This paper reports various cases of cerebral concussion which strongly supportthat cerebral concussion may be regarded as a graded phenomenon with practicalvalue for clinic forensic medicine.The diagnosis,neuropathological changes of the central nevous system,typing ofconcussion are discussed in this paper.The pathological changes of the brain hase been analysed.

OBJECTIVE:To explore the effectiveness and safety of probucol combined with rosuvastatin in the treatment of vascu-lar dementia(VD). METHODS:In retrospective study,clinical information of 88 VD patients selected from neurology department of our hospital during May 2013-Feb. 2015 were divided into observation group and control group according to therapy plan,with 44 cas-es in each group. Both groups received conventional treatments such as controlling blood pressure and blood glucose,anticoagulation. Control group was additionally given Rosuvastatin calcium tablets orally 20 mg,at bedtime;observation group was additionally given Probucol tablet 0.5 g,bid,after meal,on the basis of control group. Both groups received treatment for consecutive 3 months. MMSE and ADL score were compared between 2 groups before and after treatment as well as the levels of TC,TG,LDL-C,HDL-C,CRP, TNF-α,IL-6,IL-1β,SOD and MDA. The occurrence of ADR was also observed. RESULTS:Before treatment,there was no statisti-cal significance in above indexes between 2 groups(P>0.05). Compared to before treatment,MMSE and ALD score,serum SOD lev-el of 2 groups were increased significantly,while serum levels of TC,TG,LDL-C,CRP,TNF-α,IL-6,IL-1βand MDA were de-creased significantly after treatment,with statistical significance(P<0.05). Above indexes of observation group were significantly bet-ter than those of control group,with statistical significance(P<0.05). There was no statistical significance in HDL-C level between 2 groups before and after treatment (P>0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05).CONCLUSIONS:Probucol combined with rosuvastatin is better than rosuvastatin alone in reducing blood lipid,serum inflamma-tory factors and oxidant stress indexes levels,improving cognitive function and quality of life with good safety.

Objective To systematically evaluate the effectiveness and safety of laparoscopic radical cystectomy (LRC) versus open radical cystectomy (ORC).Methods The databases of Cochrane Library , PubMed, EMbase, SCI, Ovid, CBM, WanFang Data Knowledge Service Platform , VIP Information Chinese Science and China National Knowledge Infrastructure , were searched to collect the randomized controlled trails ( RCTs) and non-RCTs about LRC versus ORC for the treatment of muscle invasive bladder cancer . The retrieval time span was from inception to May 2013.The studies were screened according to the inclusion and exclusion criteria , the data were extracted and the quality was evaluated by 2 reviewers independently.The meta-analysis was conducted using RevMan 5.2.6 software.Results A total of 13 non-RCTs involving 783 patients were included .The meta-analysis showed that comparing with ORC , LRC had lesser intraoperative blood loss [MD =-466.85,95%CI( -603.33, -330.37), P <0.001], lower transfusion rate [OR =0.27, 95%CI(0.18, 0.41),P <0.001], shortening postoperative hospital stay [MD=-3.46, 95%CI(-5.98,-0.94), P=0.007], shortening time to oral intake [MD=-1.16, 95%CI(-1.41, -0.90), P<0.001], lesser minor complications [OR=0.52, 95%CI(0.30, 0.89), P=0.020], lower positive margins [OR=0.25, 95%CI(0.10,0.58),P=0.001], lower positive lymphs [OR=0.61, 95%CI(0.40, 0.92),P=0.020], but longer operative time[MD=52.44, 95%CI(36.67, 68.21), P<0.001].There were no significant differences between LRC and ORC in lymph node yield , local recurrence and distant metastases ( P>0.05 ) .Conclusions LRC is safe and feasible for treating muscle invasive bladder cancer when its indications are strictly controlled .However, for the quantity and quality limitation of the involved studies , this conclusion still requires to be further proved by large and high quality studies.

Auricle reconstruction involves auricular framework construction and selection of skin soft tissues that coats the auricular support. To date, there has no ideal biomaterial for the auricular framework. The materials of auricular framework include autologous costal cartilage, medical grade silicon rubber, and porous polyethylene. The autologous costal cartilage avoids rejection, and has advantages such as good flexibility, easy combination with surrounding coated tissues, and low surgical cost. However, the acquisition causes injury, increases pain of patients, alters thoracic cage structure, and the cartilage graft is absorbable and deformable. The medical grade silicon rubber exhibits good exposure rate and high inflammation, which limit its clinical application. Medpor implant has been used recently as novel medical chemical synthesis materials. It makes of high density polyethylene, with strong plasticity, time-efficacy, stable fusion with local tissue and good biocompatibility. However, the exposure of Medpor implant is the complication. In this study, the Medpor implant in combination with total auricle reconstruction was used to treat 12 cases of congenital microtia, trauma-induced auricular defect, auricular defect complicated by atresia of external auditory canal and hearing disturbance. Postauricular fascial flap was expanded to form reconstructed auricle, followed by wound skingrafting. The expanded fascial flap improves blood supply, with close coating, decreases complications. Moreover, all reconstructed auricle survived, with no ulcerate or exposure, and the appearance is similar to normal auricle.

Objective To study the clinical features and methods of early diagnosis of juvenile ankylosing spondylitis(JAS). Methods Twenty-four cases with JAS were prospectively analyzed and followed up. Results Among these 24 cases, ratio of male to female was 11∶1.The onset age was 8 to 15 years (mean 12 years). 63% cases aged 12~15 years. 63% cases had peripheral arthritis, 25% hips involved and only 2 patients (9%) had low back pain at onset . Eleven cases (46%) fulfilled modified New York diagnostic criteria for AS and 21 cases (88%) fulfilled the Shantou diagnostic criteria for AS. Additional 3 cases (13%) fulfilled the Shantou diagnostic criteria for AS after 2 years follow-up. Conclusion 90% cases with JAS has peripheral arthritis and hip involvement at onset. The Shantou diagnostic criteria for AS has higher sensitivity than modified New York diagnostic criteria for AS.

Aged ; Aging ; Health Services for the Aged ; Humans

In order to investigate the effects of TGF-beta1 on the expression of MMP-2, -9 and TIMP-1 in human retinal pigment epithelial (RPE) cells, the third-sixth passage cultured RPE cells were treated with TGF-beta1 at different concentrations (0.01, 0.1, 1.0, 10 ng/mL), the expression of MMP-2, -9 and TIMP-1 mRNA was detected by semi-quantitative RT-PCR assays. MMP-2, -9 and TIMP-1 mRNA were expressed in the cultured RPE cells. The values of MMP-2/beta-actin in the cells treated with 0.1, 1.0, 10 ng/mL TGF-beta1 were 1.04 +/- 0.04, 1.07 +/- 0.02 and 1.11 +/- 0.03, respectively, significantly higher than in the control group (0.96 +/- 0.03, P < 0.05-0.01). The expression of MMP-2 mRNA could be up-regulated by TGF-beta1, in a dose-dependent manner. The expression of MMP-9 mRNA in the cultured RPE cells was slightly up-regulated by various TGF-beta1 concentrations treatment. The values of TIMP-1/beta-actin in the cells treated with 0.01 and 0.1 ng/ mL TGF-beta1 were 0.85 +/- 0.01 and 0.97 +/- 0.02 respectively, significantly lower than in the control group (1.07 +/- 0.04, P < 0.01), indicating that the expression of TIMP-1 mRNA was down-regulated by TGF-beta1 at low concentrations. But along with the increase of TGF-beta1 concentrations (1.0 and 10 ng/mL), the expression of TIMP-1 mRNA was slightly up-regulated, not significantly different from that in the control group (P > 0.05). It was concluded that TGF-beta1 might play an important role in the up-regulation of the expression of MMP-2 in RPE cells and result in a directional shift in the balance between MMP and TIMP. This may be facilitated for RPE cells to migrate in the pathogenesis of vitreoretinopathy.

Objective To determine the significance and expression of S100A9 and NMP238 in cervical carcinoma with different concurrent chemoradiotherapy sensitivities. Methods Fresh carcinoma tissues were collected from untreated cervical carcinoma patients and preserved at -80 ℃. The tissues were classified into 2 groups:a high sensitivity group (HS) and a low sensitivity group(LS) according to their response to concurrent chemoradiotherapy. Protein was separated by 2-dimensional gel electrophoresis (2-DE). Peptide mass fingerprintings (PMF) were acquired by matrix assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) and the proteins were identified by data searching in the Mascot-database. Differential expressed proteins were assayed by Western blot and immunohistochemistry.Results Most of the gels were clear and were successfully and reproductively analyzed. Intensity and rate of S100A9 expression were higher in the HS group than in the LS group,and those of NMP238 expression were higher in the LS group than in the HS group. Conclusion S100A9 and NMP238 expression is associated with concurrent chemoradiotherapy sensitivity in cervical carcinoma.

BACKGROUND: The water extract of white mulberry root-bark plays certain roles in decreasing the blood glucose and blood lipids of rats, antagonizing inflammation and analgesia, relieving asthma and inducing diuresis,as well as relaxing the smooth muscle.OBJECTIVE: To analyze the hypoxic tolerance of white mulberry rootbark by using the hypoxic tolerance test under normal pressure, rapid head-cut test and the test of isoproterenol in enhancing myocardial oxygen consumption.DESIGN: A randomized control study.SETTING: Department of Pathology and Department of Pharmacology,School of Basic Medical Sciences, Gannan Medical College.MATERIALS: The experiments were conducted in the laboratory of the Scientific Research Center of Gannan Medical College between May and June in 2003. Totally 106 healthy adult Kunming mice were used in the following three independent experiments. The white mulberry root-bark extract was provided by the Department of Pharmacology of Gannan Medical College, injection of propranolole hydrochloride by Beijing Pharmaceutical Factory.METHODS: ① Hypoxic tolerance test under normal pressure: Forty mice were divided into four groups with 10 mice in each group according to the method of random number table: saline group, propranolol group, white mulberry root-bark extract groups treated with 0.10 and 0.20 mL/g respectively, and the mice were treated with intraperitoneal injection of saline (0.02 mg/g), propranolol (10 g/L), white mulberry root-bark extract (0.10 and 0.20 mL/g) respectively. After 15 minutes,the mice in the groups were placed into the enclosed 250mL ground and wide mouthed bottles separately, and the survival time of the mice was observed by taking the last breath as the index. ② Rapid headcut test: Thirty mice were divided into three groups with 10 mice in each group according to the method of random number table: saline group, white mulberry root-bark extract groups treated with 0.10 and 0.20 mL/g respectively, and the mice were treated with intraperitoneal injection of saline (0.02 mg/g), white mulberry root-bark extract (0.10and 0.20 mL/g) respectively. After 15 minutes, the heads of the mice were rapidly cut down without anesthesia, and the time from cutting head to the last breath was recorded. ③ Test of isoproterenol in enhancing myocardial oxygen consumption: Thirty-six mice were divided into three groups with 12 mice in each group according to the method of random number table: saline group, isoproterenol group and white mulberry root-bark extract group treated with 0.10 mL/g. In the saline group, the mice were injected with saline subcutaneously (0.03 mL/g),and then intraperitoneally (0.02 mL/g) after 5 minutes. In the isoproterenol group, the mice were firstly treated with subcutaneous injection of isoproterenol (0.015 mg/g), and the intraperitoneal injection of saline (0.02 mL/g) was given after 5 minutes. In the white mulberry root-bark extract group treated with 0.10 mL/g, the mice were firstly injected subcutaneously with isoproterenol (0.015 mg/g), and then injected intraperitoneally with white mulberry root-bark extract (0.01 mL/g)was given after 5 minutes. After 15 minutes, the mice were placed into the enclosed wide mouthed bottles separately, and the survival time of the mice was observed.MAIN OUTCOME MEASURES: The survival time of mice in each group was observed in the three independent experiments.RESULTS: All the 106 healthy adult Kunming mice were involved in the analysis of results. ① Effect of white mulberry root-bark extract on the survival time of mice in the condition of hypoxic tolerance under normal pressure: As compared with the saline group, the survival times in the propranolol group and white mulberry root-bark extract groups treated with0.10 and 0.20 mL/g were obviously prolonged [(36.2±4.3), (81.0±17.0), (66.4±8.9), (90.3±7.4) minutes, t=3.358-3.617,P ＜ 0.01]. ② Effect of white mulberry root-bark extract on the survival time of mice under the condition of cerebral ischemia: As compared with the saline group, the times from cutting head to the last breath in the white mulberry root-bark extract groups treated with 0.10 and 0.20 mL/g were obviously prolonged [(17.8±1.3), (21.2±0.8), (23.5±0.7) minutes, t=2.824-3.432, P ＜ 0.05 or 0.01]. ③ Effect of white mulberry root-bark extract on the survival time of mice under the condition of myocardial oxygen consumption enhanced by isoproterenol: As compared with the saline group, the survival time in the isoproterenol group was obviously shortened, but those in the white mulberry rootbark extract groups treated with 0.10 and 0.20 mL/g were markedly prolonged [(36.2±4.3), (27.9±2.6), (50.6±3.4) minutes, t=2.734-3.035, P ＜ 0.05].CONCLUSION: White mulberry root-bark extract has obvious effect on hypoxic tolerance.

Objective To understand the key points of the differential diagnosis between osteitis condensanse ilii(OCI)and early sacroiliitis.Methods From 1997 to 2004,33 cases of OCI were examined with HLA-B27 determination and sacroiliac joint CT scan,and needle biopsy was performed in some cases when needed.Data of clinical history,laboratory,CT scan,as well as pathological examination were collected and analyzed.Results Sacroiliitis was diagnosed in 17(51.5%)cases of the 33 X-ray OCI cases either by CT scan or by pathological examination.Clinical features of these 17 cases included:(1)HLA-B27 was positive in more than 80%of these cases;(2)The age in these cases was younger than that in the OCI cases;(3)About 1/3 of these cases were male,and most of the female were unmarried and nanparous;(4)Most of the cases were with the signs of sacroiliits;(5)? globulin/ ESR/CRP/alkali phosphatase were elevated in most cases.However,among OCI cases,the prevalence of HLA-B27 was similar to general population;all of the cases were female;most of them were pluripara,and few cases were with the signs of sacroiliitis or laboratory abnormalities.Conclusion In X-ray OCI,many cases might be early sacroiliitis.Attention should be paid to avoid misdiagnosis.