Objective To evaluate the profile of transient ischemic attacks in younger patients compared with older patients effectively.Methods We study 75 younger patients(≤45 years)compared with 90 older patients(≥65 years).History of presenting transient ischemic attacks,etiology,clinical feature and lab investigation were compared on the basis of the above age groups.Results Overweight、hypercholesterolemia、insomnia and vascular disease family history being more common in the younger group and Hypertension,ischemic heart disease,long-term history of smoking being more common in the elder group.Diabetes and high serum uric acid occurred high frequently in both groups.Conclusion A significant correlation existed between etiologies contribution and adverse life custom,the early management should be take up to prevent TIA occurrence.

Objective To observe MSCT and clinical features in patients of laryngocarcinoma combined with other primary carcinomas. Methods Five patients of laryngeal cancer combined with multiple primary cancer were enrolled in the study. Three paitents had long-term smoking history more than 20 years. Three paitents had various degree of radiotherapy, chemotherapy and immunotherapy. The second primary cancer located in right upper lung lobe in 2 patients of synchronous cancer and 1 patient of metachronous cancer. The others located in soft palate, uvula and the left side of zone Ⅱ and zone Ⅳ in the neck, respectively. MSCT and clinical characteristics were analyzed. Results Five patients of multiple primary cancers included 2 patients of synchronous cancer and three patients of metachronous cancer. MSCT found the appearances of malignant tumors in various parts in all 5 patients and cervical lymph nodes metastasis in 2 patients. Conclusion The possibility of prime laryngocarcinoma combined with other primary cancers should be considered when other organ malignant tumor was detected in patients with laryngeal carcinoma, especially in patients with history of long-term smoking, radiotherapy and chemotherapy and immunotherapy. Long-term following-up of cervix and other organs should be taken for the postoperative patients of laryngocarcinoma.

Objective To investigate the efficacy and safety of intravitreal ranibizumab and (or) triamcinolone combined with laser photocoagulation for macular edema secondary to branch retinal vein occlusion (BRVO) during one year period.Methods The data of 31 eyes from 31 consecutive patients with macular edema secondary to BRVO during one year follow-up visit were retrospectively analyzed.Mean best corrected visual acuity (BCVA) logMAR was (0.74±0.36) and mean central retinal thickness (CRT) was (484.48± 164.81) μm at baseline.All patients received standardized clinical comprehensive examinations including vision,intraocular pressure and optical coherence tomography for diagnosis before treatment.All patients received intravitreal injections of 0.5 mg ranibizumab (0.05 ml) at first visit.The continue PRN treatment were based on the visual acuity changes and the optical coherence tomography findings.Eyes received combined triamcinolone acetonide 0.05 ml (40 mg/ml) and ranibizumab for macular edema recurrence after two injections of ranibizumab and received laser photocoagulation during 10-14 days after third injections of ranibizumab.Mean injection of ranibizumab was 3.52± 2.01,15 eyes with triamcinolone acetonide (0.84 ± 1.21),21 eyes with laser photocoagulation (0.97± 0.95) and 12 eyes with three treatment.Compared the visual acuities and CRTs of the first and the last visits by statistical analysis.Results Mean visual acuity improved significantly to 0.42±0.33 logMAR (t=6.611,P=0.000).Mean improvement of visual acuity was 2.90± 3.07 lines.A gain of three or more logarithmic lines was evaluated in 20/31 eyes (64.52％) at the last visit.Mean CRT was (326.19± 117.80) μm (t=4.514,P=0.000).Mean reduction of CRT was (333.58±134.17) μm.A decrease of 100 μm of CRT was evaluated in 17/31 eyes (54.84％).No severe ocular and systematic side effect was found.Conclusion The efficacy and safety of intravitreal ranibizumab and (or) triamcinolone combined with laser photocoagulation for macular edema secondary to BRVO were assured.

Disasters ; Emergency Medical Services ; Humans ; Wounds and Injuries ; therapy

Acquaintance of the lymph node is very important to evaluate whether the tumor is malignant or benign and therefore to the treatment of the tumors. Lymphography is now considered the gold standard for this purpose. Many computer aided diagnose (CAD) technologies have been developed to help radiologists to diagnose the tumor by the lymphography cases. In this paper, a computer aided diagnose model is constructed by Semi-naive Bayes Classification. The experiments carried out in our laboratory validated the Semi-Naive Bayes Classification on lymphography case. The result of experiments showed that Semi-Naive Bayes Classification could classify lymphography case effectively.
Algorithms ; Bayes Theorem ; Diagnosis, Computer-Assisted ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; diagnosis ; Lymphography ; Neoplasms ; diagnosis

Corticosteroids,anti-vascular endothelial growth factor,antibiotics and antiviral were the main 4 classes of drugs for intravitreal injection.Depending on the class and volume of medication,age and gender of patients,ocular axial lengths or vitreous humour reflux,intraocular pressure (IOP) can be elevated transiently or persistently after intravitreal injection.Transient IOP elevation occurred in 2 weeks after intravitreal injection,and can be reduced to normal level for most patients.Only a small portion of such patients have very high IOP and need intervention measures such as anterior chamber puncture or lowering intraocular pressure by drugs.Long term IOP elevation is refers to persistent IOP increase after 2 weeks after intravitreal injection,and cause optic nerve irreversible damage and decline in the visual function of patients.Thus drug or surgical intervention need to be considered for those patients with high and long period of elevated IOP.Large-scale multicenter clinical trials need to be performed to evaluate the roles of the drug and patients factors for IOP of post-intravitreal injection,and to determine if it is necessary and how to use methods reducing IOP before intravitreal injection.

Objective: To investigate the loneliless situation of the elderly, and explore the relationship between loneliness,filial expectations and intergenerational social support among the elderly. Methods: Using UCLA Loneliness Scale, Intergenerational Social Support and Fealty Expectation Questionnaire, we investigated 423 samples of old people aged 60 ～94 of Changsha City. Results: The mean score of loneliness was 39.8 (s =7.3). Ordinal regression analysis indicated that the loneliness of the elderly was significantly related to received adult children social support (OR=2.208, P=0.006),afforded adult children social support(OR=2.056,P=0.01) and filial expectation(OR=1.872,P=0.027),controlled by age, sex, level of education, marriage, level of family income, and residence status. Filial expectation directly affected loneliness and indirectly affected loneliness through received adult children social support and afforded adult children social support. Conclusion: The loneliness of the elderly are significantly related to filial expectation and intergenerational support.

Inhibitor of DNA binding 1 (ID1) has an aberrantly high expression in multiple cancer tissues, including colon cancer, lung cancer, breast cancer, and so on, which is closely related to cancer aggressiveness and poor clinical outcomes in cancer patients. It has been reported that ID1 maintains colorectal cancer cells (CRCs) stemness traits and contributes to the CRC drug resistance. While, the biological molecular mechanisms have not been fully elucidated. In this research, we found that ID1 upregulates octamer binding transcription factor (OCT4) protein level as well as OCT4 signaling pathway via Western blot, gene set enrichment analysis (GSEA), dual-luciferase reporter assay, and real-time PCR. Through the in vitro sphere formation assay, we found that overexpression of OCT4 reverses the inhibitory effect of knocking down ID1 on CRC sphere formation ability. With the help of JASPAR and GEPIA database, we predicted a novel transcriptional repressor—forkhead box D3 (FOXD3) of OCT4. Finally, by using co-immunoprecipitation (Co-IP), confocal and real-time PCR, we demonstrated that ID1 interacts with FOXD3 to inhibit its transcriptional repression activity and therefore to upregulate OCT4 transcription and OCT4 signaling pathway. In conclusion, this study provides a new theoretical basis for the regulation mechanism of colon cancer stem cells, and the newly found protein-protein interaction of ID1-FOXD3 provides a potential drug target for the therapy of CRC.

General practice is a clinical practice which integrates a variety of disciplines and aims at providing basic health care services for individuals, families and communities. General prac-tice in China is now experiencing increasing development. In 2011, the Academic Degrees Committee of the State Council approved of the addition of general practice under the category of clinical medicine, initiating the education of postgraduates with professional degree majoring in general prac-tice. Through analyzing supervisor instruction, curriculum, skill training and assessment of postgrad-uates majoring in general practice, this paper thoroughly explored its training mode.

Carotid atherosclerosis is an important pathogenesis of ischemic stroke.Inflammation plays a crucial role in the artery atherosclerotic genesis and development as well as its caused complications.Human CXC chemokine ligand 16 (CXCL16),as a novel chemokine,involves in the formation and development of atherosclerotic plaques.It may be associated with atherosclerotic stroke.