Purpose To improve the understanding of features and diagnostic value of PET/CT imaging in primary tracheal cancer as it is a rare disease.Materials and Methods The18F-FDG PET/CT image data of 11 patients with primary tracheal cancer confirmed pathologically were retrospectively analyzed. The contrast-enhanced CT scan was performed in 9 patients. The PET/CT and contrast-enhanced CT imaging data were analyzed.Results Out of the 11 cases, 5 were adenoid cystic carcinoma, 4 were squamous cell carcinoma and 2 were adenocarcinoma. Endotracheal round or elongated uptake lesions were found in PET imaging. The maximum standardized uptake value of adenoid cystic carcinoma, squamous cell carcinoma and adenocarcinoma were 4.5±1.2, 8.1±1.7 and 4.5±2.4, respectively. The accuracy of diagnosis of PET/CT was 100%(11/11). Soft tissue density nodule or mass in trachea was found in CT scan. The accuracy of CT diagnosis was 81.8% (9/11). Among the 9 patients who underwent enhanced CT scan, 3 had significantly enhanced lesions and 6 had moderate enhanced ones. Mediastinal lymph node metastasis was found in 1 patient. There was no distant metastasis in all the 11 patients.Conclusion Primary tracheal cancer has features of PET/CT imaging such as soft tissue nodules or mass in tracheal lumen or on its walls accompanied by FDG increase. The utilization of metabolic and anatomic imaging of PET/CT has great significance in clinical diagnosis and therapy of primary tracheal cancer.

BACKGROUND: The marginal division, a new sub-region in rat brain striatum discovered in recent decades, has been found to closely relate to learning and memory function of the brain. The immediate-early genes such as c-fos and c-jun participate in the signal transduction of learning and memory in the marginal division. But what other intermediate events are initiated in the marginal division in the process of learning and memory?Cyclic adenosine monophosphate (cAMP) response element-binding protein (CREBP) is an molecule essential for the formation of long-term memory,and investigation of the expression and distribution of phosphorylated CREBP in the striatum may help understand the signal transduction mechanism in the striatum during learning and memory at the molecular level.OBJECTIVE: To investigate the expression of phosphorylated CREBP in rat brain stratum during learning and memory process.DESIGN: Completely randomized controlled study.SETTING: Institute of Neurosciences, Zhujiang Hospital of the First Military Medical University of Chinese PLA.MATERIALS: This experiment was conducted in the Institute of Neurosciences, Zhujiang Hospital of the First Military Medical University of Chinese PLA between April and August 2003. Totally 48 normal male adult SD rats were provided from the Experimental Animal Center of First Military Medical University, and after two Y-maze tests, 40 rats were selected for this study (MG-2 type, Sanshengxing electricity company).METHODS: The 40 SD rats were randomized into 4 equal groups. The rats in the first group were subjected to training to acquire dark avoidance reflex in a Y maze, those in the second group underwent sham training with only light stimulation in the Y maze without electricity on the floor.The rats in the third group were trained in the Y maze with electricity on the floor but not light stimulations, with the rest 10 rats serving as the control group subjected to sham training in the Y maze without either electric or light stimulations. After the training in the Y maze, the rats were sacrificed immunohistochemical detection of phosphorylated CREBP expression in the brain striatum.MAIN OUTCOME MEASURES: Expression of phosphorylated CREBPin rat brain striatum.RESULTS: All the 40 rats enrolled in this study were examined for phosphorylated CREBP expression. Positive expression of phosphorylated CREBP was observed in the medial marginal division of the brain striatum after the rats were trained in the Y maze with electric stimulation, but no obvious expression was seen in rats in the sham training or control groups.Massive expression of phosphorylated CREBP could be observed, typically,in the hippocampus, front prefrontal lobe cortex and cingulate gyrus of the rat brain.CONCLUSION: The transcriptional factor phosphorylated CREBP in the marginal division of the striatum participates in the signal transduction for learning and memory in rats receiving Y maze training to acquire dark avoidance reflex.

Objective To understand health literacy levels in elderly people aged 60 years and above in Hunan, and explore factors related to health literacy.Methods Hunan residents aged 60 years and above were randomly recruited by the multistage stratified cluster sampling method.A total of 611 elderly people from 13 counties of Hunan were included in the study, which was conducted through questionnaires.Results The median health literacy score for elderly people aged 60 years and above was 51.00 (4-90), and it was lower than that for people under 60 years old, which was 56.00.Single factor analysis found that education level, occupation, number of family members, and household income each had an influence on health literacy scores (H=59.526, 20.609, 17.214, and 50.749, respectively;P=0.000, 0.002, 0.001 and 0.000, respectively).The number of people with basic health literacy accounted for 10.6％ (65/611) of the total.Multiple logistic regression analysis found that chronic disease was a factor affecting basic health literacy.Compared with elderly people without chronic diseases, a higher percentage of people with basic health literacy was among elderly people with chronic diseases (OR =1.870, 95％ CI: 1.037-3.373).Conclusions The health literacy level is lower in elderly people aged 60 years and above than those under 60 years old in Hunan.Only 10.6％ (65/611) of them show basic health literacy.Education level, occupation, number of family members, and household income are the factors related to health literacy.Health education about healthy lifestyle and behavior as well as chronic disease prevention and control should be increased in order to improve the health literacy level in elderly people.

Objective To explore the effect of docosahexaenoic acid (DHA) on long-term learning and memory disorders and potential mechanism in rats after hypoxic ischemic brain damage. Methods Sixty neonatal 7-day-old SD rats were ramdonly divided into three groups: group S (sham operation+vehicle treatment), group C (hypoxic-ischemic brain damage [HIBD]+vehicle treatment) and group D (HIBD+DHA treatment). After left common carotid artery was isolated and ligated for 2.5 h, rats of group C and group D were put into a condition which oxygen concentration was about 8%for 2 h;rats in the group S were only isolated the left carotid artery, without ligation or hypoxia treatment;rats in the group D were intraperitoneally injected DHA of 15 mg/kg after modeling, and rats in the group S and group C were intraperitoneally injected equivalent volume of vehcle, once a day for 10 consecutive days. The pathomorphology changes of the hypocampal CA1 area, and marginal division of striatum were observed by Nissl staining 48 h after modling; the apoptosis cells were measured by TUNEL;immunohistochemical method was used to detect the expressions of Bax and Caspase-3 positive cells in the two brain areas. Morris water maza test was used to evaluate the long-term lerning and momory functions of 2-month-old rats, and the expressions of N-methyl-D-aspartate receptor 1 (NMDAR1) positive cells were detected by immunohistochemical method. Results The pathomorphology damage was significantly improved, the expressions of Bax and Caspase-3 positive cells and the neuron apoptosis in hypocampal CA1 areas and marginal division of striatum in group D were all signficantly decreased as compared with those in the group C (P<0.05). Rats in group D had significantly decreased escape latency as compared with those in group C in Morris water maze test (P<0.05), and the expression of NMDAR1 positive cells in the two brain areas of group D was significantly increased as compared with that in the group C (P<0.05). Conclusion DHA has the ameliorative effect on long-term learning and memory disorders after hypoxic ischemic brain damage in rats, which may be associated with inhibitory action of cell apoptosis at early phase and up-regulation of expression of NMDA1 at the late phase.

Objective Marginal division (MrD) of striatum is a universal structure in the mammalian brain,and it plays an critical role in learning and memory.In the present study,we try to investigate the synaptic ultrastructure of Methionine enkephalin (MET-ENK) immunoreacted fibers connected with neurons in the marginal division of the striatum in the monkey brains to explore the ultrastructural basis of the mechanism of learning and memory function in MrD.Methods Six male monkeys (macaque) were perfused with paraformaldehyde through heart to fix the brain and the brains were sectioned by a cryostat.Sections of the brains were performed immunohistochemical staining to detect the MET-ENK expression in the stfiatum; the areas with positive immumohistochemical staining was performed ultrastructural observation for morphological characteristics of the MET-ENK synapses in the MrD.Results Immunohistochemistry staining showed a dense arrangement of MET-ENK immunoreactive cells between the putamen and globus pallidus.Five major types of MET-ENK synapses were identified in the MrD:the axo-dendritic synapses,the axo-spinous synapses,the axo-somatic synapses,the axo-axonic synapses and the compound synapses.Conclusion The MET-ENK synapses in the MrD are diverse and complex,and can be distinguished from the rest of the striatum.

Objective:To improve the understanding of the relationship between antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE).Methods:The clinical characteristics and process of diagnosis and treatment of a case was reported and analyzed. This patient was initially diagnosed as antiphospholipid syndrome and later developed new skin lesion and positive anti-dsDNA antibody, which made the diagnosis of systemic lupus erythematosus.Results:A 15-year-old girl suffered acute pulmonary embolism, lower extremity deep vein thrombosis, and high titer of anti-phospholipid antibody, but negative for other autoantibodies. So primary antiphospholipid syndrome was diagnosed. Symptoms were improved after thrombolysis and anticoa-gulation treatment. During the follow-up period, the patient developed malar erythema, lymphocytopenia, proteinuria, positive ANA, anti-dsDNA antibody, and reduced complement level. So she was diagnosed with systemic lupus erythematosus. After glucocorticoid pulse therapy and immunosuppressants treatment, the symptoms were relieved and lupus disease activity was decreased.Conclusion:A few primary APS patients can progress into SLE. Patients with risk factors such as a younger age of onset, positive ANA and positive Coomb's test results should be closely followed up.

OBJECTIVE To provide ideas and reference for the treatment and pharmaceutical care of infective endocarditis （IE） caused by Micrococcus luteus complicated with severe pneumonia. METHODS The clinical pharmacist participated in the treatment of a patient with IE caused by M. luteus complicated with severe pneumonia； all anti-infective treatment plans were agreed upon after the doctor invited the clinical pharmacist for consultation. After the implementation of the plan， the clinical pharmacist conducted pharmaceutical care of effectiveness and safety for the plan， including adopting suitable drug， adjusting the dose of vancomycin by using parameters such as steady-state valley concentration and creatinine clearance rate， monitoring renal function and adverse drug reactions. RESULTS IE caused by M. luteus was cured after surgery and full treatment with anti-bacterial drugs， the severe pneumonia was improved， and the decline of renal function caused by drugs and the primary disease were recovered； clinical pharmacists had ensured the effect of anti-infection treatment by assisting in the formulation of treatment plans and the implementation of pharmaceutical care， avoiding further renal damage and solving the problem of cefoperazone sulbactam- related drug fever. CONCLUSIONS IE caused by M. luteus is relatively serious， and the treatment drug can be vancomycin and rifampicin. During the treatment， it is necessary to monitor the renal function， and adjust the dose of vancomycin or change other drugs； anti-infection pharmaceutical care provided by clinical pharmacists can guarantee the effectiveness and safety of anti- infection plan， and avoid the occurrence of severe adverse drug reactions.

Objective To investigate the effects of granulocyte-colony stimulating factor (G-CSF) on neuronal apoptosis after hypoxia-ischemia brain damage (HIBD) and the possible role of the mTOR/p70S6K signaling pathway in neonatal rats.Methods Ninety seven-day-old Sprague-Dawley rats were assigned into 5 equal groups (n=18):sham group,HIBD group,G-CSF group,rapamycin group and ethanol group by random number table method.Pups were subjected to unilateral carotid artery ligation followed by 2hrs hypoxia or sham surgery.HIBD animals received normal saline,G-CSF (50 μg/kg),G-CSF combined with rapamycin (250 μg/kg) or ethanol (vehicle for rapamycin).Pups were euthanized 48hrs post-HIBD to quantify the percentage of brain infraction area.The pathomorphologic changes in the hippocampal CA 1 area and cortex were observed by Nissl staining.Neuronal cell death was determined using terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL).mTOR,activated mTOR (p-mTOR),p70S6K,activated p70S6K (p-p70S6K),Cleaved Caspase-3 (CC3),Bax,and Bcl-2 were quantified using Western blot analysis.Results G-CSF treatment resulted in significantly reduced percentage of brain infraction area (P＜0.05) and neuronal apoptosis in the hippocampal CA1 area and cortex (P＜0.05) after HIBD in neonatal rats.However,rapamycin administration reversed the neuroprotective effect of G-CSF.G-CSF administration ameliorated the pathomorphologic damage in the ipsilateral hemisphere.Compared with the HIBD group,the Nissl stained neurons significantly increased in the G-CSF group (P＜0.05).Furthermore,G-CSF increased the expression ofp-mTOR,p-p70S6K and Bcl-2 but decreased the expression levels of CC3 and Bax in the ipsilateral hemisphere,which were all significantly reversed by rapamycin (P＜0.05).Conclusion G-CSF may attenuate caspase activation and reduce neuronal apoptosis by up-regulating the activity of mTOR/p70S6K signaling pathway after experimental HIBD in rat pups.

OBJECTIVE: To comprehensively evaluate the interventional effect on unexpected injury among children and adolescents in China, and to provide scientific basis for the injury control strategy.
 METHODS: Meta analysis was utilized to analyze the selected literatures. After heterogeneity test of the data, a relevant model was chosen to estimate the combined effect values relative risk (RR) and the corresponding 95% confidence interval (95% CI). Subgroup analysis were performed based on the intervention measures, objects and places. Sensitivity and publication bias were analyzed.
 RESULTS: A total of 18 papers were included in the Meta analysis with a sample size of 32 599. The combined RR value was 0.54 (95% CI 0.44 to 0.68). Subgroup analysis showed that the RR value of health education and comprehensive intervention were 0.59 and 0.50, respectively, with no significant difference between them (P>0.05). The RR values of the interventions in school alone, in school and community or in community alone were 0.51, 0.78 or 0.63. The RR values on children alone, children and parents or parents alone were 0.53, 0.65 or 0.35. The differences were significant when the interventions were performed among different places or objects (P<0.05). Sensitivity analysis revealed that meta-analysis results were relatively stable.
 CONCLUSION The targeted interventions were significant in the prevention of unexpected injuries among children and adolescents. It is worth further promoting and spreading.
Adolescent ; Child ; China ; Humans ; Schools ; Wounds and Injuries ; epidemiology ; prevention & control

Objectives:Analyze the clinical characteristics of patients with primary antiphospholipid syndrome (PAPS) progressing to systemic lupus erythematosus (SLE).Explore the risk factors for the progression from PAPS to SLE.Methods:The clinical data of 262 patients with PAPS enrolled in Peking Union Medical College Hospital from February 2005 to September 2021 were evaluated. Assessments included demographic data, clinical manifestations, laboratory tests (serum levels of complement, anti-nuclear antibodies, anti-double-stranded DNA antibodies), treatment, and outcomes. Kaplan-Meier analysis was used to calculate the prevalence of SLE in patients with PAPS. Univariate Cox regression analysis was employed to identify the risk factors for PAPS progressing to SLE.Results:Among 262 patients with PAPS, 249 had PAPS (PAPS group) and 13 progressed to SLE (5.0%) (PAPS-SLE group). Univariate Cox regression analysis indicated that cardiac valve disease ( HR=6.360), positive anti-double-stranded DNA antibodies ( HR=7.203), low level of complement C3 ( HR=25.715), and low level of complement C4 ( HR=10.466) were risk factors for the progression of PAPS to SLE, whereas arterial thrombotic events ( HR=0.109) were protective factors ( P<0.05 for all). Kaplan-Meier analysis showed that the prevalence of SLE in patients suffering from PAPS with a disease course>10 years was 9%-15%. Hydroxychloroquine treatment had no effect on the occurrence of SLE in patients with PAPS ( HR=0.753, 95% CI 0.231-2.450, P=0.638). Patients with≥2 risk factors had a significantly higher prevalence of SLE compared with those with no or one risk factor (13-year cumulative prevalence of SLE 48.7% vs. 0 vs. 6.2%, P<0.001 for both). Conclusions:PAPS may progress to SLE in some patients. Early onset, cardiac-valve disease, positive anti-dsDNA antibody, and low levels of complement are risk factors for the progression of PAPS to SLE (especially in patients with≥2 risk factors). Whether application of hydroxychloroquine can delay this transition has yet to be demonstrated.