Objective To describe the clinical features of pulmonary epithelioid hemangioendothelioma and heighten the ratio of diagnosis.Methods With a case report and review of the related literature,the etiology,clinical manifestations,pathology diagnosis,differential diagnosis,management and prognosis of pulmonary epithelioid hemangioendothelioma were described.Results The etiology of this rare disease remained unknown.Symptoms were scanty and usually mild.Chest radiograph or computed tomography usually revealed multiple bilateral pulmonary nodules.Primitive lumen formed by a single cell was the pathologic feature.Immunohistochemical stains showed that the malignant cells are of the endothelial type.There was no effective treatment for this disease and its prognosis was unpredictable.Conclusion Pulmonary epithelioid hemangioendothelioma is rare and often misdiagnosed as other pulmonary diseases.

Aged, 80 and over ; Aorta, Abdominal ; pathology ; Embolism, Cholesterol ; therapy ; Female ; Humans

Objective To establish the preferable puberty pathological aggression animal model.Methods The experimental models were established towards puberty rats by frustration test of non-reward and instigation test.Rat models were tested for specificity using open-field test,saccharine test,elevated plus-maze(EPM)and olfactory sensibility.Results ①Compared with normal aggression(52.5±5.36)and control group(8.83±1.34)in total aggressive times,the pathological aggression group(101.17±2.85)increased significantly(P<0.01);②Some behavior items of each model group were moderately or hishly correlated to total score(r=0.379～0.929);③There was a significant difference between pathological aggression group and normal aggression group in the numbers of attack toward vulnerable-body regions,persistence attack after intruder displayed submissive and hish attack/threat ratios(P<0.01);④The pathological aggression group did not show depression,anxiety and olfactory disorder,except for space cognitive function(P>0.05).However,the normal aggression group displayed obvious depressive mood.Conclusion Each behavioral index matches the criteria of pathological aggression model.Meanwhile,it also excludes other factors of disturbing the specificity of the model.It suggests this model may be preferable puberty pathological aggression animal model.

Objective To investigate the prevalence of vitamin D deficiency in medical intensive care unit (ICU) and its relationship with severity of disease and prognosis.Methods A prospective study was performed to evaluate vitamin D status in 216 patients admitted to the medical intensive care unit.The incidence of hypovitaminosis D was observed.Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score,days kept in ICU and on ventilator,main laboratory findings,and mortality rate were compared among patients with different serum 25-hydroxyvitamin D [25 (OH) D] levels.Potential risk factors for mortality were analyzed by multivariate logistic regression analysis.Results One hundred and fifty-three patients (70.8％) developed hypovitaminosis D.25 (OH) D deficiency was identified in 95 (44.0％),25 (OH) D insufficiency in 58 (26.8％),and 25 (OH) D sufficiency in 63 (29.2％) patients.APACHE Ⅱ score,positive blood culture,the incidence of multiple organ dysfunction syndrome(MODS),and mortality rate were higher in deficiency group compared with the other two groups [APACHE Ⅱ score:deficiency group 25 (20,28) score,insufficiency group 22 (17,26) score,sufficiency group 19 (18,20) score,P＜0.01 ; positive blood culture:deficiency group 18.9％,insufficiency group 13.8％,sufficiency group 3.2％,P=0.015 ; MODS:deficiency group 48.4％,insufficiency group 43.1％,sufficiency group 25.4％,P=0.025; mortality rate:deficiency group 40％,insufficiency group 24.1％,sufficiency group 15.9％,P =0.003].25 (OH)D levels were negatively correlated with APACHE Ⅱ score and mortality rate (r =-0.325,P＜0.01 ; r=-0.276,P＜0.01,respectively).Analysis by multiple logistic regression demonstrated that 25 (OH) D deficiency (OR =3.005,95 ％ CI 1.321-5.875,P =0.008) was independent risk factor for mortality.Conclusions This study demonstrates that vitamin D deficiency is highly prevalent among patients admitted into ICU.Vitamin D deficiency is associated with disease severity,and seems to be an independent risk factor for mortality.

AIM: To examine the change of serum tumor necrosis factor-? (TNF-?), nitric oxide (NO) in patient with congestive heart failure (CHF) and the effect of angiotensin Ⅱ (AngⅡ), valsartan on TNF-? and NO production in culture peripheral blood mononuclear cells (PBMC), to assess the relationship between the renin-angiotensin system and cytokines. METHODS: Venous blood of both healthy volunteers (n=12) and patients with CHF (n=16) were collected. Serum TNF-? and NO were examined. Peripheral blood mononuclear cells (PBMC) were obtained from both the control and the patients groups and cultured with AngⅡ at concentrations of 0, 0.01, 0.1, 1 ?mol/L, respectively. AngⅡ at concentration of 0.1 ?mol/L combined with 0.1 ?mol/L of valsartan was also used. After 24 h incubation, the contents of TNF-? and NO in the culture supernatants were measured. RESULTS: Serum TNF-? and NO production in CHF group were significantly higher than that in control group (P0.05) were observed. AngⅡ stimulated TNF-? and NO release from PBMC of patients with CHF and normal person, which was inhibited by valsartan. CONCLUSIONS: AngⅡ obviously increases TNF-? and NO production from PBMC, which indicates there is relationship between the renin-angiotensin system and TNF-?, NO. The fact that valsartan inhibits TNF-? production may be one of the mechanisms in treating CHF.

Objective To analysis of the thyroid hormone test results of Abbott Architect ci16200 automatic biochemical-im-mune analyzer (Abbott system) and Roche Cobas e601 automated immunoassay analyzer (Roche system) .Methods The thyroid hormone(including T4 ,FT4 ,T3 ,FT3 ,TSH ) levels of 93 cases of serum samples were respectively detected by Abbott system (CMIA) and Roche system (ECLIA) ,and the results were analyzed .Results The thyroid hormone test results of the two systems had a good correlation ,and the coefficients of T4 ,FT4 ,T3 ,FT3 ,and TSH were 0 .960 ,0 .962 ,0 .976 ,0 .900 ,and 0 .999(P<0 .01) . However ,there were significant difference of the detection results of the two systems(P<0 .05) .Conclusion The thyroid hormone test results of Abbott system and Roche system are not comparable .

Objective To analyze the pregnancy outcomes of 204 cases of multiple pregnancies following early transvaginal fetal reduction and sum up the experiences of peri-operation nursing care. Methods A total number of 204 twin and triplet pregnancies under treatment in the reproductive medical center from Jan. 2009 to Dec. 2012 were involved in the study. All patients underwent transvaginal multifetal pregnancy reduction during pregnancy of 7 to 8 weeks . The pregnancy outcomes were analyzed , and the nursing measures including preoperative preparation , intraoperative cooperation and postoperative nursing were analyzed . Result The successful rate of multifetal reduction was 100%, and the rate for taking the infants home reached 77.0% ~ 92.3%. Conclusion The outcomes of multifetal reduction for the twin or triplet pregnancy are good . Such nursing measures as perioperative mental care , intraoperative cooperation and postoperative follow-up are key to the alleviation of mental pressure during operation , raise of the success rate of fetal reduction and prevention of postoperative complications.

Objective To observe the effect of low molecular weight heparin calcium combined with astraga-lus injection in the treatment of diabetic nephropathy.Methods From January 2013 to December 2014,78 patients with stage III diabetic nephropathy in our hospital were enrolled into the study.They were randomly divided into con-trol group(41 cases) and treatment group(37 cases).The control group received general therapy,such as low protein diets,compound alpha keto acid,insulin,irbesartan,simvastatin.The treatment group was treated with low molecular weight heparin calcium and astragalus injection on the basis of general therapy.The changes of urinary albumin and 24 hours urinary protein after treatment in the two groups were observed.Results After treatment,the negative rate of urinary micro albumin in the treatment group ( 75.68%) was significantly higher than that of the control group (29.27%)(χ2 =16.765,P<0.01).24 hour urinary protein of the treatment group[(176.2 ±82.3)mg/24h]was significantly lower than that of the control group[(223.8 ±87.8)mg/24h](t=2.471,P<0.05).Conclusion Low molecular weight heparin calcium combined with astragalus injection can reduce the proteinuria of diabetic nephropa-thy,it is an effective intervention therapy for early diabetic nephropathy.

Antimony ; blood ; Humans ; Spectrophotometry, Atomic ; methods

The perivascular space is formed by the pia mater around the blood vessels and participates in the fluid exchange and waste clearance in the brain. The enlarged perivascular space (EPVS) indicates the disorder of brain clearance mechanism, which is closely related to the occurrence and development of a variety of clinical diseases. In recent years, there are a lot of studies on the pathogenesis and influencing factors of EPVS. This article reviews its anatomy, neuroimaging, pathogenesis, and risk factors.