Objective To analyze the pathophysiological variation in patients with penetrating cardiac trauma (PCT) and discuss the classified treatment strategies.Methods A retrospective analysis was conducted on pathogenetic condition,medical interventions and other clinical information of 133 PCT patients.The patients were divided into four groups in accordance with their symptom classification on arrival at emergency department,including sub-clinic type,cardiac tamponade type,hemorrhagic shock type and agonal type.Meanwhile,the patients were classified into three groups according to their pathogenesis phase,including sub-clinical phase,clinical phase and agonal phase.Development characteristic of patients' condition in each group was investigated in each time point by survival analysis.Impacts of medical interventions on prognosis of those patients were analyzed,such as pericardial space exploration,emergency room thoracotomy (ERT),operating room thoracotomy (ORT).Results Some patients at sub-clinical phase were aggravated into clinical phase or agonal phase,as well as some patients at clinical phase were aggravated into agonal phase during in-hospital treatment.There were significance differences of posttraumatic suvival course among the four groups,namely sub-clinical type,cardiac tamponade type,hemorrhagic shock type and agonal type (P ＜ 0.01).The differences of posttraumatic survival course were also significant among the three groups,namely sub-clinical phase,clinical phase and agonal phase (P ＜ 0.01).Conclusion Clinical symptom classification (or pathogenesis phase) of PCT may not be always unchangeable,thus it is recommended that PCT patients should be treated based on their clinical symptom classification or patbogenesis phase at consultation.

Objective To evaluate the preoperative localization value of MRI and MRCP for congenital biliary dilatation.Methods 30 cases of congenital biliary dilatition diagnosed by either surgery or pathology were studied.MRI and MRCP findings of all these cases were analyzed.Results MRI and MRCP preoperative examination manifested the place of choledochal cyst and the relation between choledochal cyst and the biliary ductal system around in all 30 patients.Through surgery findings as follow,using Todani's classification,the accuracy of MRI and MRCP in evaluating the site and classification of congenital biliary dilatation was 100%,the accurate visualization rate of pancreatic duct was 73.3% and the junction of pancreaticobiliary duct was 33.3%.Conclusion MRI and MRCP manifestations are very reliable in preoperative localization of congenital biliary dilatation.

Objective To explore the cause and epidemiologic characteristics of Keshan disease.Methods The cases observation method,epidemiologic methods,fungus-mycotoxin methods and the analytic chemistry methods were used in our studies.Results From the year 1973-1975,in serious endemic areas,fifteen families and one disease outbreak village were investigated,it was found that all patients and his family members had eaten a vast amount of mould millet or maize 4-12 months before onset of the disease; the millet samples collected from endemic areas were cultured and they werc found to be polluted mainly by fungus(20％ of all),the toxin was citreoviridin(CIT).The cause factor of Keshan disease entered into human body through grain but not drinking water,and the transmitting effect was not different with different grains,millet and maize transmit but wheat did not;according to data of endemic disease inspection,after 1990 no new cases of Keshan disease had been reported in the country,at the same time the CIT content in grain produced in endemic areas did not reduced so quickly.However,after 1983,the reform of agriculture promoted significantly the hygienic quality of grain which was considered to be a specific cause for the decreasing of Keshan disease threatening; Keshan disease was distributed on the narrow-long areas from Yunnan till Heilongjiang.These areas were the connection parts,between the cold west north high lands and the warm-moist east-south flatlands,a narrow-long region.The year mean temperature and humidity in endemic areas might be suitable for growing of fungus and production of its toxin ; of animal experiment,rats were feed with CIT contaminated grain every day 4 mg/kg(body weight) for 4-6 weeks,the necrosis of myocardium and cell mitochondria swelling,proliferation and damage were found,just like what had been seen in died cases of Keshan disease.Conclusions The cause of Keshan disease is CIT toxin,the endemic conditions are geographic climate suitable for growing of fungus and production of its toxin and bad hygienic situation of grain storage.Some discussion about the prevention mcthod was proceeding.

For better adaptation to clinical work and scientific research as well as self-development,medical postgraduates are required to improve their reading ability to harvest information from medical English articles.Constructing formal schema based on linguistic schema and enriching content schema can significantly enhance medical English reading ability,according to schema theory and education practice.Therefore,the learning mode was explored based on schema theory and this theory was applied in practice to elevate reading ability by means of reading report.

Cinobufacini is an aqueous extract of Bufo bufo gargarizans Cantor dried skin, which has been widely used for cancer therapy in China. So far, its active components are still not very clear. In previous reports, bufadienolides with low-concentration were usually studied because of their anticancer effects. However, the high polarity constituents in cinobufacini are less investigated. The present study found that more than 50% contents of cinobufacini were water-soluble peptides. Then, in vitro anticancer experiments were carried out, including human stomach cancer cell lines BGC823 and MCG803, human colon cancer cell lines DLD-1 and HT-29, and human pancreatic cancer cell line MIAPACA-2. The IC50 for these cell lines model were ranged from 25-123 microgmL(-1). The results indicated that these peptides showed similar activity with cinobufacini injection. As a conclusion, this study provides a new and further understanding of anticancer components in cinobufacini injection.

Female ; Humans ; Liability, Legal ; Middle Aged ; Occupational Diseases ; diagnosis ; Occupational Health ; legislation & jurisprudence ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; diagnosis ; etiology

Child ; Humans ; Muscular Atrophy, Spinal ; blood ; diagnosis ; Polymerase Chain Reaction ; methods

Aim Toinvestigatetheroleofbrain-de-rived neurotrophic factor(BDNF)-tyrosine receptor ki-nase B (trkB ) signaling pathway in the therapeutic effects of ketamine on diabetic neuropathic pain.Meth-ods Forty-eightWistarrats,aged3months,weighing 200~250 g,were equally randomized into 4 groups(n=12 ):control group (C group ), saline group (S group),ketamine group (K group)and ketamine +ANA-12 group (KA group ).Rats in S,K and KA groups were intraperitoneally injected with a single of streptozotocin(STZ)65 mg·kg-1 to construct diabetic neuropathic pain model.After twenty-eight days,rats in S,K and KA groups were intraperitoneally injected with saline, ketamine 10 mg·kg-1 and ketamine 10 mg·kg-1 +ANA-12 0. 5 mg·kg-1 for consecutive 7 days, respectively. On the 8th day, mechanical withdrawal threshold(MWT)of rats was measured.Af-ter that,the rats were immediately sacrificed,and dor-sal ganglion of lumbar spine and prefrontal cortex (PFC)were harvested for measuring BDNF,p-trkB/trkB,synaptophysin and spine density by Western blot andglogistaining.Results ComparedwithCgroup, rats in S group significantly decreased MWT,BDNF, p-trkB/trkB,synaptophysin and spine density in dorsal ganglion and PFC (P <0. 05 ).Compared with S group,rats in K group showed a significant increase of MWT,BDNF,p-trkB/trkB,synaptophysin and spine density in the all observed regions(P<0. 05 ).On the contrary,rats in KA group showed a significant de-crease of MWT and BDNF,p-trkB/trkB,synaptophys-in and spine density as compared with K group in all regions(P<0. 05 ).Furthermore,BDNF was positive-ly correlated with spine density in all regions (P <0.05).Conclusion BDNF-trkBsignalingpathway mediates ketamine-induced therapeutic effects in dia-betic neuropathic pain.

The present study is aimed to investigate the early clinical effects of nano-hydroxyapatite/polyamide 66 intervertebral fusion cage (n-HA/PA66 cage) for the treatment of lumbar degenerative diseases. We selected 27 patients with lumbar degenerative diseases who were managed by posterior decompression or reset operation combined with n-HA/PA66 cage intervertebral fusion and internal fixation from August 2010 to January 2012. The oswestry disability index (ODI), low back and leg pain visual analogue score (VAS), and intervertebral height (IH) were evaluated at preoperation, 1 week postoperation and the last follow-up period, respectively. Intervertebral bony fusion was evaluated at the last follow-up time. The patients were followed up for 12-24 months (averaged 19 months). The ODI, VAS and IH were significantly improved at 1 week postoperation and the last follow-up time compared with those at preoperative period (P < 0.05). But there was no significant difference between 1 week postoperative and the last follow-up time (P < 0.05). Brantigan's standard was used to evaluate fusion at the last follow-up time. There were 19 patients with grade 5 fusion, 8 with grade 4 fusion, with a fusion rate of 100%, and none with grade 1-3 fusions. There was no cage translocation and internal fixation breakage. These results suggested that n-HA/PA66 cage was an ideal biological material in the posterior lumbar interbody fusion and internal fixation operation for treatment of lumbar degenerative diseases. It can effectively maintain the intervertebral height and keep a high rate of bony fusion. The early clinical effect has been satisfactory.
Back ; Decompression, Surgical ; Durapatite ; Follow-Up Studies ; Fracture Fixation, Internal ; Humans ; Lumbar Vertebrae ; Nanostructures ; Nylons ; Spinal Fusion ; Treatment Outcome

Xuzhou Cancer Hospital explored a development and reform of the hospital in the PPP framework,while adhering to the principles of Public nature as before,staff status as before,and government supervision as before. The reform features proactive attempts in operation and management,personnel management,and remuneration system,in an effort to build an operation system featuring board governance,total cost accounting,and dynamic total salary management in its reform toward building an innovative mixed ownership.