Objective To investigate a method for postmortem diagnosis of the sudden death from hypersensitivity by detection of serum tryptase and IgE.Methods Venous blood samples were collected from 9 cases of sudden death from hypersensitivity,19 cases of death from other causes and 10 health living adult individuals.The serum levels of the mast cell tryptase(MCT)and IgE were detected with immunofluorescent enzyme assay and enzyme linked immunosorbent assay(ELISA)respectively.MCT in the lungs was detected by immunohistochemistical method.Results The serum level of both MCT and IgE in cases of sudden death from hypersensitivity were higher than those in health living adults and cases of death from other causes(P﹤0.01).However,there was significant difference(P﹥0.05)in the serum level of IgE and MCT between the health living individuals and cases of death from other cause.More cells containing MCT-positive granules were detected in the lung in cases of sudden death from hypersensitivity than in cases of death from other causes(P

AIM To study the effects of matrine (Ma) on the action potential and contractile force in guinea pig papillary muscles. METHODS Conventional microelectrode technique was used to record the fast action potentials (FAP) and slow action potentials (SAP) induced by histamine and BaCl_2 of guinea pig papillary muscles. RESULTS Ma 10,25,50 ?mol?L -1 dose-dependently prolonged the action potential duration at 50%, 90% repolarization (APD_ 50 , APD_ 90 ) and effective refractory period (ERP) of FAP, and lengthened the APD_ 50 , APD_ 90 of SAP induced by histamine and BaCl_2 when perfused with KCl 25 mmol?L -1 Tyrode's solution. The maximal upstroke velocity (V_ max ) of FAP, SAP and contractile force (Fc) were not affected by matrine 10,25,50 ?mol?L -1 . CONCLUSION It was suggested that Matrine could block K + channels in the myocardium.-

Objective To explore the value of mast cell tryptase and brain natriuretic peptide(BNP)in the differential diagnostic of sudden death due to hypersensitivity and coronary atherosclerotic heart dis-ease.Methods Totally 30 myocardial samples were collected from the autopsy cases in the Department of Forensic Pathology, Shanxi Medical University during 2010—2015. All samples were divided into three groups:death of craniocerebral injury group, sudden death of hypersensitivity group and sudden death of coronary atherosclerotic heart disease group, 10 cases in each group. Mast cell tryptase and BNP in myocardium were detected by immunofluorescence staining and Western Blotting.Results Immunofluo-rescence staining showed that the positive staining mast cell tryptase appeared in myocardium of sudden death of hypersensitivity group and coronary atherosclerotic heart disease group. Among the three groups, the expression of mast cell tryptase showed significantly differences through pairwise comparison(P<0.05); The expression level of BNP in sudden death of coronary atherosclerotic heart disease group were significantly higher than the sudden death of hypersensitivity group and death of craniocerebral injury group(P<0.05). The difference of the expression level of BNP between the sudden death of hypersensitivity group and the death of craniocerebral injury group had no statistical significance(P>0.05).Conclusion The combined detection of the mast cell tryptase and BNP in myocardium is expected to provide help for the forensic differential diagnosis of sudden death due to hypersensitivity and coronary atherosclerotic heart disease.

Objective To investigate the diagnostic significance of basophil activation test (B A T) in ana-phylaxis to non-ionic contrast media through testing the content of CD 63, m ast cell-carboxypeptidase A 3 (M C-CPA 3), and term inal com plem ent com plex SC5b-9 of the individuals by testing their levels in the norm al im m une group and the anaphylaxis groups to β-lactam drugs and non-ionic contrast media. Methods The CD 63 expression of basophilic granulocyte in blood w as detected by flow cytom etry. The levels of M C-CPA 3 in blood serum and SC5b-9 in blood plasm a w ere detected by ELISA . Results The CD 63 expression of basophilic granulocyte in blood, the levels of M C-CPA 3 and SC5b-9 of anaphylaxis to non-ionic contrast media and β-lactam drugs w ere significantly higher than that in norm al im m une group (P<0.05). Conclusion There is activation of basophilic granulocytes, m ast cells and com plem ent system in anaphylaxis to non-ionic contrast media. B A Tcan be used to diagnose the anaphylaxis to non-ionic contrast media.

To establish a highly sensitive and specific method to detect the presence of Cryptosporidium homini, the RT-PCR-ELISA assay was tried, in which the primer with a biotin-labeled probe was designed to amplify fragment containing the highly variable region by multiple alignment between p23 gene of C.hominis and other Cryptosporidium spp. The RT-PCR was used to amplify the target fragment, and the amplified product was used to hybridize with the probe primer. The hybridized product was then captured on micro-plate wells coated with streptavidin and reacted with anti-digoxin antibody labeled with horse-radish peroxidase. This method of testing was then used for the detection of C.hominis in 22 clinical specimens and compared with the conventional methods of testing. It was demonstrated that the RT-PCR--ELISA for the detection of C.hominis was proved to be quite sensitive and specific. Its sensitivity was 100 times higher than that of the general PCR. From the result of clinic detection, the detection rate of RT-PCR-ELISA assay attained to 86%(19/22), while those of RT-PCR, sucrose floating method and anti-acid staining were 27%, 27% and 50% respectively. This result indicates that the RT-PCR-ELISA assay is more sensitive to detect C.hominis than the other three methods of testing.

OBJECTIVETo investigate the diagnostic value of liquid-based cytology test (LCT) in pancreatic lesions sampled by ultrasound-guided fine needle aspiration (EUS-FNA).

METHODSA retrospective analysis of 556 cases of LCT smears sampled by EUS-FNA of pancreatic lesions was performed, and 164 cases had histologic diagnosis with subsequent surgical resection or biopsy and immunohistochemistry. The accuracy of the cytologic diagnosis was assessed using the histologic diagnosis as the gold standard. The discrepant cases were reviewed to identify sources of errors.

RESULTSThe satisfactory rate for EUS-FNA was 96.0%(534/556). The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were 87.7%(128/146), 13/16, 97.7%(128/131), 41.9%(13/31) and 87.0%(141/162) respectively. The diagnostic accuracy was lower in cystic lesions than that in solid lesions. The LCT sensitivities of adenocarcinoma, lymphoma and neuroendocrine tumors were higher than those of cystic tumors and mesenchymal tumors. False positive diagnosis was mainly due to epithelial abnormalities in inflammatory reaction. False negative diagnosis was mainly due to scanty or lack of tumor cells in the smears, or mild atypia that was insufficient for diagnosis.

CONCLUSIONSEUS-FNA is a valuable tool for the diagnosis of pancreatic lesions. Standardized terminology and nomenclature are helpful to improve the diagnostic accuracy.

Adenocarcinoma ; diagnosis ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Humans ; Inflammation ; Neoplasms, Connective and Soft Tissue ; diagnosis ; Neuroendocrine Tumors ; diagnosis ; Pancreas ; cytology ; diagnostic imaging ; pathology ; Pancreatic Neoplasms ; diagnosis ; Retrospective Studies ; Sensitivity and Specificity ; Specimen Handling

Objective To investigate the clinical characteristics of fat embolism syndrome (FES) and explore the diagnosis and therapy efficacy.Methods The etiology,clinical manifestations,laboratory and radiological characteristics,diagnosis,treatments and outcomes of 11 patients with FES,admitted to our hospital from 2004 to 2014,were retrospectively analyzed.Results There were 9 patients with traumatic long bone fracture,2 with artificial knee joint replacement in 11 patients.Disturbance of consciousness was noted in 10 patients,dyspnea in one in the first onset.There were 2 with "snow storm appearance" in chest X-ray,8 with abnormality in pulmonary CT and 3 with multiple cerebral infarction in MRI.The rates of final diagnosis and misdiagnosis within 72 h were 63.63％ and 36.36％,respectively.After comprehensive treatment,7 patients were cured,one was at vegetative state and 3 died,with a mortality rate of 27.2％.Conclusions The main causes of FES include traumatic long bone fracture and operation of joint.Early definite diagnosis and effective combined modality therapy are key points of successful treatment.

Objective:To survey the teaching ability of general practitioners(GPs) in community health centers of Shanghai, and its influencing factors.Methods:A questionnaire survey on the teaching ability of general practice trainers was conducted from January to February 2017. The participants of the survey were GPs with teaching experiences from community health centers in Shanghai selected by a stratified and proportional cluster sampling method. The questionnaire included two aspects: the general information and teaching ability of the participants. The influencing factors of teaching ability were analyzed by univariate and multivariate regression analysis.Results:A total of 1 138 GPs from 116 selected community health centers participated in the questionnaire survey, among whom 63.6% (724/1 138) worked in community teaching bases and 78.5% (893/1 138) had received training for trainers. The total score of teaching ability was 38.00 (30.00, 40.00). The score of the item"interesting in teaching"was (3.46±0.80), 75%—80% of the other questions answered "yes". The score of"application of multi-teaching methods"was (3.78±0.72). Multivariate analyses showed that working for 5—9 and 10—19 years [ OR=7.14 (2.47—11.81), P=0.003; OR=5.32 (1.30—9.33), P=0.009], working in community teaching bases [ OR=13.23 (9.88—16.57), P<0.001] and receiving training for trainers [ OR=17.76 (13.80—21.71), P<0.001] were influencing factors of teaching ability. Conclusion:The main problems related to teaching ability in community GPs are lack of teaching interest and the poor application of multi-teaching methods, the relevant training is necessary for them in the future.

ObjectiveTo investigate the intestinal absorption characteristics of multi-index components in Danggui Buxuetang with drug absorption simulating system （DASS） established by everted intestinal sac model. MethodThe intestinal absorption solution at different time points after administration of Danggui Buxuetang was collected and detected by high performance liquid chromatography （HPLC）， acetonitrile （A）-0.2% glacial acetic acid solution （B） was used as the mobile phase for gradient elution （0-16 min， 15%-23%A； 16-20 min， 23%-28%A； 20-25 min， 28%-30%A； 25-30 min， 30%A； 30-35 min， 30%-65%A； 35-45 min， 65%-95%A）， the detection wavelength was 302 nm. HPLC fingerprint of intestinal absorption solution was established and the common peak was calibrated， and the relative cumulative absorption rate of each index component was calculated. The relative cumulative absorption curves of components were fitted with various mathematical models by DDSolver 1.0 to explore the absorption law of different components. ResultThe absorption process of C2 （calycosin-7-glucoside） and C6 in Danggui Buxuetang was in line with zero-order equation， C9 was best fitted by Weibull equation， and the remaining 7 components were in line with Makoid-Banakar equation. C1 with C2， C3， C5， C7 and C10， C2 with C5 and C7， C3 with C4， C5， C7 and C10， C4 with C6 and C10， C5 with C7， C6 with C10， C7 with C10， C8 with C9 were absorbed simultaneously during the absorption process. With the prolongation of time， the overall cumulative absorption rate of Danggui Buxuetang increased. At 120 min， the overall cumulative absorption rate of Danggui Buxuetang exceeded 38%， and reached 49.14% at 180 min. ConclusionTen ingredients in Danggui Buxuetang are absorbed in the jejunum， but absorption law of various components is different， which shows that the intestinal absorption of compound preparations of traditional Chinese medicine （TCM） has multiple characteristics. Intestinal absorption study of TCM compound preparations with chemical composition as the index can reveal some of its absorption law， but it is not complete.