BACKGROUND: It is now know that the clinical presentations of subcortical arterioselerotic encephalopathy(SAE) could be mainly manifested by hypertension,stroke and chronic developed dementia,but there are very a few explorations on its definite pathogenesis and earlier assessment.OBJECTIVE: To investigate the correlation of CT classification of SAE with intellectual and neuropsycholohical disturbance,so as to explore the significance of CT classification of SAE to the assessment of SAE.DESIGN: Clinical case analysis based on patients.SETTING: A department of internal medicine in a military general hospital of Chinese PLA.PARTICIPANTS: From January 1999 to December 2002,totally 68 elders Guangzhou Military Area Command of Chinese PLA,included 65 males and 3 females,aged from 64 to 93 years old with the average age of(75. 8 ± 8. 1 )years old took part in the study.METHODS: Low-density focus around ventricle were observed with skull CT scanning and classified according to GOTO classification. Meanwhile the intellectual test and neuropsycholohical test were carried out,and the correlative analysis was conducted.MAIN OUTCOME MEASURES: Intellectual test,neuropsycholohical test,skull CT scanning,and analysis of correlation of CT classification with scores of intellectual test and neuropsycholohical test.RESULTS: Of 68 patients,91% (62/68) was proved to have different degree intellectual obstacle,100% was found to be vascular dementia; and low-density focus around ventricle were proved to be existed in all patients with skull CT scanning,GOTO classification indicated that type Ⅰ was found in 22 patients,type Ⅱ in 32 patients and type Ⅲ in 14 patients; skull CT classification was negatively correlated with the scores of intellectual test and positively correlated with scores of neuropsychiological test,with the correlative coefficient of -0. 83 and 0.75 respectively( P ＜ 0.01 ).CONCLUSION: GOTO classification of skull CT of SAE is related to intellectual obstacle and neuropsychiological disturbance in elder SAE.

Objectives To investigate the expression of matrix metalloproteinase-9 (MMP-9) and its tissue inhibitor (TIMP-1) in cutaneous squamous cell carcinomas (SCC) and the relationship between the expression and invasive growth and metastasis of SCC. Methods Immunohistochemical method of streptavidin-peroxidase (SP) was used to detect the expression of MMP-9 and TIMP-1 proteins on the paraffin embedded sections of 65 patients with cutaneous SCC and 5 cases of normal epidermis. The immunohistochemical results were analyzed quantitatively using an image analysis system. Results MMP-9 and TIMP-1 proteins were diffusely expressed on the tumor nests and the mesenchymal cells around the nests, while in normal epidermis MMP-9 and TIMP-1 were weakly positive. The expression level of MMP-9 protein and the ratio of MMP-9/TIMP-1 were higher in aggressive SCC group than those SCC in situ group (t = 2.33 and 2.36, respectively, P

Objective To analyze the clinical characteristics and the outcome of severe trauma of various ages in emergency department,to improve the therapeutic effect of emergency rescuing.Methods Two thousand and sixty nine patients of severe trauma were treated during a seven-year period from October 1997 to October 2004.The studied patients were divided into 5 groups:(1)adolescent group(Group A,＜13 years old,n=106);(2)juvenile group(Group B, 13-18 years old,n=128);(3)youth group(Group C,18-40 years old,n=1518);(4)middle age group(Group D, 40-60 years old,n=215);and(5)elderly group(Group E,＞60 years old,n=102).All the patients were evaluated with Injury Severity Score(ISS),and the result was≥16 in all of the studied patients.Results The incidence of severe trauma in male in all 5 groups was higher than that in female,and it was significantly higher in Group C,Group D and Group E when compared with that in the other groups(P＜0.01).Traffic accident was the leading cause of injury,and its incidence in Group A,Group B and Group D was higher than that in other groups(P＜0.01).However,injury caused by falling from high places was the second cause of injury,being significantly increased in Group A,while armed fighting and injury during work being significantly increased in Group B,Group C and Group D,slip fall injury being significantly increased in Group E(P＜0.01).Head injury was mainly found in Group A and Group E,extremities injury and/or spinal injury were increased markedly in Group B,Group C and Group D(P＜0.05),abdominal injury was significantly decreased in Group E(P＜0.001).The total mortality was 11.9%(246/2069).The mortality within 24 hours (20.6%,21/102)was significantly higher than that beyond 24 hours(7.8%,8/102)in Group E(P＜0.01).The time of staying in the emergency department differed significantly between the survived patients and those died in all 5 groups (P＜0.01).Conclusion The gender,the incidence and the characteristics of the injury causes and injury sites differed between severely injured patients of various ages.Mortality in the elderly is significantly increased following severe trauma. The idea of“golden one hour”and“platinum ten minutes”,measures of shortening the time of staying in the emergency clinic,early definite operation and damage control operation should be emphasized.

Clinical study of modified Ganmai Dazao decoction in the treatment of yang deficiency climacteric depression and observe the effects of modified Ganmai Dazao decoction on neuroendocrine system in patients with yang deficiency climacteric depression. 86 cases were randomly divided into treatment group treated with modified Ganmai Dazao decoction and control group treated with Deanxit. The curative effect was evaluated with Hamilton's depressive scale (HAMD) and pittsburgh sleep quality scale (PSQI) before and at the end of the two and four weeks of the treatment, the serum levels of serotonin (5-HT), norepinephrine (NE), estradiol (E2), follicle stimulating hormone (FSH), luteotropic hormone (LH) were detected before and after the four weeks of the treatment The results showed that the total effective power of treatment group was 88.4% and the total effective power of control group was 81.4% after four weeks interference, with insignificant difference between the two groups. After two and four weeks of the treatment, the score of HAMD decreased remarkably in both groups (P < 0.01), with insignificant difference between the two groups in same phase. After two and four weeks of the treatment, the total score of PSQI decreased remarkably in both groups (P < 0.05), with significant difference between the two groups after four weeks (P < 0.01). After four weeks of treatment, the serum levels of 5-HT and NE increased (P < 0.01), with insignificant difference between the groups. After four weeks of treatment, the serum levels of E2 increased obviously (P < 0.05), the levels of FSH decreased obviously (P < 0.05), the levels of LH decreased insignificant, with insignificant difference between two groups. This study indicates that modified Ganmai Dazao decoction has obvious therapeutic effects in the treatment of climacteric depression, and showed equivalent efficacy with Deanxit, and modified Ganmai Dazao decoction has better effect on improving the sleep quality in patients than Deanxit, the effect of improved clinical symptoms may be through adjusted levels of 5-HT, NE, E2, FSH and LH of climacteric depression.
Adult ; Depression ; blood ; drug therapy ; etiology ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Follicle Stimulating Hormone ; blood ; Humans ; Menopause ; drug effects ; psychology ; Middle Aged ; Neurosecretory Systems ; drug effects ; metabolism ; Norepinephrine ; blood ; Phytotherapy ; Serotonin ; blood

This article makes a pilot study on the key points of the quality management system of in-vitro diagnostic reagents by analyzing the technical characteristics and production methods of these products as well as the status in quo, and problems the in-vitro diagnostic reagent industry in China is facing nowadays. It can serve as a reference to the supervision departments and the manufacturers in this field which are establishing and running the quality management system.
China ; Equipment and Supplies ; standards ; Humans ; Indicators and Reagents ; chemistry ; standards ; Pilot Projects ; Quality Assurance, Health Care ; organization & administration ; Quality Control ; Reagent Kits, Diagnostic ; standards ; Safety Management ; Technology, Pharmaceutical ; organization & administration ; standards ; Total Quality Management

OBJECTIVETo investigate risk factors associated with peritoneal metastasis in colorectal cancer.

METHODSClinicopathological data of 873 patients with colorectal cancer treated at the Nanfang Hospital of Southern Medical University from January 2003 to December 2008 were retrospectively analyzed. The associations between peritoneal metastasis and clinicopathological factors were evaluated by univariate analysis including independent-samples t test and χ(2) test, and multivariable logistic regression analysis.

RESULTSUnivariate analysis showed that age(P=0.032), tumor size(P=0.001), tumor differentiation(P=0.008), depth of bowel wall invasion(P=0.000), lymph node metastasis(P=0.000), serum carcinoembryonic antigen (CEA) level(P=0.003), and serum carbohydrate antigen 19-9(CA19-9) level(P=0.009) were associated with peritoneal metastasis. On multivariable logistic regression analysis, depth of bowel wall invasion, lymph node metastasis, serum CEA level and CA19-9 level remained as significant risk factors(all P<0.05).

CONCLUSIONDepth of bowel wall invasion, lymph node metastasis, serum CEA level, and CA19-9 level are risk factors for peritoneal metastasis in colorectal cancer.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Chi-Square Distribution ; Colorectal Neoplasms ; diagnosis ; pathology ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Neoplasm Metastasis ; Peritoneum ; pathology ; Prognosis ; Retrospective Studies ; Risk Factors ; Young Adult

Objective To observe the effect of iodine excess(HI),polyinosinic-polycytidylic acid[Poly(I:C),Poly]and thyroglobulin(TG)on the thyroid of mice by the expression of Toll-like receptor 3(TLR3)to reveal the functional role of TLR3 in autoimmune thyroiditis.Methods Forty-two non-obese diabetic mice,body weight (20±3)g,were divided into six groups:control group,HI group,Poly group,TG group,HI+TG group,HI+Poly group. Fed with deionized water and injected intraperitoneally with physiological saline 0.1 ml each day for a week, the mice in control group were injected with physiological saline every other day at the same dose for 1 week before they were sacrificed; HI group drank 0.05% NaI water and were injected intraperitoneally with physiological saline same as control group; Poly group drank deionized water and were injected intraperitoneally with poly 0.1 ml (1 g/L)each day of the week, then the mice were injected with Poly every other day at the same dose for 1 week before they were sacrificed; TG group drank deionized water and were injected intraperitoneally with physiological saline same as control group, immunized with 0.1 mg TG by subcutaneously injecting and the immunization was enhanced after they were fed half dose for 4 and 8 weeks separately. In HI + Poly group, the treatment was the same as HI group and Poly group; HI + TG group: the treatment was the same as HI group and TG group. Eight weeks later, mice were sacrificed and thyroids were taken to make frozen sections, Hematoxylin-Eosin (HE) staining was employed to observe the morphological change of the thyroids. The expression of TLR3 of thyroids was observed under fluorescence microscope after Immumofluorescence using TLR3 antibody and TR3-positive cells were analyzed in the thyroid density. Results HE staining showed thyroids of Poly group had no inflammation under microscope.There were different degrees of inflammatory cell infiltration in HI group and TG group. The inflammatory cell infiltration and the damage of follicular thyroid of HI + TG group and HI + Poly group were serious, and the degrees of inflammation were higher over "++". Thyroid follicular epithelial cell with TLR3 expression could be seen in Poly group and HI group, meanwhile, there were TLR3 strong positive inflammatory cells in HI group under fluorescent microscope. Using stereological analysis of TLR3-positive cell density in the thyroid, the difference between groups was statistically significant(F=7.870, P<0.01 ). TLR3-positive cell density in the thyroid of HI + Poly group was higher[ (9.287 ± 0.522)mm2] than control group[ (0.062 ± 0.025)mm2, P < 0.01] significantly, meanwhile, the density in HI + Poly group was higher than HI group [ (2.574 ± 0.257 )mm2] and Poly group[ (1.361 ± 0.148 )mm2, all P < 0.01]. The density in HI + TG group[ (4.843±0.405)mm2] was higher than HI group and TG group[(1.601 ±0.268)mm2, all P < 0.01 )]. Conclusions Excessive iodine and thyroglobulin can induce thyroiditis, and stimulate the expression of TLR3 in the thyroid follicular epithelial, Poly aggravated thyroiditis induced by iodine excess in NOD mice; TLR3 positive inflammatory cells also appeared in inflammatory region, suggesting that TLR3 is involved in the pathogenesis of autoimmune thyroiditis

OBJECTIVETo better understand the acquired factor V (FV) inhibitors.

METHODSThe clinical features, laboratory manifestations, treatment options and prognosis of 3 cases were reported and related literature were reviewed.

RESULTSAll the 3 patients were older than 50 years without family history and related disease. Their clinical manifestations included spontaneously mucous bleeding, hematuria, epistaxis and encephalic bleeding. Laboratory test showed prolonged prothrombin time (PT) and activated partial thromboplastin time (APTT). The FV levels decreased and the presence of FV inhibitor was confirmed by Bethesda method. All patients were treated with glucocorticoid and immunosuppressive agents. The haemorrhages of two patients stopped but their coagulation test and FV level recovered slowly. One patient died from encephalic bleeding.

CONCLUSIONSAcquired FV inhibitor is a rare coagulation disorder with variable clinical symptoms. Immunosuppressive agents are effective to eliminate the inhibitors. The prognosis of acquired FV inhibitors seemed to be strictly related to the basic disease.

Coagulation Protein Disorders ; Factor V ; antagonists & inhibitors ; Female ; Humans ; Male ; Middle Aged

This work aims to analyZe and compare the potential biomarkers between cervical cancer ( CC ) patients and healthy controls (HC).The urine samples of 11 CC patients (age (45.65 ± 5.6) years) and 11 HC patients (age (45.9 ± 3.2) years) were collected.The metabolites of urine samples from CC and HC were analyZed by using ultra performance liquid chromatography coupled with quadrupole orbitrap tandem mass spectrometry ( UHPLC-Q-Orbitrap MS/MS ) , which could provide evidence for early diagnose and disease pathway.The LC-MS data of urines were analyZed by principal components analysis ( PCA) and orthogonal partial least squares discriminant analysis ( OPLS-DA) to identify the potential biomarkers.Urine samples of CC patients were successfully discirminated from those of healthy controls.A total of twelve significant metabolites were found and identified as potential biomarkers according to the established UHPLC-Q-Orbitrap MS and MS/MS method.Identification of biomarkers between CC and HC patients may play an important role in the study of mechanism of UC and its pathway.

Objective To investigate the influence of iodine excess on expression of TRAIl/TRAIL-sR1 in NOD and Balb/c mice and to study the effect of TRAIl/TRAIL-sR1 on the pathogenesis of experimental autoimmune thyroiditis(EAT). Methods Both Balb/c and NOD mice were divided randomly into control and iodine excess group by feeding with water containing no NaI or 0.05% Nal. The mice were sacrificed after 8 weeks. TRAIL and TRAIL-sR1 mRNA levels were detected by RT-PCR. The function, morphology and apoptosis of thyroids were also observed by ELISA and Tunnel stain. Results Treated by HI, enlarged follicles and flattened epithelium by accumulation of colloid were found in thyroids of both NOD and Balb/c mice. But significant lymphoid cell infiltration and local fibrosis were only found in thyroids of NOD HI group. The relative weight of thyroids of NOD mice in HI group[(104.8±14.5)mg/kg]was heavier than that of control group [(71.8±20.4)mg/kg]. The level of TT4 declined in HI group[(30.77±3.59)mmol/L]compared with control group[(36.43±2.66)mmol/L], meanwhile, the level of TSH was higher in HI group[(6.98±0.66)μg/L]than that in control group [(5.55±0.56)μg/L]. The difference being statistically significant(t=7.773,-9.526,-4.458, all P < 0.05). The relative weight of thyroids of Balb/c mice of HI group[(155.8±20.8)mg/kg]also heavier than that of control group [(105.1±22.0) mg/kg]. The level of TT4 droped in HI group [(19.75±3.32) mmoL/L]was higher than that in control group[(23.46±6.21)mmoL/L], the level of TSH in HI group[(4.14±1.71)μg/L]was higher than that in control group[(3.55±1.41)μg/L], the difference being statistically significant(t=7.554,-7.239,3.140, all P< 0.05). A great deal of apoptotie ceils observed in NOD (3.97±0.91) and Balb/c mice (1.05±0.45) by Tunnel stain were greater than control groups (0.21±0.15, 0.10±0.03), the difference being statistically significant in beth of the two species(t=-7.167,-17.772, both P < 0.05). The apoptosis index of thyroid follicular epithelium in NOD was obviously higher than Balb/c(t=-7.625, P<0.05). The level of TRAIL mRNA did not remarkably change in Balb/c between control group(0.000 59±0.000 39) and HI group(0.001 24±0.000 46, t=-1.940, P>0.05), but it increased apparently in NOD mice HI group(0.018 88±0.005 77) than that of control group(0.009 61± 0.00591, t=-2.71, P<0.05). The level of the expression of TRAIL-sR1 mRNA increased in HI groups of NOD (0.000 53±0.000 15) and Balb/c mice(0.000 42±0.000 09) than that in control groups of NOD(0.000 28± 0.000 05) and Balb/c mice (0.000 17±0.000 06) and the differences were statistically significant between the two species(t=3.050,3.990, all P<0.05). The differences of the expression of TRAIL and TRAIL-sR1 mRNA between the two species were significant(t=-3.37,-4.76, all P<0.05). Conclusions Iodine excess induces colloid goiter in beth species of mice and thyroiditis in NOD mice. The increase of TRAIL and TRAIL-sR1 influenced by iodine excess is one of the molecular bases of follicular epithelium apoptosis and inflammation in thyroids. Genetic factor is a key factor in the pathogenesis of thyroiditis.