In the acute phase of traumatic brain injury or cerebrovascular disease,disorders of hypothalamic-pituitary-cortical axis,hypothalamic-pituitary-thyroid axis and hypothalamic-pituitary-gonad axis may exist.The main cause is primary or secondary impairment of hypothalamus as well as pituitary after brain injury.Most of the variations of endocrine after acute brain injuries may be temporary and reversible,but some patients will accompany with hypopituitarism or neuroendocrine deficiency.It is important to set a guideline to decide who and when to test.Hormone replacement therapy should also be verified if it can improve the outcome of patients with brain injuries.

ObjectiveTo investigate the effect of age on long-term prognosis of patients with traumatic brain injury (TBI).Methods102 inpatients with TBI were evaluated by following-up, using Glasgow Outcome Scale (GOS), Functioning Item of Disability Rating Scale (DRS-F) , Employability Item of Disability Rating Scale (DRS-E) and Quality of Life Index (QLI).ResultsThe average age of 102 cases was 29.7±12.5. There were no significant differences among different groups in GOS and DRS-F (P>0.05), but the level of DRS-E or QLI showed much higher in <27 years old group than those in >45 years old group (P<0.01).ConclusionThe factor of age may affect the long-term prognosis of TBI, quality of life and employability of young patients are better than elder patients.

Objective To predict the occurrence of hypoparathyroidism following total thyroidectomy. Methods In this study, 124 patients underwent total thyroidectomy, 46 for thyroid cancer and 78 for multinodular goiter, additional neck dissection was performed on cancer patients. Serum calcium and parathyroid hormone (PTH) levels were examined preoperatively and at 1 h, 1 d and 2 d postoperatively. The occurrence of postoperative hypoparathyroidism was observed. Receiver operating characteristic curve analysis was employed to identify the best indicator to early predict the occurrence of clinical hypocalcemic symptoms. Results Fifty-eight (46.8%) patients suffered from postoperative transient hypoparathyroidism, with 22 ( 47. 8% ) cases in thyroid cancer group and 36 ( 46. 2% ) in multinodular goiter group ( λ2 = 0. 033, P = 0. 857). One (0.8%) patient in cancer group had permanent hypoparathyroidism. 90 patients (72.6%) had postoperative hypocalcaemia, 58 (46. 8% ) had subnormal serum PTH levels, 40 (32. 3% ) had hypocalcaemia symptoms. Postoperative serum calcium (F=21. 358,P =0. 000) and PTH ( F = 18.253, P =0.000) levels decreased more in cancer group than in goiter group.Receiver operating characteristic curve analysis demonstrated that the percentage of serum PTH level decline at 1 h postoperatively was most predictive and 76. 6% decline was the best cut-off value for the occurrence of clinical hypocalcaemia symptoms ( area under the curve being 0.933 ) with a sensitivity of 89. 7% and a specificity of 87.9%. Conclusions Neck dissection added to total thyroidectomy can decrease the postoperative serum calcium and PTH levels more seriously, but may not increase the incidence of postoperative transient hyperparathyroidism. The percentage of serum PTH level decline at 1 h postoperatively predicts the occurrence of clinical hypocalcaemia symptoms.

Objective:To study expressions of CD117 and CD34 in the patients with acute promyelocytic leukemia(APL,M3) and in M1-M2 subtype from FAB classification for acute leukemia(AL).The focus of the study would be laid on the clinical significance of CD117/CD34 co-expression in the patients of M3 subtype.Methods:Researched cases of acute nonlymphoblastic leukemia(ANLL) were divided into two groups:M1-M2 subtype and M3 subtype.Flow cytometery(FCM) was used to detect the rates of positive expression of CD117 and CD34 on bone marrow mononuclear cell(BMMNC) in 54 patients of M3 and 63 patients of M1-M2 subtype respectively.Meanwhile,we compared the differences between the rates of expression of CD117 and CD 34.And,the rates of CD117/CD34 co-expression in patients of M1-M2 subtype and M3 subtype were studied.Results:Our results revealed that the positive rates of CD117 expression in M1-M2 subtype and M3 subtype were 71.4%(45/63) and 66.7%(36/54) respectively(P=0.58).The positive rates of CD34 expression in M1-M2 subtype and M3 subtype were 66.7%(42/63) and 11.1%(6/54) respectively(P=0.000).The positive rates of CD117/CD34 co-expression in M1-M2 subtype and M3 subtype were 71.1%(45/63) and 7.4%(4/54) respectively(P=0.000).Conclusion:CD117 may be used as immunology marker for leukemia of myeloid origin.CD34 had lower expression in M3 subtype than in M1-M2 subtype.The positive rate of CD117/CD34 co-expression in M3 subtype was significantly lower than that in M1-M2 subtype,which can help for diagnosis of M3 subtype and help differentiate M3 subtype from M1-M2 subtype as well.

Background Currently,the recommendation when treating acute biliary or pancreatic disease during pregnancy is to perform endoscopic retrograde cholangiopancreatography (ERCP) without radiation exposure,either empirically (with no radiographic guidance) or with ultrasound guidance.However,few published studies compared these two ways.This study aimed to compare ultrasound-guided ERCP with the procedure without radiographic guidance in the treatment of acute pancreaticobiliary disease in pregnant patients.Methods The clinical data of 68 pregnant patients with acute pancreaticobiliary disease admitted to our hospital between January 2004 and May 2010 were reviewed retrospectively.ERCP was performed without radiographic guidance in 36 cases (group A) and with ultrasound guidance in 32 cases (group B).Data on the following variables were compared between the two groups:surgical success rate,rate of complete stone removal,time to resolution of clinical manifestations and laboratory indicators,length of hospital stay,complications,outcome and differences in efficacy of ERCP during different stages of pregnancy.Results In group A,the rates of surgical success and complete removal of stones were 69％ and 60％,respectively; the corresponding values were 91％ and 89％ in group B (P ＜0.05).Postoperatively,clinical manifestations improved rapidly in all patients; there was no statistically significant difference between the groups (P ＞0.05).Leukocyte counts and liver function had improved significantly after one week in all patients; they recovered more quickly in group B ((8.64±1.83)days vs.(14.57±3.74) days,(14.29±4.64) days vs.(20.00±5.40) days,P ＜0.01).The hospital stay was shorter in group B ((16.28±7.25) days vs.(28.00±6.83) days,P＜0.001).The complication rate was 14％ in group A and 3％ in group B (P ＜0.05).There were no significant differences between the two groups in the procedure's efficacy during different stages of pregnancy.Conclusions In the treatment of acute pancreaticobiliary disease during pregnancy,ultrasound-guided ERCP is safer and more effective than performing the procedure empirically without radiographic guidance when performed by experienced practitioners.Its more widespread use is recommended.

Adenocarcinoma ; metabolism ; secondary ; surgery ; Carcinoembryonic Antigen ; metabolism ; Carcinoma, Hepatocellular ; metabolism ; secondary ; surgery ; Colectomy ; Colonic Neoplasms ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Humans ; Keratin-18 ; metabolism ; Liver Neoplasms ; metabolism ; secondary ; surgery ; Male ; Middle Aged ; alpha-Fetoproteins ; metabolism

Adult ; Boronic Acids ; therapeutic use ; Bortezomib ; Combined Modality Therapy ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; POEMS Syndrome ; therapy ; Pyrazines ; therapeutic use

Objective To investigate whether Tumor Necrosis Factor-alpha (TNFα) is capable of activating Rho kinase pathway which leads to smooth muscle cell proliferation and the intervention function of Rosuvastatin, and clarify the mechanism and intervention manner of anti-atherosclerosis by Rosuvastatin. Methods Wistar neonate rat smooth muscle cells were cultured, and the activity of cell proliferation was determined by methyl thiazolyl tetrazolium (MTT). The expression of Rho kinase genes after the stimulation of TNFα was evaluated by RT-PCR. Western blot method was used to measure the protein expression of proliferating cell nuclear antigen (PCNA) after TNFα stimulation and Rosuvastatin intervention in smooth muscle cell. Results The TNFα stimulation significantly enhanced the expression of Rho kinase and increased the expression of PCNA protein in smooth muscle cells (P < 0.05). These effects were positively correlated with prolonged treatment whereas additional Rosuvastatin administration inhibited the above-mentioned effects (P < 0.05). Conclusions The activation of TNFα mediated Rho kinase signaling pathway can significantly promote smooth muscle cell proliferation, and Rosuvastatin can not only inhibit this pathway but also the induced proliferation.

Objective To evaluate the effectiveness of transcatheter arterial chemoembolization(TACE) combined with radiofrequency ablation(RFA) and TACE combined with 125I interstitial brachytherapy in the treatment of primary hepatocellular carcinoma(HCC) and to compare the results of the two therapies.Methods Fifty patients with HCC underwent TACE and RFA during laparotomy and 34 patients received TACE and radioactive 125I particle seeding.Four weeks after the procedure,dynamic enhanced CT or MR scanning was performed for a check.If the lipiodol deposit was poor,TACE was repeated.Follow-up check was made at regular intervals to observe the results.Results One month after the treatment,the local control rate of the tumor for TACE +RFA and TACE + 125I particle seeding combination therapy was 98.0% and 97.1%,respectively.No statistically significant difference existed between the two therapies.Conclusions Both TACE combined with RFA or with 125I particle seeding are effective therapies for HCC,which can be regarded as an ideal alternative therapy for patients who have failed to respond to TACE alone.

Cells, Cultured ; Fibroblasts ; cytology ; drug effects ; metabolism ; Humans ; Lung ; cytology ; metabolism ; Macrophages, Alveolar ; metabolism ; Matrix Metalloproteinase 2 ; metabolism ; Matrix Metalloproteinase 9 ; metabolism ; Silicon Dioxide ; toxicity ; Silicosis ; metabolism