40/h) and non-severe group(n=15,AHI 5-40/h).Anthropometric measurements,fasting plasma glucose,insulin,blood fat,and CT quantitative measurement of abdominal adipose tissue were recorded. Results Insulin resistance index(HOMA-IR) in patients with OSAS was related to hypoxia independently of obesity variables.The severe group was characterized by more serious metabolic disorders and higher prevalence of metabolic syndrome than the non-severe group.OSAS was positively associated with an increased metabolic disorders risk for the severe group versus the non-severe group(OR=8.8).Using the receiver operating characteristic(ROC) curve analysis,waist circumference had the greatest areas under the ROC curves compared with body mass index and neck circumference.The results of multiple stepwise regression of lowest pulse oxygen saturation(LSpO2)during overnight sleep indicated that neck circumference followed by epworth sleepiness score(ESS) entered the equation(P

OBJECTIVE: To explore the changes and rules of biochemical markers in serum of guinea pigs after death caused by hypothermia and to provide references for fatal hypothermia diagnosis by serum biochemical markers. METHODS: Twenty guinea pigs were randomly divided into experimental group and control group. The guinea pigs in the experimental group were kept at -30 °C until death, while the ones in control group were decapitated after same survival intervals at 25 °C. The serum was extracted from the whole blood of right ventricular immediately. Subsequently, a series of serum biochemical markers were analyzed by auto bio-chemical analyzer. RESULTS: The levels of glucose, uric acid, creatinine and urea nitrogen in the experimental group were significantly higher than those in control group, respectively (P<0.05). Compared with the control group, the levels of total protein and albumin were significantly lower in the experimental group (P<0.05). There were no significantly differences of the levels of other markers such as serum enzymes and ions observed between the two groups. CONCLUSION There are characteristic changes of some specific serum biochemical markers in fatal hypothermia, which may be potentially useful for auxiliary diagnosis of fatal hypothermia.
Animals ; Biomarkers/blood* ; Cause of Death ; Guinea Pigs ; Hypothermia

OBJECTIVETo evaluate the therapeutic effect of imatinib on chronic myeloid leukemia (CML) in different phases and analyze the factors that may affect the effects.

METHODSEighty-five patients with CML in chronic phase, 24 in accelerated phase and 19 in blastic phase patients were treated with imitinib. The hematologic response, cytogenetic response, molecular response, overall survival (OS), progression-free survival (PFS) and adverse events were analyzed in these groups.

RESULTSThe rates of complete hematologic response (CHR), complete cytogenetic response (CCyR) and complete molecular response (CMoR) of the patients in chronic phase were 100%, 82.4% and 21.2%, respectively, and the 5-year OS and PFS of these patients were 92.1% and 84.7%. All these rates were significantly higher than those in patients in accelerated and blastic phases (P<0.0001). The CCyR, CMoR, 5-year OS and PFS in the 42 newly diagnosed patients in chronic phase were 92.9%, 26.3%, 100% and 95.2%, respectively, all significantly higher than those in patients with interferon therapy failure (P<0.001). Severe leukocytopenia and thrombocytopenia occurred at greater frequencey in AP and BP patients than in chronic phase patients (P<0.0001). Non-hematologic toxicity was rarer and milder in patients in chronic phase. Multivariate analysis showed that interferon therapy prior to imitinib treatment and prolonged drug cessation were the independent factors that affected the achievement of cytogenetic response and PFS.

CONCLUSIONEarly imitinib therapy can be effective and safe, and should be used as the first line drug for CML.

Antineoplastic Agents ; therapeutic use ; Benzamides ; Female ; Humans ; Imatinib Mesylate ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; drug therapy ; Leukemia, Myeloid, Chronic-Phase ; drug therapy ; Male ; Piperazines ; therapeutic use ; Pyrimidines ; therapeutic use ; Treatment Outcome

Gastroesophageal reflux disease(GERD) is pronouncedly increased among obese population due to the incompetence of anti-reflux barrier resulting from adiposity.While lifestyle changes, medications and anti-reflux surgery have limited effects, bariatric surgery is the best treatment for GERD in patients with obesity. Roux-en-Y gastric bypass is an ideal procedure and sleeve gastrectomy can also be accepted as an option despite its controversy over GERD.Besides, some combination surgeries have emerged to be worth attempts. In case of the postoperative reflux, causes for that should be found and treated. Revisional surgery can be performed when it is necessary.

BACKGROUND: Local soft tissue lysis has been widely used in clinical rehabilitation treatment of chronic soft tissue injuries, and has achieved certain clinical outcomes. However, it is an invasive treatment, and there is little information about the pathological changes and prognosis of the local tissues post-treatment. OBJECTIVE: To observe the repair process and pathologic changes of the muscles after local soft tissue lysis with several needles. METHOD:Songjin-needle,Yinzhi-needle,Changyuan-needle,Xiaozhen-needle,Ren-needle and Pi-needle were inserted into the belly of rat gastrocnemius gastrocnemius with a depth of 0.5-1.0 cm, twice or thrice. Then the rats were killed at 3, 7, 14, 21 and 30 days after acupuncture. The corresponding parts of tissues were removed and fixed with paraformaldehyde, and stained with hematoxylin and eosin and immunohistochemistry to observe the histomorphological features and pathological changes under light microscope. The CellSens-Entry 1.15 software was used for image acquisition, and the number of fibroblast cells and microvessel density were calculated. The integral absorbance values of collagen type Ⅰ were calculated by Image Pro plus 6 software. RESULTS AND CONCLUSION: On day 3 after intervention, muscle fiber dissolution, necrosis and inflammatory cell infiltration were visible. On day 7, there was a reduction in inflammatory cells, fibroblast activation and proliferation, and granulation tissue hyperplasia. On day 14, there was local accumulation of collagen with substantial granulation tissues. On day 21, collagen fibers decreased and granulation tissues organized. On day 30, there was local scar formation. Immunohistochemical staining results showed that there was collagen type Ⅰ in the surgical area after intervention. The microvessel density, fibroblast count and integral absorbance value increased firstly and then decreased, which showed significant differences among groups (P < 0.01). These findings imply that the new types of needles for local soft tissue lysis do certain damage to the gastrocnemius muscle, and the inflammatory changes of the local tissue and granulation tissue organized will result in local scar formation after loosening therapies.

Objective To determine factors affecting postoperative survival of elderly patients with hepatocellular carcinoma (HCC). Methods A retrospective analysis of consecutive 54 elderly patients undergoing hepatectomy for hepatocellular carcinoma from Jan 1995 to Dec 2002 was performed. The data were analyzed by Kaplan-Meier method and Cox regression. Results Univariate analysis and Cox regression showed Child Pugh grading, vessel invasion, satellite nodule formation, Edmondson Steiner grading, intrahepatic recurrence and distant metastasis all related to postoperative overall survival or disease-free survival of the elderly with hepatocellular carcinoma (all P

Background The incidence of retinal vascular diseases increase annually,such as diabetic retinopathy,retinopathy of prematurity and age-related macular degeneration.The key of treatment for these diseases is how to evaluate retinal vascular change effectively and objectively.Retro-orbital injection of fluorescein isothiocyanatedextran (FITC-dextran) is a simple and effective method for observing C57BL/6J mouse retinal vessels.But,whether it is suitable for other mice and rats is seldom reported.Objective This experiment was to assess the feasibility of the observation of retinal vessels by retro-orbital injection of FITC-dextran in different genus of mouse and offer the reference for relevant study.Methods Twelve animals of C57BL/6J mice,Kunming mice,SD rats and Wistar rats were selected,respectively and divided into the experimental group and control group at average.The right eyes of the animals of the experimental group received the retro-orbital injection of 9 ml/kg FITC-dextran,and the right eyes of animals of the control group received PBS solution at the same volume and way.All the animals were sacrificed 10 seconds after injection and both eyes of each animal were obtained for retinal stretched preparation.The retrobulbar tissue and whole-mount retina were viewed under a fluorescence microscope.The use of the animals complied with Regulation for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results Retinal blood vessels labeled by FITC-dextran could be observed in both eyes of C57BL/6J mice and Kunming mice to present with a green fluorescence in experimental group under a fluorescence microscope,but no any fluorescence-labeled retinal blood vessel was exhibited in the control mice.The retinal blood vessel could not be observed in all eyes of SD rats and Wistar rats after the injection of FITC-dextran both in the experimental group and the control group under a fluorescence microscope.The surrounding tissues of the right eyes of mice and rats dyed with green fluorescence of FITC-dextran in the experimental group,however,green fluorescence could not be seen in the surrounding tissues of the left eyes of mice and rats.Conclusions Retro-orbital injection of FITC-dextran is a suitable method of observing the retinal vessels of mouse but not rat.

Objective To explore the value of dual-phase contrast-enhancement multislice computed tomography (MSCT) in the assessment of acute myocardial infarction volume and perfusion in porcine models. Methods The distal left anterior descending coronary arteries of 5 pigs were balloon-occluded for 90 min and followed by reperfusion. MSCT was performed 1 min (early phase) and 5 min (delayed phase) after administration bolus of 100 mL of iodinated contrast material 30 min after reperfusion. On the same day, hearts were excised, sectioned in 8 mm short-axis slices, and stained with TTC. Infarction volume was defined as the sum of the hyper-enhanced area and surrounding hypo-enhanced area in all slices on delay enhanced phase of MSCT and the TTC-negative area on TTC staining slices. Infarction volume was expressed as percentage of total slice volume. Results Acute infarction detected by MSCT was characterized by early myocardial perfasion defects in the early phase of the contrast bolus (early defects) with surrounding residual defects and late enhancement observed in the late phase. Mean CT attenuation value of early defects was significantly different from CT attenuation value of remote myocardium [(213±55)HU vs (304±30)HU](P < 0.05), CT attenuation values of residual defects and late enhancement were also significantly different from those of remote myocardium [(360±75) HU vs (90±37) HU and (152±23) HU vs (190±37) HU, repectively](P < 0.01, P < 0.05). The mean infarction volume was (8.9± 1.0)% on MSCT and (9.2±1.4)% on TTC pathology images. The infarction volume assessed by MSCT compared well with TTC staining slices. Conclusion Acute reperfused myocardial infarction zone has specific enhancement pattens different to remote normal zone on dual phase MDCT, which is in good agreement with in vivo Trc pathology in the assessment of acute reperfused myocardial infarction shortly offer reperfusion.

The combination use of dexamethasone and calcium gluconate can be applied to hypersensitivity. Severe hypokalemia is a usual complication of dexamethasone and calcium gluconate therapy, which occurs frequently with therapeutic use. Fatal cases, accidental and intentional, occur frequently in forensic practice. The current case report presented a 43-year-old man with diabetes mellitus with infection, to whom dexamethasone and calcium gluconate were administered in the private clinic. With the development of such clinical symptoms of severe hypokalemia as quadriplegia, he was confirmed to have severe hypokalemia through a biochemical test before dying of arrhythmia. And also it presented pathophysiologic mechanism underlying severe hypokalemia as well as suggestions for clinical practice regarding combination use of dexamethasone and calcium gluconate.
Adult ; Anti-Inflammatory Agents/adverse effects* ; Calcium Gluconate/adverse effects* ; Dexamethasone/adverse effects* ; Diabetes Mellitus ; Fatal Outcome ; Humans ; Hypokalemia/chemically induced* ; Male

Postmortem chemistry is becoming more and more essential in routine forensic pathology and has made considerable progress over the past years. Biochemical analyses of vitreous humor, blood, urine and cerebrospinal fluid may provide important information in determining the cause of death or in elucidating forensic issues. Postmortem chemistry may be essential for the determination of cause of death when morphological methods (diabetes mellitus, alcoholic ketoacidosis and electrolytic disorders) cannot detect the pathophysiological changes involved in the death process. It can also provide many information in other forensic situations, including myocardial ischemia, sepsis, inflammation, infection, anaphylaxis and hormonal disturbances. The most recent relevant research advances on glucose metabolism, liver function, cardiac function, renal function, sepsis, inflammation, infection, anaphylaxis and hormonal aspect are hereby reviewed.
Anaphylaxis ; Autopsy/trends* ; Biomarkers/analysis* ; Body Fluids/chemistry* ; Death ; Diabetes Mellitus ; Forensic Pathology/methods* ; Humans ; Postmortem Changes ; Sepsis ; Vitreous Body