Acute Disease ; Adult ; Female ; Herbicides ; poisoning ; Humans ; Inflammation ; therapy ; Male ; Paraquat ; poisoning ; Poisoning ; therapy ; Retrospective Studies ; Survival Rate ; Young Adult

Objective To evaluate the efficacy and mid-term follow-up results of endovascular treatment with Willis covered stent for traumatic pseudoaneurysms located in the internal carotid artery (ICA).Methods ICA angiogmphy was performed in 38 patients with traumatic brain and neck injury.Of the 38 patients.13 delayed traumatic pseudoaneurysms were found.All the pseudoaneurysms were treated with Willis covered stents.Follow-up angiography was performed at 1,3,6 and 12 months after the procedure,and the results were categorized as complete or incomplete occlusion.Clinical manifestations were graded as full recovery,improvement,unchanged and aggravation.Results Willis covered stent placement was technically successful in all traumatic pseudoaneurysms.No procedure-related complications occurred.The initial angiographic results showed a complete occlusion in 9 patients,and an incomplete occlusion in 4.The angiographic follow-up within 3-12 months exhibited a complete occlusion in 12 patients and the parent arteries remained patency in all patients.The clinical follow-up observation demonstrated that full recovery wag obtained in 11 patients,clinical improvement in one,and unchanged condition in one.No morbidity or mortality occurred.Conclusion Willis covered stent implantation iS a feasible and practical treatment for traumatic pseudoaneurysms located in the ICA.This technique can well preserve the parent artery with excellent therapeutic results.

Objective Chronic atrial fibrillation (AF) results in dedifferentiation of atrial cardiomyocytes that plays an important role in the perpetuation of AF.In this study,we aimed to investigate the changes of titin and α-smooth muscle actin (α-SMA) after long time of AF reversal.Methods Twenty-four goats were randomized into four groups:(1) sinus rhythm (SR),(2) 3 months AF (3-mo AF),(3) 3 months SR after 3 months AF (3-mo post AF),(4) 6 months SR after 3-mo AF (6-mo post AF),with 6 in each group.By pacing on the anterior bottom of left atria appendage (LAA),we established a goat model of chronic AF.Atria effective refractory period (AERP) was measured with electrophysiological methods.Ultra-structure was studied with echocardiography,light and electron microscopy.Titin and α-SMA protein expressions were determined by Western blot.Results The animals underwent high rate pacing on LAA for a mean of 42.23±21.70 days before presenting AF.Electrophysiological analysis revealed that AERP completely resumed in 3-mo post AF goats.Echocardiography displayed that the size of left atrium resumed almost in 6-mo post AF goats (P＜ 0.01).Pathological and electron microscopic examination revealed the disorder of myofibrils,augmentation of intercellular space,myolysis,accumulation of glycogen,and numerous bigger mitochondria among atrial cardiomyocytes in 3-mo AF goats.They recovered mostly in 6-mo post AF goats.Western blot showed that the band density of titin significantly reduced in 3-mo AF goats compared to SR ones [1826±319 vs 5012±854,P＜0.01].In 3-and 6-mo post AF goats,titin increased gradually and it reversed completely in 6-mo post AF goats (3841±601 and 4523±833 respectively,P ＜ 0.01).Conversely,the band density of α-SMA was significantly higher in 3-mo AF goats (5324±948) than in SR ones (1619± 271,P＜0.01).In 3-and 6-mo post-AF goats,α-SMA decreased gradually,and it recovered mostly in 6mo post AF goats (4437± 792 and 2205±540 respectively,P＜0.01,).Conclusions These data indicate that the reversal of dedifferentiation of atrial cardiomyocyts is a very slow process,and it is definitely essential for normal cardiac function.

OBJECTIVETo investigate the clinical characteristics of children with Castleman's disease and to improve doctors' awareness of this disease.

METHODSClinical characteristics of 5 cases with Castleman's disease were observed and analyzed and relevant reports in literature were reviewed.

RESULTS(1) All the five patients' histories were long, and the first symptoms of them were painless lymphnode enlargement, and all of them were at school age; 3 patients' abdominal lymphnodes were enlarged, mediastinum lymphnodes enlarged in 3 cases, cervical lymphnodes were involved in 3 cases; (2) The clinical subtypes: the disease in 3 cases was localized Castleman's disease (LCD), all of their pathological subtype was hyaline vascular variant (HV). The rest of them were multicentric Castleman's disease (MCD), whose pathology was plasma cell variant (PC), and both of them had a febrile symptoms; (3) The white blood cells, C-reactive protein and ferritin levels were all elevated to different extents. Four of them had viral infections, and their cellular immune function was abnormal; (4) The LCD patients' prognosis was good after the complete resection. There is no standard therapy for MCD, the available therapies include antiviral, immune modulatory regimens, CD20 B cell monoclonal antibody and chemotherapy, but the prognosis was worse than that of LCD.

CONCLUSIONSCastleman's disease is rare in children, which can be misdiagnosed because it has no specific manifestations. The prognosis depends on the subtype.

Castleman Disease ; diagnosis ; Child ; Female ; Humans ; Male ; Prognosis ; Retrospective Studies

Objective The present study was to differentiate the hyperdensities on CT immediately after intra-arterial thrombolysis in patients with acute isehemic stroke.Methods Twenty two patients with acute ischemic stroke were treated with intra-arterial combining with intravenous thrombolysis within 6 hours after onset.All patients underwent nonenhaneed CT scans before,immediately and 24 hours after thrombolytic therapy.The hyperdensities on CT after intra-arterial thrombolysis were analyzed retrospectively.Results Five hyperdense areas were seen in 22 patients immediately after thrombolytie therapy.According to their locations, CT values and follow-up CT scans,the hyperdensities on CT imaging were classified into two groups:contrast enhancement and hemorrhagic transformation.The former was characterized by rapid clearance of the hyperdensity lesion with maximum Hounsifild Unit＜90,on the contrary,the latter was noted by persistence of hyperdensity lesion after 24 hours CT scan with maximum Hounsifild Unit＞90.Two of the five hyperdense lesion patients were confirmed to be contrast enhancement with location in cerebral cortex,the other were hemorrhagic transformation,mostly located in basal ganglia.Hyperdensity in patients with contrast enhancement showed neurological improvement although no further medical cares were offered.Conclusions Different kind of hyperdensity on CT immediately after intra-arterial thrombolysis in patients with acute ischemic stroke can be differentiated according to its location,CT value and follow-up CT scan.When contrast enhancement occurred,no further medical care is needed.

Objective To investigate the water quality and running status of the dringking water improving project in Xuchang,Pingdingshan and Nanyang,thus to provide basis for scientifically evaluating social effects.Methods Stratified sampling was used in the levels of counties and townships and villages,with the number of checked counties greater than or eaquel to half of the projected counties(13/24),the checked townships more than 40 percent of the projected townships(42/102),the checked villages greater than or eaquel to 30% of the projected villages(56/186).We listened their statement,reviewed the documents,examined carefully the water projects before we made the appraisal.Results More than 95%(129/136)of the projects had water quality reports,among which 90%(122/136)were provided by county level centers for disease prevention and control,75% (102/136) of water samples were collected by centers for disease prevention and control,80%(109/136)ofcounties organized an acceptance check-up group,92%(125/136)projects well preserved water source.Conclusions The dringking water improvement projeets in countryside are basically normal in terms of construction and management,the water supplied is qualified,so the expected goal is achieved.However,duties of each department are not explicit and the communication is inadequate,so collaboration should be reinforced.

Objective To present our single-center experience in treating traumatic direct carotidcavemous fistulas (TDCCFs)by using detachable balloon,coil and Willis covered stent via arterial route.Methods During the last five years,transarterial endovascular treatment by using detachable balloon,coil and Willis covered stent was performed in fifty-one consecutive patients of traumatic direct carotid-cavernous fistulas.with a total of 54 TDCCFs.The detachable balloon was the material of first choice,while Willis covered stents and coils were regarded as the back-up materials.A clinical and angiographic follow-up for 348 months (mean 20.8 months) was conducted to evaluate the arterial patency and the stability of embolization.The clinical data were retrospectively analyzed.Results By using the detachable balloon alone via transarterial route.85%TDCCFs were successfully treated with good preservation of ICA.A total of 98% TDCCFs in this study were successfully treated by using detachable balloon,coil and/or Willis coveted stent,the fistulas became occluded,and ICAs were preserved except one patient.Forty TDCCFs were treated with detachable balloons alone,two TDCCFs with the Willis covered stent alone,and one DCCF with coils alone.Eight TDCCFs were treated with detachable balloons together with Willis covered stent.Of these eight TDCCFs,two were treated with a single session,three were treated with detachable halloons in combination with coils,and one had to receive Willis covered stent.Second and third times of endovascular treatment were needed in 12 TDCCFs.The TDCCF-rel(at)ed symptoms were gradually relived or improved within 1 day to 6 months after treatment,except for five patients who suffered from ipsilateral moderate visual loss or cranial nerve deficit.No perioperative complications.such as vessel rupture,distal embolization or new neurologic deficits,occurred.During the follow-up period lasting for six months,neither delayed neurologic or vascular complications nor recurrence of the lesions developed.Conclusion Via the transarterial route,using detachable balloon to occlude the fistula and at the same time to preserve ICA remains the optimal treatment for TDCCFs.When the standard treatment fails.various coils and the Willis covered stents can be used as an effective alternative or remedial tool in the treatment of TDCCFs,which can preserve ICA.Willis covered stent deployment seems to be an effective,safe,feasible and economical endovasculal treatment for TDCCF,but more clinical studies are needed before we can further clarify its specifications and indications.

Objective To explore the cognitive level of medical statistics course in undergraduate nurse students studying traditional Chinese medicine and the methods to improve the present teaching method,and to develop statistical thinking of students with the view of promoting the research level of students.Methods With the nursing project and teaching method of enlightening interesting,A self-designed questionnaire was used to survey the cognitive level of 142 undergraduate nurse students studying traditional Chinese medicine in Nanjing University of TCM,all of them had completed the medical statistics curricula.Results Total of 142 students were collected,most students had confidence in studying the course.90.1％ students had gasped the basic thought,51.4％ students did not think about the future research work,80.3％ students had realized the existence of variance and error,16.9％ students thought nursing of Chinese medicine had disadvantages compared to Western medicine.Most students supported the application of statistical software.Among several examination methods,practice a specific data or distinguish data processing error was the methods that more accepted by students.Conclusions Nursing of Chinese medicine has broad and bright prospects,thus,it is essential to raise the scientific cognition and data procession level of nursing students.Data pertaining Chinese medicine is complicated and it is vital to deep the teaching of medical statistics course,to raise the studying interesting,to practice the concrete data and to teach the theory course combine with the software.

OBJECTIVETo summarize the clinical features and to evaluate outcomes and to assess therapeutic effects in 34 children and adolescents with Hodgkin lymphoma treated with risk-adapted combination chemotherapy and low-dose, involved-field radiation therapy (IFRT) in China.

METHODFrom January 2003 to April 2009, 34 hospitalized children with Hodgkin lymphoma were enrolled into the BCH-HL 2003 protocol (revised CCG 5942) in our hospital. Pathological samples were reviewed centrally and classified based on the World Health Organization guidelines. Staging was based on clinical evaluation and was defined by the Ann Arbor staging system. The 34 patients were treated according to the different risk factors in three treatment groups (standard, intermediate, and high risk), and received risk-adapted combination chemotherapy and IFRT. All analyses were calculated by the statistical program SPSS.

RESULTOf the 34 Hodgkin lymphoma patients, 28 were male and 6 were female. The median age was 8.7 years (range from 4 years to 15 years) at the time of diagnosis. In terms of clinical presentation, 53% had bulky lymph nodes, 47.1% had more than 4 node regions involved and 44% had "B" symptoms at presentation. The distribution for stage of disease was 0% for Stage I, 21% for Stage II, 35% for Stage III and 44% for Stage IV disease. All patients had classical histology consisting of three different sub-discipline: 22 cases of mixed cellularity (64.7%). In pathological samples of 25 cases there was EBV encoded RNA (EBER) or latent membrane protein (LMP) staining. The overall survival (OS) was 100% and the 5-year event-free survival was 94.1% with a median follow-up of (26.1 ± 16.3) months. Two patients had early relapse after treatment was finished. Organ toxicity was limited to hematological grades III and IV at rates of 40% and 71% respectively.

CONCLUSIONChildhood Hodgkin lymphoma in our study was more frequently seen in male school aged children. Combined-modality therapy using risk-adapted chemotherapy with radiation is effective and well tolerated. The overall prognosis was good.

Adolescent ; Child ; Child, Preschool ; Combined Modality Therapy ; Female ; Hodgkin Disease ; therapy ; Humans ; Male ; Risk Factors ; Treatment Outcome

Objective: The current study was designed to explore the relationship between the epithelial cadherin (E-cd) expression and clinical appearances of salivary tumor. Method: The paraffin embedded tissue specimens were studied immunohistochemically using the ployclone antibody against E-cd and ABC method. The E-cd expression level was determined semiquantatively. The semi-quantitative parameters of E-cd expression were analyzed retrospectively with the clinical information. Result: The E-cd positive expressions were normal (＋ ＋ ) in two cases of normal salivary tissue, 5 cases of benign mixed tumor and paracancerous salivary tissue, 39 cases of of 47 malignant salivary malignancies it was decreased even to no E-cd expression. There was a significant correlation between decreased E-cd expression and preoperative clinical appearances, postoperative survival, recurrence or metastasis. Conclusion: The E-cd expression level may be a useful prognostic parameter for salivary malignancies.