Abstract: Objective To research the relationship between promoter polymorphism-438 A/G of thrombin-activatable fibrinolysis inhibitorgene (TAFI-438 A/G) and atherosclerotic cerebral infarction (ACI) in Chinese Han population. Methods TAFI-438A/G genotypes andtheir allele frequencies were identified with the polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) in225 ACI patients and 184 healthy controls. Results There was no significant difference of TAFI-438A/G polymorphism between ACI groupand control group. Stratified by gender, in males, the incidence of A allele was 28.6% in ACI group, and 20.6% in control (P=0.039); of theAA genotype was 9.0% in ACI group, and 1.9% in control (P=0.019). But no significant difference was found in females. ConclusionTAFI-438A/G polymorphism is associated with the risk of ACI in males, that AA genotype may increase the risk of ACI.

To explore the effect of Kudiezi injection on renal function in the real world, in order to provide the basis for the clinical medication safety. Patient aged between 18-80 were selected from 18 large hospitals information system (HIS) databases established by clinical research institute for basic traditional Chinese medicine of China academy of Chinese medical sciences. The patients who were treated with Kudiezi injection (24 225 cases) were defined as the exposed group, whereas those who were not treated with Kudiezi injection (14,191 cases) were defined as the non-exposed group. The propensity score method was used to balance the confounding factors. Classic logistic regression, GBM weighted propensity score logistic regression, GBM propensity score weighted logistic regression with covariate and sensitivity analysis were adopted to study the effect of Kudiezi injection on renal function. The results showed no significant difference in the possibility in abnormality in serum creatinine (Scr) (P = 0.940, 0.679, 0.834) and urea nitrogen (BUN) (P = 0, 0.045, 0.164) between both groups. Therefore, the existing data indicated no damage of Kudiezi injection on renal function. Because this study is a retrospective study based on the real world, there may be unknown confounding factors and potential bias. Therefore, further studies shall be conducted to monitor whether Kudiezi injection causes damage on renal function, in order to ensure the clinical medication safety.
Blood Urea Nitrogen ; Drugs, Chinese Herbal ; adverse effects ; Hospital Information Systems ; Humans ; Injections ; Kidney ; drug effects ; physiology ; Kidney Function Tests ; Logistic Models ; Propensity Score ; Retrospective Studies

This study based on twenty 3A grade hospital information system (HIS) database in China, adopt toprescription sequence analysis (PSA) with nested case control study (NCCS) to analysis mainly suspected allergy factor of Shenqi Fuzheng injection (Shenqi Fuzheng). Study design according to start to stop using Shenqi Fuzheng whether using dexamethasone injection will crowd divided into cases group and control group, each case matched 4 controls were selected, two groups according to the ratio of the age and sex matched well. Square test, Fisher exact test, single factor and multiple factor logistic regression were used to analyze data Condition on admission, allergic history, dosage and drug combinations were taken into account in cases of suspected allergic reactions. After analysis in two subgroups we found that the single dose (P = 0.000 2) and the combined use of matrine (P < 0.000 1, OR = 14.312, confidence interval [8.184, 25.029]) had significant effects on the suspected allergic reaction. Study on the existing HIS data and the study method based on screening suspected risk factors for allergic reaction. This study can provide guidance for Shenqi Fuzheng injection safety using in clinical practice, and it can also provides new method for the clinical safety reevaluation of post-marketing Chinese medicine injection.
Case-Control Studies ; Drugs, Chinese Herbal ; adverse effects ; Female ; Humans ; Male

This study aims to assess if adverse drug reactions (ADRs) to Kudiezi injection are allergic in origin. Hospital information system (HIS) data from 18 hospitals in China were used to carry out a nested case control design study. Included were patients who received dexamethasone for suspected allergic reactions after receiving Kudiezi injection. These were compared with non-allergic reaction people. Single factor logistic regression and multiple factor logistic regression were used to analyze data. Condition on admission, allergic history, dosage, disease status and drug combinations were taken into account in cases of suspected allergic reactions. After analysis in two subgroups we found that the condition on solvents had a significant effect, P values were 0.005 5 and < 0.000 1 on suspected cases of allergic reactions. For the first subgroup analysis, we found using other eight injections at the same time as Kudiezi injection could be risk factors in suspected cases of allergic reactions. For the second subgroup analysis combining using mannitol or fructose could increase risks. Based on this current research, condition on admission as well as the concomitant use of some other drugs may be the risk factors in suspected cases of allergic reactions. However, further research for verification is required. This study can provide guidance for safe clinical practice in using Kudiezi injection.
Adult ; Aged ; Case-Control Studies ; Drug-Related Side Effects and Adverse Reactions ; diagnosis ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; therapeutic use ; Female ; Hospital Information Systems ; Humans ; Hypersensitivity ; diagnosis ; Injections ; Male ; Middle Aged

OBJECTIVE: To seek a precise method for estimating postmortem interval (PMI) in forensic medicine practice. METHODS: This study detected the concentration of 21 elements in the vitreous humor of rabbit within 96 hours after death and explored the relationship between their concentration and PMI using the method of ICP-MS. RESULT: It was shown that the concentration of 9 elements in vitreous humor of rabbit within different intervals after death were correlated to PMI available as a reference indicator to estimate PMI. CONCLUSION The changes in the concentration of certain elements in vitreous humor of vitreous humor are correlated with PMI and determination of such changes can be used to estimate the time of death.
Animals ; Calcium/analysis* ; Forensic Medicine ; Iron/analysis* ; Magnesium/analysis* ; Postmortem Changes ; Potassium/analysis* ; Rabbits ; Time Factors ; Vitreous Body/chemistry*

OBJECTIVETo investigate the factors associated with postoperative fecal incontinence after anorectal procedures.

METHODSA total of 1074 patients underwent anorectal procedures in the Department of Colorectal Surgery at the Coloproctology Hospital of Shenyang. Factors associated with postoperative fecal incontinence were analyzed retrospectively.

RESULTSFollow-up was available in all the patients. One hundred and forty-four(13.4%) patients developed mild incontinence, and 57(5.3%) moderate incontinence. There was no complete incontinence. The overall incontinence rate was 18.7%. The incontinence rate was 41.8%(107/256) after fistula procedures, higher than that after hemorrhoid procedures(12.4%,73/591) and fissure procedures(9.2%,21/227), and the differences were statistically significant (P<0.01). Among 490 patients who received injection therapy for internal hemorrhoids, patients who received 10 ml of Xiaozhiling or more had a mild incontinence rate of 10.4%(27/259) and a moderate incontinence rate of 2.3%(6/259), and in those who received less than 10 ml of Xiaozhiling, the mild incontinence rate was 9.5%(22/231) and moderate incontinence rate was 4.3%(10/231). The differences were not statistically significant (all P>0.05). In 354 patients who underwent hemorrhoidectomy, the mild incontinence rate and moderate incontinence rate were both 14.1% in those who had excision of 3 or more hemorrhoids, and were 3.9%(11/283) and 2.1% (6/283) in those who had excision of less than 3 hemorrhoids, and the differences were statistically significant (P<0.01). There was no difference in Incontinence rate was not associate with fistula or fissure procedure (P>0.05).

CONCLUSIONSThe incidence of incontinence is high after fistula procedures. Excision of hemorrhoids should not exceed 3 hemorrhoids. Wider adoption of injection therapy is encouraged.

Adult ; Anus Diseases ; surgery ; Fecal Incontinence ; etiology ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Retrospective Studies

Objective To investigate the clinical features and neuroimaging features of patients with osmotic demyelination syndrome (ODS).Methods The clinical features and examination results ,including the clinical manifestations,the data of cranial MRI/CT,changes of EEG,treatment and prognosis,were analyzed in 4 patients with ODS.Results All the 4 patients had the history of hyponatraemia.The common clinical manifestations included psychiatric disorder,altered consciousness,dysphasia,dysphagia,quadriplegia and dystonia.Severe transient abnormal EEG was found in these patients,and all the brain CT scanning and CSF were negative.MRI features could only be noted 10 d after the appearing of clinical manifestations and all the first time MRI was negative in these 4 patients.Four patients were diagnosed as having extrapontine myelinolysis,showing symmetrical low T1-weighted signal and high T2-weighted signal within the pons,the basal ganglia,the thalami,the insular cortex and the hippocampal head.Three patients were also diagnosed as having central pontine myelinolysis,showing symmetrical T1 low signal and T2 high signal in the basilar part of pons; much clear imaging could be noted with the help of weighing the abnormal signals.Three patients got improvement with 1 having dystonia sequel.Conclusion ODS is correlated with chronic hyponatraemia,and both hypokalaemia and hypochloremia may be the 2 possible triggers; when they appear,quick correction is not needed.MRI features may be significantly delayed,thus,repeated imaging study is necessary.

Objective To investigate the effective treatments of combined injury with craniocerebral firearm wound in dogs immersed by seawater under maritime environment. Methods Models of combined injury with craniocerebral firearm wound, including craniocerebral gunshot wound,open chest injury, open abdominal injury, open trauma of extremities and burn injury, were established in 60 healthy adult mongrel dogs. Animal models after being wounded were immersed by the seawater for 30 min, and then, they were equally randomized into conventional treatment group and comprehensive treatment group; 30 dogs in the conventional treatment group were given routine treatment and the other 30 dogs in the comprehensive treatment group were given lukewarm glucose liquid, β-aescin, naloxone hydrochloride, levofloxacin and re-warming treatments besides the conventional treatment. Transcranial Doppler ultrasound, blood gas analysis, measurement of plasma osmotic pressure and intracranial pressure (ICP) monitoring were performed on the dogs of the 2 groups; and the treatment efficacy of the 2groups were compared. Results Low incidence rate of brain vasospasm was noted and TCD indicated that blood flow speed approached normal in the comprehensive treatment group 3 h after the treatment.The plasma osmotic pressure and the indicators of metabolic acidosis reached normal levels in the comprehensive treatment group 12 h after the treatment. The ICP significantly decreased in the comprehensive treatment group 24 h after the treatment. Survival rate in the comprehensive treatment group (70%) was significantly higher as compared with that in the conventional treatment group (53%)7 d after the treatment (P＜0.05). All the indexes in the comprehensive treatment group were better than those in the conventional treatment group (P＜0.05) Conclusion Early infusion of lukewarm hypotonic solution can significantly reduce the osmotic pressure, correct the electrolyte balance, help the re-warming and prolong the survival rate. Naloxone possesses protective effect on brain. The β-aescine sodium can diminish viscosity, slow down brain edema progress, obviously reduce ICP and improve brain tissue oxygen metabolism. In a word, comprehensive treatment in effective in treating combined injury with craniocerebral firearm wound.

OBJECTIVE: To seek a exact method of estimating postmortem interval (PMI). METHODS: This study detected the concentration of zincum(Zn) and nickel(Ni) in vitreous humor of rabbit at hour 96 after death and explored the relationship between their concentration and PMI using a method ICP-MS. RESULTS: The concentration of Zn and Ni in vitreous humor of rabbit at hour 24 after death were related to PMI significantly; The formulae of the relationship between PMI and Zn concentrations is y = 0.1404x2 - 1.3351x + 3.8298 (within 24 h; R2 = 0.9202). The formula of the relationship between PMI and Ni concentrations is y = 0.0043x2 - 0.0596x + 0.2665(within 24 h; R2 = 0.9103). CONCLUSION The concentration of Zn and Ni in vitreous humor of rabbit may be a reference indicator to estimate early PMI.
Animals ; Female ; Forensic Medicine ; Male ; Nickel/analysis* ; Postmortem Changes ; Rabbits ; Time Factors ; Vitreous Body/chemistry* ; Zinc/analysis*

OBJECTIVETo investigate the characteristics of the spontaneous isolated superior mesenteric artery dissection (SISMAD) on computed tomography angiography (CTA).

METHODSTwenty-five patients with unexplained acute abdominal pain received CTA.

RESULTSFour cases with the SISMAD were found and all were male with a mean age of (45.3±6.7) years. Two patients had hypertension history. CT showed enlarged diameter of the superior mesenteric artery with dissection in 4 cases, intimal flap and visible false lumen in 2 cases, ulcer-like laceration in 1 case, and intramural hematoma in 1 case. The proximal lacerations or entries were all at the proximal segment of the superior mesenteric artery. CTA classifications were type Ia (n=2), IIb (n=1), and III (n=1). Two patients underwent repeated CTA when discharged, and progressive changes were discovered.

CONCLUSIONCTA can clearly show the characteristics of the superior mesenteric artery dissection, confirm the diagnosis, and provide an important basis for the classification and follow-up observation.

Adult ; Aged ; Aged, 80 and over ; Aneurysm, Dissecting ; diagnostic imaging ; Angiography ; methods ; Female ; Humans ; Male ; Mesenteric Artery, Superior ; diagnostic imaging ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed ; Young Adult