Objective To research the Alzheimer disease(AD) patients' hippocampal structure and cognitive function with the susceptibility weighted imaging (SWI) and morphological measurement,and explore the changing regularity and correlation.Methods Sixty patients (divided equally into mild,moderate and major group as the condition of the severity of the AD) and 20 healthy control groups were scanned with SWI and T1MR,then the differences between AD and healthy controls were analyzed.Results The hippocampal volumes of AD patients were smaller than that of control group.The biggest variability occured in the major group(the left was Dunnett-t =-7.03,P ＜ 0.01 ;the right was Dunnett-t =-7.52,P ＜ 0.01),the moderate group was next(the left was Dunnett-t =-6.71,P ＜ 0.01 ; the right was Dunnett-t =-6.62,P ＜ 0.01) ;and the least variability occurred in the mild group.They did not achieve statistical significance (the left was Dunnett-t =-0.86,P＞ 0.05 ;the right was Dunnett-t =-0.68,P ＞ 0.05).The hippocampus vein' s length,diameter had reduced significantly in the mild group(Dunnett-t were-5.62,-7.02,P＜ 0.001),but the number of the branches was slightly increased,which was close to the statistical significance.(Dunnett-t =1.86,P ＞ 0.05).With the progress of the AD,all of the hippocampus vein's length,diameter,and branches were reduced significantly(the Dunnett-t of the moderate were-10.10,-11.40,-2.83,P＜0.05;the Dunnett-tofthe major were-11.69,-14.68,-5.74,P＜ 0.001).AD patients blood vessel diameter,length and cognitive have correlation(r =-0.034 ～-0.517,P ＜0.05,P ＜ 0.01).Conclusion The hippocampus vein and cognitive function function change in AD patients happened in the mild stages of disease.An important supplement to the MRI conventional sequences.

Fistula ; complications ; surgery ; Humans ; Male ; Maxilla ; pathology ; Middle Aged ; Osteomyelitis ; complications ; surgery

Objective To study B lymphocyte subsets(na(?)ve B cells,memory B cells and plas- mablasts)of peripheral blood in patients with rheumatoid arthritis(RA)and its relationship with autoantibod- ies and clinical manifestation.Methods Blood samples and clinical data of 60 patients with RA were enrolled into this study.They were divided into three groups:active,inactive and refractory RA based on clinical mani- festations and 24 healthy controls were included.CD19 and CD27 of B cells in peripheral blood of RA patients and healthy controls were detected using flow cytometry at single-cell level.Frequence of na(?)ve B cells (CD19~+CD27~-),memory B cells(CD19~+CD27~(dim)),plasmablasts(CD19~+CD27~(high))and average fluorescence in- tensity of CD19 were analyzed,and their relationship with clinical manifestations and rheumatoid factor(RF), anti-typeⅡcollagen(anti-CⅡ),anti-cyclic citrullianted peptide(CCP)antibodies were investigatied.Results Frequence of na(?)ve B cells and plasmablasts in peripheral blood of patients with RA was increased compared with normal control.In contrast,memory B cells in patients with RA were decreased.The na(?)ve B cells subset in inactive and refractory RA was higher than that of healthy controls(P＜0.05),and the memory B cells subset in those groups was lower than that of healthy controls(P＜0.05).The plasmablasts in active and refractory groups of RA were higher than those of healthy controls(P＜0.05).The average fluorescence intensity of CD19 in peripheral blood in patients with RA was positively correlated with ESR,C-reactive protein(CRP),healthy assessment questionaire(HAQ),and plasmablasts was positively correlated with arthrocele index.Na(?)ve B cells,memory B cells and plasmablasts subsets had no relation with RF,anti-CⅡand anti-CCP antibodies. Conclusion B cell subsets in peripheral blood of patients with RA are significantly abnormal,characterized by expanded naive B cells and plasmablasts but diminished memory B cells.Plasmablasts are increasesd in active and refractory groups of RA,and have positive correlation with swollen joint index.B cells may play an important rote in the pathogenesis of RA.

[ABSTRACT]OBJECTIVETo investigate the diagnosis, treatment method, key points of operation, and postoperative complications of high-risk esophageal foreign body.METHODSA retrospective analysis of 41 cases of high-risk esophageal foreign body from January 1996 to December 2014. After adequate preparation, the foreign body was removed via esophageal endoscope under general anesthesia.RESULTSThe foreign bodies in 41 patients were removed via esophageal endoscope once or twice. Two cases suffered postoperative subcutaneous emphysema, that may be a result of a small perforation in esophagus. Emphysema was disappeared by fast, rehydration and anti-infection for 6 to 8 days, and other serious complications did not occur.CONCLUSIONMost high-risk esophageal foreign bodies can be removed through rigid esophagoscopy. Some of the foreign bodies of the patients were difficult to remove, some patients were presented with mediastinal emphysema and pneumothorax due to esophageal perforation, and some foreign body stuck in oesophagus so long to cause esophageal mucosa ulcer. In these conditions, foreign bodies should be removed by lateral neck incision or thoracotomy.

Objective To understand the epidemiological characteristic of committing suicide and to provide the scientific evidence for prevention and crisis intervention.Method A descriptive epidemiological method was employed to analyze the data of 153 individuals of committing suicide successfully saved by doctors of Emergency Department of Gongli Hospital,Pudong New Area,Shanghai.Results Female suicide committers were predominent over male ones,in the ratio 4.6 to 1.Most of the suicide committers were adolescents who had only received junior high school education.The major social support system of the suicide attempters was family support.The majority,of the suicide committers tried to kill themselves by drug ingestion such as hypnotice, sedatives and pesticides,and most of them haven't resorted to psychological counseling.Conclusions It is necessary to pay more attention to the psychological education of adolescents,and popularize the knowledge of psychological counseling in rural areas where are lack of psychological sense among pelple.Emergency department of general hospital which saves suicide committers is playing an important role in suicide prevention and crisis intervention.

Objective To determine chromosomal localization of the primary gout susceptibility gene in a pedigree.Methods The clinical data and the peripheral blood samples were collected in the pedigree members and the genomic DNA was extracted from peripheral blood.A genome-wide screening was performed using 400 micro-satellite DNA markers in this family,and linkage analysis was used to determine the chromosomal location of the primary gout susceptibility gene.Results Linkage analysis showed that the maximum LOD score reached 1.50 at marker D4S1572 (at recombination fraction?=0.00).Conclusion Since D4S1572 is localized at 4q25,the primary gout susceptibility gene of this pedigree is localized at 4q25.

OBJECTIVETo analyze the toxicity of high-frequency electromagnetic field (HF-EMF) on the reproductive and endocrine functions of female workers.

METHODS180 female workers exposed to HF-EMF for more than one year were selected as the exposure group, and 349 female workers in the marketplace were selected as the control group. Their menstrual status and pregnancy outcomes were evaluated with historical cohort study. Meanwhile, the serum levels of reproductive hormones including follicle stimulation hormone (FSH), luteinizing hormone (LH), estradiol (E(2)) and progesterone (P(4)) from 30 workers respectively in the exposure group and the control group selected randomly (in periovulatory period) were detected with the radio immunoassays.

RESULTSWith the increase of residue of HF-EMF, the incidence of menstrual disorder was increased (33.8% and 26.8% in the exposure group compared with 12.0% in the control group) (P < 0.01) and the incidence of menorrhagia in the exposure I group (16.9%) was significantly higher than that in the control group (8.0%) (P < 0.01). However, serum P(4) was significantly lower in the exposure group [(2.10 +/- 1.57) and (2.39 +/- 1.35) mg/L] than in the control group [(3.80 +/- 2.67) mg/L] (P < 0.01). There was no significant difference in serum E(2), LH and FSH between the exposure and the control groups.

CONCLUSIONIncrease of the incidence of menstrual disorder as well as that of menorrhagia, and decrease of levels of some reproductive hormones are closely associated with HF-EMF (25 approximately 30 MHz).

Adolescent ; Adult ; Case-Control Studies ; Electromagnetic Fields ; adverse effects ; Endocrine System ; radiation effects ; Female ; Hormones ; blood ; Humans ; Menstruation Disturbances ; epidemiology ; Occupational Exposure ; adverse effects ; Surveys and Questionnaires ; Young Adult

The active ingredient of traditional Chinese medicine, silybin (SBN), can inhibit the proliferation of cancer cells and enhance the anticancer effect of doxorubicin (DOX). However, due to non-targeting and short half-life of SBN and DOX, as well as different administration routes and pharmacokinetic processes, this combination drug cannot act on the tumor in the set order, seriously eliminating the synergistic effect between them and limiting the effect in vivo. Therefore, we intended to construct a nano-delivery system based on molybdenum disulfide (MoS₂), modified by polyethylene glycol (PEG) and sialic acid (SA), and co-loaded with SBN and DOX. The system induced the release of combined drugs under the dual-stimulation of pH and near infra-red (NIR), increased the free concentration of intracellular drugs, so as to achieve the synergistic effect between them. The animal welfare and experimental procedures were in accordance with the regulations of the Animal Ethics Committee of Fujian University of Traditional Chinese Medicine. MoS₂-PEG-SA-SBN/DOX circulated in vivo, and effectively accumulated at tumor sites through enhanced permeability and retention effect (EPR) and SA-mediated active targeting. Under near infrared light irradiation, MoS₂-PEG-SA-SBN/DOX realized the combination of synergistic chemotherapy and photothermal therapy for tumor, thus achieving excellent anti-tumor effect in vivo. This study can provide a new idea and strategy for the clinical treatment of lung cancer. Taken together, MoS₂-PEG-SA-SBN/DOX can offer a new idea and strategy for the clinical treatment of lung cancer.

OBJECTIVETo describe a novel mechanism for TRAIL up-regulation of CD4+, CD8+ T cells to participate in the pathophysiological process in patients with chronic hepatitis B (CHB).

METHODSThe serum levels of soluble TRAIL (sTRAIL), IFN-gamma and membrane bound TRAIL expression on peripheral leucocytes from 58 CHB patients were examined by ELISA and flow cytometry respectively. The levels of TRAIL were compared with the baseline levels of 15 healthy controls, and correlation analysis were performed between ALT, TBil and PT, morphological change in hepatic tissues.

RESULTSThe results showed that TRAIL levels on membranes of CD4+, CD8+ T cells in CHB patients were much higher than the healthy controls (P < 0.001), which of CD4+ T cells positively correlated with serum TBil (r=0.354, P = 0.008), Serum IFN-gamma level (r=0.302, P = 0.011) and which of CD8+ T cells positively correlated with serum TBil (r=0.522, P = 0.000), ALT (r=0.393, P = 0.003), PT (r=0.385, P = 0.004), serum IFN-gamma level (r=0.307, P = 0.009). The serum levels of soluble TRAIL only correlated with serum HBeAg expression (r=0.695, P = 0.001).

CONCLUSIONThese findings suggest that the expression of TRAIL on the membranes of lymphocytes was up-regulated, which may take part in the immunopathogenesis in CHB patients. TRAIL expression can be induced either by virus-specific protein expression or by inflammation cytokine IFN-gamma

Adult ; Aged ; Apoptosis Regulatory Proteins ; CD4-Positive T-Lymphocytes ; chemistry ; CD8-Positive T-Lymphocytes ; chemistry ; DNA, Viral ; blood ; Female ; Hepatitis B, Chronic ; immunology ; pathology ; Humans ; Interferon-gamma ; blood ; Male ; Membrane Glycoproteins ; biosynthesis ; blood ; Middle Aged ; TNF-Related Apoptosis-Inducing Ligand ; Tumor Necrosis Factor-alpha ; biosynthesis ; Up-Regulation

BACKGROUNDThe current diagnostic algorithms for chronic cough require the establishment of the primary presumptive causes followed by the confirmation of diagnosis with the specific therapies. The aim of the study was to investigate the discrepancy between presumptive and definite causes and its clinical implication.

METHODSA total of 109 patients with chronic cough underwent laboratory investigations to identify the cause of cough; including sinus computerized tomography (if needed), histamine bronchial provocation, induced sputum cytology and 24-hour esophageal pH or multi-channel intraluminal impedance combined with pH monitoring. The presumptive causes were confirmed by treating them sequentially. The difference between presumptive and definite causes of chronic cough was compared.

RESULTSSingle cause was more frequent in the definite diagnosis than in the presumptive diagnosis (78.9% vs. 54.1%, χ(2) = 15.01, P = 0.0001). In contrast, multiple causes were significantly fewer in definite diagnosis than in the presumptive diagnosis (15.6% vs. 37.6%, χ(2) = 13.53, P = 0.0002). There was a discrepancy between definite and presumptive causes in 30 patients (27.5%). Compared with the presumptive causes, definite upper airway cough syndrome (24.8% vs. 11.9%, χ(2) = 6.0, P = 0.01) and gastroesophageal reflux disease (6.4% vs. 0, χ(2) = 7.23, P = 0.007) was more frequent as a single cause of chronic cough while cough variant asthma plus gastroesophageal reflux disease (3.7% vs. 11.9%, χ(2) = 5.17, P = 0.02) and upper airway cough syndrome plus nonasthmatic eosinophilic bronchitis (0 vs. 9.2%, χ(2) = 10.48, P = 0.001) were fewer as multiple causes of chronic cough.

CONCLUSIONSA discrepancy was common between presumptive and definite causes of chronic cough. To treat presumptive causes sequentially may be a suitable solution for avoidance of erroneous multiple causes and possible over-treatment.

Adult ; Chronic Disease ; Cough ; etiology ; Female ; Humans ; Male ; Middle Aged