Objective To investigate the mortality and cause of death in inpatients with cerebral infarction. Methods The clinical data of 515 patients with cerebral infarction as the underlying cause of death from January 2005 to December 2009 were analyzed retrospectively. The hospital mortality, direct cause of death,and constituent ratio of the cause of death were calculated. The clinical features,such as classification of the Trial of Org 10 172 in acute stroke treatment( TOAST),age and duration of hospital-ization were analyzed. Results ( 1 )The hospital mortalities in patients with cerebral infarction from 2005 to 2009 were 2. 0%(91/4 659),2. 1%(110/5 264),1. 9%(95/5 035),1. 2%(100/8 656),and 1. 0%(119/11 640),respectively. The overall mortality rate was 1. 5%(515/35 254),basically had a declining trend year by year(χ2 =42. 39;P<0. 01).(2)The mortalities of the inpatients with cerebral infarction in the young( <45 years),middle-aged(45 to 59 years),elderly(60 to 74 years),and aged ( >74 years)groups were 1. 1%( 22/2 009 ),1. 0%( 112/11 158 ),1. 5%( 221/14 311 ),and 2. 1%(160/7 776),respectively. They increased with increasing age(P<0. 01).(3)The TOAST classification in 515 died patients were as follows:57. 3%(n=295)for large-artery atherosclerosis,19. 4%(n=100) for cardioembolism,14. 4%(n=74)for cryptogenic stroke,7. 0%(n=36)for small-artery occlusion and 1. 9%(n=10)for other reasons. The five leading direct cause of death were cerebral hernia 49. 3%(n=254),primary central respiratory and circulatory failure 25.0%(n=129),pneumonia 8. 9%(n =46), cerebral-cardiac syndrome 5. 8%( n =30 ),and multiple organ failure 5. 6%( n =29 ).( 4 ) The mean age of death was 67 ± 12 years old. The patients who died of cerebral hernia and primary central respiratory and circulatory failure were younger than those who died of pneumonia(65 ± 13,68 ± 11,and 75 ± 10,respectively;all P<0. 01). The median length of hospital stay was 3 days. The length of hospital stay in patients who died of hernia,primary central respiratory and circulatory failure,and cerebral-cardiac syndrome were significantly shorter than those who died of pneumonia and multiple organ failure( the median length of hospital stay was 3. 0,3. 0,3. 0,12. 5,and 9. 0 days,respectively;all P <0. 05). Conclusions The mortality of hospitalized patients with cerebral infarction have a declining trend year by year. Brain disease itself is the most important reason of early death for patients with cerebral infarction, indicating that it is the important point of prevention and treatment in clinical work.

Objective To investigate the safe directions of screw trajectory in atlas via posterior arch and lateral mass and its clinical significance. Methods Lateral radiographs and CT axial scans of atlases were performed in 30 cases with normal morphology of atlases and axes. The minimal height of posterior arch, the maximum inclination of screw projection relative to sagittal plane, and the maximum medial angle of screw projection relative to axial plane were evaluated radiologically. According to the safe directions obtained radiologically 21 cases of atlantoaxial instability were treated with screw fixation atlas via posterior arch and lateral mass. During operation the influence of screws on surrounding structures was investigated and postoperative neural symptoms were documented also. Preoperative and postoperative radiographs and CT scans of 13 patients were available and some related parameters were measured to evaluate the safety of the screw placements. Results 1) The maximum angle of screw projection to sagittal plane is about 10? cephalad to 6? caudal, with the tendency of increasing maximum angle as the minimal height of posterior arch increases. 2) When the entry point on the posterior arch was switched laterally, the medial angle of screw projection should be adjusted from 0? to 30?, correspondingly. 3) The actual directions of screw trajectory might differ from preoperative ones, but all were in the estimation range. 4) All screws were placed successfully, and the postoperative radiographs and CT scans shows no neural or vascular complications relative to atlantal screws placed in traditional way. Conclusion There is a safe range to insert atlas screw via posterior arch and lateral mass both in sagittal and axial plane.

Objective To research the effect of poria cocos on the immune function of mice.Methods We filled the stomaches of mice with 100% water extract of poria cocos regularly and tested the ability of antibody-forming cells of mice,specific rosette forming cells(SRFC) and serum immunoglobulin(IgG).Results The immune function of poria cocos group improved remarkably compared with control group(P

Aged ; Bone and Bones ; pathology ; Carcinoma, Small Cell ; complications ; pathology ; Female ; Humans ; Hyoid Bone ; pathology ; Plasmacytoma ; complications ; Small Cell Lung Carcinoma ; Thyroid Gland ; pathology ; Thyroid Neoplasms ; pathology

Objective: To construct a prediction model of non-alcoholic fatty liver disease (NAFLD) in middle-aged and elderly patients with type 2 diabetes mellitus (T2DM), so as to provide basis for early screening and prevention of T2DM complicated with NAFLD. Methods: Patients aged 45 years and above and diagnosed with T2DM in Karamay Hospital of People's Hospital of Xinjiang Uygur Autonomous Region in 2021 were collected as the study subjects. The data of general demographic characteristics and biochemical test results were collected. The patients were randomly divided into training group (n=3 241) and validation group (n=1 389) according to the ratio of 7∶3. LASSO regression and multivariable logistic regression model were used to select predictive factors. The nomograph model for prediction of NAFLD risk in T2DM patients was established. The predictive value of the model was evaluated using the receiver operating characteristic (ROC), adjusted curve and decision clinical analysis. Results: Totally 4 630 T2DM cases were included, including 1 279 cases (27.62%) complicated with NAFLD. LASSO regression and multivariable logistic regression analysis identified gender, age, diastolic blood pressure, body mass index, alanine transaminase, triglycerides, low density lipoprotein cholesterol and platelet count as risk prediction factors for NAFLD in T2DM patients. The area under the ROC curve was 0.823 (95%CI: 0.814-0.832) for the training group and 0.809 (95%CI: 0.799-0.818) for the validation group, and Hosmer-Lemeshow test showed a good fitting effect (P>0.05). Decision curve analysis showed higher net clinical benefit of using the predictive model to predict NAFLD risk when the risk threshold probability was 0.27 to 0.85. Conclusion The nomogram model established has a good predictive value for the risk of NAFLD in T2DM patients aged 45 years and above.

Objective To evaluate the effectiveness of TCM combined with western medicine for advanced gastric cancer.Methods We retrieved literatures of randomized controlled clinical trials related (from January 1991 to June 2012) to the use of TCM combined with western medicine treatment for advanced gastric cancer and made meta-analysis including:the effectiveness,Kamofsky scores and publication bias.Results 44 papers (including 3088 AGC patients) were included.Meta analysis suggested a difference between the treatment group and the control group in effectiveness (Z＝ 6.12,P＜ 0.01),and K score (Z＝ 3.31,P＜0.01).The effectiveness of the reatment group and the control group are 97.8％ and 73.4％ respectively.Conclusion The combined treatment resulted in an improved quality of effectiveness and Kamofsky scores.

Introduction of problem-based learning (PBL) teaching is the demand of teaching reform.Teaching and research section of physiology in Chongqing medical university implemented PBL teaching throughout the whole process of clinical medicine undergraduate education.The overall quality of students and the teaching quality were improved by constructing a new mode suitable for physiology teaching,focusing on training students' active learning ability and stimulating students' enthusiasm for learning.

Objectives To explore the change of interleukin-17 (IL-17) in Kawasaki disease (KD). Methods Fourty KD pediatric patients, among them 12 patients with echocardiographic abnormalities in acute phase, 25 age-matched non-KD patients were enrolled. The level of serum IL-17 was measured by enzyme linked immunosorbent assay in acute and convalescent phase of KD patients and non-KD patients. At the same time, C-reactive protein (CRP), globulin, albumin were detected. Results In acute phase of KD patients, the level of serum IL-17 were signiifcantly higher than that in convalescent phase of KD patients and non-KD patients (P<0.05). The level of serum IL-17 was no signiifcant differences in convalescent phase of KD patients and non-KD patients (P>0.05). In acute phase of KD patients with echocardiography abnormalities, the level of serum IL-17 was signiifcantly higher than that with non-echocardiography abnormalities (P<0.05). The level of serum IL-17 in acute phase of KD patients were positively correlated with CRP and globulin (r=0.750, 0.750, P<0.05), and negatively correlated with albumin (r=-0.779, P<0.05). Conclusions IL-17 may be involved in KD immune pathogenesis. Serum IL-17 is one of the activity index of KD, which associ-ated with cardiovascular damages.

Objective To investigate the specific anti-tumor immune response induced by dendritic cells (DCs) transfected with total RNA of human pancreatic cancer Capan-2 cells.Methods DCs were isolated and cultured from peripheral blood mononuclear cells (PBMCs) derived from six patients with pancreatic cancer.Total RNA of Capan-2 cells and MUC4 mRNA were transfected into DCs by electroporation.The survival rate of transfected DCs was determined by MTT method and the expression of MUC4 mRNA in DCs was detected by Western blotting.The activity of cytotoxic T lymphocyte cells (CTLs) induced by DCs transfected with total RNA of Capan-2 cells were evaluated by IFN-γ ELISA and the induction of specific CTL response to the killing effect on pancreatic cancer cell in vitro were measured by 51 Cr standard cytotoxicity test.Results The survival rate of DCs transfected with total RNA of Capan-2 cells (DC-Capan-2-total RNA) showed a decrease in a time dependent manner and the survival rate was reduced to 60.81％ after transfection for 96 h.The survival rate of MUC4 mRNA transfection DCs (DC-MUC4 mRNA) was stable at around 80％.The difference of DCs surviral rate between the two groups was statistically significant (P ＜ 0.05).The amount of MUC4 protein expression of DC-Capan-2-total RNA was significantly lower than that of DC-MUC4 mRNA (P ＜0.05).The quantity of CTL IFN-γ release induced by DC-Capan-2-total RNA was (89.34 ± 3.85)U/mL and the quantity of DC-MUC4 mRNA induced CTL IFN-γ release was (21.77 ± 21.77)U/ml There was statistically significant between the two groups (P ＜0.05).In addition,the specific CTLs induced by DC-Capan-2-total RNA could effectively identify and kill the HLA-A2+/MUC4+ Capan-2 and the HLA-A2+/MUC4-PANC 1 cells,and could not effectively identify and kill the HLA-A2 /MUC4-MiaPaCa-2 cells and the HLA-A2-/MUC4 + AsPC-1 cells.Conclusions A more pronounced CTL anti-tumor immune response can be induced by DCs transfected with total RNA of Capan-2 cells compared with a single tumor associated antigen,but it is limited by MHC class Ⅰ antigen presented.

Objective To further investigate the threshold value and the dose-effect relationship of infrasound on the rat pallium, and to observe the effects on the pallium's ultrastructure. Methods Rats were exposed to 16 Hz, 90 dB infrasound for 2 hours daily. With a transmission electron microscope, changes in the ultrastructure of the cortex of the rats' parietal lobes were observed 2 hours, 3 days and 7 days after the treatment. Results There were no changes in the ultrastructure of the pallium in rats which had been exposed for 7 days or 14 days. Denaturation appeared when the rats had been exposed for 21 days, 28 days or 35 days. Denaturation become more serious as the exposure time increased beyond 21 days. Denaturation and damage gradually returned to normal with time after exposure. Conclusion 16 Hz, 90 dB infrasound exposure over an extended time may cause denaturation and other changes in the ultrastructure of the pallium in rats. Such changes can return to normal with time.