OBJECTIVETo explore the optimal treatment for craniocerebral trauma complicated with thoraco-abdominal injuries.

METHODSA total of 2165 cases of craniocerebral trauma complicated with thoraco-abdominal injuries admitted to our hospital between July 1993 and June 2003 were retrospectively studied. Among them, 382 cases sustained severe craniocerebral trauma (in which 167 were complicated with shock), 733 thoracic injuries, 645 abdominal injuries and 787 thoraco-abdominal injuries. On admittance, 294 cases had developed shock. With the prime goal of saving life, respiratory and circulatory systems and encephalothilipsis were especially treated and monitored. Priority in management was directed to severe or open injures rather than to moderate or closed injures. For cases with cerebral hernia due to intracranial hematoma and severe shock due to blood loss, cerebral hernia and shock were treated concurrently.

RESULTSAfter treatment, 2024 (93.49%) cases survived and the other 141 (6.51%) died. Among patients who had severe craniocerebral injury with shock and those without, 78 (46.71%) and 53 (24.56%) died, respectively. For patients who had underwent craniocerebral and thoraco-abdominal operations concurrently and those who had not, the death rates were 58.49%-65.96% and 28.57% respectively, indicating a significant difference (P<0.05).

CONCLUSIONSTreatment for hematoma hernia, shock and disturbed respiration is the key in the management of multiple trauma of craniocerebral, thoracic or abdominal injuries, especially when two or three conditions occurred simultaneously. Unless it is necessary, operations at two different parts at the same time is not recommended. It is preferred to start two concurrent operations at different time.

Adult ; Craniocerebral Trauma ; surgery ; therapy ; Encephalocele ; etiology ; therapy ; Female ; Humans ; Male ; Multiple Trauma ; surgery ; therapy ; Retrospective Studies ; Shock, Hemorrhagic ; etiology ; therapy ; Thoracic Injuries ; surgery ; therapy

Adenoid cystic carcinoma usually occurs in the salivary glands of the head and neck. It is a malignant tumor with a high degree of malignancy, resistance to radiotherapy and chemotherapy and poor prognosis. The clinical course of adenoid cystic carcinoma is slow and easy to be misdiagnosed. The main diagnosis and treatment means are individualized and precise treatment under the multi-disciplinary consultation mode, that is, surgical treatment and radiotherapy and chemotherapy. Adenoid cystic carcinoma is prone to relapse and hematologic metastasis, and the traditional radiotherapy and chemotherapy based therapies have not achieved satisfactory efficacy in the past three decades. How to detect, diagnose and treat early is an urgent task faced by clinicians.
Humans ; Carcinoma, Adenoid Cystic/pathology* ; Neoplasm Recurrence, Local ; Neck/pathology* ; Oropharynx/pathology* ; Diagnostic Errors

OBJECTIVETo investigate the role of expression of hepatocyte growth factor (HGF) and its receptor (c-Met) in gastric cancer.

METHODSThe expression of HGF and c-Met was detected with SABC immunohistochemistry in 44 specimens of gastric cancer, 20 chronic superficial gastritis, 10 chronic atrophic gastritis and 16 gastric ulcer tissues.

RESULTSNo positive expression of HGF/c-Met was found in the chronic superficial gastritis specimens. The positivity rates of HGF in the gastric cancer was 72.7% (32/44), significantly higher than that in chronic atrophic gastritis [20% (2/10), P<0.005] and gastric ulcer [37.5% (6/16). P<0.025]. The positivity rates of c-Met in gastric cancer [77.3% (34/44)] was also significantly higher than that in chronic atrophic gastritis [40% (4/10), P<0.05] and gastric ulcer [37.5% (6/16), P<0.025].

CONCLUSIONCo-expression of HGF and c-Met in gastric cancer may promote the progression of the malignancy, and also opens a new pathway for the therapy of gastric cancer.

Adult ; Aged ; Female ; Hepatocyte Growth Factor ; metabolism ; Humans ; Male ; Middle Aged ; Proto-Oncogene Proteins c-met ; metabolism ; Stomach Neoplasms ; metabolism ; pathology ; Young Adult

Objective: To analyze the current status of latent tuberculosis infection (LTBI) among freshmen in boarding middle schools in Longgang District, Shenzhen, so as to provide reference for formulating tuberculosis prevention and control strategies in the next stage. Methods: Data for tuberculosis health examination conducted among primary and secondary school students in Longgang District of Shenzhen in September 2022 to May 2023 were utilized to analyze the latent tuberculosis infection rate, and to explore the differences in latent tuberculosis infection rate among different grades, school nature, school categories and school levels. Results: The latent tuberculosis infection rate among freshmen in boarding secondary schools in Longgang District, Shenzhen in 2022 was 2.45%. The infection rate among full middle school (6.45%) and high school (3.37%) were higher than that in boarding junior high school (0.28%), nine year education school (0) and twelve year education school (1.00%) ( P <0.01). Moreover, the infection rate of high school freshmen (2.68%) was higher than that of bording junior high school (0.33%), and the rate of public schools (2.87%) and municipal schools (3.24%) were higher than those of private schools (1.78%) and distric-level schools (2.13%) respectively, with statistical significance observed for all differences( χ 2=43.58, 25.15, 22.69, P <0.01). Conclusions The latent tuberculosis infection rate among new boarding secondary students is relatively low in Longgang District of Shenzhen. However, the infection rate is higher in high school, public and municipal school. School should fully guarantee sports participation of students, enhance students awareness of tuberculosis through health knowledge lectures, and reduce the incidence of tuberculosis among students.

OBJECTIVETo investigate the effects of the expression of the PPAR-gamma gene on the proliferation and glycolysis metabolism of prostate cancer cells.

METHODSUsing RNAi, we constructed lowly--expressed shRNA-PPARgamma adenoviruses and transfected them to PC3 prostate cancer cells, with blank vectors as controls. Then we detected the proliferation and apoptosis of the cells, glycolysis metabolism related genes and lactate accumulation by CCK-8 kit, and compared the results between the two groups.

RESULTSCompared with the control group, the PPAR-gamma gene expression was obviously inhibited by RNAi in the PC3 cells, and its protein expression was reduced to (26.00 +/- 4.06)%. The proliferation inhibition rate was (39.5 +/- 4.92)% on the 2nd day, and the apoptosis rate was as high as (21.03 +/- 3.08)%. The glycolysis metabolism related gene products (Myc and Glut-1) were significantly decreased, and the lactate concentration was reduced to 69.71% of that of the controls on the 4th day. There were statistically significant differences in the above findings as compared with the control group (P < 0.01).

CONCLUSIONPPAR-gamma gene knockdown is expected to be a new way to treat prostate cancer.

Apoptosis ; Cell Line, Tumor ; Cell Proliferation ; Genetic Vectors ; Glucose Transporter Type 1 ; metabolism ; Glycolysis ; Humans ; Male ; PPAR gamma ; genetics ; metabolism ; Prostatic Neoplasms ; metabolism ; pathology ; Proto-Oncogene Proteins c-myc ; metabolism ; RNA Interference ; RNA, Small Interfering ; Transfection

OBJECTIVE:To provide reference for better carrying out safe medication intervention for the empty-nest elderly.METHODS:Two communities with different levels of income and culture were collected from Pudong New District of Shanghai,i.e.new community A and traditional community B.By cluster sampling,69 and 110 empty-nest elderly were selected as respondents respectively.The questionnaire survey about drug storage and medication habits of the elderly was conducted.The data of the survey were analyzed statistically.RESULTS:A total of 69 and 110 questionnaires were sent out,and 44 and 63 questionnaires were recovered with effective recovery rate of 63.8％ and 57.3％,respectively.The rate of drug storage in families from traditional community B was higher than new community A (100％ vs.88.6％,P=0.010).The proportions of residents in two communities storing their drugs in special drawers were the highest (59.0％ and 57.1％).Nearly half of the surveyed households in 2 communities did not form the habit of regularly clearing stored drugs.The frequency of residents who cleared stored drugs in traditional community B was higher than those in new community A (P=0.009).Nearly more than 70％ of the residents threw their expired drugs to garbage and only 11％ to drug stores or community health service center.The proportion of residents who were used to reading drug instructions in new community A was higher than traditional community B (95.5％ vs.77.8％,P=0.024).The proportion of the residents consulted community doctors when they were puzzled by drug use in new community A was lower than traditional community B (56.8％ vs.76.2％);The proportion of the residents consulted physicians in major hospitals was higher than traditional community B (34.1％ vs.9.5 ％);there was statistical significance (P=0.034).The most popular health service for the residents in the new community A was the hotline for the drug use (65.9％),while the residents in traditional community B needed blood pressure and sugar monitoring service and set up the health records (41.3％).The proportion of the residents' following demands in new community A was higher than traditional community B:opening drug use hotline,publicizing the knowledge of diseases and medication and conducting lectures (P＜0.001,P=0.006,P=0.018).CONCLUSIONS:The proportion of drug storage in empty-nest families of two communities is in very high level,but drug storage methods,cleaning frequency are not satisfactory.There are still a small number of elderly people who do not have the habit of reading drug instructions.There are some differences between the old and new communities.At the same time,the needs of health services in new and old communities are different.

OBJECTIVE: To describe the anatomy,radiographic manifestation, and surgical treatment of pulsatile tinnitus due to sigmoid sinus diverticulum. METHOD: The retrospectively study of diagnosis,clinical and radiographic manifestations,and surgical treatment of 2 cases of pulsatile tinnitus caused by sigmoid sinus diverticulum was carried out. RESULT: Bony defect was found in the anterior sigmoid wall in both cases, and one of them was combined with invasion of soft tissues in mastoid cells. Both of them undertook a surgery to reconstruct sinus wall and received a satisfactory results. CONCLUSION Sigmoid sinus diverticulum is one of causes which lead to pulsatile tinnitus. It can be identified by imaging examination and can be cured by sinus wall reconstruction.
Adult ; Diverticulum ; complications ; Female ; Humans ; Male ; Meninges ; Retrospective Studies ; Tinnitus ; etiology ; pathology ; surgery

In the context of modern medicine， it’s difficult for doctors lacking narrative thinking to get into the hearts of patients and offer high-quality medical service. Precise classification terms and decontextualized abstract language have become communication barriers between doctors and patients， creating an atmosphere of unusual indifference and fear during the medical process. William Osler， the father of modern medicine， emphasized that doctors should respect the individuality of patients， and advocated that doctors should use life-oriented language to provide humanistic care to patients. This echoes the concept of the “doctor-patient narrative community” in the construction of the Chinese narrative medicine system. As a brand new clinical humanistic practice path， narrative medicine focuses on the keyword “narrative” and revolves around the theme of “inter-subjective relationship” in the medical context， advocates that doctors switch flexibly in the two references of science and life， achieve visual fusion with patients and their families， pay attention to patients’ life experiences， and establish narrative connections with them. On this basis， it can achieve two-way narrative interaction， build a harmonious doctor-patient narrative community， and thus enhance the patient’s medical experience.

OBJECTIVECoronary arterial plaque rupture and secondary thrombosis are the major pathogenesis of acute coronary syndrome (ACS). Metalloprotease (MMPs) secreted by monocyte/macrophage was the main predisposing factor of the plaque rupture and peroxisome proliferator-activated receptor-gamma (PPAR-gamma) is involved in a variety of inflammatory cytokine gene transcriptional regulations. We explored the possible role of PPAR-gamma in the regulation of MMP-9 and TIMP-1 expressed by peripheral monocyte-derived macrophages (MDMs) from patients with ACS.

METHODSPeripheral blood mononuclear cells were isolated from 48 patients with ACS and 28 healthy controls and stimulated by macrophage colony-stimulating factor (0.1 microg/ml for 24 hours) to form MDMs. MDMs were then incubated under various concentrations of rosiglitazone (0, 1, 10, 20 micromol/L) for 48 hours. The concentrations of MMP-9 and TIMP-1 in the supernatant were measured by enzyme linked immunosorbent assay, and the mRNA expression of PPAR-gamma, MMP-9 by RT-PCR and nuclear factor-kappaB P65 (NF-kappaB P65) expression by immunohistochemistry.

RESULTSPPAR-gamma mRNA expression was significantly lower while NF-kappaB P65 and MMP-9 expression as well as MMP-9 and TIMP-1 concentrations in supernatant were significantly higher in ACS group than those in control group (all P < 0.05). After rosiglitazone intervention, PPAR-gamma mRNA expression was significantly upregulated in both ACS and control groups in a dose-dependent manner. Both the MMP-9 concentration in the supernatant and MMP-9 mRNA expression were reduced post intervention with rosiglitazone in both groups. The TIMP-1 mRNA expression and concentration in supernatant were not affected by rosiglitazone in both groups. Rosiglitazone induced significant downregulation of NF-kappaB P65 expression in both groups.

CONCLUSIONRosiglitazone intervention may downregulate MMP-9 expression by upregulating PPAR-gamma expression, and by downregulating NF-kappaB expression in MDMs isolated from patients with ACS.

Acute Coronary Syndrome ; blood ; Aged ; Case-Control Studies ; Cells, Cultured ; Female ; Humans ; Macrophages ; metabolism ; Male ; Matrix Metalloproteinase 9 ; metabolism ; Middle Aged ; PPAR gamma ; agonists ; Thiazolidinediones ; pharmacology ; Tissue Inhibitor of Metalloproteinase-1 ; metabolism ; Transcription Factor RelA ; metabolism ; Vasodilator Agents ; pharmacology

Objective:To study the effect of Yupingfeng San （YPFS） on the expressions of GATA binding protein 3 （GATA3） and forkhead transcription factor3 （Foxp3） in ovalbumin （OVA）-induced lung tissue of allergic rhinitis （AR） mice， and explore the mechanism of YPFS on AR. Method:The allergic rhinitismice model was established by intraperitoneally injecting with OVA and Al （OH）₃， and challenged with OVA intranasally. The mice were divided into four groups： normal，model，chloretadine（3 mg·kg^-1） and YPFS（6.5 g·kg^-1） group， the corresponding drugs were orally administrated for three weeks. At the end of administration，the infiltration of inflammatory cells， such as mast cells， eosinophils and neutrophils in nasal mucosa， were observed by htoxylin eosin （HE） staining. The serum concentrations of OVA-specific IgE and cytokines ［interleukin-4（IL-4）， IL-5 and γ-interferon （INF-γ）］ were determined by enzyme-linked immune sorbent assay （ELISA）. The expressions of GATA3 and Foxp3 proteins in nasal mucosa tissue were detected by Western blot. Result:The AR mice had such symptoms as scratching， sneezing and running nose. Nasal mucosa section by HE staining showed significant desquamation of AR mouse nasal mucosa cilia， obvious tissue stromal edema， telangiectasia， and a large number of eosinophilic cells， lymphocytes， plasma cells infiltration. YPFS obviously improved nasal symptoms of allergic rhinitis mice. Nasal mucosa epithelial structure was complete and arranged evenly， with no obvious tissue clearance edema and vasodilation， and inflammatory cell infiltration was significantly reduced. Compared with normal group， the levels of OVA specific IgE， IL-4 and IL-5 in peripheral blood of AR model group were significantly higher（P<0.01）， and the INF-γ level was significantly lower （P<0.01）. Compared with AR model group， the administration of chloretadine and YPFS can significantly reduce the level of OVA specific IgE and IL-4， IL-5， and increase the level of INF-γ in AR mice peripheral blood （P<0.05， P<0.01）. Western blot results showed that compared with normal group， GATA3 protein expression was significantly increased， while Foxp3 protein expression was significantly decreased in AR model group （P<0.05， P<0.01）. Compared with AR model group， YPFS inhibited GATA3， and promoted Foxp3 protein expression （P<0.01）. Conclusion:YPFS has an effect in alleviating OVA-induced allergic rhinitis．YPFS may modulate the immune response by regulating the balance of Th2/Treg cells.