Objective To improve the recognition of sarcoidosis in elderly patients.Methods Clinical data of 13 elderly patients with sarcoidosis were retrospectively analyzed.Results There were three cases without symptom and five cases with intra-pulmonary and extra-pulmonary manifestations respectively.Eight cases had atypical radiological appearances and five cases showed inflammatory changes through bronchofibercopy.There were three cases with increased percentage of lymphocytes and high ratio of CD4/CD8 in bronchoalveolar lavage fluid (BALF) respectively.Seven cases were diagnosed through biopsy.And the symptoms of all thirteen patients diminished after treatmeit.Conclusions The clinical symptom and radiologieal manifestation of sarcoidosis in elderly patients are varied and usually atypical.The diagnosis should be based on comprehensive analysis including clinical manifestation and examination.The elderly patients with indication of treatment can be given corticosteroid therapy with close clinical monitoring.

Apoptosis ; Female ; Gardening ; Humans ; Leukocytes ; drug effects ; pathology ; Male ; Occupational Exposure ; adverse effects ; Pesticides ; adverse effects

Slow coronary flow phenomenon(SCFP) is an angiographic observation characterized by delayed distal vessel opacification in the absence of significant epicardial coronary disease. Only limited studies have been focused on the etiologies, clinical manifestations and treatment of this unique angiographic phenomenon. In our case report, we described an 85-year-old man who came with significant ST segment elevation in leads V1-V4 and V3R-V5R without increase in myocardial enzyme. The patient also developed respiratory failure requiring intubation and mechanical ventilation. Coronary angiography revealed only mild atherosclerosis without spasm or thromboembolic occlusion. Slow flow was seen in all coronary arteries, especially in the left anterior descending and right coronary arteries. This case speculated that transmural myocardial ischemia with ST segment elevation might be resulted from slow coronary flow. Transmural myocardial ischemia can occur owing to abnormalities of the coronary microcirculation.

In 1989, Fitz defined and classified severe acute pancreatitis (SAP) and he thought that surgical treatment of SAP is feasible. Since then, the strategy of treating SAP was a controversial issue over past decades. Currently, relevant literatures reported that medical or minimally invasive treatments are superior to surgical treatment, while it is too early to make the final conclusion because of the complexity of SAP. From 1989 to 2008, 1852 patients with acute pancreatitis were treated at the General Hospital of PLA, and the clinical data of 18 patients who died of SAP were retrospectively analyzed. Based on the analysis, we concluded that medical conservative therapy and surgical operative therapy should not be opposed to each other. Selecting ideal timing and appropriate operation on the basis of pathological changes of retroperitoneum and pancreatitis should be considered seriously, and the new concept of "miniaturization of trauma" should also be introduced in treating SAP.

To investigate the association between Helicobacter pylori ( Hp ) infection and type 2 diabetes.Total 4 129 health check up subjects aged (49.1 ±11.3) years (18-92 years), including 2 649 males and 1 480 females were enrolled in this cross-section study.Hp infection was confirmed by 13 C-urea breath test;type 2 diabetes mellitus was diagnosed according to WHO criteria (1999).Single factor analysis and multiple regression analysis were used to evaluate the association between Hp affection and the prevalence of type 2 diabetes.Hp infection rate in diabetic group was significantly higher than that in non-diabetic group (45.6%vs.39.0%, P<0.05).Hp infection rate in subjects with newly diagnosed diabetes was highest than those with previously diagnosed diabetes and non-diabetic subjects ( P<0.05).The glycosylated hemoglobin level in Hp infection group was higher than that in non infection group [ ( 5.88 ±0.64 )% vs.( 5.62 ± 0.88)%, P<0.05];the fasting plasma glucose and postprandial blood glucose levels in Hp infection group were also higher than those in non-infection group ( P<0.05 ).Logistic regression analysis showed that Hp infection was one of the independent risk factors of type 2 diabetes (OR=2.002, 95%CI:1.564-2.563, P<0.05).The study indicates that Hp infection is closely associated with type 2 diabetes mellitus.

Objective To establish the quality standard for Tongluo Tangtai Granules. Methods TLC was applied to the qualitative identification of Rhizoma Coptidis, Semen Sinapis Albae and Radix Scrophulariae, and HPLC was applied to the quantitative determination of berberine in the prescription. Results Rhizoma Coptidis, Semen Sinapis Albae and Radix Scrophulariae could be detected by TLC, the spots were clear and there was no interference for the negative sample. A good linearity of berberine was showed in the range of 0.037 29-2.610 3 μg (r=1.000 0). The average recovery of berberine was 98.85%, and RSD was 0.70% (n=6). Conclusion The methods are simple, sensitive, accurate with good reproducibility. It can be used for the quality control of Tongluo Tangtai Granules.

OBJECTIVETo observe the effects of electroacupuncture (EA) with branch-foundation acupoint combination on the indices regarding pituitary-target gland axis in aging rats with yang deficiency, so as to explore its regulating mechanism on aging rats with yang deficiency.

METHODSForty healthy Sprague-Dawley female rats were randomly divided into a normal control group, a model group, an EA group and an EA control group, 10 rats in each group. Except the normal control group, the rats in the rest 3 groups were all treated with subcutaneous injection of D-galactose for 40 d, followed by intramuscular injection of hydrocortisone for 7 d to establish aging model with yang deficiency. After the successful establishment of model, the EA group was treated with EA at "Guanyuan" (CV 4), "Housanli" (ST 36) and "Baihui "(GV 20) while the EA control group was treated with EA at "Zhongji" (CV 3) "Yinlingquan" (SP 9) and "Yintang" (GV 29); the rats in the normal control group and model group were immobilized and fixed during the same time period. The treatments were given 6 times per week totally for 4 weeks. With radiation immunity analysis method, the 8 biological indices of pituitary-target gland axis, including thyroid-stimulating hormone (TSH), triiodothyronine (T3), tetraiodothyronine-4 (T4), adrenocorticotropic hormone (ACTH), corticosterone (CORT), estradiol (E2), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were detected to observe the changes of their content.

RESULTSCompared with the normal control group, the serum level of TSH, T3, T4 and E2 were reduced in the model group (P<0.05, P< 0.01) while those of ACTH, CORT, FSH and LH were increased (P<0.05, P<0.01). Compared with the model group, the serum level of TSH, T3, T4 and E2 were increased in the EA group (P<0.05, P<0.01) while those of ACTH, CORT, FSH and LH were significantly reduced (P<0.05, P<0.01). Compared with the EA control group, the content of TSH was increased in the EA group without statistical significance (P>0.05), that of T3, T4 and E2 was increased (all P<0.05) and that of ACTH, CORT, FSH and LH was significantly reduced (all P<0.05).

CONCLUSIONThe electroacupuncture with branch-foundation acupoint combination has benign regulating effects on the key hormones of pituitary-target gland axis, which could effectively improve the dysfunction of pituitary-target gland axis that is caused by aging with yang deficiency; the efficacy of electroacupuncture with branch-foundation acupoint combination is superior to that of adjacent control acupoint combination.

Acupuncture Points ; Adrenocorticotropic Hormone ; blood ; secretion ; Aging ; blood ; metabolism ; Animals ; Disease Models, Animal ; Electroacupuncture ; Estradiol ; blood ; secretion ; Female ; Follicle Stimulating Hormone ; blood ; secretion ; Humans ; Pituitary Gland ; secretion ; Rats ; Rats, Sprague-Dawley ; Thyroid Hormones ; blood ; secretion ; Yang Deficiency ; blood ; metabolism ; therapy

Objective To explore the association between the infection rate of Helicobacter pylori (Hp) and intake frequency of capsicum in dietary pattern. Methods A total of 914 health check-up participants were recruited from Tianjin Medical University General Hospital (male: 510,female:404). All participants were asked about the intake frequency of capsicum. Diagnostic criteria of the Hp infection included positive C13 breath test. Results The intake frequency of capsicum was ≥2 times/week, 1 time/week and <1 time/week. The infection rate of Hp was 56.08%, 49.04% and 48.29%. After adjusting for covariates, compared with the≥2 times/week, the odds ratios(95%confidence interval)of intake frequency of capsicum 1 time/week and <1 time/week: the frequency of capsicum intake ≥2 times/week was 1.00 (reference), the frequency of capsicum intake 1 time/week was 0.57(0.33-0.97) and the frequency of capsicum intake<1 time/week was 0.69(0.42-1.14) in men;the frequency of capsicum intake≥2 times/week was 1.00 (reference), the frequency of capsicum intake 1 time/week was 1.01(0.54-1.88), and the frequency of capsicum intake<1 time/week was 0.71(0.41-1.23) in women. Conclusions This study found that food intake frequency of capsicum≥2 times/week was associated with the infection rate of Hp in men. But similar relationship was not observed in women.

BackgroundMouse has been used in laboratory studies as the model of ocular diseases.Electroretinogram (ERG)is a non-invasive method for primary examination to evaluate retinal function.Though flash ERG has been widely applied in the mouse ocular disease model for the functional assessment of the retinal outer layer,pattern ERG(PERG) is seldom used for inner retinal evaluation.ObjeetiveThe present experimental study was to investigate the recording parameters and method,wave characteristics of PERG and influencing factors in mouse,and to build the foundation for further research.Methods Thirty C57BL/6 mice aged 6 weeks old were included in this research.RETLport ( Roland Consult,Germany) was adopted for the recording of PERG.The positive needle electrode was placed in the cornea,and the reference and earth electrodes were placed under the derma in the cheek and tail.The PERG under different temporal frequencies (0.5,1.0,2.0 and 4.0 Hz),and special frequencies (0.05,0.10,0.20 cpd) were recorded in a photopic environment,and different contrast ratio (95％ and 99％ ) of stimulator or different transmission bands ( 1-100 Hz,5-30 Hz) in the same temporal frequency and spatial frequency were regulated to analyze the influence on mouse PERG.The use of animals was in compliance to the Regulations for the Administration of Affairs Concerning Experimental Animals by the State Science and Technology Commission.ResultsThe latency of N1 PERG showed a negative N1wave at around 37 ms and positive P wave at about 86 ms in adult mice.The amplitude of N1-P was 2-6 μV.Different spatial frequency,temporal frequency and contrast can affect the final results,and the different temporal frequencies were statistically significant.The wave was stable and the amplitude was unaffected at 5-30 Hz transmission bands with pronounced interference (mean amplitude of N1-P waves were(3.40±0.71),(5.08±0.88),(3.21±1.54),(3.85±1.96)μV in 0.5,1.0,2.0,4.0 Hz,F=7.43,P=0.00).ConclusionsPERG wave from adult mouse is similar to that from human.It is a useful method in evaluating the inner retinal function.Appropriate stimulating parameters are critical for recording.

Objective:To meet the individualized needs of residents in standardized residency training of cardiac intervention specialty for cardiac ultrasound teaching, to construct a bionic 3D printing model of ultrasound source, and to discuss its application value in ultrasound teaching and simulation exercises.Methods:Sixty residents majored in cardiovascular medicine receiving standardized residency training of ultrasound in ultrasound imaging department of Renmin Hospital of Wuhan University were randomized into experimental group and control group in average. The experimental group adopted ultrasound bionic 3D printing heart model combined with problem-based learning (PBL) teaching method, and the control group adopted traditional multimedia PPT combined with PBL teaching method. At the end of teaching activities, theoretical examination, operation assessment and questionnaire survey were conducted to evaluate and compare the teaching effect between the two groups. SPSS 21.0 software was performed for t test. Results:The theoretical examination scores of the experimental group and the control group were (81.4±8.2) points and (74.8±9.4) points, respectively, P=0.002, and the operation assessment scores were (89.1±5.6) points and (71.5±8.8) points, respectively, P<0.001. The questionnaire survey showed that the experimental group had better feedbacks than the control group in the aspects of mastery of heart anatomy knowledge, learning experience, learning interest, learning efficiency, understanding of interventional heart disease, clinical skills of interventional operation and overall satisfaction (all P<0.05). Conclusions:Ultrasound bionic 3D printing combined with PBL teaching method can help strengthen the mastery of cardiac anatomy knowledge, promote the learning experience of cardiac ultrasound and improve the skills of interventional operation. The teaching effect is significant and the students' satisfaction is high.