Objective To determine the prevalence and clinical characteristics of orthostatic hypotension (OH) and orthostatic hypertension (OHT) in the elderly patients with hypertension.Methods 489 elderly patients with hypertension were enrolled and divided into the OH group,the OHT group and the non-OH-OHT group,which represents no or symptom.The orthostatic blood pressure was measured in supine position after resting for more than 5 minutes and at 3 min standing.Results The prevalence of OH in the 60～79 years old group was lower than that in ≥ 80 years old group.The morbility of coronary heart disease,diabetes and ischemic stroke was significantly higher in the OH and OHT group than that in the non-OH-OHT group.Conclusions OH and OHT are common disease in the elderly patients with hypertension and associated with increased risk of cardiovascular disease and diabetes mellitus.To strengthen nursing and health education for elderly patients with hypertension could prevent the incidence of malignant cardiovascular events due to OH and OHT.

Objective To analyze the clinical and ultrasonic features of primary squamous cell carcinoma of the thyroid(PSCCT)and diagnostic value of ultrasonography (US) in PSCCT in order to improve the cognition of PSCCT.Methods The clinical data and ultrasonic characters of 5 patients with PSCCT confirmed by pathology post surgery were retrospectively reviewed.Results The average age of the 5 patients was 62 years (range from 46 to 79).All of 5 patients with PSCCT were presented with a painless neck mass in clinical palpation examination.Of them,2 patients had different degrees of difficulty in breathing and swallowing,2 patients had hoarseness.Four of 5 patients had died after surgery with average survival time of 9.5 months.On US,the size of lesions was large(a maximum diameter of 2.9-5.5 cm),all of 5 lesions appeared as single solid mixed-echogenicity mass including irregular lamellate marked hypoechoic region,with irregular margin and undefined boundary.Of them,2 lesions presented with lobulated,only 1 lesion exhibited microcalcification and another 4 lesions had no calcification,3 lesions exhibited a? sign of breakthrough thyroid envelope.Color Doppler flow imaging showed few blood flow (3/5) and moderate blood flow (2/5),a higher vascular resistance spectrum was detected in 4 lesions (RI 0.72-0.88).Three patients exhibited suspicious cervical lymph nodes.Conclusions The characteristic ultrasonic appearance combined with the clinical features enables a confident preoperative diagnosis of PSCCT.

Pulmonary cyst is a relatively common benign lesion.It is easy to be misdiagnosed when the cyst complicated with infection.Tnis paper reported a case of a giant traumatic pulmonary cyst (diameter 10 cm) combined with chronic infection.Firstly,the patient was diagnosed as cholesterol pleurisy after undergoing thoracoscopic biopsy.With repeated pleural effusion,the patient was scheduled for right anterolateral thoracotomy,which showed a thin-walled cyst (10 cm in diameter) attached to parietal and diaphragm,with the stem of cavity originated from the right lower lobe after the cyst cavity was dissociated.Pathological examination revealed that it was apseudocyst,which could be diagnosed as traumatic pulmonary cyst combined with chronic infection according to history of trauma.After undergoing right lower lobectomy and stripping of fiberboard,the prognosis was good.Traumatic pulmonary cyst,which was discovered interval 10 years after chest trauma,was rare.Traumatic pulmonary cyst combined with cholesterol cystic fluid was very rare.Huge pulmonary cyst complicated with infection was easily misdiagnosed as loculated pleural effusion.Therefore,to be correct diagnosis and treatment,clinician must carefully ask medical history.In addition,early image examination should be considered in those patients with chest trauma whether there are clinical symptoms or not.

BACKGROUND: Insufficient bone mass in the posterior maxilla region often increases the difficulty of dental implantation. The application of maxillary sinus floor elevation successfully solves this problem. In the surgery bone grafting can be used to obtain sufficient bone mass. However, nonuse of graft materials can shorten the cycle of patient's treatment and reduce trauma and cost. OBJECTIVE: Combining the latest relevant research trends, to review the advances in the study of maxillary sinus floor elevation with and without bone grafting. METHODS: The first author searched PubMed, VIP, WanFang and CNKI databases using computer for relevant articles published from January 1985 to August 2018. The key words were "dental implant, maxillary sinus, bone augmentation, bone substitute" in English and Chinese, respectively. Finally, 78 articles were included in result analysis after screening and summarizing. RESULTS AND CONCLUSION: Ideal results can be achieved in the maxillary sinus floor elevation with or without simultaneous bone grafting In addition, the nonuse of grafting materials have the advantages of simplifying surgical procedures, shortening treatment cycles, reducing trauma and pain, reducing treatment costs, reducing complications and failure rates, thus gaining the favor of doctors and patients. Therefore, the maxillary sinus floor elevation without simultaneous bone grafting will be the primary choice of the doctors engaged in dental implantation in the future.

Primary mediastinal choriocarcinoma in male is not a very common disease,with nonspecific clinical manifestations.Gynecomastia and testicular atrophy are present in some cases.The levels of serum human chorionic gonadotropin are often significantly increased.Giant lump in the mediastinum and bilateral lungs multiple metastases can be seen on the computed tomography for lung.The diagnosis for it depends on pathological biopsy.Current treatment method is a comprehensive,consisting of chemotherapy,radiotherapy and surgery.This paper reported a case of primary mediastinal choriocarcinoma in male,who were diagnosed and treated in the Second Xiangya Hospital of Central South University.He was admitted for cough and hemoptysis,and finally diagnosed by biopsy.The prognosis is very poor.Therefore,it is important to take physical examination regularly because it can be detected and diagnosed early.

A 61-year-old woman with pulmonary alternariosis and aspergillosis was reported.The patient presented with recurrent hemoptysis and cough for 3 years.Alternaria was identified by fungal culture.Biopsy specimen showed pulmonary aspergillosis.The patient had been treated with voriconazole at 400 mg/d through intravenous guttae for 7 days,and then switched amphotericin B at 25 mg/d through intravenous guttae for 11 days.The patient was treated with voriconazole at 400 mg through oral when she was discharged from hospital.After the treatment,the clinical symptoms ofhemoptysis and cough were recovered,and the lung CT examinations showed normal.

Objective:To revaluate the systematic reviews/meta-analysis of the literature on acupuncture in the treatment of stroke spastic hemiplegia.Methods:CNKI, Wangfang, VIP, CBM, Cochrane Library, PubMed and Embase were searched for systematic reviews/meta-analyses of acupuncture in the treatment of stroke spastic hemiplegia from the establishment of the databases to July 27, 2022. AMSTAR 2 Scale, Prisma statement (2020) and GRADE system were used to evaluate the quality of the collected literature.Results:A total of 5 systematic reviews/meta-analyses were included, all of which were rated as very low by AMSTAR 2. The 5 studies involved a total of 22 outcome measures, and the GRADE rating results were intermediate evidence in 5, low evidence in 8, and very low evidence in 9.Conclusions:Acupuncture therapy has certain therapeutic effects on reducing the degree of limb spasms and improving limb motor function in patients. However, the methodological quality of the included literature is poor, and there is limited high-level evidence to support conclusions. More high-quality experimental research is still needed to provide strong evidence-based medicine evidence.

Cryptogenic organic pneumonia (COP) refers to organic pneumonia that has not been identified a clear cause by current medical methods. A small proportion of COP can exhibit severe and progressive characteristics, while severe COP can cause systemic inflammatory storms and can be secondary to hemophilia. This article reported a case of acute severe COP secondary to hemophilia. A 67-year-old male patient was admitted to the hospital due to cough, shortness of breath, and fever. At first, he was misdiagnosed as severe pneumonia, but failed to receive anti infection treatments. Sputum pathogenetic examination and Macrogene testing of alveolar lavage fluid were performed, and no etiology was found to explain the patient's condition. The condition was gradually worsened and hemophilia occurred to explain, suggesting that acute severe COP was relevant. After receiving hormone treatment, the condition gradually relieved and the absorption of lung lesions improved. Hemophilia secondary to COP is rare, and the specific mechanism needs further study.
Male ; Humans ; Aged ; Hemophilia A/complications* ; Pneumonia/diagnosis* ; Bronchoalveolar Lavage Fluid ; Cough ; Dyspnea/etiology*