Objective To investigate the value of dialysis and ethics of withdrawal dialysis.Method Through analysis of some typical cases of ESRD patients,to investigate the value of dialysis.Conclusion A lot of ESRD patients can survive through dialysis,thanks to the improvement of medical science in last 30 years.On the other hand,it can also keep some patients with no living calculation surviving,becoming the burdensome of families,hospitals and societies.Our object is to discuss the ethics of withdrawal dialysis in our country.

Objective To study the sonographic features of papillary thyroid carcinoma (PTC) associated with cervical lymph nodes metastasis for early diagnosis and prediction of the invaded cervical lymph nodes. Methods The sonographic features of 170 patients with pathologically confirmed PTC in First Afifliated Hospital of Harbin Medical University between 2011 and 2013 were retrospectively reviewed. There were 59 cases with neck lymph nodes metastases and 111 cases without neck lymph nodes metastases. Receiver operating characteristic (ROC) curve was aaplied to analyze the cut-off values of resistance index (RI) and peak systolic velocity (PSV) for judging the presence or absence of cercical lymph node metastasis. The Chi-square test and rank sum test were used to compare the different sonographic features between each group. The Logistic regression analysis was used to obtain the relevant factors of PTCs with cervical lymph node metastasis. Results ROC curve analysis showed that the cut-off values of RI and PSV were 0.735,13.95 cm/s. The primary tumor diameter, the existence of halo, the involvement of thyroid upper pole, the microcalciifcation, the blood suply classiifcation and the RI, PSV were statistically signiifcantly different between PTCs with and without cervical lymph node metastasis, whereas no statistical signiifcance was detected between the primary tumor echo pattern, boundary and the longitudinal/transveral ratio between the metastatic and nonmetastatic group. Logistic regression analysis showed that the PTC primary tumor diameter and PSV were independent factors coorelated with cervical lymph node metastasis. Conclusion Some sonographic features of PTC are closely correlated with lymph nodes metastasis, which are valuable in predicting the cervical lymph nodes metastasis in patients with PTC pre-operatively.

Objective To explore the initial clinical and imaging characteristics of basal ganglia germinoma in children.Methods Four patients with basal ganglia germinoma were reported.Their clinical features,laboratory findings,radiological manifestations,treatment and outcome were analyzed.They recieved radiation therapy and chemotherapy after diagnosis.All patients were clinically diagnosed,according to the results of low-dose cranial irradiation.The outcomes were followed up for 2 years.Results All patients were male and school-aged(9-13 years) children.The course of the disease ranged from 5 to 13 months.All patients were presented with slowly progressive hemiparesis,and 2 cases of them were presented with cognitive decline and psychosis.Seizure occurred in 2 patients.The serum ?-human chorionic gonadotropin(?-hcG) level was significantly increased in 2 patients(30.16 IU/L and 77.85 IU/L,respectively),and mildly elevated in 1 patient(4.29 IU/L),while serum ?-hcG level in another case was within normal control range.MRI demonstrated mildly high intensity in the left or right basal ganglia on T1-weighted and T2-weighted images without remarkable occupying lesion.Ipsilateral hemiatrophy of the hemisphere and midbrain was also noted.Inhomogeneous Gd-DTPA enhancement was observed.All patients had been treated with radiation therapy and chemotherapy.During 2 years follow up,significant improvement was observed in all patients after therapy,imaging lesions disappeared and the elevated ?-hcG level of those elevated before therapy returned to normal.Conclusions Early diagnosis and treatment for basal ganglia germinoma are critically important to improve the prognosis.In young male patients with progressive hamiparesis,basal ganglia germinoma should be considered for differentiation,if abnormal high intensity signals in basal ganglia on T1-weighted and T2-weighted image with ipsilateral hemiatrophy of the hemisphere are demonstrated on MRI,even without occupying effect.

Objective This epidemiologic survey aims to investigate the changes in prevalence and risk factors for non-alcoholic fatty liver disease (NAFLD)in the elderly people who are living within Pudong San-lin region.Methods We retrospectively analyzed annual physical check-up data in 2012 and 2014 for elderly people living in this region (aged≥70years).Demographic variables including age,sex,blood pressure,body mass index (BMI)were recorded.Serum fasting glucose level was determined and liver and kidney function were assessed.Abdominal echo-Doppler examination was performed.NAFLD was diagnosed according to Chinese guideline on management of NAFLD (revised version).Results Among 2127 sub-jects with physical check-up in 2012,the occurrence rate of NAFLD was 27.46% (23.02% and 31.02%for men and women,respectively).Type 2 diabetes was detected in 224 subjects and 33.93% of them de-veloped NAFLD (26.73% and 39.84% for males and females,respectively).Among 1771 subjects who received physical check-up in 2014,the occurrence rate of NAFLD increased up to 32.29%,with NAFLD rate being 29.97% and 34.19% for men and women,respectively.In 185 subjects with type 2 diabetes, 49.19% developed NAFLD (47.56% and 50.49% for men and women,respectively).Thus,compared with the findings during physical check-up in 2012,the occurrence rate of NAFLD was significantly in-creased during physical check-up in 2014 for both male and female subjects of overall and diabetic popula-tions (P <0.05 for all comparisons).Further analysis showed that for 185 diabetic patients who had phys-ical check-up in 2014,systolic and diastolic blood pressures,BMI,and serum levels of fasting glucose lev-el,alanine aminotransferase,aspartate aminotransferase,total cholesterol,and triglyceride were significant-ly higher in patients with NAFLD than in those without NAFLD (all P <0.05).Multivariate regression a-nalysis revealed that BMI,total cholesterol and triglyceride levels were independent risk factors for occur-rence of NAFLD in diabetic patients.Conclusions This epidemiologic survey demonstrates a significant increase in the occurrence rate of NAFLD for the elderly people (especially with type 2 diabetes).Hyper-lipidemia,obesity,and hypertension are major risk factors for NAFLD in diabetic patients.

AIM: To observe the changes of cardiomyocytes after stimulation by TNF-?, IL-1?, LPS.METHODS: Cardiac ventricular myocytes were cultured in vitro. Different doses of TNF-?, IL-1?, LPS were added to stimulate the cardiomyocytes, the hypertrophy of cardiomyocytes 8 h, 24 h, and 48 h after stimulation was determined and the apoptosis were also observed 24 h, 48 h, 72 h after stimulation. RESULTS: Compared to the normal myocytes, the cardiomyocytes were hypertrophied after stimulation by 10 ?g/L, 15 ?g/L of TNF-?, 20 ?g/L, 100 ?g/L of IL-1? and 10 mg/L, 15 mg/L, 20 mg/L of LPS, and the effect was dose-dependent, the strongest effect was showed in 24 h. Moreover, 20 ?g/L of TNF-?, 100 ?g/L of IL-1? and 30 mg/L of LPS caused cardiomyocyte apoptosis, especially in 72h. CONCLUSION: TNF-?, IL-1?, LPS induced the cardiomyocyte hypertrophy and apoptosis, suggesting the inflammation may be the main cause of cardiovascular disease.

Bone Marrow Cells ; metabolism ; pathology ; CD28 Antigens ; blood ; metabolism ; CD4 Antigens ; blood ; metabolism ; CD4-Positive T-Lymphocytes ; metabolism ; Dendritic Cells, Follicular ; metabolism ; pathology ; Humans ; Immunoblastic Lymphadenopathy ; metabolism ; pathology ; Immunophenotyping ; methods ; Lymphoma, T-Cell ; metabolism ; pathology ; Neprilysin ; blood ; metabolism ; Receptors, Complement 3d ; blood ; metabolism ; fas Receptor ; blood ; metabolism

Objective To assess the new edition of WHO Japanese Encephalitis (JE) Surveillance Standards (WHO Standards) based on syndrome surveillance data and to provide field evidence regarding the standards. Methods Based on syndrome surveillance data, acute encephalitis syndrome (AES) case was categorized, according to the WHO Standards. A cohort study was applied to estimate the AES definition set in the Standard and relative risk was computed to estimate the existence and intensity of statistical correlation between AES and JE cases. Percentage of attributable risk was counted to describe the coverage of AES for JE cases in the studied population. Sensitivity,specificity, Youden index and positive predictive value of AES components were calculated for the purpose of identifying the clinical values under the screening program. Results 1424 suspected cases were evaluated in the surveillance program and 1396 cases with ELISA result, of which 109 positive cases were detected. According to the "standardized" classification, a total of 706 cases in line with AES case deftuition, were categorized into 83 cases of JE, 425 cases of AES unknown and 198 cases of AES other agent. In the cohort study,a relative risk of 4.62 (95% CI:2.80-7.63 ) and the percentage of attributable risk as 78.35% (95% CI: 64.25% -86.89% ) were observed. Conclusion The AES definition for JE was significantly effecting on the screening programs and a strong correlation strength was observed in the study. AES syndrome could cover most of the JE cases. "Convulsions",with appreciative screening value, was recommended to be involved into the new version of the WHO Standards.

OBJECTIVE: To search for the prevalence and a screening model for hearing impairment in the neonatal intensive care unit (NICU) infants. METHOD: Two-stage hearing screening program by automated auditory brainstem response (AABR) were used. A first test was performed as late as possible before discharge from the NICU. Those cases who failed the initial screening underwent a second test in an outpatient setting with an interval of one month. After a failure at the second screening, the infants were referred to our audiological center for further diagnostic evaluations within three months. RESULT: The subjects included were 824 infants who discharged from NICU between September 2007 and August 2008. Seventy newborns (8.5%) failed the pre-discharge AABR test. Of those, fifty-five (78.6%) received the second AABR screening after one month, and nine referred again. These nine babies were evaluated with additional diagnostic audiological tests. Three of them were eventually identified to have sensorineural hearing loss, and one was diagnosed as auditory neuropathy. The total prevalence of hearing loss was 0.48%. CONCLUSION Two-stage screening program of AABR may be an ideal model for hearing screening in NICU infants. The prevalence of hearing loss in our group is lower than that reported in the literature.
Evoked Potentials, Auditory, Brain Stem ; Female ; Hearing Disorders ; epidemiology ; prevention & control ; Hearing Tests ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Male ; Neonatal Screening ; Otoacoustic Emissions, Spontaneous ; Prevalence

Objective: To observe the efficacy of long-retaining scalp acupuncture plus interactive training in improving upper- extremity dysfunction in cerebral stroke patients. Methods: Ninety-five patients with upper-extremity dysfunction after cerebral stroke were randomized into two groups, with 48 cases in the treatment group and 47 cases in the control group. Conventional internal medicine treatment was offered to both groups. In both groups, Anterior Oblique Line of Vertex-temporal (MS 6, the middle 2/5) and Posterior Oblique Line of Vertex-temporal (MS 7, the middle 2/5) were selected from the same side of the brain lesion (the side apposing to the hemiplegic limb) for scalp acupuncture treatment. In the treatment group, the scalp acupuncture needles were retained for 7 h, in combination with interactive training, while the needles were also retained for 7 h in the control group but without interactive training. Prior to treatment and at 2-week and 4-week treatment, the two groups were scored using the functional test for the hemiplegic upper extremity-Hong Kong (FTHUE-HK) and simplified Fugl-Meyer assessment-upper extremity (FMA-UE). Results: The total effective rate was 97.9％ in the treatment group, higher than 74.5％ in the control group (P<0.01). The FTHUE-HK score was higher at 2-week and 4-week treatment than before treatment in both groups, presenting statistically significant intra-group differences (all P<0.001); the FTHUE-HK score was higher at 4-week treatment than at 2-week treatment in both groups, presenting statistically significant intra-group differences (both P<0.001). At 2-week and 4-week treatment, the FTHUE-HK score was higher in the treatment group than in the control group, showing significant between-group differences (both P<0.05). During the whole treatment process, the treatment group had higher FTHUE-HK scores compared with the control group, but there was no statistical significance comparing the change of the score between the two groups at 2-week treatment (P>0.05), while the between-group difference in the change of the score was statistically significant at 4-week treatment (P<0.05). The FMA-UE score was higher at 2-week and 4-weeks treatment than before treatment in both groups, presenting statistically significant intra-group differences (all P<0.001); the FMA-UE score was higher at 4-week treatment than at 2-week treatment in both groups, presenting statistically significant intra-group differences (both P<0.001). At 2-week and 4-week treatment, the FMA-UE was higher in the treatment group than in the control group, and the between-group differences were statistically significant (both P<0.01). The FMA-UE score rose gradually with the increase of treatment session, and there was statistical significance comparing the change of the score between the two groups at 2-week and 4-week treatment, respectively (both P<0.05). Conclusion: Long-retaining scalp acupuncture plus interactive training results in more significant efficacy than long-retaining scalp acupuncture alone in improving the upper-limb dysfunction after cerebral stroke and the advantage becomes more notable after 2-week consecutive treatment.

Based on the different permeability of DNA-intercalant dyes YO-PRO-1(YP) and propidium iodide (PI) to the membrane of viable, apoptotic and necrotic cells, cell samples were stained with 4?mol/L YP and 4?g/ml PI for 10 min, and the fluorescence intensity of both YP and PI were measured by fluorometer at Ex/Em wavelength of 485/538nm and 530/590nm, respectively. The correlation between YP fluorescence intensity and the apoptotic cell number was confirmed by fluorescence microscope and linear regression(r=0.999,P