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 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 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

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 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 study the application of correlation statistical analysis model in IMRT planning optimization. Methods A correlation statistical analysis model was established. IMRT plans of 5 prostate cancer patients were randomly chosen from the ADAC Pinacal 7.6 version planning system. The beam parameters, objective functions of the target area and optimization parameters of the primary plan were kept unchanged. The main optimization parameters including EUD parameter a,weight (w) and EUD_(max) of OAR were adjusted in optimization procedure successively. The correlation analysis (CF) and optimization efficiency analysis (OF) were carried out on the results of the optimization. The optimal value of parameters (MORt{}) with the best dose distribution was obtained and substituted in the corresponding primary plan.After optimization, the dose distributions of the two IMRT plans were compared. Results There were signif-icant differences with different optimization methods. The EUD parameter a and weight factor (w) almost had no effect on volume dose of OAR (OF < 0.01), though had obvious effect on the maximum dose and mean dose (OF≈1). The CF analysis showed that the correlation between the PTV ( V_(95)) volume and OAR dose was different when the EUD parameter a and w were applied for optimization. Meanwhile, the difference was proportional to the distance between the target area and OAR. The mean dose of OAR was decreased and the mean dose of PTV was more close to the prescription dose when the optimization parameters of the prima-ry plan were substituted with MOR{a} ,MOR{w} and MORt{EUD_(max)}. Besides, the DVH and isedose dis-tribution of the secondary plan were better. Conclusions The correlation statistical analysis model can be used to accurately determine the scope of optimization parameters in the IMRT planning procedure in prostate cancer, and an IMRT plan which fulfils the clinical requirement can be obtained efficiently.

Objective To assess the changes in frequency of peripheral T lymphocytes expressing different cytokines in patients with atopic dermatitis (AD) before and after treatment with BCG-PSN and their relationship with disease severity. Methods A randomized, double blinded and placebo cross-over control study was conducted. A total of 8 patients with AD were recruited in this study. Intramuscular BCG-PSN or placebo was given to patients every other day for 36 days. Flow cytometry was performed to measure the frequency of IL4-, IL5-, IFN-γ- and TNFα-expressing peripheral CD4+ T cells and CD8+ T cells before and after the therapy. Disease severity was evaluated by atopic dermatitis area and severity index score (ADASIS). Results The difference value in IFN-γ+CD8+ T cell frequency before and after therapy was significantly higher in patients treated with BCG-PSN than in those with placebo (8.056 ± 13.962 vs -6.549 ± 10.491, U = 2.26, P< 0.05). There was no statistical difference in the frequency of IL4-, IL5-, TNFa-expressing CD8+ T cells between BCG-PSN- and placebo-treated patients (all P > 0.05). The decrease in ADASIS was 1.56 ± 1.49 in patients treated with BCG-PSN, which was statistically higher than that in placebo-treated patients (-0.05 ± 1.54, U = 2.00, P< 0.05). Conclusion As an immunomodulator, BCG-PSN may control AD by restoring the balance of T-cell subsets.

Animals ; Brain Diseases ; parasitology ; Child ; Female ; Humans ; Sparganosis ; Sparganum

Objective: To investigate the relationship between Bilirubin blood lipid comprehensive index and ifbrinogen (FIB) to severity of coronary lesions in patients with coronary artery disease (CAD).
Methods: A total of 324 patients with angiography (CAG) conifrmed diagnosis were divided into 2 sets of groups.①By CAG examination, the patients were divided into 2 groups: CAD group,n=262 and Non-CAD group,n=62.②By Gensini scoring system, the patients were divided into 4 quartile groups: 1st quartile group,n=58, 2nd quartile group,n=110, 3rd group, n=80 and 4th quartile group,n=76. The blood levels of total bilirubin (TBIL), total cholesterol (TC), LDL-C, HDL-C, TG and ifbrinogen were measured and bilirubin blood lipid comprehensive index, TC/(HDL-C+TBIL) and LDL-C/(HDL-C+TBIL) were calculated respectively.
Results:①By CAG examination, compared with Non-CAD group, CAD group had increased TC, LDL-C, ratios of TC/(HDL-C+TBIL), LDL-C/(HDL-C+TBIL) and FIB,P<0.05; decreased TBIL and indirect bilirubin (IBIL),P<0.05.②By Gensini scoring system, the level of TBIL, IBIL, ratios of LDL-C/(HDL-C+TBIL), TC/(HDL-C+TBIL), HDL-C and FIB were different among 4 groups,P<0.05.③ Logistic regression analysis indicated that with excluded interactional factors, the bilirubin blood lipid comprehensive index was the independent risk factor for CAD[TC/(HDL-C+TBIL): OR: 1.668, 95% CI:1.065~2.784,P=0.028; LDL-C/(HDL-C+TBIL ): OR: 1.786, 95% CI: 1.021~2.879,P=0.030].④Correlation analysis presented that TC/(HDL-C+TBIL), LDL-C/(HDL-C+TBIL) and FIB were positively related to Gensini scoring system (r=0.423,P<0.01), (r=0.417,P<0.01) and (r= 0.293,P <0.01) respectively.
Conclusion: Bilirubin blood lipid comprehensive index and ifbrinogen were positively related to severity of coronary lesions in CAD patients.

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.