Objective: To explore the value of diffusion-weighted imaging (DWI) combined with conventional magnetic resonance imaging (MRI) in diagnostic staging and the decision of treatment method in patients with cervical cancer. Methods: The data of DWI MRI from 42 patients pathologically confirmed with cervical cancer were retrospectively analyzed. The apparent diffusion coeffcient (ADC) and exponential ADC (eADC) values were measured. The ADC and eADC values were compared according to different pathologic types and stages of cervical cancer, and between the cervical cancer and normal cervix. The diagnostic accuracy of DWI combined with conventional MRI for pathologic staging was examined. The ADC and eADC values were compared between radiochemotherapy group and the surgery group. Results: The cervical cancer demonstrated high signal intensity on DWI, whereas the normal cervix showed no obviously abnormal signal intensity. The mean ADC value of 42 patients with cervical cancer was lower than that of normal cervix (P = 0.000); the mean ADC value of cervical squamous-cell cancer was lower than that of adenocarcinoma (P = 0.036); the mean ADC value of radiochemotherapy group before treatment was lower than that of surgery group (P = 0.000), whereas the eADC value was higher than that of surgery group (P = 0.000). There were no significant differences in mean ADC and eADC values among different pathologic stages of cervival cancer (all P values < 0.05). The diagnostic accuracy of conventional MRI and DWI combined with conventional MRI for pathologic staging were 92.9% (39/42) and 95.2% (40/42), respectively (Kappa = 0.903 5 and 0.935 8, respectively; P < 0.01). Conclusion: DWI combined with MRI exerts a high value in diagnostic staging of cervical cancer. The ADC value can be used as reference in selection of therapeutic methods for stage II B cervical cancer.

OBJECTIVETo explore the integrative quantitative index of the extent of pneumoconiotic changes by dusts and to evaluate the extent of pulmonary injury by the dusts containing different contents of free silica.

METHODSIn accordance with the morphometric principle, the areas of each kind of pathologic changes in the lung tissue sections of pneumoconiosis model were measured by utilizing a computer-aided graphic analyzer, and the volume density of each pathologic change and the value of pulmonary injury by dust(VPID) were calculated. Meanwhile the extent of pulmonary injury were compared among the rat groups treated with the dusts containing different contents of free silica.

RESULTSThere were significant differences among each groups in the volume density of some pathologic changes in the same exposed periods. There were significant correlation between VPID and the content of free silica dust or the lung collagen content (r = 0.535-0.849, P < 0.005 or P < 0.01). Furthermore, the degree of cor relationship of VPID with both of the latter were higher than the sum of unweighted volume density of the various pathologic changes in lung.

CONCLUSIONIt is suitable, reasonable and simple to use VPID an index to indicate the extent of pulmonary injury by dust and to diagnose pneumoconiosis in pathology, and the extent of pulmonary injury by dust may be aggravated with the increasing of the content of free silica.

Animals ; Dust ; Lung ; pathology ; Pneumoconiosis ; pathology ; Rats ; Silicon Dioxide ; toxicity

OBJECTIVETo study the clinical and epidemiologic characteristics and the serum types of enterovirus of hand, foot and mouth disease (HFMD) in children.

METHODSThe RT-nPCR method was established with universal primers within 5' untranslated region of enterovirus and VP1 region of Coxsackievirus A16 (CAV16) and enterovirus 71 (EV 71). Enteroviruses were detected with RT-nPCR in 237 children with HFMD. Clinical and epidemiologic characteristics and serum types of enterovirus of the patients with HFMD were studied.

RESULTSThe patients'age ranged from 7 months to 11 years (mean 4.2 +/- 0.5 years). The majority (94.5%) were less than 6 years old. HFMD was mostly seen in spring and winter (67.9%). Oral mucosal pox or ulcer as well as hand and foot rashes were observed in all 237 patients. Fever occurred in 141 patients (59.5%). Of the 237 patients, 133 (56.1%) were RT-nPCR positive. Of the 133 cases, 38 were positive for EV71, 64 were positive for CAV16, and 31 were negative for both EV71 and CAV16. The patients infected by different types of enteroviruses had similar clinical characteristics. Gene colon and sequence analysis for 12 strains of enteroviruses PCR positive products presented as EV71 (n=5), CAV16 (n=5), ECHO13 (n=1), and CAV5 (n=1).

CONCLUSIONSHFMD tends to occur in younger children less than 6 years old. The majority are affected in spring and winter. EV71 and CAV16 are common pathogens of HFMD. There is no relationship between clinical characteristics and serum types of enteroviruses in HFMD patients.

Child ; Child, Preschool ; Enterovirus ; classification ; Female ; Hand, Foot and Mouth Disease ; virology ; Humans ; Infant ; Male ; Reverse Transcriptase Polymerase Chain Reaction ; Seasons ; Serotyping

OBJECTIVETo objectively assess the effect of Qiming Granule in the treatment of diabetic retinopathy (DR) by fluorescence fundus angiography (FFA).

METHODSIn a multi-center, randomized, parallel controlled clinical trial, patients with DR were randomly assigned to the control group (calcium dobesilate capsule) and the test group (Qiming Granule). Changes in the retinal blood circulation time were recorded by FFA after 3 months of medication.

RESULTSSignificant reduction was observed in the retinal arterio-venous circulation time (AVCT) in both groups (P<0.01), the value was 7.635+/-3.149 s before treatment and 5.165 +/-3.382 s after treatment in the treated group, and 7.737+/-3.413 s and 5.313+/-3.472 s in the control group respectively. Qiming Granule also reduced the arm-to-retinal circulation time (ARCT, P<0.05). The value was 17.867+/-3.872 s before treatment and 15.643+/-4.648 s after treatment in the treated group, and 17.217+/-3.833 s and 16.312+/-3.613 s in the control group (P>0.05) respectively. The ARCT in the tested group was reduced, with a statistically significant difference post-medication (P<0.01).

CONCLUSIONAs a Chinese medicine complex prescription, Qiming Granule may alleviate retinal hypoxia and ischemia by increasing retinal blood flow and improving the blood circulation.

Aged ; Diabetes Mellitus, Type 2 ; complications ; Diabetic Retinopathy ; drug therapy ; physiopathology ; Drugs, Chinese Herbal ; adverse effects ; pharmacology ; therapeutic use ; Female ; Fluorescein Angiography ; Humans ; Male ; Middle Aged ; Retinal Vessels ; drug effects ; physiopathology

OBJECTIVETo compare the diagnostic performance of prospective electrocardiogram (ECG)-triggered computed tomography coronary angiography (CTCA) versus retrospective ECG-gated CTCA.

METHODSPatients with suspected coronary artery disease divided into two groups which underwent 64-slice CTCA with prospective ECG-triggered or retrospective ECG-gated scanning (n = 100 each, HR < or = 65 bpm). Multi-planar reconstruction (MPR), curved-planar reconstruction (CPR), maximum intensity projection (MIP) and volume rendering (VR) were made to demonstrate the coronary arteries. The image quality was defined as excellent, good and poor by motion and stair-step artifacts. Individual radiation exposure dose was estimated from the dose-length product.

RESULTSThe mean effective radiation dose of prospective ECG-triggered CTCA [(2.81 +/- 0.48) mSv] was significantly lower than that of retrospective ECG-gated CTCA [(10.16 +/- 1.09) mSv, P < 0.01]. Segments of diagnostic image quality (95.2%, 1165/1224) and non-diagnostic coronary segments (4.8%, 59/1224) in prospective ECG-triggered group were similar as those of retrospective ECG-gated group (94.1%, 1186/1261 and 5.9%, 75/1261, all P > 0.05).

CONCLUSIONThough the radiation exposure dose required is significantly lower, the diagnostic performance of prospective ECG-triggered 64 slice CTCA is comparable with that of retrospective ECG-gated 64 slice CTCA on patients with stable heart rates up to 65 bpm.

Adult ; Aged ; Aged, 80 and over ; Coronary Angiography ; methods ; Electrocardiography ; methods ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Retrospective Studies ; Tomography, X-Ray Computed ; methods

OBJECTIVETo study the incidence and the risk factors of dysphagia after ischemic stroke in Chengdu City, China.

METHODSReview was made with unified questionnaire on dysphagia after ischemic stroke in 563 patients from four hospitals, from January to December 2005. Over 20 risk factors related to dysphagia after ischemic stroke were analyzed by logistic regression.

RESULTSThe total incidence of dysphagia after ischemic stroke was 13.3% in Chengdu. Data from logistic regression analysis indicated that gender, morbidity frequency, basal nuclei, periventricular lesion, hypertension, pneumonia, hyperlipemia, cervical spondylosisi, internal carotid artherosclerosis were closely related to dysphagia after ischemic stroke,with OR values as 0.416, 0.489, 0.327, 0.454, 2.187, 2.146, 0.352, 0.242 and 0.273 respectively.

CONCLUSIONThe total incidence was lower than literature published from home and abroad. Gender, morbidity frequency, basal nuclei, periventricular lesion, hypertension, pneumonia, hyperlipemia, cervical spondylosisi and internal carotid artherosclerosis seemed to be risk factors to dysphagia after ischemic stroke.

Aged ; Aged, 80 and over ; Brain Ischemia ; complications ; Carotid Artery Diseases ; complications ; China ; epidemiology ; Deglutition Disorders ; epidemiology ; etiology ; Female ; Humans ; Hyperlipidemias ; complications ; Hypertension ; complications ; Logistic Models ; Male ; Middle Aged ; Pneumonia ; complications ; Risk Factors ; Sex Factors ; Spondylosis ; complications

To analyze the use of outcome indicators of randomized controlled trial(RCT) of acupuncture in the treatment of acute ischemic stroke in recent three years, so as to provide a basis for building a study on the core outcome indicators for the treatment of acute ischemic stroke with acupuncture. The RCTs of acupuncture treatment for acute ischemic stroke in recent three years were collec-ted through computer retrieval of eight Chinese and English databases and two clinical trial registries at home and abroad. Literature was screened out, and data was extracted. Risk of assessment bias tool Cochrane 6.1 was used for bias risk assessment, outcome indicators were summarized and analyzed. A total of 47 RCTs were included, and 3 studies were trials registration scheme. Outcome indicators were divided into 6 categories according to functional attributes, namely physical symptoms/signs, physical and chemical examination, quality of life, traditional Chinese medicine symptoms/syndromes, safety events and long-term prognosis. The study found that in addition to the common problems in previous studies covered by the status quo of outcome indicators selection of RCT of acupuncture in the treatment of acute ischemic stroke, there were also the other problems as follows: emphasis on macroscopic efficacy indicators but neglect of acupuncture specific indicators, lack of characteristic indicators and economic indicators of traditional Chinese medicine therapy, and unification of indicators measurement tool and measurement time point. In the future, the outcome indicators set for the treatment of acute ischemic stroke with acupuncture shall be established, and the core outcome indicators set shall be in line with the characteristics of traditional Chinese medicine treatment.
Acupuncture Therapy ; Brain Ischemia/therapy* ; Humans ; Ischemic Stroke ; Quality of Life ; Randomized Controlled Trials as Topic ; Stroke/therapy* ; Treatment Outcome

There have been many clinical trials, systematic reviews/Meta-analysis proving that Xingnaojing Injection has a good clinical efficacy in treatment of cerebral ischaemic stroke, but with fewer comprehensive descriptions. In this study, an overview of systematic reviews/Meta-analysis of Xingnaojing Injection in treating cerebral ischaemic stroke was performed to provide current situation of evidences and basis for clinical practice. CNKI, Wanfang, VIP, CBM, EMbase, PubMed, Cochrane Library, Web of Science were retrieved through computers. A total of 6 literatures were included in this study. By AMSTAR-2 checklist and GRADE, the quality of included systematic reviews and the efficacy of Xingnaojing Injection were evaluated. The results of AMSTAR-2 checklist showed an extremely low quality for all of the 6 systematic reviews. According to the results of GRADE evaluation, among 55 outcomes, there were 2 outcomes with a medium quality, 4 outcomes with a low quality and 49 outcomes with an extremely low quality. The 6 systematic reviews reached a consistent conclusion that Xingnaojing Injection was effective in the treatment of cerebral ischaemic stroke. This therapy could improve the total efficacy, neurological deficit scores, hemodynamic and hemodynamic parameters. However, the methodolo-gical quality of all literatures was extremely low. The evidence levels of outcomes were between extremely low to medium. The effectiveness of Xingnaojing Injection in the treatment of cerebral ischaemic stroke still needs to be further verified by more high-quality studies. In the future, relevant clinical studies and systematic reviews/Meta-analysis shall be carried out in a strict accordance with relevant regulations.
Brain Ischemia/drug therapy* ; Drugs, Chinese Herbal ; Humans ; Ischemic Stroke ; Stroke/drug therapy* ; Systematic Reviews as Topic

The origin of medical jurisprudence in China can be traced back to as early as 1920s, and since then, the discipline has undergone a great development. This paper, based on the disciplinary development of medical jurisprudence at Xiangya School of Medicine, illustrates its evolution in three aspects covering the scientific and theoretic foundation, legal system and policy support. The current investigation reflected a glimpse of the modern forensic science in China, providing useful historical reference for the development of Chinese forensic science.
China ; Forensic Medicine/legislation & jurisprudence* ; History, 20th Century ; History, 21st Century ; Humans

By referring to the standards and procedures of WHQ Handbook for Guideline Development, under the guidance of relevant laws, regulations, and technical documents, in line with the principle of "evidence-based, consensus-based, experience-based", and based on the best available evidences, fully combined with expert experience and patient preferences, we summarized eight clinical questions in this paper: can traditional Chinese medicine(TCM) treatment improve the clinical symptoms and the degree of dyspnea in patients with stable chronic obstructive pulmonary disease(COPD) Can TCM treatment reduce the number of exacerbations in patients with stable COPD? Can TCM treatment improve the exercise tolerance of patients with stable COPD? Can TCM treatment improve the quality of life of patients with stable COPD? Can TCM treatment delay the decline of lung function in patients with stable COPD? Can TCM treatment improve anxiety and depression in patients with stable COPD? Does the point application therapy benefit patients with stable COPD? Can non-pharmacological treatment benefit patients with stable COPD? Based on these eight clinical problems, the cha-racteristics of TCM itself, and actual clinical situation, the recommendations of TCM to treat the stable COPD were formed in this guideline, with intention to provide advice and guidance to clinicians in the use of TCM to treat stable COPD, to relieve symptoms, improve exercise tolerance, improve health status, prevent disease progression, prevent and treat exacerbations, and improve clinical efficacy. Due to the influence of the user's region, nationality, race and other factors, the implementation of this guideline should be based on the actual situations.
Dyspnea ; Humans ; Medicine, Chinese Traditional ; Pulmonary Disease, Chronic Obstructive/drug therapy* ; Quality of Life ; Treatment Outcome