Objective To analyze the relationship between CT characteristics of chronic subdural hematoma (CSDH) and its recurrence, as well as relevant pathological mechanism. Methods The study involved 178 patients with CSDH who underwent surgery, of whom 38 patients (40 lesions) experienced recurrence of CSDH. Univariate and multivariate logistic analyses were performed to assess the correlation among CT characteristics ( including side, density, width, subtype and midline shift of the hematoma) and CSDH recurrence. Results ( 1 ) The width of hematoma, midline shift, type of hematoma were found to be correlated with the recurrence of CSDH in the univariate analysis. The odds ratio (OR)and 95% confidence interval (CI) value of patients with hematoma width ＞30 mm, midline shift ＞10 mm and the separated type were 18. 400 (2.024-167. 301 ), 4. 643 ( 1. 815-11. 877 ) and 14. 385 (3. 601-57.467 ), respectively. (2) The midline shift and type of hematoma were found to be correlated with the recurrence of CSDH in the multivariate analysis, when the OR and 95% CI value of patients with hematoma midline shift ＞ 10 mm and separated type were 5. 280 ( 1. 339-20. 823) and 19. 125 (4. 175-87.619), the OR and 95% CI value of patients with hematoma width ＞30 mm was 14. 838 ( 1. 353-162.698). Conclusions Type of hematoma and midline shift are found to be independently correlated with the recurrence of CSDH, and the width of hematoma is also related with its recurrence.

OBJECTIVE: To find out some evidence that may indicate the theory of voice pitch of the five tones being correlated with the five zang viscera in Huangdi Neijing, which was lost 2 000 years. METHODS: Eight-four healthy females were divided into younger group (<34 years old) and older group (> or =34 years old) according to their ages. The pronunciations of these females were examined by sono-frequency analysis facility. RESULTS: The frequency of Jiao tone was much higher than those of the other tones in both groups (P<0.01) and the frequency of Jiao tone increased as aging. The frequency of Zhi tone in the younger group was higher than that in the older group (P<0.05). CONCLUSION: The results of higher frequency of Jiao tone in females is in accordance with the theory put forward by Ye Gui (a famous doctor in Qing Dynasty of China) that the liver is the congenital base of female life. In traditional Chinese medicine, Jiao tone is correlated with the liver, and Zhi tone is correlated with the heart. The high frequency of Zhi tone in younger females implies that regulating the Small Intestine Meridian of Hand-Taiyang and Heart Meridian of Hand-Shaoyin may be beneficial to the health maintenance of younger female.

ObjectiveTo investigate the features and methods of clinical diagnosis and treatment of elderly patients with acute calculous cholecystitis. MethodsA retrospective analysis was performed for the clinical data of elderly patients who were diagnosed with acute calculous cholecystitis in 451 Hospital of PLA from June 2012 to June 2015. After admission, all patients received fasting treatment, electrocardiographic monitoring, anti-infective therapy, and maintenance of body fluid balance and stable blood pressure and glucose. According to patients condition choose laparoscopic cholecystectomy open cholecystectomy, open cholecystectomy and common bile duct exploration. ResultsA total of 129 patients were enrolled; among these patients, 119 had acute calculous cholecystitis, 2 had gallstones with adenomatous hyperplasia of the gallbladder mucosa, 6 had pyogenic cholecystitis, and 2 had gallbladder gangrene. Among the patients enrolled, 52 were complicated by at least one internal disease. Among them, 67 underwent emergency surgery since there were no significant improvements in symptoms, and 62 showed relief of symptoms and underwent surgical treatment at other times. Of all patients, 108 underwent laparoscopic cholecystectomy, 9 underwent laparoscopy and were converted to open cholecystectomy, and 9 underwent open cholecystectomy and common bile duct exploration. All the surgeries were successful and all the patients were cured and discharged. There were no deaths. ConclusionElderly patients with acute calculous cholecystitis are in a critical condition and often complicated by various internal diseases. Laparoscopic cholecystectomy is the most commonly used therapeutic method. Clinicians should be fully prepared before surgery, take the perioperative management seriously, and accurately judge the surgical indications and timing.

OBJECTIVETo analyze the early expression differences of lung tissue proteins in rats exposed to silica using comparative proteomics method, to explore the effects of Chinese traditional medicine (Gymnadenia conopse alcohol extract, GcAE) on silicosis (50 mg/ml).

METHODSAdult male Wistar rats were randomly divided into silica-treated group and GcAE-treated group, four rats a group. The rats were exposed to silica by intratracheal (IT) instillation of 1 ml silica suspension for 24 h. After exposure, the rats in GcAE-treated group were intragastric administration with 0.8 ml GcAE (0.8 ml/100 g a day) and the rats in silica-treated group were intragastric administration with 2 ml sterilized saline a day for 14 days. Then all rats were sacrificed and lung tissues were collected. The total proteins were separated by means of two-dimensional gel electrophoresis (2-DE) and the differentially expressed proteins were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS). Western blotting was used to validate the expression of certain candidate proteins in lung tissues.

RESULTSObvious pathological changes of lung could be observed in silica-treated group, such as the thicken of interalveolar septum, which was infiltrated with lymphocytes, macrophages and a few neutrophils with the proliferation of fibroblasts and smooth muscle cells. The accumulation of collagen, the destruction of alveolus structure and the more dotted fibrosis or granuloma could also be found. However, the pathological changes of lung in GcAE-treated group were lighter than those of silica-treated group. Thirty three differentially expressed proteins were identified, including cathepsin D precursor, peroxiredoxin-1 (Prx-1) and SEC14-like protein 3. Compared with silica-treated group, cathepsin D precursor and Prx-1 were significantly downregulated in GcAE-treated group, and SEC14-like protein 3 was significantly upregulated (P < 0.01). The results of western blot indicated that the expression level of Prx-1 in GcAE-treated group was 0.26 ± 0.02, which was significantly lower than that (0.35 ± 0.04) in silica-treated group (P < 0.01).

CONCLUSIONGcAE may inhibit the progress of silicosis in the early period and cathepsin D precursor, SEC14-like protein 3 and Prx-1 may participate in this process.

Animals ; Lung ; drug effects ; metabolism ; Male ; Orchidaceae ; Plant Extracts ; pharmacology ; Proteomics ; methods ; Rats ; Rats, Wistar ; Silicosis ; metabolism

Objective To observe the effect of adenosine A1 receptor (A1AR) on the megalin defect in type 1 diabetic mice with early kidney disease.Methods 7-8 week-old,baseline body weight and fasting blood glucose matched wild type (WT) C57BL/6J mice were selected,and randomly divided into two groups:control group (n=6) and WT DM group (n=6).In the same way,male A1AR knock-out C57BL/6J mice were selected as A1AR-/-DM group (n=6).DM model was established by intraperitoneal injection of streptozocin.The blood glucose (BG),body weight (BW),kidney weight (KW),24 h proteinuria (24hUP) and albumin creatine ratio (ACR) were measured at 4 weeks.The renal pathological lesion was observed and the expression of megalin in proximal tubules was examined by immunohistochemistry.The expression of caspase-1,IL-18 and A1AR were detected by Western blotting.Results At 4th week,compared with WT control mice,the BG,BW,KW and 24hUP of WT DM mice were increased significantly (n=6,P ＜ 0.01),with the pathological glomerular enlargement,mesangial cell proliferation,extracellular matrix accumulation and renal tubule hypertrophy being observed.Immunohistochemistry revealed decreased expression of megalin,an important multiligand protein receptor on the brush border of proximal tubular epithelial cells in WT DM mice,which was correlated with 24hUP (r=-0.645,P ＜ 0.01).Compared with the control mice,the expressions of caspase-1,IL-18 and A1AR were significantly increased in WT DM mice (P ＜ 0.05).For A1AR-/-DM mice,more serious pathological lesion and megalin defect,together with increasing of casapase-1 and heavier proteinuria were observed than those in WT DM mice.Conclusion A1AR may play a protective role in megalin expression of diabetic mice with early kidney disease,in which the mechanism may be associated with caspase-1 related pyroptosis pathway.The details need further exploration.

Objective To study the diagnosis and treatment of hepatic hemangioma. Methods (Retrospective) analysis was made on the clinical data of 50 patients with hepatic hemangioma in our hospital from January 1998 to January 2003. Results The accuracy diagnotic rate of ultrasound, CT, MRI were 90%(45/50), 97.6%(40/41), 100%(5/5) respectively.The correct diagnostic rate was 96.0% in this series. The operative indications were symptomatic hemangioma, diameter of tumor larger than 4.0 cm, or tumor with uncertain diagnosis. The operations performed were as follows:Laparoscopic(enucleation) of hemangioma in one cases. 3 patients treated by transcatheter arterial embolization, and(thirty-nine) patients underwent surgical(excision).No death occurred in this series. Four(10.3%, 4/39) had postoperative complications. (Conclusions) Hepatic hemangioma can usually be correctly diagnosed.Ultrasound, CT and MRI are the main(diagnostic) methods for the diagnosis of hepatic hemangioma.For patients with hepatic hemangioma that is(symptomatic), increasing in size,or of uncertain diagnosis, surgical treatment is safe and effective. Laparoscopic(enucleation) of hemangioma can be performed in selected cases.

Objective To summarize the experience on diagnosis and treatment of splenic neoplasm. Methods Clinical data of 40 patients with primary splenic space occupying lesion treated in our hospital were retrospectively analyzed. Results Thirty four out of the 40 cases were diagnosed as primary splenic neoplasm preoperatively. The detectable rate of B-US was 94%, and that of CT was 96%. The discrimination rate of benignancy and malignancy by CT was 84%. Serum AKP and ?-GT were significanfiy increased in most of the malignancies. Seventeen among 22 cases with benignancy were treated by splenectomy, and the others underwent partial splenectomy or tumor resection. Sixteen of 18 patients with malignancy underwent splenectomy, and two did biopsy. Pathology revealed cysts in 13, angiocavernoma in 4, inflammatory pseudotumor in 3, caverous lymphangioma in 1, and cystic degeneration of liomyoma in 1; malignant lymphoma and lymphsarcoma in 9, hemangiosarcoma in 3, and fibrosarcoma, liomyosarcoma, malignant fibrous histiocytoma in 1 each. Three cases with malignancy have survived more than 5 years. Conclusions Splenic neoplasm is diagnosed mainly according to clinical manifestation and image examination. The discrimination of benignancy and malignancy depends on CT, angiography, and serous AKP and ?-GT level. Radical operation and complex treatment could improve the prognosis of splenic malignant tumor.

We investigated the pathogen of an outbreak of lung infection with unknown causes.By epidemiological analysis,we used real-time PCR,ELISA,gold dipstick,VITEK2 and MALDI-TOF-MS to identify suspicious bacteria.We made use of serum plate agglutination test to confirm the suspicious bacteria and the patient serum.We isolated 2 strains of Cryptococcus albidus from environmental samples.There has been specific agglutination between suspicious bacteria and patient serum.This pneumonia may be related to the infection of Ccryptococcus albidus.

Urbanization has increased the population density and exposure to environmental risk factors, accelerated changes of people's lifestyles and aggravated population health disparities. A general population cohort in eastern China, Shanghai Suburban Adult Cohort and Biobank (SSACB), was established to understand the incidence and prevalence of chronic and non-communicable diseases, and identify environmental, lifestyle, and genetic risk factors in adults (aged 20-74 years old) living in the suburban of Shanghai, where urbanization process is rapid, and provide evidence for the precise prevention and control of chronic diseases. The cohort study was launched by School of Public Health,Fudan University depended on "Discipline Construction Project Shanghai Peak for Public Health and Preventive Medicine". Four districts in Shanghai, i.e. Songjiang, Jiading, Minhang and Xuhui, were selected. A total of 69 116 permanent residents aged 20-74 years were recruited. Epidemiological investigation, physical examination and laboratory tests were conducted to collect the basic information of the study subjects. Blood and urine samples were collected from them to establish a biobank. An information platform was established, from which the baseline data of the study subjects in electronic medical record system, chronic disease management system, cancer registry, infectious disease reporting system, and death registry can be shared. This paper introduces the design concept, process and future plan of SSACB.