OBJECTIVE: To explore the relationship between pedestrian traffic accidents and the type of vehicles and summarize the characteristics. METHODS: Ninety cases of pedestrian traffic accidents were reviewed, and the relationship between the types of vehicles and the injuries (site, feature and severity) were analyzed. RESULTS: Different impact injuries were caused by different types of vehicles. The primary sites of the impact injuries depended on the body posture and the height of protruding parts of the front when the accident happened. The injury characteristics were related to the size, direction of acting force and contact surface. CONCLUSION The analysis of position, feature, and severity of pedestrian injury can determine the type of injury vehicle.
Accidents, Traffic/statistics & numerical data* ; Female ; Humans ; Injury Severity Score ; Male ; Motor Vehicles ; Posture ; Sickness Impact Profile ; Walking ; Wounds and Injuries/mortality*

Aged ; Female ; Humans ; Neurilemmoma ; Pharyngeal Neoplasms

A series of isoindoline derivatives were designed, synthesized, and evaluated for their double inhibitory activities. All of them were new compounds, and their structures were confirmed by 1H NMR and HR-MS. Preliminary in vitro pharmacological tests showed that all compounds exhibited 5-HT or NE reuptake inhibition activity. Among the tested compounds, compound I-3 exhibited potent inhibitory activity against 5-HT and NE reuptake in vitro, and exhibited potent antidepressant activity in vivo. These compounds designed can be further optimized for finding more potent 5-HT/NE dual reuptake inhibitors and antidepressant candidates as well.
Antidepressive Agents ; chemical synthesis ; chemistry ; Biological Transport ; Drug Design ; Isoindoles ; chemical synthesis ; chemistry ; Serotonin Uptake Inhibitors ; chemical synthesis ; chemistry ; Structure-Activity Relationship

Objective To investigate the imaging characteristics of lymphoscintigraphy in postoperative breast cancer patients and evaluate its diagnostic value in breast cancer-related lymphedema (BCRL).Methods Seventy-nine breast cancer patients who underwent mastectomy and axillary lymph node dissection were studied. Patients ( n = 158 ) were divided into the study ( affected arms, n = 79 ) and control groups ( contralateral arms, n = 79). After subcutaneous injection of 99Tcm-dextran via the first interphalangeal space, lymphoscintigraphy was performed at 10 min, 1,3, 6 h respectively. Sensitivity and specificity of lymphoscintigraphy for detection of BCRL were calculated. Results There were significant differences in the amount of visualized lymph nodes, lymphatic integrity and backflow pattern between the two groups.Lymphatic drainage was preserved in 96.2% (76/79) of the contralateral arms and only 5.1% (4/79) of affected arms. 87.3% (69/79) and 74.7% (59/79) of control arms had ≥2 lymph nodes in axilla and supraclavicular regions, respectively; while none ( 0/79 ) and 5.1% (4/79) of the affected arms had ≥ 2lymph nodes in both regions, respectively. Four backflow patterns of radiotracer in subcutis were observed in the affected arms: normal (2.5% , 2/79), dilatated (55.7%, 44/79), diffused (36.7%, 29/79) and without backflow (5.1%, 4/79 ). The sensitivity and specificity of "lymphatic integrity" and "backflow pattern" on lymphoscintigraphy for detecting BCRL were 97.5% (77/79) and 96.2% (76/79), 94.8%(73/77) and 100.0% (81/81), respectively. Conclusion Lymphoscintigraphy is a noninvasive, accurate and effective imaging modality for the evaluation of BCRL.

This study is to determine six chlorogenic acids (chlorogenic acid, 5-O-caffeoylquinic acid, 4-O-caffeoylquinic acid, 3,4-di-O-caffeoylquinic acid, 3,5-di-O-caffeoylquinic acid and 4,5-di-O-caffeoylquinic acid) by quantitative analysis of multi-components with a single marker (QAMS). Chlorogeinc acid was used as internal reference to calculate the relative correction factors (RCF) of five compounds. Then the ruggedness of relative correction factors was tested on different instruments and columns. Meanwhile, a total of 4 batches of Lonicerae Flos and 20 batches of Lonicerae Flos extract with five different processing procedures were analyzed by external standard method (ESM) and QAMS, respectively. The ruggedness of relative correction factors was good. And the analytical results calculated by ESM and QAMS showed no difference. The quantitative method established was suitable for the quality evaluation of Lonicerae Flos extract.
Biomarkers ; analysis ; Chlorogenic Acid ; analysis ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; analysis ; Flowers ; chemistry ; Lonicera ; chemistry

Prostatic artery of 12 elder and 9 younger cadavers were isolated and transected.Vascular inner diameter and thickness of vascular wall of these cross sections were observed microscopically.Atherosclerotic plaque could be seen in the prostatic artery of 12 elders.And there were the thickening of tunica intima and the narrowing of inner diameter.The inner diameter of elderly prostatic artery was (452 ± 97) μm,the thickness of their tunica intima (228 ± 82) μm and inner diameter/thickness 3.14 ± 0.68.Tunica intima of 9 younger prostatic arteries were glabrate.The inner diameter of younger prostatic artery was (864 ± 17)μm,the thickness of their tunica intima (57 ± 4)μm and inner diameter/thickness 15.52 ± 0.18.Statistically significant differences existed between elder and younger cadavers in the above 3 parameters.As compared with younger counterpart,prostatic artery of elders was more stenotic and its tunica intima tended to he thicker.

Objective To evaluate the lymphoscintigraphic imaging characteristics for the patients with lower limb lymphedema and to establish a novel grading system for the injury to lower limb lymphatic system. Methods One hundred and sixty six consecutive patients (332 lower limbs) with lower limb lymphedema after surgical and(or) radiotherapy treatment for gynecological cancer were recruited into this retrospective study. The lymphoscintigraphy studies were performed after subcutaneous injection of 111～185 MBq (0. 1～0. 15 ml) of 99Tcm-DX into the webbed space between the first and second toes of both feet. Based on the integrity of lymphatic vessel and the extension of dermal diffusion on lymphoscintigram,the lymphatic injury to the lower limb was graded as 0, 1,2 and 3 respectively. The lymphedema of the limb was staged as 0, Ⅰ , Ⅱ a, Ⅱ b, Ⅲ by the standard of Consensus Document of the International Society of Lymphology (ISL). Chi square test was carried out to validate the established grading system for the assessment of the injury to the lower limb lymphatic system. Results The lymphoscintigraphic imaging characteristics included lymphatic blockage, dermal backflow, no visualization of lymphatic or lymph node, lymphocele and lymph fistula in the lower limb, pelvis and abdomen. There were 65 (19.6%), 71 (21.4%),131 (39.5%), 62 (18.7%) and 3 (0.9%) limbs staged as 0, Ⅰ , Ⅱa, Ⅱb, and Ⅲ for lymphedema while 36(10.8%), 79(23.8%), 116(34.9%) and 101 (30.4%) limbs graded as 0, 1, 2, and 3 for lymphatic injury. There was a statistically significant correlation between the grading methods (χ2 =313.483, P <0.001). The patients who underwent radiotherapy had a higher incidence rate of grade 2 and 3 (70.5%, 158/224) than those who underwent surgery (53.6%, 59/108) (χ2 = 9.662, P = 0.022).The patients with erysipelas had a higher incidence rate of grade 3(73.1%, 38/52) than those without erysipelas (43.9%, 50/114) (χ2= 12.238, P<0.001). The incidence rate of grade 3 increased with the duration of lymphedema after treatment: 36.6% (34/93) for less than 1.5 years, 72.3% (34/47) for between 1.5 to 5 years, and 76.9% (20/26) for more than 5 years (χ2 = 23.123, P<0.001). The grade of lymphatic injury showed no significant difference among 3 types of gynecological cancers (χ2 = 4.000, P =0.676), or between the patients with and without chemotherapy (χ2 =0.411, P=0.938). Conclusions Lymphoscintigraphy is a reliable modality to diagnose lower limb lymphedema after treatment for gynecological cancer. The injury grading system could provide objective assessment of the lymphatic damage.

OBJECTIVETo explore the clinical application value of Provider-Initiated HIV Testing and Counseling (PITC) by analyzing the positive rate of HIV tests for people in need of PITC and that of routine HIV tests.

METHODSWe retrospectively analyzed the demographic and epidemiologic data about the patients seeking PITC services or undergoing routine HIV tests in Nanjing Drum Tower Hospital between January and December 2013.

RESULTSThe positive rate of initial HIV screening was 1.98% in the PITC group and 0.24% in the routine test group, while that of confirmed HIV was 0. 40% in the former and 0.07% in the latter, both with statistically significant differences between the two groups (P < 0.01). The positive rate of HIV was markedly higher in males than in females, particularly in the PITC group.

CONCLUSIONPITC has a high clinical value in HIV detection for targeted subjects and therefore deserves general application in dermatology.

Counseling ; Dermatology ; Female ; HIV Seropositivity ; diagnosis ; epidemiology ; Humans ; Male ; Mass Screening ; methods ; Retrospective Studies ; Sex Factors

Objective To observe the post-systolic shortening (PSS) during isovolumic relaxation phase and its clinical significance in regional myocardium in chronic heart failure (CHF) patients.MethodsLeft ventricular regional myocardium movement in 60 CHF patients (CHF group) and 30 healthy volunteers (control group) were assessed with tissue velocity imaging (TVI). QLAB software was used to measure the systolic peak velocity (V_s), regional systolic time (T_s), post-systolic shortening velocity (V_(pss)) and post-systolic shortening time (T_(pss)) at the basal and middle levels of left ventricle. Results In CHF patients, the rate of isovolumic relaxation phase PSS was 34.44% both in basal and mid segments, the rate of pathological PSS was 29.44% and 29.72%, respectively. The rate of isovolumic relaxation phase PSS in control group was 26.11% and 20.56%, respectively; none pathological PPS occured. Compared with the physiological PSS of control group, the pathological PSS of CHF group had a higher peak velocity and a longer time (P<0.05). Conclusion The pathological PSS of CHF patients has high peak velocity and long duration, which may be one of the causes leading to the asynchronous movement of left ventricle in CHF.

Objective To explore the ways to decrease the postoperative complications of pancreaticoduodenectomy. Methods Thirty-four patients who underwent pancreaticoduodenectomy between January 1998 and December 2004 were reviewed retrospectively. A duct-to-mucosa pancreaticojejunostomy was performed mostly for patients, and an end-to-end pancreaticojejunal invagination for 5-patients with a soft pancreas and a small pancreatic duct. The end-to-side hepaticojejunostomy and the Roux-en-Y reconstruction of gastrointestinal continuity were performed for all patients. Results The hospital mortality was zero. The postoperative complications occurred in the form of wound infection was 4(12%), delayed gastric emptying was 1(3%), pneumonia was 1(3%), intra-abdominal collections was 1(3%) and pancreaticojejunostomy leak was 1(3%). In 1 patient with pancreaticojejunostomy leak, the closure was achieved with the conservative treatment. Intra-abdominal bleeding, intra-abdominal abscess and other anastomotic leakage were not seen in any of patients. The median follow-up was 21 months (ranging from 6 months to 5 years), none of patients had clinical evidence of steatorrhea, bile reflux gastric disease, anastomotic ulcer, retrograde cholangitis and dumping syndrome, there was no new case of diabetes. Conclusions Proper method of reconstruction produces encouraging results in decreasing the complications after pancreaticoduodenectomy.