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.

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

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

BACKGROUND:It is crucial for us to find an objective and sensitive means for the assessment ofthe severitv and development of dementia,so as to make instant diagnosis and examination of therapeutic effect on patientswith vascular dementias(VD).Event related potential endogenetic eomponent P300 is proved closely correlated with the cognitive management of examinees but not with stimulus property,thereby considered as one of the most valuable and objective index for brain superior psychological activity.OBJECTIVE:To study the role and significance of events related potential P300,providing objective basis for clinical diagnosis and therapeutic assessment for patients with VD.DESIGN:Non-randomized simultaneous controlled explorative study based on patients. SETTING:Neurological department and electromyography department in aprovincial hospital and neurological department in a medical college hospital.PARTICIPANTS:Between February 2000 and June 2001,64 patients were of VD at neurological clinic and ward ofthe Second Affiliated Hospital of Chongqing Medical College,including 38 males and 26 females with theaverage age of(66.0±4.6)years(VD group).Culturallevel:19 cases re-ceiyed over senior school education,31 cases of junior school education and14 cases of illiteracy.Meanwhile 60 inpatients without VD were enrolled(non-VD group)including 35 males and 25 females withthe average age of(68.0±3.7)years.Culturallevel:senior school or above,15 cases,junior school, 29 cases and illiteracy,16 cases.METHODS:Mental sate of both VD and non-VD groups were assessed with mini-mental state examination(MMSE),and tested with P300 potential observing the variability of latency and amplitude of P300 in patients.Both methods were compared between VD group and non-VD group, moreover relationship between P300 latency and MMSE scores was also explored.MAIN OUTCOME MEASURES:Variability of P300 latency and amplitude Relationship between P300 latency and MMSE scores.RESULTS:P300 latency was found prolonged in 74% and 7% of VD group and non-VD group respectively,with obvious significance between them,meanwhile prolonged P300 latency was proved closely correlated with the MMSE scores(r=0.609 6,P＜0.05).CONCLUSION:P300 latency can be considered as an obiective predictor for the earlier diagnosis and the assessment of therapeutic effects in patients with VD.

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

Background and Purpose:It has been proved that CD117 may be used as an immunology marker for diagnosis of leukemia of myeloid origin.The relationship between CD117 expression and effect of chemotherapy on the patients with Acute Nonlymphoblastic Leukemia(ANLL) remains unclear.This study is to investigate the relationship between CD117 expression and the response of patients with ANLL to chemotherapy.Methods:Flow cytometery(FCM) was used to detect the positive rate and the levels of CD117 expression of the bone marrow mononuclear cell(BMMNC) from 38 patients with acute lymphoblastic leukemia(ALL) and 81 patients with ANLL,respectively.All-trans Retinoic Acid(ATRA) was taken to treat M_(3) type of ANLL and protocol DA and/or HA was used to treat the other types.ANLL was divided into two groups: positive(+) and negative(-) expression of CD117.At the same time we compared the difference of rates of complete remission(CR) between CD117(+) and CD117(-) groups from ANLL after chemotherapy.Results:Positive percentage of expression of CD117 in ALL and ANLL groups were 13% and 70% respectively(P=0.000).Positive levels of CD117 decreased successively as follows: M_(3)/ M_(1)、M_(2)/ M_(6) / M_(4)、M_(5).CR rates of CD117(+) and CD117(-) groups of ANLL after chemotherapy were 51%(29/57) and 67%(16/24)(P=0.192),respectively.Conclusions:CD117 may serve as an immunology marker for the diagnosis of ANLL,but positive or negative expression of CD117 in ANLL was not associated with the response of the patients with ANLL to chemotherapy.