1375 cases of autopsy in our university from 1950～1989 were analysed in this paper. The results showed that the consistency between clinical and pathological diagnosis reached 79.3%. The clinical misdiagnosis were found to be 20.7%. The statistcal figures indicated that the infectious diseases occupied a dominant position in 1950s, while malignant tumors and cardiovascular diseases have become the major diseases in 1980s. Reasons of the lowering down of autopsy rate and clinical misdiagnoses are discussed. It demonstrates that autopsy is still of extreme importance in investigations of modern medical sciences.

Objective Our retrospective study is aimed to discuss the relationship between the curve changes of T lymphocyte subsets before and after the operation and the infectious complications after radical resec -tion of gastric cancer .Methods Clinical data of patients with gastric cancer received treatment at Central Hospi -tal of Panjin City,Liaoning Province from 2012 to 2014 were retrospectively analyzed .The enrolled patients were divided into two groups according to the infectious complications ,observe group ( patients with infectious complica-tions) and control group ( patients without infectious complications ) .The results of T lymphocyte subsets in two groups were compared .Results A total of 70 patients was retrospective analyzed , including 33 pationts in ob-serve group and 37 pationts in control group.At the 4th day after operation,the levels of CD3,CD4 in the observe group were obviously lower than those in control group .There was no statistical difference at the other time points . At the 4th and 9th day after operation,the levels of CD8,CD4/CD8 rate in the observe group were obviously lower than those in control group .There was no statistical difference at the other time points .Conclusion There is re-markable relationship between the curve changes of T lymphocyte subsets before or after the operation and the in -cidence of infectious complications after radical resection of gastric cancer .

AIM　To observe the effect of intravenous injection of erythromycin (EM) on interdigestive migrating motor complex (MMC) and postprandial gastrointestinal contraction in conscious dogs , and to study its possible mechanism. METHODS　Gastrointestinal contractile activity was recorded using low compliance capillary water perfusion manometric system. EM was administered intravenously during phaseⅠ and after meal, and blood samples were drawn for measuring plasma motilin concentrations. RESULTS　①Plasma motilin levels showed cyclical fluctuations in different phases of MMC, and plasma motilin reached peak during phaseⅢ and lowest during phaseⅠ.②EM induced phaseⅢ-like contractions in the antrum and duodenum, which was not accompanied by a peak in plasma motilin level. The optimum dose of EM for resulting in a premature phaseⅢ with the same characteristics as the spontaneously occurring phaseⅢ was established to be 0.5 mg*kg-1. The dose of 10 mg*kg-1 EM induced gastrointestinal continuous contractions and duodeno-gastric retrograde peristalsis which was associated with retching and vomiting. ③Atropine obviously inhibited EM-induced phaseⅢ activity in the antrum and duodenum. ④EM powerfully enhanced postprandial gastrointestinal contractile activity. CONCLUSIONS The results suggests that EM is a potent prokinetic agent. The mechanism is not related to the release of motilin, but may be mediated partially by cholinergic pathway.

AIM To observe the effect of intra- venous injection of erythromycin (EM) on interdigestive migrating motor complex (MMC) and postprandial gastrointestinal contraction in conscious dogs, and to study its possible mechanism. METHODS Gastrointestinal contractile activity was recorded using low compliance capillary water per fusion manometric system. EM was administered intravenously during phase I and after meal, and blood samples were drawn for measuring plasma motilin concentra- tions. RESULTS ①Plasma motilin levels showed cyclical fluctuations in different phases of MMC, and plasma motilin reached peak during phaseⅢ and lowest during phase Ｉ. ②EM induced phase Ⅲ -like contractions in the antrum and duodenum, which was not accompanied by a peak in plasma motilin level. The optimum dose of EM for resulting in a premature phaseⅢ with the same characteristics as the spontaneously occurring phaseⅢ was established to be 0. 5 mg.kg-1. The dose of 10 mg.kg-1 EM induced gas- trointestinal continuous contractions and duodeno-gas-tric retrograde peristalsis which was associated with retching and vomiting. ③Atropine obviously inhibited EM-induced phase Ⅲ activity in the antrum and duodenum. GEM powerfully enhanced postprandial gastrointestinal contractile activity. CONCLUSIONS The results suggests that EM is a potent prokinetic agent. The mechanism is not related to the release of motilin, but may be mediated partially by cholinergic pathway.

Objective:To analyze the causes and clinical features of chronic suppurative lung disease(CSLD) in children.Methods:We retrospectivly analyzed the primary disease, imaging changes, electronic fiber bronchoscope changes, blood gas analysis, lung function, treatment outcome and other clinical data of CSLD in children hospitalized in our hospital from September 2018 to February 2020.Results:A total of 14 children with CSLD were collected, including six males and eight females, aged (5.9±2.7) years old.Among 14 cases of CSLD, six cases were diagnosed with upper airway cough syndrome, three cases with upper airway cough syndrome and bronchial asthma, two cases with cough variant asthma, and one case with combined immunodeficiency disease.There were different degrees of purulent inflammation under electronic fiber bronchoscopy, and three cases had airway inflammatory stenosis.The lavage fluid suggested neutrophil inflammation.Blood gas analysis was normal in ten cases and hypoxemia in four cases.In seven cases, pulmonary function examination was abnormal in six cases, and one case had emphysema on lung CT examination.After intravenous administration of antibiotics and sequential oral antibiotics, the symptoms of 14 children were relieved.Fourteen cases were followed up for 12 weeks.Among them, 12 cases had complete relief of clinical symptoms, one case had repeated cough with combined immunodeficiency disease, and one case was lost to follow-up.Conclusion:CSLD mostly has primary disease.Electronic fiber bronchoscopy is not only a necessary examination of CSLD, but also one of the important means for treatment.Purulent inflammation of the airways can lead to abnormal obstructive lung.Sufficient course of treatment and standardized use of antibiotics are the key to the treatment for CSLD.

OBJECTIVETo investigate the effect of delayed skin grafting combined traction in severe joint cicatricial contracture.

METHODSAt the first stage, the joint cicatricial contracture was released completely with protection of vessels, nerves and tendons. The wound was covered with allogenetic skin or biomaterials. After skin traction for 7-14 days, the joint could reach the extension position. Then the skin graft was performed on the wound. 25 cases were treated from Mar. 2000 to May. 2013.

RESULTSPrimary healing was achieved at the second stage in all the cases. The skin graft had a satisfactory color and elasticity. Joint function was normal. All the patients were followed up for 3 months to 11 years with no hypertrophic scar and contraction relapse, except for one case who didn' t have enough active exercise on shoulder joint.

CONCLUSIONDelayed skin grafting combined traction can effectively increase the skin graft survival rate and improve the joint function recovery.

Biocompatible Materials ; therapeutic use ; Cicatrix, Hypertrophic ; Combined Modality Therapy ; methods ; Contracture ; surgery ; Female ; Humans ; Male ; Recovery of Function ; Recurrence ; Skin Transplantation ; methods ; Tendons ; Traction ; methods ; Wound Healing

Objective To explore the risk factors of complicating urogenic sepsis after percutaneous nephrolithotripsy(PCNL)and construct a nomogram prediction model.Methods The data of 291 patients with stage 1 PCNL in 940 Hospital of Joint Logistics Support Force from October 2016 to October 2021 were retrospectively analyzed.The patients were divided into the sepsis group and non-sepsis group according to whether complicating urogenic sepsis after operation.The general data,stone-related data,operation-related data and laboratory detection related data were included.The independent risk factors were screened by the univariate and multivariate logistic regression analysis,and the nomogram prediction model was constructed.Results The results of univariate and multivariate logistic regression analysis showed that age≥60 years old(OR=6.438,95％CI:1.548-26.769),urinary leukocyte 3+(OR=5.651,95％CI:1.614-31.766),urinary nitrite positive(OR=7.117,95％CI:1.190-42.561),operation time≥90 min(OR=4.626,95％CI:1.137-18.817)and perfusion volume 30 L(OR=3.312,95％CI:1.090-10.061)were the independent risk factors of postoperative complicating urogenic sepsis.C-index of the constructed nomogram prediction model in the modeling samples was 0.937,the calibrated C-index was 0.914,and the model predictive efficien-cy was good.Conclusion Age ≥60 years old,urinary leukocyte 3+,urinary nitrite positive,operation time 90 min and perfusion volume ≥30 L are the independent risk factors for complicating urogenic sepsis after PCNL;the constructed nomogram prediction model has a good predictive efficiency for the occurrence of post-operative urogenic sepsis.

With the use of computer image analysis (IA) and manual counting, the immunohistochemistry (IHC) results on PS2, ER and c-erB-2 of breast cancer which represent positive expression of cytoplasm, cell nucleus and cytomembrane are analyzed and compared. Then the advantages, disadvantages and repetition of the two methods are discussed and the correlation between image analysis and manual counting is estimated. The results of this study indicate that IA has better repetition in estimation of positive expression of cytoplasm, cell nucleus and cytomembrane, whereas manual counting has better repetition only in the positive expression of cell nucleus and cytomembrane, and the two methods have positive correlation in estimation of IHC results. In addition, some problems in image processing are discussed in this paper.
Breast Neoplasms ; pathology ; Cell Count ; Cluster Analysis ; Female ; Humans ; Image Processing, Computer-Assisted ; Immunohistochemistry ; methods ; Receptor, ErbB-2 ; analysis ; Receptors, Estrogen ; analysis ; Receptors, Progesterone ; analysis

OBJECTIVETo correlate the clinical characteristics with mutations of the STK11 and FHIT genes in 16 patients with Peutz-Jeghers syndrome (PJS).

METHODSPotential mutations in the coding regions and flanking sequences of the STK11 and FHIT genes were detected with PCR and Sanger sequencing.

RESULTSOf the 16 patients with PJS, 8 had novel mutations in the coding region of the STK11 gene, 1 had a previously reported mutation. 1 carried a mutation in the exon 10 of the FHIT gene, which is a non-coding region. None of the mutations was detected in the immediate family members. None of the patients with STK11 gene mutations had mutation in the FHIT gene. The mutation rate of the STK11 gene among patients with PJS was 56.25%.

CONCLUSIONMutations of the STK11 gene are the major cause of PJS. Few such patients had mutations of the FHIT gene. Mutations of the FHIT gene may play a part in the pathogenesis of PJS.

Acid Anhydride Hydrolases ; genetics ; Adolescent ; Adult ; Base Sequence ; Child ; DNA Mutational Analysis ; Exons ; Female ; Humans ; Male ; Middle Aged ; Molecular Sequence Data ; Mutation ; Neoplasm Proteins ; genetics ; Pedigree ; Peutz-Jeghers Syndrome ; genetics ; Protein-Serine-Threonine Kinases ; genetics ; Young Adult

Objective:To comprehensively evaluate the ability of common resting state functional magnetic resonance imaging (rs-fMRI) indices to detect abnormal brain activity in childhood absence epilepsy (CAE).Methods:Simultaneous electroencephalography-functional magnetic resonance imaging (fMRI) data of 20 patients with CAE who were treated in the Jinling Hospital, Nanjing University School of Medicine from February 2010 to September 2021 were retrospectively collected. After excluding 2 patients with CAE with greater head movement, 44 fMRI data containing discharges from 18 patients were obtained finally. The generalized spike and slow-wave discharges (GSWD) related fMRI activation mappings were obtained by using the generalized linear model. At the same time, 94 age- and sex-matched healthy controls underwent rs-fMRI scanning. Meanwhile, 12 indices of rs-fMRI were calculated respectively [amplitude of low frequency fluctuation (ALFF), fractional amplitude of low frequency fluctuation (fALFF), regional homogeneity (ReHo), functional connectivity density (FCD), long FCD, local FCD, granger causality density (GCD)-in, GCD-out, GCD-int, resting state functional magnetic resonance imaging lag analysis (RSLA), Hurst index and brain entropy]. Two-sample t-tests were employed to detect significant differences in 12 indices of rs-fMRI. The Dice coefficient was used to evaluate the overlap between different brain maps of 12 indices of rs-fMRI and the GSWD-related blood oxygenation level dependent (BOLD) activation. Results:Positive activation of GSWD-related BOLD in CAE was mainly in the bilateral thalamus, and negative activation was mainly in default mode network (DMN) related brain regions. There was a significant overlap between the abnormal brain regions detected by various resting-state indicators: compared with normal controls, ALFF, fALFF, ReHo, GCD-in, GCD-out and local FCD were elevated in the bilateral thalamus, while FCD, long FCD, GCD-int and RSLA were decreased in CAE; ALFF, fALFF, ReHo, local FCD, GCD-out, RSLA and brain entropy were decreased in the DMN, while FCD, long FCD, GCD-in and GCD-int were increased in CAE. The Dice coefficient of long FCD was the highest (0.365),FCD was 0.362, while the Hurst index showed the lowest (0.142).Conclusions:Rs-fMRI indices variously revealed abnormal brain activity in CAE, in which the FCD is better for detection of epileptic activity. Rs-fMRI could be helpful to understand the pathophysiological mechanism of CAE, and to find reliable imaging markers.