Objective To compare the clinical diagnoses with autopsy findings and evaluate the frequency of misdiagnosis.Methods The findings of 356 cases who were autopsied in our department due to medical treatment dispute during the period of 1988 to 2007 were retrospectively analyzed.The clinical diagnosis and autopsy findings,sex and age of the death,length of hospitalization,the hospital department,distribution of death disease and the rank of hospital were analyzed.The concordance between diagnosis before death and at autopsy was calculated.Results In 162 cases(45.5%),the autopsy findings confirmed the clinical diagnosis.In 101 cases(28.4%),the clinical diagnosis suggested by clinicians were discordant with the autopsy findings.In 63 cases(17.7%),some diagnoses made by clinicians were proved by autopsy,and in 30 cases(8.4%),the clinical and postmortem diagnosis were beyond comparison.The most frequently misdiagnosed diseases were from cardiovascular and respiratory diseases,and among them,cardiomyopathy,aortic atherosclerosis and pneumonia were most common.Conclusion Autopsy is not only helpful for the management of medical dispute,but also beneficial to reduce the misdiagnosis in clinical practice.

OBJECTIVE: Oral zhongfeng an liquid is a new dose form of traditional Chinese medicine for treating cerebrovascular diseases. Its main components are astragalus and hirudo, the former is of obvious effects of replenishing qi and activating blood, and the latter is of stronger effects of antiplatelet, antithrombosis and arteriospasm-reducing, as well as improving tissue anoxia.OBJECTIVE: To investigate the effects of oral zhongfeng an liquid on arterial thrombosis in rats, and blood coagulation and tolerance in mice.DESIGN: A completely randomized and controlled trial.SETTING: Pharmacological Division of Basic Medical College, Hebei Medical University.MATERIALS: The experiment was completed from September 2001 to April 2002 at the Pharmacological Division of Basic Medical College,Hebei Medical University. The experiment of effect of the drug on thrombosis in rats: In the first study, totally 40 Wistar rats were at random divided into five groups: zhongfeng an liquid 3.0, 6.0, 12.0 g/kg, aspirin 0.3 g/kg and control group, with 8 in each group. In the second study, totally 50 Wistar rats were also at random divided into five groups: zhongfeng an liquid 3.0 and 6.0 g/kg, naoxue kang 3.0 and 6.0 g/kg and control group,with 10 in each group. Clotting time study in mice: Totally 50 mice were randomly divided as zhongfeng an liquid 6.0, 12.0, 24.0 g/kg, aspirin 0.3 g/kg and control group, with 10 in each group. Measurement of swimming exhaustion time of mice: Totally 90 mice were randomly divided as zhongfeng an liquid 6.0 and 24.0 g/kg, naoxue kang 6.0 and 24.0 g/kg, benzedrine 0.2 g/kg and control group, with 15 in each group.METHODS: In the experiment of effect of the drug on thrombosis: For the first study, 24 hours and 1 hour before operation the rats in all groups were respectively by gavage given oral zhongfeng an liquid (3, 6, 12 g/kg), aspirin (0.3 g/kg), and water. For the second study, 24 hours and 1 hour before operation the rats were respectively by gavage given oral zhongfeng an liquid (3, 6 g/kg), naoxue kang (3, 6 g/kg) and water. After administration,ketamine 50 mg/kg was peritoneally given for anesthesia, silk ligature thrombosis was used, then the wet thrombus was weighed for comparison of difference in thrombosis among the groups. Measurement of clotting time of mice: The mice were respectively by gavage given oral zhongfeng an liquid (24.0, 12.0, 6.0 g/kg), aspirin (0.3 g/kg) and water, one hour after administration the clotting time of mice was detected with the slide method. Measurement of swimming exhaustion time of mice: The mice were respectively by gavage given oral zhongfeng an liquid (6.0, 24.0 g/kg), naoxue kang (6.0, 24.0 g/kg), Benzedrine (0.2 g/kg) and water, once a day for 5 days.On the fifth day 1 hour after administration, the swimming exhaustion time of mice was measured, the mean value of swimming exhaustion time of mice in each group was calculated.haustion time of mice in each group.RESULTS: All 90 rats and 140 mice involved entered into the result thrombus in rats of the oral zhongfeng an liquid 3.0, 6.0 and 12.0 g/kg groups were obviously lower than those in the naoxue kang groups of the same dose [(24±4), (21±4), (16±6), (39±7) mg, (t=5.88-7.90, P ＜ 0.01)]; in the second study, the wet quality of rats in the oral zhongfeng an liquid 6.0 g/kg group was obviously lower than that in the same dose naoxue kang group [(23.6±2.6), (30.0±4.1), (t=4.18, P ＜ 0.01)], the wet quality of mice in the oral zhongfeng an liquid 3.0 g/kg group was obviously lower than that in the same dose naoxue kang group [(30.6±2.1), (33.1±1.6) mg, (t=2.96,zhongfeng an liquid 24.0 and 12.0 g/kg groups were obviously higher than that in the control group [(222±66), (190±52), (116±26) s, (t=4.02, 4.72, P the oral zhongfeng an liquid 24.0 and 6.0 g/kg groups were obviously higher than that in the control group [(2 512±1 244), (899±403), (502±100) s,(t=3.70-6.24, P ＜ 0.01)].CONCLUSION: Oral zhongfeng an liquid was of obvious inhibition to arterial thrombosis of rats and venous thrombosis of mice, and could enhance the tolerance of mice with a role of antifatigue.

Purpose: We compared the cataract grades with slit lamp examination and anterior segment photography using the Lens Opacities Classification System (LOCS) III criteria. We also explored the effect of a yellow filter on the photographic results. Methods: Eighty eyes with cataracts were examined by three inspectors (1, 2, and 3). Anterior segment photographs taken by inspector 1 were divided into two groups depending on whether cortical opacity or nuclear sclerosis predominated. In each group, the cataract grades determined by inspector 1 on slit lamp examination and anterior segment photography were compared. Also, after randomly assigning the anterior segment photographs taken by inspector 1 to inspectors 2 and 3, the cataract grades of these photographs were compared to the grades of photographs taken by all inspectors using a yellow filter. Results: The average cortical opacity evaluated by inspector 1 on slit lamp examination (3.48 ± 0.91) was significantly higher than that apparent on anterior segment photographs (2.35 ± 0.77) (p < 0.001). In the photographs, the average cortical opacity when a yellow filter was used was significantly higher for both inspectors 1 (p < 0.001) and 2 (p = 0.022) than when the filter was absent. The average extent of nuclear sclerosis evaluated by inspector 1 on slit lamp examination (4.08 ± 0.94) was significantly higher than that of anterior segment photography (3.73 ± 1.24) (p = 0.042). Conclusions Cataract evaluation via anterior segment photography underestimates the extent of damage compared to direct slit lamp examination. However, use of a yellow filter during photography aids cataract evaluation, especially cortical opacity.

Purpose: We used anterior segment optical coherence tomography (AS-OCT) to measure the pterygial subepithelial invasion length and thickness before and after surgery, and to evaluate the corneal epithelium and the extent of astigmatism. Methods: This was a retrospective study. Ten eyes that underwent pterygial excision surgery were analyzed. We used corneal topographic data to assess astigmatism before surgery and employed AS-OCT to measure corneal epithelial thickness and the length of subepithelial invasion. We measured the relative pterygial length, width, and area on anterior segment photographs. Corneal topographic assessment and AS-OCT were repeated 1 month after surgery. Multiple regression and Pearson correlation analyses were used to analyze the relationships between normalization of astigmatism and the size and thickness of the excised pterygium. Results: The mean With-the-Rule proportion of preoperative astigmatism was 2.9 ± 2.3 D and the mean corneal epithelial thickness 269.60 ± 84.17 µm. The mean thickness of the excised pterygia was 210.73 ± 80.36 µm. Pterygial thickness was significantly associated with the extent of preoperative With-the-Rule astigmatism and the normalized With-the-Rule astigmatism after pterygial excision. These correlations were stronger than those of the relative pterygial length, width, and area. The mean subepithelial invasion length was 595.00 ± 310.32 µm. Conclusions An increase in pterygial epithelial thickness influenced the extent of With-the-Rule astigmatism to a much greater extent than did the relative pterygial length, width, and area. AS-OCT measurement of the subepithelial invasion length identifies the required excisional area prior to surgery.

OBJECTIVE: Despite the good prognosis of borderline ovarian tumors (BOTs), a few BOT patients experience the relapse of disease, either borderline or malignant. However, the risk of recurrence of BOTs is somewhat controversial. We intended to find out the specific characteristics and prognosis of the recurrence of BOTs. METHODS: Between 1995 and 2012, 130 women were diagnosed with BOTs at a single institution. Eleven patients diagnosed and treated for the recurrence of BOTs including seven cancerous and four borderline relapses were included for the analysis in this retrospective study. Clinicopathological characteristics and surgical procedures as well as follow-up data with overall survival were assessed. Statistical analyses was performed using the chi2 test, t-test and log-rank test with Cox regression. RESULTS: One hundred and thirty patients with mean follow-up of 65.8 months were evaluated, of whom half were below 40 years old at their first diagnosis of BOTs. Among 11 recurrent cases (8.5%), 7 cancerous transformations (5.4%) and 4 borderline recurrences (3.1%) were detected with median time of 6 and 71 months after the primary surgery, respectively. Nine out of 11 recurrences were happened at their equal or below 40-years-old age at the primary diagnosis (P=0.027). Also, all 7 cancerous relapses arose from premenopausal women of median age of 35 years old. Twenty (15%) patients had laparoscopic surgery and they were all treated conservatively. Among those 20, 5 were suffered from relapse of BOTs and laparoscopic approach was proved to be a significant risk factor for disease relapse in our study (P=0.013). Although laparoscopic surgery was revealed had meaningful influence on disease free survival (P=0.024), it was not significant on overall survival (P=0.226). CONCLUSION: Laparoscopic conservative surgery for BOTs can be accepted under close follow-ups. And younger patients should be followed for long period to evaluate recurrence.
Diagnosis ; Disease-Free Survival ; Epithelial-Mesenchymal Transition ; Female ; Follow-Up Studies ; Humans ; Laparoscopy ; Ovarian Neoplasms ; Prognosis ; Recurrence* ; Retrospective Studies ; Risk Factors

Objective To analyze the HLA-A ,B and DRB1 alleles high-resolution polymorphism in Chongqing Han population . Methods The PCR-SSOP and PCR-SBT methods were applied for the HLA high-resolution genotyping of 2 067 unrelated healthy donors in the registry of Chongqing branch of Chinese National Marrow Donor Program (CMDP) .The allele frequencies of HLA-A , B and DRB1 were estimated by the direct counting method and the Hardy-Weinberg equilibrium inspection was performed by using the Arlequin software 3 .1 .Results 168 high-resolution alleles were detected out ,in which 42 alleles of A*11 :01 ,A*24:02 ,A*02:07 ,A*02 :01 and A*33:03 at the HLA-A locus were observed with the frequencies greater than 0 .05 ;81 alleles were detected at HLA-B locus ,including B*46 :01 ,B*40:01 ,B*58 :01 ,B*13 :01 and B*15 :02 with the frequencies greater than 0 .05 ;45 al-leles of DRB1*09:01 ,DRB1*15 :01 ,DRB1*12 :02 ,DRB1*08 :03 and DRB1*11 :01 at the HLA-DR locus were observed with the frequencies greater than 0 .05 .Conclusion The data of the HLA-A ,B and DRB1allelic frequencies at high-resolution level in Chongqing Han population are obtained ,which provides the reliable reference data for the studies of anthropology ,forensic medi-cine ,transplantation matching and disease association .

Objective To investigate the correlation between baseline serum lipid levels and hematoma enlargement in patients with acute intracerebral hemorrhage (ICH). Methods From October 2013 to January 2018, patients with ICH admitted to the Department of Neurosurgery, Heze Municipal Hospital, were enrolled retrospectively. The first CT scan was completed within 6 h after onset, and the second one was completed at 48 h after onset. Hematoma enlargement was defined as an increase >33 % in the volume of hematoma on CT. The demographic and baseline clinical data in the hematoma enlargement group and the non -hematoma enlargement group were compared. Multivariate logistic regression analysis was used to identify the independent risk factors for hematoma enlargement. Results A total of 470 patients with acute ICH were enrolled, including 187 females (39.8%) and 283 males (60.2%), aged 47-81 years. Seventy-nine patients (16.8%) had hematoma enlargement. The proportion of patients with atrial fibrillation and who used warfarin before onset, as well as age, baseline National Institutes of Health Stroke Scale score, baseline hematoma volume, international normalized ratio, prothrombin time, activated partial thromboplastin time, and thrombin time of the hematoma enlargement group were significantly higher than those of the non -hematoma enlargement group ( all P< 0.05 ), while from the onset to the first CT scan time, total cholesterol, triglyceride, low-density lipoprotein cholesterol levels were significantly lower than those in the non- hematoma enlargement group (all P<0.05). Multivariate logistic regression analysis showed that baseline total cholesterol <3.20 mmol/L (odds ratio [ OR] 1.32, 95% confidence interval [ CI] 1.08-1.83; P=0.004), baseline hematoma volume≥30 ml (1.76,95% CI 1.30-2.15; P<0.001), and using anticoagulant before onset ( OR 2.37, 95% CI 1.81-3.02; P<0.001 ) had significantly independent correlation with hematoma enlargement. Conclusion Baseline total cholesterol <3.20 mmol/L, hematoma volume ≥30 ml, and using anticoagulant before onset were the independent risk factors for hematoma enlargement in patients with acute ICH.

Waterborne viruses that can be harmful to human health pose significant challenges globally,affecting health care systems and the economy.Identifying these waterborne pathogens is essential for preventing diseases and protecting public health.However,handling complex samples such as human and waste-water can be challenging due to their dynamic and complex composition and the ultralow concentration of target analytes.This review presents a comprehensive overview of the latest breakthroughs in waterborne virus biosensors.It begins by highlighting several promising strategies that enhance the sensing performance of optical and electrochemical biosensors in human samples.These strategies include optimizing bioreceptor selection,transduction elements,signal amplification,and integrated sensing systems.Furthermore,the insights gained from biosensing waterborne viruses in human sam-ples are applied to improve biosensing in wastewater,with a particular focus on sampling and sample pretreatment due to the dispersion characteristics of waterborne viruses in wastewater.This review suggests that implementing a comprehensive system that integrates the entire waterborne virus detection process with high-accuracy analysis could enhance virus monitoring.These findings provide valuable insights for improving the effectiveness of waterborne virus detection,which could have sig-nificant implications for public health and environmental management.

PURPOSE: We performed this retrospective study to investigate the outcomes of patients with hemangioma of the cavernous sinus after fractionated radiotherapy. MATERIALS AND METHODS: We analyzed 10 patients with hemangioma of the cavernous sinus who were treated with conventional radiotherapy between January 2000 and December 2016. The median patient age was 54 years (range, 31–65 years), and 8 patients (80.0%) were female. The mean hemangioma volume was 34.1 cm3 (range, 6.8–83.2 cm3), and fractionated radiation was administered to a total dose of 50–54 Gy with a daily dose of 2 Gy. RESULTS: The median follow-up period was 6.8 years (range, 2.2–8.8 years). At last follow-up, the volume of the tumor had decreased in all patients. The average tumor volume reduction rate from the initial volume was 72.9% (range, 18.9–95.3%). All 10 of the cranial neuropathies observed before radiation therapy had improved, with complete symptomatic remission in 9 cases (90%) and partial remission in 1 case (10%). No new acute neurologic impairments were reported after radiotherapy. One probable compressive optic neuropathy was observed at 1 year after radiotherapy. CONCLUSION: Fractionated radiotherapy achieves both symptomatic and radiologic improvements. It is a well-tolerated treatment modality for hemangiomas of the cavernous sinus.
Cavernous Sinus* ; Cranial Nerve Diseases ; Female ; Follow-Up Studies ; Hemangioma* ; Humans ; Optic Nerve Diseases ; Radiotherapy* ; Retrospective Studies ; Tumor Burden

PURPOSE: We performed this retrospective study to investigate the outcomes of patients with hemangioma of the cavernous sinus after fractionated radiotherapy. MATERIALS AND METHODS: We analyzed 10 patients with hemangioma of the cavernous sinus who were treated with conventional radiotherapy between January 2000 and December 2016. The median patient age was 54 years (range, 31–65 years), and 8 patients (80.0%) were female. The mean hemangioma volume was 34.1 cm3 (range, 6.8–83.2 cm3), and fractionated radiation was administered to a total dose of 50–54 Gy with a daily dose of 2 Gy. RESULTS: The median follow-up period was 6.8 years (range, 2.2–8.8 years). At last follow-up, the volume of the tumor had decreased in all patients. The average tumor volume reduction rate from the initial volume was 72.9% (range, 18.9–95.3%). All 10 of the cranial neuropathies observed before radiation therapy had improved, with complete symptomatic remission in 9 cases (90%) and partial remission in 1 case (10%). No new acute neurologic impairments were reported after radiotherapy. One probable compressive optic neuropathy was observed at 1 year after radiotherapy. CONCLUSION: Fractionated radiotherapy achieves both symptomatic and radiologic improvements. It is a well-tolerated treatment modality for hemangiomas of the cavernous sinus.
Cavernous Sinus* ; Cranial Nerve Diseases ; Female ; Follow-Up Studies ; Hemangioma* ; Humans ; Optic Nerve Diseases ; Radiotherapy* ; Retrospective Studies ; Tumor Burden