Child ; Community-Acquired Infections ; microbiology ; Humans ; Pneumonia, Bacterial ; microbiology

Objective To explore pathogenes and pathogenesis of acute cerebral infarction (ACI) from the perspective of integrated traditional and western medicine.Methods To categorize the tongue and pulse manifestation of 64 ACI patients and calculate their frequency,constituent ratios.Meanwhile,patients' blood pressure and laboratory examination results are given descriptive and statistical analysis,showing their means and standard deviations,etc.Results The frequency of dark-red tongue,thin-greasy tongue fur,greasy-yellow tongue fur and taut-slippery is respectively 48,34,20,and 41,constituting 77.4％,54.8％,32.3％,64.1％ of the patients examined respectively; Mean and standard deviation of systolic blood pressure (SBP),total cholesterol (TC),white blood cell (WBC),neutrophil percentage (NEUT％),fasting plasma glucose (FPG),and hemoglobin A1c (HbA1c) is respectively (141.20± 19.20)mm Hg (1 mm Hg=0.133 kPa)、(4.47±0.97) mmol/L、(7.83±2.63) × 109/L、(71.61±9.65)％、(6.16±2.25)mmol/L、and (6.60±1.66)％.Conclusion In terms of pathogens,wind,stasis,heat (fire) and turbid pathogen (phlegm,dampness,etc.) are important factors in bringing out ACI; In respect of ACI pathogenesis characteristics,healthy qi is slightly damaged and pathogenic qi is exuberant.Yet,the role of modern medical examination results,such as blood pressure,blood glucose,blood lipids etc.in the assessment of ACI pathogens and pathogenesis awaits further exploration.

OBJECTIVE:To observe therapeutic efficacy and safety of S-1 capsules combined with recombinant human end-ostatin in the treatment of middle and advanced primary liver carcinoma. METHODS:Totally 94 patients with middle and advanced primary liver carcinoma in the First College of Clinical Medical Science of China Three Gorges university during Feb. 2012-Dec. 2014 were divided into combination group(48 cases)and control group(46 cases)according to random number table. Both groups were given S-1 capsules 40-60 mg orally within 30 min after breakfast and supper. Combination group additionally received Recom-binant human endostatin injection 150 mg added into 0.9%Sodium chloride injection 210 mL with portable micro pump for continu-ous pump of 120 h. A course involved 14 d treatment and 7 d interval. Short-term objective therapeutic efficacy,clinical benefit re-sponse (CBR) and ADR were evaluated after 2 courses. Disease progression time and average survival period were compared be-tween 2 groups. RESULTS:Objective response rate,disease control rate,disease progression time and average survival period of combination group were 14.6%,66.7%,(5.5 ± 1.3) months,(10.7 ± 3.8) months;those of control group were 8.7%,45.6%, (4.8±1.2)months,(8.9±3.3)months,with statistical significance between 2 groups(P<0.05). CBR rate of combination group (79.2%)was significantly higher than control group(52.2%),with statistical significance(P<0.05). There was no statistical sig-nificance in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:S-1 combined with recombinant human end-ostatin show good therapeutic efficacy and tolerance for patients with middle and advanced primary liver carcinoma,and do not in-crease the incidence of ADR.

AIM: To investigate the clinicopathological features of orbit primary liposarcoma. METHODS: By means of histological, ultrastructural and immunohistochemical studies, the clinical and pathological features of two cases of orbit primary liposarcoma were analyzed and compared with 6 cases of primary retroperitoneum liposarcoma. RESULTS: Two cases of orbit primary liposarcoma were young persons. The majority of cases of primary retroperitoneum liposarcoma were aged over 40 years. The tumors were located at the retrobulbar region, and involved the wall of eyeball and optic nerve. The tumor cells of case 1 were round, with abundant eosinophilic granules in the cytoplasm, and there were lipoblasts in the tumor cells of two cases. Local recurrence following excision occurred in case 2.Immunohistochemical expression of S100 protein was positive in all cases, and CK (AE1/AE3), desmin, MyoD1, melanoma were negative. Ultrastructure observation showed lipid drops in the tumor cells in case 2 of orbit primary liposarcoma. CONCLUSION: Primary liposarcoma of the orbit may recur.The diagnosis was based on histological,ultrastruc-tural observation and immunohistochemical staining.

Amyloid ; metabolism ; Humans ; Male ; Middle Aged ; Pituitary Neoplasms ; metabolism ; pathology ; surgery ; Plaque, Amyloid ; pathology ; Prolactin ; secretion ; Prolactinoma ; metabolism ; pathology ; surgery ; Synaptophysin ; metabolism

Objective To evaluate the cause of ischemia related to myocardial bridge (MB) by using SPECT/CT MPI and CTCA.Methods A total of 294 patients with chest pain,tightness or palpitation undergoing both CTCA and MPI were retrospectively enrolled in this study from March 2008 to March 2013.Among them,49 patients (26 males,23 females,age:32-85 (55.4± 16.6) years) had MB.Locations of MB and myocardial ischemia were recorded.Fused MPI/CTCA was analyzed.If there was no mural atherosclerotic plaque-related stenosis on CAG at the same location of coronary artery where ischemic myocardium was found,then MB was considered as the ischemic cause.Myocardial ischemia rates of different MB locations were compared by x2 test.Results Among 49 patients with MB,3 cases had MB in proximal segment of LAD,34 in mid LAD,4 in distal LAD,3 in septal branch,2 in distal LCX,1 in intermedius,and 2 in mid RCA.There were 41 cases with myocardial ischemia.Myocardial ischemia in 32 cases was caused by MB,including 23 caused by MB in mid LAD.The myocardial ischemia rates of the most common MB location (mid LAD,n =34) and other locations (n =15) were not significantly different (67.6％ (23/34) vs 60.0％ (9/15),x2 =0.27,P＞0.05).Conclusions MB is commonly found in the mid LAD.The myocardial ischemia rates caused by MB is not related the MB location.Hybrid MPI/CTCA could evaluate the sites of coronary MB and myocardial ischemia simultaneously and therefore may be useful to evaluate the relationship between MB and myocardial ischemia.

ObjectiveTo investigate clinical risk factors and coronary angiographic features in young men with acute myocardial infarction (AMI).MethodsWe retrospectively studied 200 young men with AMI and compared with 104 non-CHD men,89 old men with AMI.All patients were admitted to hospital from January 2009 to December 2010 and undergone coronary angiography,and the clinic and coronary angiographic features were assessed.The relation between body mass index (BMI),smoking history,familial history of early coronary artery disease,essential hypertension,type 2 diabetes mellitus,hyperlipidemia,serum uric acid ( UA),lipids,hemoglobin (Hb),fasting blood glucose (FBG) with coronary artery disease and its severity was observed.The severity of CAD was diagnosed by the number of diseased vessel.Results In young men with AMI group,the factors such as smoking history,obesity,essential hypertension,type 2 diabetes mellitus,familial history of early coronary artery disease were remarkably different ( P ＜ 0.05 ) ; body mass index,fasting blood glucose,total cholesterol,triglyceride,low density lipoprotein cholesterol were higher than the control group ( P ＜ 0.05 ),hemoglobin was lower than the control group ( P ＜ 0.05 ).Applying Logistic regression analysis,obesity ( OR =11.020),type 2 diabetes mellitus ( OR =5.805 ),essential hypertension ( OR =4.428 ),familial history of early coronary artery disease ( OR =2.883 ),smoking history ( OR =2.153 ) and lower concentration hemoglobin ( OR =1.034) are independent risk factors (P ＜ 0.05) for young men with AMI. According to coronary angiography in young men with AMI,there were 14 cases with zero-vessel disease,109 cases with singlevessel disease (54.50％,69 cases involved with left anterior descending artery) and 42 cases with twovessel disease,35 cases with three-vessel disease.The ratio of single vessel disease involved left anterior desending artery in young men was higher than that of old men with AMI ( P ＜ 0.05 ).Conclusions Obesity,type 2 diabetes mellitus,essential hypertension,familial history of early coronary artery disease,smoking history and lower concentration of hemoglobin are risk factors of young men with AMI ; Single vessel coronary disease is seen more frequently in young men with AMI.

Objective To build the theoretical system model and research assessment indicators for equalization of basic medical and health services of both urban and rural residents.This aims at providing a theoretical and empirical basis for advancing basic medical health system covering rural and urban residents.Methods Literature research and Delphi expert consultation are used to build the indicator model and structure.The extremal standard method,health resources sharing by geography method,Gini coefficient method and other statistical analysis were used for an empirical analysis and test in an eastern provincial capital city.Results The indicator system comprises three dimensions of opportunity,process and result,as well as seven second-level indicators of health financing,resource allocation,accessibility etc.and twenty-seven third-level indicators.The grand mean value of the urban and rural regional indicators for H city in 2010 was calculated as 63.53,while the mean values for urban and rural were 74.75 and 45.58 respectively.Conclusion The assessment indicators focus on three combinations:basic public health services and basic medical services,service supply and demand,as well as the number and quality of services.This approach can help with the assessment of equalization of basic medical and health service for urban and rural areas and policy making.

Objective:To investigate the efficacy of bevacizumab on the treatment of serious peritumorous brain edema. Methods:A total of 16 patients with malignant brain tumors and serious peritumorous brain edema, (13 cases of lung cancer, 2 cases of breast can-cer, and 1 case of recurrent glioblastoma) were analyzed. Treatment with glucocorticoids, osmotic dehydration, and other convention-al approaches were not effective for these patients. Bevacizumab was administered at a dose of 5 mg/kg at least once every three or four weeks. The Karnofsky performance score (KPS) and the changes in cerebral edema symptoms, such as cerebral edema volume, tu-mor volume, edema index (EI), and changes in magnetic resonance imaging (MRI) were compared before and after treatment. The t-test and least-significant difference method were used to compare treatment groups. Results:All bevacizumab-treated patients had re-duced symptoms. The KPS after treatment was significantly higher than that before treatment (P<0.001). The cerebral edema vol-umes, tumor volumes, and EI of 16 patients were significantly decreased (P<0.05). Bevacizumab caused mild clinical side effects. Con-clusion:Preliminary results showed that treatment of serious peritumorous brain edema with bevacizumab was safe and effective.

Objective To investigate the value of 99Tcm-Duramycin SPCET/CT in the detection of vulnerable plaque (VP) in atherosclerotic (AS) rabbit models.Methods Sixteen New Zealand male rabbits were randomly divided into three groups:group A (sham-operated group,n =4),group B (stable plaque group,n =4) and group C (VP group,n =8).Group A was fed on normal diet,and the other 2groups were fed on cholesterol diet for 12 weeks.Femoral artery dissection sham-operation was done in group A and group B,while balloon-induced abdominal aorta wall injury was produced in group C after 2 weeks'feeding.Animals were injected with 99Tcm-Duramycin (74 MBq/kg) and then SPECT/CT imaging was performed at the end of 4,8,and 12 weeks,respectively.Abdominal aortas were explanted for ex vivo imaging and histological characterization of plaque.The apoptosis index (AI) was calculated.One-way analysis of variance was used to analyze data.Results There was no radioactive uptake by the abdominal aorta in each group at the end of 4 weeks and no uptake in group A and group B at the end of 8 weeks.There was slightly uptake radioactive uptake by the abdominal aorta in group B at the end of 12 weeks and in group C at the end of 8 weeks.There was intense uptake at the lesions of AS rabbits in group C at the end of 12 weeks,and the T/NT value significantly higher than that of the other two groups (3.40±0.22 vs 2.12±0.65,2.68±0.18,F=198.775,P＜0.05).The result was confirmed in the ex vivo imaging of the explanted aorta.The AI of group C was significantly higher than that of group A and B ((25.4±6.32) ％ vs (0±0.02)％,(5.3± 1.97)％,F=70.260,P＜0.05).Conclusions 99Tcm-Duramycin scimigraphy could identify the apoptosis of VP in the rabbit AS models.It is a promising non-invasive method to diagnose AS plaques.