Informed Choice', and widely launching post-coital contraception programs including emergency contraception, luteal phase contraception and menstrual induction should be stressed.

Abortion Applicants ; statistics & numerical data ; Abortion, Induced ; statistics & numerical data ; Adolescent ; China ; epidemiology ; Contraception Behavior ; Cross-Sectional Studies ; Female ; Humans ; Pregnancy ; Risk Factors ; Socioeconomic Factors ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo investigate the constituents of Ervatamia hainanensis systematically.

METHODVarious chromatographic techniques were applied to isolate and purify the constituents of this plant. The structures were elucidated by spectroscopic analysis.

RESULTEight compounds were obtained, which were identified as alpha-amyrin acetate (1), 11-oxo-alpha-amyrin acetate (2), beta-sitosterol (3), cycloart-23-ene-3beta, 25-diol(4), cycloart-25-ene-3beta, 24-diol (5), 5alpha, 8alpha-epidioxyergosta-6, 22-dien-3beta-ol (6), ibogamin-3-one (7), beta-daucosterol (8).

CONCLUSIONCompounds 1, 2, 4- 7 were isolated from this plant for the first time.

Apocynaceae ; chemistry ; Ergosterol ; analogs & derivatives ; chemistry ; isolation & purification ; Oleanolic Acid ; analogs & derivatives ; chemistry ; isolation & purification ; Plant Roots ; chemistry ; Plant Stems ; chemistry ; Plants, Medicinal ; chemistry ; Triterpenes ; chemistry ; isolation & purification

OBJECTIVETo observe the liver oxidant damage for diabetic model in mice.

METHODSMale kunming mice were feed with high fat dietary for a week and then were randomly divided into two groups by weight, with 10 mice in each group. One group was induced by small dose streptozotocin (STZ) and obtained STZ-induced diabetic mice, and the other group was regarded as the control. Both of the two groups were feed with high fat dietary. After 6 weeks, the activities of enzymes, such as superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-PX) and nitric oxide synthase (NOS) were measured. Glutathione (GSH), maleic dialdehyde (MDA), nitric oxide (NO) levels in the liver and the liver viscera quotient were also measured. Liver histological manifestations were observed.

RESULTSIn diabetes group, there was a significant decrease in body weight, and the activities of GSH, CAT, and NOS decreased significantly (t value were 5.370, 10.639, 5.235, 3.089, respectively, P < 0.01). While, the liver viscera quotient, the levels of MDA, GSH-PX and NO increased remarkably (t value were -6.246, -2.728, -2.660, -4.924, respectively, P < 0.01 or P < 0.05). The significant difference was not observed in SOD between the two groups (t value was -0.405, P > 0.05). The liver histological damages were observed in diabetes group, light microscope observation showed hepatocytes swelling, ballooned changing and fatty droplets clustering.

CONCLUSIONThe oxidant damage might exist in the liver diabetic model in mice.

Animals ; Diabetes Mellitus, Experimental ; metabolism ; pathology ; Liver ; metabolism ; pathology ; Male ; Mice ; Mice, Inbred Strains ; Nitric Oxide ; metabolism ; Oxidative Stress ; Superoxide Dismutase ; metabolism

OBJECTIVETo investigate the expressions of E-cadherin, CD44H, matrix metalloproteinase-3 (MMP-3), nm23H1 and vascular endothelial growth factor (VEGF) in nasopharyngeal carcinoma and its relationship to the effect of radiotherapy. Furthermore, to analyze the predict value of radiotherapy effect.

METHODSThe expressions of E-cadherin, CD44H, MMP-3, nm23H1 and VEGF in 62 patients with nasopharyngeal carcinoma were determined by immunohistochemical SP method. There were 62 patients (17 to 70 years old) with nasopharyngeal carcinoma which were treated by radiotherapy from March 1995 to October 1995 and the period of follow-up had full 10 years.

RESULTSThe expressions of CD44H (chi2 = 18.739, P = 0.028) and VEGF (chi2 = 18.523, P = 0.030) were closely related with short-term effect after radiotherapy in nasopharyngeal carcinoma. The short-term effect was descent along with enhancement of their expressions. In the group of low expressions in CD44H and nm23H1, 3-year overall survival rate were 65.5% and 45.5%, and 5-year overall survival rate were 47.3% and 22.7%. In the group of high expressions in CD44H and nm23H1, 3-year overall survival rate were 54.6% and 75.9%, and 5-year overall survival rate were 27.8% and 53.2%. There were respectively significant difference between two group of expressions in CD44H (chi2 = 7.31, P = 0.0069) and nm23H1 (chi2 = 15.64, P = 0.0001).

CONCLUSIONSThese findings indicated that to detect the expressions of CD44H and VEGF gene may predict short-term effect of radiotherapy. Furthermore, to detect the expressions of CD44H and nm23H1 gene may predict long-term effect of radiotherapy in nasopharyngeal carcinoma.

Adolescent ; Adult ; Aged ; Cadherins ; genetics ; metabolism ; Carcinoma, Squamous Cell ; genetics ; metabolism ; radiotherapy ; Female ; Humans ; Hyaluronan Receptors ; genetics ; metabolism ; Male ; Matrix Metalloproteinase 3 ; genetics ; metabolism ; Middle Aged ; NM23 Nucleoside Diphosphate Kinases ; genetics ; metabolism ; Nasopharyngeal Neoplasms ; genetics ; metabolism ; radiotherapy ; Prognosis ; Survival Rate ; Treatment Outcome ; Vascular Endothelial Growth Factor A ; genetics ; metabolism ; Young Adult

BACKGROUNDRenin-angiotensin system inhibitor and calcium channel blocker (CCB) are widely used in controlling blood pressure (BP) in patients with chronic kidney disease (CKD). We carried out a meta-analysis to compare the renoprotective effect of the combination of angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) and CCB (i.e., ACEI/ARB + CCB) with ACEI/ARB monotherapy in patients with hypertension and CKD.

METHODSPublications were identified from PubMed, Embase, Medline, and Cochrane databases. Only randomized controlled trials (RCTs) of BP lowering treatment for patients with hypertension and CKD were considered. The outcomes of end-stage renal disease (ESRD), cardiovascular events, BP, urinary protein measures, estimated glomerular filtration rate (GFR), and adverse events were extracted.

RESULTSBased on seven RCTs with 628 patients, ACEI/ARB + CCB did not show additional benefit for the incidence of ESRD (risk ratio [RR] = 0.84; 95% confidence interval [CI]: 0.52-1.33) and cardiovascular events (RR = 0.58; 95% CI: 0.21-1.63) significantly, compared with ACEI/ARB monotherapy. There were no significant differences in change from baseline to the end points in diastolic BP (weighted mean difference [WMD] = -1.28 mmHg; 95% CI: -3.18 to -0.62), proteinuria (standard mean difference = -0.55; 95% CI: -1.41 to -0.30), GFR (WMD = -0.32 ml/min; 95% CI: -1.53 to -0.89), and occurrence of adverse events (RR = 1.05; 95% CI: 0.72-1.53). However, ACEI/ARB + CCB showed a greater reduction in systolic BP (WMD = -4.46 mmHg; 95% CI: -6.95 to -1.97), compared with ACEI/ARB monotherapy.

CONCLUSIONACEI/ARB + CCB had no additional renoprotective benefit beyond than what could be achieved with ACEI/ARB monotherapy.

Angiotensin Receptor Antagonists ; pharmacology ; therapeutic use ; Angiotensin-Converting Enzyme Inhibitors ; pharmacology ; therapeutic use ; Calcium Channel Blockers ; pharmacology ; therapeutic use ; Drug Therapy, Combination ; Glomerular Filtration Rate ; Humans ; Hypertension ; drug therapy ; Kidney ; drug effects ; Renal Insufficiency, Chronic ; drug therapy