Objective To improve the awareness of rare mixed prostatic carcinoma. Methods We reviewed the clinical data of 5 patients with prostatic mixed tumor and relevant literature to ex-plore diagnosis and treatment for it. Results Patient 1 with mixed small cell carcinoma and adeno-carcinoma of the prostate who underwent transurethral electrovaporization of the prostate (TUVP) and flumamide therapy died of lung metastasis 7 months later. Patient 2 with mixed small cell carcinoma and adenocarcinoma of the prostate who underwent TUVP and bilateral testicular resection died of lung metastasis 10 months later. Patient 3 with adenosquamous carcinoma of the prostate who underwent TUVP, radiation therapy and flumamide therapy died of multiple organ failure 8 months later because of the lung, liver, and multiple bone metastasis. Patient 4 with prostatic adenosquamous carcinoma who underwent cystoprostatectomy combined with urinary diversion has already survived for 1 year. Patient 5 with prostatic carcinosarcoma who underwent cystoprostatectomy, urinary diversion, pelvic lymphadenectomy, and radiation therapy died of lung metastasis 13 months later. Conclusion Mixed prostatic carcinoma is quite aggressive with bad prognosis. Its diagnosis relies on detailed pathological examination and immunohistochemical techniques. Patients with prostate adenocarcinoma should be followed up timely after endocrine treatment or radiotherapy. Radical surgery is most effective for mixed prostatic carcinoma.

Objective To investigate the epidemiology and clinical features of epidemic cerebrospinal meningitis of children in Shanghai area in the last 2.5 years. Methods A retrospective study was conducted in 27 hospitalized patients with epidemic cerebrospinal meningitis by analyzing the clinical manifestation,epidemiology and laboratory test fingdings from Jan.2006 to Jun.2008.Statistical analysis of the clinical manifestations of cases in serogroup A,B and C was performed according to Neisseria meningitidis infection. Results There were sporadic cases of children with epidemic cerebrospinal meningitis in Shanghai area in the last 2.5 years.The seasonal distribution illustrated the peak occurrence from Feb.to Apr.Among all these cases,92.6% were floating children.Common types(74.1%) were the predominant clinical manifestations and the others were fulminate types(25.9%).Four cases in each of serogroup A and B,and 8 cases of serogroup C were identified by serotyping on 14 Neisseria meningitidis strains and genotyping on the other 2 cases′ cerebrospinal fluid specimens.All the patients in serogroup A with meningococcal diseases were not vaccinated before and 25.0% of them belonged to fulminate types.Half of the cases had petechia on the skin and the prevalence of skin necrosis was 25.0% and 50% had complications of nervous system.No fulminate type was present in cases of serogroup B meningococcal disease and only 1 case had slight petechia on the skin.However,intensive convulsions occurred in 75.0% of the patients,and all of them had complication of nervous system,with a few had sequela.Among the patients in serogroup C meningococcal disease,62.5% patients were vaccinated with serogroup A Neisseria meningitidis.In serogroup C,Neisseria meningitidis infection was found in each age group,with petechia on skin,skin necrosis,immunity correlation fever and complications of nervous system in 87.5%,50.0%,75.0% and 12.5% of the patients,respectively. Conclusions 1.Epidemic cerebrospinal meningitis occurred sporadically in children in Shanghai area,the majority of patients were floating populations.2.Clinical manifestation was typical in patients of serogroup A meningococcal disease.Subdural effusion or ventricalitis was more common in patients of serogroup B meningococcal disease.In serogroup C,Neisseria meningitidis was the most prevalent serotype leading to epidemic cerebrospinal meningitis.More cases were found in patients infected with serogroup C,Neisseria meningitidis with severe shock and immunity correlation fever compared with the other groups.Prophylactic vaccination of serogroup C polyvalent meningococcal organism should be recommended.

Adolescent ; Adult ; Drugs, Chinese Herbal ; chemistry ; therapeutic use ; Female ; Flavonoids ; therapeutic use ; Hepatitis B, Chronic ; drug therapy ; Humans ; Male ; Middle Aged ; Phytotherapy ; Salvia miltiorrhiza

Objective To study the role of the expression of P-selectin and intercellular adhesion molecule-1(ICAM-1) in hamster to rat concordant cardiac xenotransplantation.Methods Intra-(abdominal) cardiac transplantation was performed by using SD rats as recipients of Golden Syrian(hamster) hearts.The rats were divided into 4 groups randomly: group I(n=15),unmodified(recipients) were used as control; group II(n=15),splenectomy at day 0;group III(n=15),the rats were treated with cyclosporine A(CsA) 10 mg/kg every day from day 0;group IV(n=15),splenectomy in combined with CsA.The survival of hamster hearts was observed in each group.The xenograft was harvested at rejection and scheduled time in accordance with the experimental design,and analyzed for histology.The expression of P-selectin and ICAM-1 was detected by immunohistochemistry in xenograft after xenotransplantation.Results The mean survival time of the xenograft in group IV was 34.20?8.98 days,which was significantly longer in groups I,II and III (P

Objective To obeserve the effects of acute hypervolemic hemodilution(AHH) with hypertonic .sodium chloride hydroxyethyl starch 40(HSH 40) on hemodynamics and fluid balance in patients under general anesthesia.Methods Fifty patients undergoing radical surgery for gastral cancer under general anesthesia were randomly divided into 2 groups with 25 patients each.Acute hypervolemic bemodilution (AHH) was performed with HSH 40 6 ml/kg in group A or with hydroxyethyl statch(HES) 6 ml/kg in group,which was infused within 30 minuts.HR,MAP,CVP were recorded before(T_0),at 30 min (T_1),60 min (T_2) after infusionand and the end of operation (T_3).The amounts of bleeding,HSH 40 and HES and urine output were recorded as well.Results There were no significant diferences in HR and MAP between two groups at all time points.CVP was sighificantly higher at T_1-T_3 than that at To in two groups.The urine output was more in groups A than that in group B(P<0.05).Conclusion AHH with HSH 40 can effectively expand blood vlume and increase urine output in surgical patients under general anesthesia.

Objective To investigate the effect of recruitment maneuver(RM) on surfactant proteins in young piglets with acute lung injury and the possible mechanisms of lung recruitment after RM.Methods The piglet model of ALI was established by lipopolysaccharide intravenous injection,12 male piglets were randomly divided into two groups:conventional ventilation group(control group) and RM with low tidal volume group(RM group).After 8 hours of ventilation,mRNA expression of surfactant protein-A(SP-A),SP-B,SP-C,SP-D in the piglet lungs were determined by real time PCR and SP-A protein distribution was assessed by immunohistochemistry.Biochemical analyses of TP,total phospholipids(TPL),DSPC were conducted as well.SP-A levels in bronchoalveolar lavage fluid(BALF) and plasma were measured by enzymelinked immunosorbent assay(ELISA).Results As compared with control group,RM group had higher expression of SP-A,SP-B,SP-C and SP-D.SP-A average gray values of control group and RM group were 97.8±6.4 and 106.3±8.5,and there was significant difference(P＜0.01).RM group showed significant increase of TPL,DSPC and DSPC/TP.The concentration of SP-A in BALF was higher in RM group than that of the control group,however,SP-A plasma level was lower in RM group than that of the control group.Conclusion RM can increase suffactant protein expression in ALI animals,alleviate surfactant protein dysfunction and regulate the concentration of SP-A,which may improve alveolar recruitment following the RM and alleviate ventilator-induced lung injury.

Objective To investigate the carotid plaque conditions and clinical commonly used test events in patients with type 2 diabetes mellitus (T2DM) and to explore the risk factors affecting the stability of plaques in carotid artery.Methods According to the results of cervical vascular color Doppler ultrasound examination, 125 patients with type 2 diabetes mellitus were divided into unstable plaque group (n=21), stable plaque group (n =54), and non-plaque group (n =50).Analysis related results including age, gender, systolic blood pressure (SBP), diastolic blood pressure (DBP), intima-media thickness (IMT), fasting blood glucose (FBG), triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), uric acid (UA), fibrinogen (Fbg), D-dimer (D-D), free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) were analyzed.Results Age, gender, SBP, DBP, TG, HDL, D-D, and TSH were without significant differences among groups.Glucose and Fbg were significant different (P ＜ 0.05) between unstable plague group and stable plaque group/no plaque group.No significance difference was found between stable and no plaque groups.IMT, TC, LDL, and FT4 were significant different (P ＜ 0.05) between unstable and stable plaque groups, and between stable and no plaque groups.Logistic multiple regression analysis suggested that IMT and TC might be independent risk factors for the stability of plaques in carotid artery of patients with type 2 diabetes mellitus (P ＜ 0.05).Conclusions The factors affecting formation of plaques in carotid artery include glucose level, TC, and LDL in patients with type 2 diabetes mellitus.The factors affecting its stability include thickness of IMT, TC, LDL, and FT4.IMT and TC were the independent risk factors for the stability of plaques in carotid artery.

The Hippocratic oath commands doctors to be the patients supreme advocate. Coupling this command with a well trained physician is the sine qua non of orthopaedic risk management. A favorable doctor and patient relationship is also essential. The occurrence of a malpractice lawsuit is more often the result of the failure to practice the art of medicine by the orthopaedist rather than a failure to apply the science of orthopaedics. The ER (emergency room) is a dangerous area. The risk of litigation in the emergency room is not directly proportional to the severity of injury. In fact, the risk of initiation of legal action is greater in cases of relatively modest disability.

0.05) while other indicators did not. All the data were simply related to each other. The primary influencing factors to NDS score 1, in decreasing order of impact were volume of infarction, position of infarction, hs-CRP and FBS. While the primary influencing factors to NDS score 3 at the end of 1 month treatment, in decreasing order of impact, were NDS score 1, size of infarction, FG, hs-CRP and TC. Conclusions Volume of infarction and hs-CRP are very important determining factors in both NDS score 1 at the beginning of the treatment and NDS score 3 at the end of 1 month treatment. However, in determining NDS score 3 at the end of 1 month treatment, the impact of FG is greater than hs-CRP. The other influencing factors include FBS, TC and so on. Therefore we conclude that it is helpful to recover from neurologic deficit through lowing these influencing factors directly by medication.

The paper analyzes deficiencies in traditional manual screening of critical values , telephone notifications and manual record-ing of critical value reports , as well as problems existing in current critical value reporting systems in China .It designs a stable , timely and accurate reporting system for test critical values and mainly introduces the system design , system function and application features .