Objective To analyze the characteristics of diagnosis and therapeutic effect of malignant pleural effusion with lung cancer,and explore the prognostic factors and effective diagnosis and treatment plans.Methods A retrospective analysis in-cludes 728 cases of definite pleural effusion with lung cancer from October 2009 to December 2013 in our hospital,which was fol-lowed-up to September 30,2014,and 438 cases were available analyzed.The main outcome measures were incidence,efficiency,pro-gression-free survival and overall survival.Results The overall median progression-free survival and the median survival of malig-nant pleural effusions with lung cancer was respectively 4 months and 8 months.males,small cell lung cancer,massive pleural effu-sion,and right pleural effusion may be the independent factors of local unmanageable malignant pleural effusion by multivariable Lo-gistic regression.The overall survival of pleural effusion with locally control(less than four weeks )was better than those with un-manageable(mOS:9 month vs.5 month,P<0.001).It was no significant difference of the control rate for overall survival prognosis between pleural effusion with two weeks and those with four weeks.histological type,partial remission time,the number of cycles of chemotherapy and TKI therapy may be the independent development risk by progression with Multivariate Cox regression analysis. the progress risk of patients with squamous cell carcinoma and other histological types were lower than that of adeno carcinoma (P=0.007).The progress risk of development of patients with 4 weeks of pleural effusion was significantly lower than that of the non remission (P=0.004),the progress risk of complete chemotherapy cycle number > 2 cycles and takingTKI treatment were significantly reduced (P<0.001;P=0.026).Gender,histological type,pericardial effusion,partial remission time,cycles of chemo-therapy and TKI were the independent prognostic factors for overall survival.The overall survival prognosis of patients with Fe-male,squamous cell carcinoma,no pericardial effusion,and over three cycles of chemotherapy,TKI therapy,and local controlled in 4 weeks was better.Conclusion Male,massive pleural effusion and right pleural effusion are independent predictive factors of local unmanageable malignant pleural effusion.The overall survival of pleural effusion with locally control was better than the patients with refractory control.Histological type,controllable relief time of pleural effusion,cycles of chemotherapy and TKI therapy were the independent predictive factors of progression and overall survival.

OBJECTIVE: To explore the related risk facts of pulmonary thromboembolism (PTE) and analyze the relation between PTE and the trauma or medical behavior by investigating the cases of PTE. METHODS: Thirty-three cases were selected from Institute of Forensic Science (IFS) from 2000 to 2014. RESULTS: In 33 cases, 16 decedents were male, 17 decedents were female; different degrees of dyspnea, chest tight- ness and syncope symptoms were the clinical manifestation of the deceased; the thrombus was mainly distributed in the left and right pulmonary arteries. The main source of embolism was the deep vein of lower limb and the left probability was higher. Trauma, limited position, operation and cardiovascular disease showed high-risk factors of PTE; D-Dimer test, hemolytic test and computer tomography pul- monary angiography were the diagnostic tools for PTE. In some cases, trauma and medical malpractice could be involved in the cause of death. CONCLUSION Non-typical clinical symptoms present in the most cases caused by PTE, and these cases always show many high-risk factors. The relation between PTE and injury or medical behavior should be considered carefully in the forensic pathological practice.
Female ; Fibrin Fibrinogen Degradation Products/chemistry* ; Forensic Pathology ; Humans ; Lower Extremity/pathology* ; Lung/pathology* ; Male ; Malpractice ; Pulmonary Embolism/mortality*

OBJECTIVE: To observe the time-course expression of zonula occludens-1 (ZO-1) in cerebral cortex after traumatic brain injury (TBI). METHODS: The TBI model of mouse was established. The mice were divided in 1 h, 3 h, 6 h, 12 h, 24 h, 3 d, 7 d after TBI, sham and control groups. The permeability of the blood brain barrier was evaluated by measuring the extravasation of Evans blue (EB) dye. The expression of ZO-1 in cerebral cortex in the injured area was detected by Western blotting and immunohistochemistry. RESULTS: The extravasation of EB dye of injured cortex gradually increased from 1 h, peaked at 1-3 d and approximately decreased to normal at 7 d after TBI. Western blotting revealed that the expression of ZO-1 gradually decreased after 1 h, was at the lowest at 1-3 d, and then significantly increased after 7 d but was still lower than that of normal and sham groups. The result of immunohistochemistry showed that ZO-1 had strong expression in vessel of normal cortex, gradually decreased after TBI, and almost disappeared at 3 d after TBI and gradually recovered to normal level later. CONCLUSION The expression of ZO-1 in the injured cortex after TBI initially decreases and then increases. The negative correlation between ZO-1 expression and EB extravasation after TBI could be used as a new indicator for wound age estimation.
Animals ; Blood-Brain Barrier ; Blotting, Western ; Brain Injuries/physiopathology* ; Cerebral Cortex/metabolism* ; Immunohistochemistry ; Mice ; Permeability ; Tight Junctions/metabolism* ; Zonula Occludens-1 Protein/metabolism*

Fibrosis ; Hematoma, Subdural ; Humans ; Osteogenesis ; Subdural Space ; Tomography, X-Ray Computed

OBJECTIVE: To explore the injury mechanism of the human knee in a traffic accident by establishing a 3D finite element (FE) model. METHODS: The FE model, composed of femur, tibia, fibula, patella, meniscus, knee ligaments and surrounding soft tissues, was reconstructed by CT scanning data from a male volunteer. Validation was performed by the lateral impact simulation, and the stress and strain results were obtained to be compared with those previously reported for injury prediction. RESULTS: The results derived from the FE model were found to be similar with those previously reported, most of the ligaments and meniscus wounded at 40 m/s collision, which was readily observed. CONCLUSION The simulation results generated by FE model can be effectively used for the injury mechanism analysis of initial contact.
Accidents, Traffic ; Biomechanical Phenomena ; Femur ; Finite Element Analysis ; Humans ; Knee Injuries/etiology* ; Knee Joint ; Male ; Models, Theoretical ; Tibia

Adenocarcinoma ; genetics ; pathology ; Adult ; Aged ; Base Sequence ; Cell Line, Tumor ; DNA Mutational Analysis ; Exons ; Female ; Genes, erbB-1 ; Humans ; Lung Neoplasms ; genetics ; pathology ; Male ; Middle Aged ; Mutation, Missense ; Oligonucleotide Probes ; Polymerase Chain Reaction ; methods ; Real-Time Polymerase Chain Reaction ; methods ; Receptor, Epidermal Growth Factor ; genetics ; Sensitivity and Specificity

Objective To learn 2009~2014 Shaanxi Province sentinel surveillance six classes of HIV infection focus groups, and estimates of HIV-1 new infection.Methods Used enzyme-linked immunosorbent assay (ELISA)and Western blot (WB)experiments for the 2009~2014 HIV sentinel surveillance Shaanxi Province Category 6 focus groups conducted a total of 77 778 HIV antibody screening and confirmatory testing estimates of HIV-1 new infection.Results 2009~2014 men who had sex with men and people with HIV infection rate were 3.75%,8.77%,3.50%,5.00%,6.20% and 5.75%,and a slow upward trend;HIV-1 new infection were 5.04%,8.96%,5.01%,5.95%,4.68% and 6.39%,the overall downward trend. Young students,drug addicts,sex workers,pregnant women,and male STD clinic attenders five people with HIV infection and HIV-1 new infection were emerging to remain low.But male STD clinic attenders of HIV infection and HIV-1 new in-fection was emerging slowly rising trend.Conclusion Shaanxi MSM HIV infection and HIV-1 new infection were high,but HIV-1 new infection had decreased slowly.Emerging trend should continue to increase the population of the intervention ef-forts.The infection rate in other monitoring population was relatively low but a few people on the rise,the need to take the necessary coping methods.

Objective To explore the diagnostic merits of the average apparent diffusion coefficient(ADCav) for leukoencephalopathy in neonates and children.Methods One hundred and fifty-six neonates and children with central nervous system signs or symptoms were classified into 6 groups according to their ages(1 d-0.05).Contrast to the normal,the ADCav of leukoencephalopathy in neonates and children decreased.With increasing age,there showed a linear downtrend in each group.Conclusions The ADCav rises in neonates and children with leukoencephalopathy.The ADCav variation precedes changes in routine MRI.

OBJECTIVE: To explore the application value of postmortem multi-slice spiral computed tomography (MSCT) by observing and analyzing the injury features in the traffic accident victims. METHODS: Ten traffic accident victims were scanned with whole body MSCT. The systemic autopsy was subsequently performed to compare with the results of MSCT. The advantages and disadvantages of autopsy and MSCT for obtaining the information of traffic accident injuries were then analyzed. RESULTS: MSCT could reveal 3D shape of fractures clearly and detect air accumulation in different positions of the body, which showed the obvious advantages compared with autopsy. However, the resolution of MSCT was limited compared to the detection of organ and soft tissue injuries. CONCLUSION A combination of MSCT and autopsy is the best way for determining the manner and the cause of death in traffic fatality victims.
Accidents, Traffic ; Autopsy ; Fractures, Bone ; Humans ; Soft Tissue Injuries ; Tomography, Spiral Computed

Objective To observe the changes of receptor for advanced glycation end-products (RAGE) and intedeukin-1β (IL-1β) in cerebral cortex of rats after cerebral ischemic preconditioning (CIP) and to further explore the signification of CIP.Methods SPF healthy male SD rats were assigned randomly into 3 group:model Ⅰ group (n =36),model Ⅱ group (n =36),and sham group (n =36).The rats in model Ⅱ group were subjected to 2 hour of right middle cerebral artery occlusion (MCAO) reperfusion with suture-occluded method to establish focal cerebral ischemia reperfusion injury model.Ten miniutes MCAO by suture-occluded was used as model Ⅰ group,72 hours after reperfusion,given the same treatment like the model Ⅱ group.For the sham group,separate the carotid artery only.Each group was divided into 0.5 days,1 day,2 days,3 days,7days total of five time points after reperfusion,6 rats at each time point.After surgery,the infarction volume was evaluated by 2,3,5-triphenyltetrazolium chloride (TTC) staining.The neural behavioral score were measured by Zea Longa assessment criteria.The expression levels of RAGE and IL-1β mRNA were assessed by the method of real-time quantitative polymerase chain reaction.Results Comparison of rats in 1 d after ischemia,the infarct volume in model Ⅰ group was (19.04 ± 1.65) ％ which was lower than model Ⅱ group(34.55 ±4.78) ％,the difference was statistically significant (P ＜ 0.05).Compared with model Ⅱ group,the average neural behavioral scores at each time point were less than 2.2 points in model Ⅰ group,they were significantly reduced (P ＜ 0.05).The expression of RAGE mRNA:The Delta C (T) value of RAGE in the model Ⅰ and model Ⅱ groups were significantly higher than the sham group at that times,reached the peak at the time of 1 d,the Delta C (T) value of the sham group,the model Ⅰ group and model Ⅱ group were 6.56 ±0.08,9.52 ± 0.23,9.89 ± 0.17,which relative expression quantity being calculated were 1.24,9.65,12.47,both decreased with the prolonging of reperfusion time.The Delta C (T) value of the sham group,the model Ⅰ group and model Ⅱ group at 3 d were 6.18 ±0.32,7.87 ±0.36,8.61 ±0.24,the expression levels of model Ⅰ group were significantly lower than the model Ⅱ group at those five time points(P ＜0.05).The expression of IL-1β mRNA:its Delta C (T) value of IL-1β in the model Ⅰ group and model Ⅱ group were both significantly higher than the sham group at 0.5 days,1day,2 days,3days,7days,for example,the Delta C(T) value of the sham group,the model Ⅰ group and model Ⅱ group at 3 days were 7.75 ±0.32,9.94 ±0.18,10.38-±0.27,which relative expression quantity being calculated were 1.09,4.96,6.73,the difference was statistically significant(P ＜0.01),the model Ⅰ group was significantly lower than the model Ⅱ group at those five time points,the Delta C(T) value of the two groups at 0.5 d were 11.84 ± 0.43,12.51 ± 0.36,which relative expression quantity being calculated were 18.51 and 29.45,the expression was descending gradually along with the time (P ＜ 0.05).Conclusion CIP can produce cerebral ischemic tolerance,the down-regulation of RAGE and IL-1β expression may be one of the mechanisms of ischemic tolerance induced by CIP.