ObjectiveTo explore the role of parameters of organ function during heat stroke (HS) on the prognosis, and to form the treatment strategy through an analysis of parameters of organ function during HS. Methods A retrospective study was conducted. Thirty-seven patients with HS (HS group) and 54 patients with mild-to-moderate stroke (stroke group) admitted to Zhejiang Xiaoshan Hospital from 2011 to 2014 were enrolled. The experimental results of organs function indicators for patients were recorded including:① cardiac markers:troponin I (TnI);② myocardium zymogram: creatine kinase (CK), MB isoenzyme of creatine kinase (CK-MB), lactate dehydrogenase (LDH), and aspartate aminotransferase (AST);③ renal function indexes: blood urea nitrogen (BUN), uric acid (UA), and serum creatinine (SCr);④ electrolyte: serum K+, Na+, and Cl-;⑤coagulation function: prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (FIB), and D-dimer;⑥ blood gas analysis: pH value, arterial partial pressure of carbon dioxide (PaCO2), base excess (BE), standard bicarbonate (SB), and actual bicarbonate (AB);⑦ routine blood test: blood platelet count (PLT);⑧ hepatic function: alanine aminotransferase (ALT). Abnormal rates of laboratory parameters of 37 HS patients were statistically analyzed. Various laboratory parameters of organs function as well as the initial value and extreme value (maximum or minimum value) during treatment of CK and PLT in HS patients were compared between two groups.Results The abnormal rates of 37 HS patients were more than 70%, including incipient value of TnI, CK, LDH, AST, serum Na+, ALT, D-dimer, PaCO2, AB, maximum value of CK, and minimum value of PLT, the abnormal rates being 73.0%, 70.3%, 81.1%, 78.4%, 78.4%, 70.3%, 70.3%, 70.3%, 75.7%, 81.1%, 75.7%, respectively. The abnormal rates of other parameters were less than 70%. There were significant differences in incipient value of TnI, CK, LDH, AST, serum K+, serum Na+, D-dimer, and PLT between HS group and mild-to-moderate stroke group [TnI (μg/L): 0.087 (0.026, 0.306) vs. 0.007 (0.004, 0.110),Z = -7.017,P = 0.000;CK (U/L): 392.30 (287.60, 524.10) vs. 137.10 (106.33, 607.80),Z = -7.930,P = 0.000; LDH (U/L): 317.98±122.74 vs. 207.85±57.71, t = 1.678,P = 0.000; AST (U/L): 94.90 (52.80, 155.80) vs. 26.10 (18.13, 317.40),Z = -6.157, P = 0.000; serum K+ (mmol/L): 3.46±0.65 vs. 3.86±0.57,t = 1.662,P = 0.001; serum Na+ (mmol/L): 129.75±7.34 vs. 138.79±4.26,t = 1.674,P = 0.000; D-dimer (mg/L): 2.53 (0.63, 6.00) vs. 0.30 (0.21, 9.71),Z = -5.084, P = 0.000; PLT (×109/L): 144.62±86.14 vs. 219.48±64.76,t = 1.669,P = 0.000]. There were also statistically significant differences in the initial value and extreme value of CK and PLT between HS group and mild-to-moderate stroke group [CK (U/L): 392.30 (287.60, 524.10) vs. 721.50 (546.30, 964.10),Z = -6.351,P = 0.000; PLT (×109/L):132.40±82.55 vs. 68.24±44.62,t = 1.688,P = 0.000].Conclusions HS can impair several organs and systems, having complications, and it is a heavy insult for body. Increasing of CK and decreasing of PLT has some value to assess illness changes. It is helpful of laboratory results for doctors to estimate complications on time.

Objective To observe the effect of Xijiaodihuang decoction on the release of inflammatory mediators and prognosis in elderly patients with sepsis.Methods A prospective randomized controlled study was conducted. Seventy-four patients with sepsis admitted to the Department of Geriatrics of Changshu Hospital of Traditional Chinese Medicine (TCM) Affiliated to Nanjing University of TCM from March 2015 to February 2017, and they were divided into a TCM treatment group and a control group randomly, 37 cases in each group, there were 2 patients transferred to other department during the period of study to continue treatment, 2 patients discharged automatically and 1 case transferred to other hospital in the TCM treatment group; and there were 3 patients transferred to other hospital, 1 patient discharged automatically, 1 patient dead in 7 days after entering the control group and 1 patient transferred to other department during the period of observation to continue treatment in the control group. Finally, 32 patients were in TCM treatment group and 31 patients in the control group, completing the study. All patients in the two groups received conventional treatment of sepsis, patients in the TCM treatment group took Xijiaodihuang decoction 100 mL concentrated [rhinoceros horn (replaced with buffalo horn) 30 g, rehmannia root 24 g, peony 12 g, tree peony bark 9 g] taken orally or by nasal feeding, and patients in the control group received the same amount of normal saline, the two groups were treated 1 time a day for consecutive 7 days to complete 1 therapeutic course, then the treatment efficacy was evaluated in the two groups. The differences of serum interleukins (IL-1β, IL-6), tumor necrosis factor-α (TNF-α), white blood cells (WBC), C-reaction protein (CRP), lactate levels between the two groups were compared before treatment and on the 3rd, 7th and 14th day after treatment, the incidence of staying in intensive care unit (ICU), time of staying in ICU and 28-day mortality were also observed. The 28-day survival rate between two groups was analyzed by Kaplan-Meier survival curve.Results After treatment in the two groups, the levels of IL-1β, IL-6 and TNF-α had a tendency of increase at first and then decrease. After treatment for 14 days, the IL-1β was significantly lower in the TCM treatment group than that of the control group (ng/L: 83.27±21.84 vs. 96.73±26.33), the levels of IL-6 and TNF-α in TCM treatment group were obviously lower than those in the control group since 7 days after treatment [IL-6 (ng/L): 48.27±24.13 vs. 62.15±24.34, TNF-α (μg/L): 1.41±0.31 vs. 1.96±0.29]. IL-6 and TNF-α were still lower than those in the control group until 14 days after treatment [IL-6 (ng/L): 29.25±18.57 vs. 56.24±23.61, TNF-α (μg/L) 1.35±0.28 vs. 1.83±0.22, allP < 0.05]. There was no significant difference in WBC and CRP between the two groups before and after treatment (bothP > 0.05). After treatment, the lactate in the control group was gradually decreased, while in the TCM treatment group, the lactate level after treatment presented a tendency firstly decreased and then elevated, and after treatment for 3 days in TCM treatment group, the level of lactate began markedly lower than that in the control group (mmol/L: 1.26±0.43 vs. 2.01±0.59,P < 0.05). The ICU hospitalization rate and ICU length of stay in the TCM treatment group were significantly lower than those in the control group [56.25% (18/32) vs. 83.87% (26/31), (10.2±5.4) days vs. (13.5±5.8) days], and the 28-day mortality was also obviously lower in TCM treatment group than that in control group [9.37% (3/32) vs. 29.03% (9/31)]. Kaplan-Meier survival curve analysis showed that the 28-day survival rate in TCM treatment group was significantly higher than that in control group (P = 0.045).Conclusion Xijiaodihuang decoction can reduce the levels of IL-1β, IL-6, TNF-α and lactate in serum, reduce the incidence of staying in ICU, decrease the time of staying in ICU and improve the prognosis of elderly patients with sepsis.

Objective To investigate the differences in the safety of the operation of different hepatic vascular exclusion for liver surgery. Methods Sixty patients with liver resection were grouped by different hepatic blood flow blocking methods, and given pre-operative assessment prior to surgery. Results On the first day after surgery, the average levels of ALT and AST were (395.0 ± 220.2) U/L and (415.3±311.0) U/L in patients who received Pringle’s method (110.2±53.0) U/L and (125.6±78.5) U/L in patients who received regional hepatic vascular exclusion, (98.9±32.2) U/L and (96.2 ±66.5) U/L in patients who didn't receive hepatic vascular exclusion, respectively. Postoperative liver function damage was more serious in patients who received Pringle's method than patients who received regional hepatic vascular exclusion or patients who didn't receive hepatic vascular exclusion, the difference was statistically significant (P<0.05) .Conclusion Regional hepatic vascular exclusion or not can not only reduce the incidence of postoperative complications, but also expand the indications for liver resection.

Objective To observe the combined poisonous effects of fluoride and aluminum on sex hormone of male rats.Methods Sixteen weaned SD healthy male rats aged two week were selected and divided into control group,aluminum group,fluoride group,fluorine-aluminum group,four rats in each group.All rats in the experimental groups were fed with corn collected from the prevailng areas containing different fluorine contents respectively for 90 days.Serum testosterone(T)and estradiol(E2)were detected.Results Compared separatelv with the control group[(3.317±0.635)μg/L],serum T level of fluorine-aluminum group[(15.994±6.558)μg/L]was higher(P＜0.05),but aluminum[(8.134±3.134)μg/L]and fluorine[(1.868±0.367)μg/L]groups had no significant differences(P＞0.05).Compared separately with the control group[(0.319±0.072)nmol/L],E2 level of the fluorine group[(0.172±0.030)nmol/L]being lower(P＜0.05),and it was not significant differences(P＞0.05)in the control group when compared with aluminum group[(0.282±0.012)nmol/L],and fluorine-aluminum group[(0.265±0.047)nmol/L].Fluorine and aluminum interacted with each other(F=9.82,P＜0.05).Conclusion The combined poisonous effects of fluorine and aluminum may influence sex hormone levels of male rats.

OBJECTIVE The aim was to explore the clinical experiences and access the auditory performance and speech intelligibility of cochlear implantation in patients with inner ear malformations. METHODS Among 700 patients who received multi-channel cochlear implantation from 1997 to 2007 in Beijing Tongren Hospital, 108 patients were diagnosed with malformed inner ear. A retrospective study was performed about the surgical characteristics and the mapping characteristics after implantation. The long term follow-up of the rehabilitative efficacy will also be presented. RESULTS ①All patients restituted auditory after operation. ②After the regular rehabilitation, the long term follow-up of the auditory performance and speech intelligibility were very positive. Everyone has shown improved listening and communication skills evaluated by Categories of Auditory Performance and Speech Intelligibility Rating. ③Most of the children are studying or working and are actively involved in their local communities. CONCLUSION The cochlear implantation can be performed safely in patients with malformed inner ear. The results suggest that cochlear implantation could also provides long-term benefits to those malformed inner ear cases.

OBJECTIVETo discuss the clinical findings and treatment of paraneoplastic pemphigus (PNP) with Castleman's disease.

METHODSTo investigate the clinical, histopathologic and CT findings of 8 cases paraneoplastic pemphigus with Castleman's disease.

RESULTSAll of 8 patients were diagnosed PNP first and were found Castleman's tumor incidently during routine examination. All 8 cases showed severe erosion or ulcer of the oral mucosa with various skin lesions. Histopathologically, there were intraepidermal acantholytic vesicle, basal cell liquefaction, necrotic keratinocytes in the epidermis and lymphocyte infiltration in the upper dermis. CT scan appeared solitary mass in these patients. Some of them were attacked by bronchiolitis obliterans. All 8 patients were failed by use of predisone. Obvious relief of PNP and pulmonary lesion occurred after tumor was rescted.

CONCLUSIONSParaneoplastic pemphigus with Castleman's disease is a rare disease. The key step is to find and resect the tumor in abdomen. CT scan should be used to detect the tumor in patients with PNP, especially, when predisone was failed in treatment.

Adolescent ; Adult ; Castleman Disease ; complications ; diagnosis ; therapy ; Combined Modality Therapy ; Female ; Humans ; Male ; Paraneoplastic Syndromes ; complications ; diagnosis ; therapy ; Pemphigus, Benign Familial ; complications ; diagnosis ; therapy ; Retrospective Studies

Objective Analysis the epidemiological characteristics on rabies cases occurred in Guangxi from 2004 to 2008 and summarize the result of healthy-dog infection rabies virus investigation from 2006 to 2008.Exploring the high-occurrence and correlated factors on rabies in Guangxi.Methods Data collected from the National Disease Surveillance System and the National Active Surveillance System for Rabies from 2004 to 2008 and Data of healthy-dog infection rabies virus investigation from 2006 to 2008 were analyzed.Results The total rabies cases were 2463 in Guangxi from 2004-2008 and average incidence rate was 0.98 per 100 thousand per year.There were 95 counties had rabies case reported,anyway more than 10 cases occurred county number was declined while less than 5 cases rose year by year.The rabies case incidence area was expanded and the cases in middle and west area of Guangxi rose significantly.Rabies cases were reported whole year and no seasonal peak.Human rabies eases mainly were farmers,students and children.Yanger than 20 years old and elder 40 years old were the highest age groups in the population of the investigation,83.79% cases were attacked by dogs.78.5% cases classification category Ⅲ.83.17% cases had exposed on the upper and lower limbs,10.56% exposed to the head,face or neck.But 67.88% cases did not received any PEP and only 18.31% cases vaccinated and 3.63% category Ⅲ exposure cases combined administration of RIG.The incubation median was 60 days.The rabies virus infection rate among randomly collection healthy-dog brain samples from 2006 to 2008 was 1.92%,0.93% and 0.89%.Conclusion Unsuccessful and inadequate PEP of patients were the main factors leading to the high-occurrence of human rabies in Guangxi.And there axe a lot of infection rabies virus healthy-dogs alive in Guangxi also as a high-occurrence factor.

OBJECTIVETo study the nature of the residue hard tissue after liposuction in lipoma and its role in lipoma recurrence.

METHODSThe residue hard tissue after liposuction was collected for histologic study, including HE-staining and immunohistochemistry with antibody of stem cell marker (CD29 and CD44). The average density and area of positive cells were analyzed statistically.

RESULTSThe residue hard tissue had a medium hardness. The center tissue was light yellow surrounding by soft, loose, irregular and cord-like tissue. The normal fat tissue is light yellow with a soft and unanimous texture. HE-staining showed abundant stromas in residue hard tissue, with lots of fibroblast-like cells locating among adipocytes. The cytoplasm was less with large and blue-staining nucleus. In normal fat tissue, the fat cells were uniform which were round or polygon. The stromas was less and the fibroblast-like cells were comparatively less. The slices were stained with antibody (CD29, CD44) of stem cell marker. The density and area of positive cells were much more in residue hard tissue than those in normal adipose tissue. Two Independence Samples T test were as follows: (t'CD29 = 9.931, P = 0.000; (t'CD44 =10.171, P = 0.000 for density; and (t'CD29 = 7.761, P = 0.000; tt'CDRR = 6.639, P = 0.000 for area. The difference was significant.

CONCLUSIONSAbundant fibroblast-like cells that are signed by the marker of stem cells exist in residue hard tissue. Those cells are proven to be lipoma derived stem cells (LDSCs) which may play an role in lipoma recurrence after lipoma liposuction.

Adipocytes ; cytology ; pathology ; Adipose Tissue ; pathology ; Humans ; Lipectomy ; Lipoma ; pathology ; surgery ; Recurrence ; Stem Cells ; pathology

Objective To develop a magnetic resonance imaging (MRI) system for pelagic definitive treatment platforms, large support ships and ocean vessels.Methods The system was designed based on normal electromagnetic MRI technology, which was composed of six parts of gradient system, magnet system, coil system, radiofrequency system, spectrum control system and imaging system.The magnet system was developed with C-shaped open magnet,five systems were designed such as a super-stability excitation system, a super-sensitivity signal detection system, a magnetic filed dissipation precision control system, a shipborne sensitive equipment vibration control system and a software system, and a set of technical detection standards was proposed.Results The developed MRI system realized mobile imaging,gained advantages in imaging velocity,resolution,magnetic field dissipation control,ship bump resistance and environmental suitability,and thus could be used in marine mobile conditions. Conclusion The developed MRI system meets the requirements of pelagic medical treatment, and contributes to improving pelagic medical support ability of Chinese navy.

OBJECTIVETo investigate the clinical characteristics, surgical treatment and prognosis analysis of localized retroperitoneal Castleman disease (CD), and to improve the level of diagnosis and treatment of retroperitoneal Castleman disease with paraneoplastic pemphigus (PNP).

METHODSThe clinical data of retroperitoneal CD with PNP from January 1993 to May 2009 were compared with CD without PNP retrospectively, including clinical features, tumor site, lab examination, surgical treatment, pathologic subtype and results of surgery.

RESULTS(1) Retroperitoneal Castleman disease more likely originated in para-kidney and iliac fossa with middle age of 36 years old, especially in left retroperitoneum. Of the 20 cases, 18 tumors (90%) were hyaline vascular variants and 2 were mixed variants. There was no statistical difference in gender, age, tumor site and pathological subtype between two groups. (2) Retroperitoneal CD with PNP more likely complicated with bronchiolitis obliterans (BO) and high level of serum CEA/CA242. (3) Retroperitoneal Castleman tumors had clear margin, intact envelop and were easily resectable, however the biological behavior of CD with PNP might tend malignant changing, invade adjacent blood vessel or seed locally, and eventually relapse after operation. (4) The 5-year survival rate of retroperitoneal CD with PNP was 42.8%, significantly lower than those without PNP. The average survival time was 30 months. Bronchiolitis obliterans and radical resection were the key effect in prognosis of retroperitoneal CD.

CONCLUSIONSRetroperitoneal CD with PNP has distinctive clinical features. Early diagnosis, prompt removal of tumor and termination secretion of causative antibody are critical to the management of this disease.

Adolescent ; Adult ; Castleman Disease ; complications ; diagnosis ; therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Paraneoplastic Syndromes ; complications ; Pemphigus ; complications ; Prognosis ; Retroperitoneal Space ; Retrospective Studies ; Young Adult