Objective To explore the intervention effect of emodin on organophosphorus poisoning induced respiratory failure.Methods 60 male Wistar rats of clean grade were randomly divided into:normal control group, model control group, positive drug group and emodin group, with 15 rats in each group.Except the normal control group rats were given intraperitoneal anesthesia, the right common carotid artery intubation, when rats stayed awake began a septic model.Blood gas analysis and serum level of oxygen free radicals and respiratory rate were compared before poisoning, respiratory failure, intervention of 5, 10, 30 min.Results Mouth breathing, slow respiratory frequency and cyanosis, appeared after exposure.Respiratory frequency decreased after exposure , compared with the positive drug group, respiratory frequency of emodin group 10 min and 30 min was higher ( P<0.05), PaO2, SaO2, BE decreased, PaCO2 increased after respiratory failure, Compared with the positive drug group, PaO2, PaCO2, SaO2 and BE of emodin group for the treatment of 10 min, 30 min was higher,(P <0.05).The level of oxygen free radicals in rats of each group had no significant difference before the exposure and the respiratory failure.Compared with the positive drug group, SOD and MDA of emodin group in 30 min after intervention were higher,( P<0.05 ) .Conclusion Emodin can improve the respiratory frequency of organic phosphorus poisoning induced respiratory failure ,improve blood gas analysis of the indicators and the level of oxygen free radicals.

OBJECTIVE:To establish a method for simultaneously determination of glycyrrhizic acid and glycyrrhetinic acid in Yaotongning capsule. METHODS:HPLC was performed on the column of Agilent TC-C18 with mobile phase of methanol-0.2 mol/L ammonium acetate(gradient elution) at a flow rate of 1.0 ml/min;detection wavelength was 250 nm and column temperature was 25 ℃ and injection volume was 10 μl. RESULTS:The linear range was 0.007 1-0.178 0 mg/ml(r=0.999 8)for glycyrrhizin acid and 0.354 8-8.720 0 μg/ml of glycyrrhetinic acid(r=0.999 8);RSDs of precision,stability and reproducibility tests were no more than 1.74%,average recoveries were 95.49%-100.62%(RSD=1.98%,n=9)and 96.80%-102.26%(RSD=1.83%,n=9),respec-tively. CONCLUSIONS:The method is simple,reproducible,accurate and reliable,and can be used for the simultaneous determi-nation of glycyrrhizic acid and glycyrrhetinic acid in Yaotongning capsule.

Objective To study the histopathological features of hepatic portal area in autopsy specimens of elderly men with type 2 diabetes mellitus (T2DM).Methods One hundred and three autopsy cases with T2DM (diabetic group) and contemporary 48 non-diabetic cases matched by gender and age (control group) were selected in the study.The histopathological changes of hepatic portal area were observed by histochemical and immunohistochemical methods.Results (1) In diabetic group, endothelial denudation, eosinophilie deposits, eccentric intimal thickening and luminal stenosis were found in hepatic interlobular artery (arteriole, the lumen diameter < 100 μm).The medial smooth muscle cells proliferated and migrated into intima, and fibroplasia occurred in adventitia.62.1% (64/103) of the patients with T2DM had microangiopathy and there was statistically significant difference between the two groups (χ2= 27.14, P< 0.01 ).(2) Hyaline collagen fiber tissues deposited around interlobular artery, interlobular vein and interlobular bile ducts, resulting in enlargement of the portal area and the secondary atrophy and disappearance of portal triad.65.0% (67/103) of the patients with T2DM had this pathological changes in the portal area and there was statistically significant difference between the two groups(χ2= 23.27,P<0.01).(3) Terminal portal area was notable.Conclusions Mieroangiopathy can be observed in the hepatic portal areas of elderly men with T2DM, which may induce the fibrotic tissue hyperplasia, the atrophy of the portal triad and the sclerosing portal area.

Objective To observe the incidence rate of non-alcoholic fatty liver disease (NAFLD) in elderly male patients with type 2 diabetes mellitus (T2DM) and the features of pathological changes of liver. Methods The 89 cases with T2DM (T2DM group) and contemporary non-diabetic cases (control group, n=48) from 858 autopsy samples matched for gender and age were selected in the study. The histopathological changes of liver were observed by microscopy,histochemistry and immunohistochemistry. Results The incidence rates of NAFLD and nonalcoholic steatohepatitis(NASH) were 49.4% (44/89) and 14.6% (13/89) in T2DM group, 22.9 %(11/48) and 4.2% (2/48) in control group, respectively. The incidence rates of NAFLD and NASH were significantly higher in T2DM group than in control group(P＜0.01, P＜0.05). All of the NASH patients from T2DM group and one patient from control group were complicated with different stages of liver fibrosis. One patient from T2DM group was diagnosed as cirrhosis, no cirrhosis patient was found in control group. Conclusions Compared with control group, the incidence rate of NAFLD is higher and the damage of liver is more severe in T2DM group. The ratio of the progress from NAFLD to liver cirrhosis is low.

OBJECTIVETo study the clinicopathological characteristics diagnosis, differential diagnosis and etiology of demyelination pseudotumors of the brain.

METHODSThe clinical features, CT, MRI scan findings, corticosteroid therapeutic effects and follow-up data of 3 cases of demyelination pseudotumors of the brain were analysed, and pathological changes were observed by histologic (HE, Luxol fast blue and Bodian) and immunohistochemical (S-P method) techniques.

RESULTSThe acute onset of demyelination pseudotumors appeared to be more predominant in our data. Clinical manifestations included headache, vomiting, a depressed conscious level, dysphasia, and paresis. CT, MRI scans showed solitary or multiple lesions in cerebral hemisphere. All the patients presented excellent response to steroid treatment. Follow-up for a period of 6 to 31 months, revealed the absence of progression or recurrence. The pathological changes were mainly located in both cerebral hemispheres, in which there were relative axonal preservation in foci loss of myelin, reactive gliosis, profuse perivascular lymphocytic infiltration and mixtures of foamy macrophages.

CONCLUSIONDemyelination pseudotumor is a distinct clinicopathologic encephalitic entity. The findings of this study suggest that the cause of tumefactive demyelination may be related to an allergic reaction triggered by viral infection.

Adolescent ; Adult ; Demyelinating Diseases ; diagnostic imaging ; metabolism ; pathology ; physiopathology ; Female ; Humans ; Immunohistochemistry ; methods ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pseudotumor Cerebri ; diagnostic imaging ; metabolism ; pathology ; physiopathology ; Tomography, X-Ray Computed ; methods

Objective To explore the association of interleukin (IL)-1 genotypes with Alzheimer′s disease (AD). Methods Using polymerase chain reaction and restriction fragment length polymorphism, the IL-1A (-889) and IL-1B (+3953) genotypes in 84 cases of AD and 139 controls were detected and analyzed. Results The frequencies of IL-1A(- 889) C/C, C/T and T/T genotypes were 72.6% and 84.2%, 23.8% and 14.4%, 3.6% and 1.4% in AD cases and controls respectively. The genotypes frequencies of IL-1A (-889) C/C, C/T and T/T in AD cases were similar to that of controls (χ2=4.53, P＞0.05), but the frequencies of IL-1A (-889) T allele were significantly higher in AD cases than in controls (15.5% vs. 8.6%, χ2=4.93, P＜0.05). The frequencies of IL-1B (+3953) C/T genotypes and T allele were also significantly higher in AD cases than in controls (16.7% vs. 6.5%, 8.3% vs. 3.2%, χ2=5.88,5.56, both P＜0.05). Conclusions IL-1 genotypes are associated with AD. IL-1 genotypes may play an important role in the development of AD.

OBJECTIVETo explore the prevalence and clinicopathological features of aortic aneurysm (AA) in elderly inpatients at autopsy.

METHODSAll the AA cases were retrospectively analyzed in 909 autopsy cases aged 60-100 years in our hospital. The pathological changes, comorbidities and death reasons were evaluated.

RESULTSAA was diagnosed pathologically in 59 patients (6.5%), clinical diagnosis was not made in 37(62.7%) cases. The AA prevalence in patients aged ≥ 80 years was significantly higher than patients <80 years (10.2% vs. 2.9%, χ(2)=19.97, P<0.01). Abdominal AA was more common (91.5%) and the prevalence of multiple AA was 20.3%. Coronary artery disease (CAD) was diagnosed in 44 AA patients (74.6%) including 21(35.6%) with severe coronary artery stenosis and 7(11.9%) with three-vessel disease, 31 patients (52.5%) died of cardiac-cerebral diseases, including 7(11.9%) with ruptured AA.

CONCLUSIONSThe prevalence of AA was high in elderly inpatients aged ≥80 years with a relatively high missed diagnosis rate. AA was often complicated with CAD. The main cause of death of AA patients was cardiac-cerebral diseases. The screening, evaluation and treatment of AA should be enhanced in elderly patients, especially in patients aged 80 years and over.

Aged ; Aged, 80 and over ; Aortic Aneurysm ; Aortic Rupture ; Autopsy ; Coronary Artery Disease ; Coronary Stenosis ; Humans ; Inpatients ; Middle Aged ; Prevalence ; Retrospective Studies

Objective: To analyze the cardiac pathological features of elderly coronary artery disease (CAD) patients (60 years and over) and evaluate the pathological features at autopsy and risk factors of patients with acute myocardial infarction (AMI). Methods: Data from 471 elderly patients (aged from 60 to 100 years old) with CAD confirmed by autopsy hospitalized in our hospital from April 1969 to October 2013 were retrospectively reviewed. Patients were divided into 2 groups: AMI group(n=128) with AMI as the primary cause of death and the rest served as control group(n=343). The pathological features of coronary lesion and related risk factors of AMI were analyzed. Results: In patients aged 60 and over with CAD, 48.8%(230/471) had severe coronary stenosis, 18.7%(88/471) had three-vessel disease, 71.8% cases (338/471) had left anterior descending artery(LAD)grade Ⅲ and over stenosis, 29.9% (141/471) had LAD grade Ⅳ stenosis, 25.9%(122/471) had left main coronary artery(LM) grade Ⅲ and over stenosis, 9.6%(45/471) had LM grade Ⅳ stenosis, 27.1%(128/471) had AMI. The first AMI accounts for 39.1%(50/128), and 60.9%(78/128) had both AMI and old MI. Compared with the control group, AMI group were younger ((77.1±11.6) years vs. (83.2±9.1) years, P<0.01), had more severe coronary artery stenosis lesion (77.3%(99/128) vs. 38.2%(131/343), P<0.01), higher coronary index which reflects the overall arteriosclerosis (9.9±2.8 vs. 8.0±2.5, P<0.01), more three-vessel disease (30.3%(43/128) vs. 13.7%(45/343), P<0.01), heavier heart weight ((447.8±90.6)g vs. (426.6±99.1)g, P<0.05), higher prevlence of pulmonary congestion or edema (57.8%(74/128) vs. 39.9%(137/343), P<0.01). Twenty-three cardiac ruptures (23/128, 18.0%) were observed in AMI group. Logistic regression analysis showed that grade Ⅳ LAD stenosis (OR=3.55, 95%CI 2.05-6.17, P<0.01), three-vessel disease(OR=2.47, 95%CI 1.30-4.67, P<0.01) were the independent risk factors of AMI in elderly patients with CAD. Conclusions Severe coronary stenosis is common in CAD patients aged 60 and over. Patients aged 60 and over with AMI have more severe coronary artery stenosis lesion and heavier heart weight. Cardiac rupture is not uncommon in elderly patients with AMI. Severe LAD stenosis and three-vessel disease are the independent risk factors of AMI in the elderly.

Objective: To analyze the pathological feathers of the heart in elderly (60-99 years old) heart failure patients with preserved ejection fraction (HFpEF) and coronary artery disease (CAD) and to explore the misdiagnosis and missed diagnosis rates. Method: This retrospective study included 154 HFpEF (left ventricular ejection fraction (LVEF)≥50%) cases and 49 heart failure with reduced ejection fraction (HFrEF) (LVEF≤40%) cases aged 60-99 years old out of 1 485 consecutive autopsy cases. Pathological changes of the heart and coronary artery were compared between patients with HFpEF and HFrEF. The misdiagnosis and missed diagnosis rates of HFpEF were analyzed based on pathological examination. Results: Patients with HFpEF were older than those with HFrEF ((85.7±7.4) vs. (82.9±7.8) years old, P=0.017). Among all the cases, CAD was diagnosed in 105 (68.2%) HFpEF patients and 38 (77.6%) HFrEF patients. Compared with patients with HFrEF, HFpEF patients displayed less acute myocardial infarction (12.3%(19/154) vs. 59.2%(29/49), P<0.01) and more chronic myocardial ischemia (18.2%(28/154) vs. 6.1%(3/49), P=0.041). 51.9% (80/154) HFpEF and 71.4% (35/49) HFrEF patients (P=0.017) displayed >50% left anterior descending artery stenosis. Prevalence of >75% coronary arterial stenosis (51% (25/49) vs. 20.1%(31/154), P<0.001) and more than one vessel lesions (55.1%(27/49) vs. 33.8%(52/154), P=0.008) were significantly higher in HFrEF patients than in HFpEF patients. The misdiagnosis rate of CAD in HFpEF was 63.3% (31/49). Among HFpEF, the missed diagnosis rate of acute myocardial infarction was 57.9% (11/19) and the missed diagnosis rate of old myocardial infarction was 57.7% (45/78). Conclusions CAD and chronic myocardial ischemia are common in elderly patients with HFpEF. Chronic myocardial ischemia may play an important role in the development of HFpEF of elderly CAD patients. Among HFpEF patients, the misdiagnosis rate of CAD and missed diagnosis rate of myocardial infarction are high, so the accurate evaluation of myocardial ischemia status is of great importance.

Objective To systematically review the risk prediction models for intradialytic hypotension in maintenance hemodialysis patients,with a view to provide references for clinical practice.Methods PubMed,Embase,Web of Science,Cochrane Library,CINAHL,CNKI,VIP,Wanfang and CBM were searched from inception to May 29,2023.2 reviewers independently screened the literature,extracted information and assessed methodological quality using the Prediction Model Risk of Bias Assessment Tool.Results A total of 20 studies and 25 models were included with the sample size of 68～9 292 cases and the incidence of outcome events of 2.1～51％.Baseline systolic blood pressure,age,ultrafiltration rate,diabetes and dialysis duration were the top 5 predictors of repeated reporting of the models.20 models reported the area under the curve of ranging from 0.649 to 0.969,and 5 models reported calibration metrics.There were 9 internal validations and 4 combined internal and external validation models.The overall applicability of the 20 studies was good,but all had a high risk of bias,mainly in data analysis.Conclusion Research on risk prediction models for intradialytic hypotension in maintenance hemodialysis patients is still in the developmental stage.Future studies should improve the research design and reporting process,and validation studies of existing models should be carried out to further evaluate the effectiveness and feasibility in clinical practice.