Cardiomyopathies ; diagnosis ; Carnitine ; deficiency ; Humans ; Hyperammonemia ; diagnosis ; Infant, Newborn ; Male ; Muscular Diseases ; diagnosis

Objective To investigate the efficacy and toxicity of conventional fractionated three-dimensional conformal radiotherapy (3D-CRT) on unresectable hepatocelluar carcinoma(HCC).Methods Fifty two patients with unresectable HCC,all without extrahepatic metastases,were treated by 3D-CRT conducted 5 times a week with the total radiation dose of 36-66 Gy and a daily dose of 2 Gy.The curative effect was evaluated by CT scan to observe the maximum tumor size.Survival rates,survival time,and adverse responses were recorded.Results The total effective rate of the 52 patients was 69.2％ with complete response (CR) in 2 patients and partial response (PR) in 34 patients.The incidence rate of radioactive hepatitis was 1.92％.The 1-,2-,3-,and 4-year survival rates were 57.7％,34.6％,23.1％,and 9.61％ respectively,and the median survival time was 10.5 months.The 1-,2-,3-,and 4-year local control rates were 67％,51.5％,32.3％,and 2.24％,and the 1-,2-,3-,and 4-year distant metastasis rate were 17.2％,23.5％,36.7％,and 76.9％ respectively.The intrahepatic metastases rate was 62.5％ and 37.5％ of the patients suffered from extrahepatic metastasis,including metastases of lung,bone,and retroperitoneal lymph nodes.The remission rate of the≥50 Gy group was 76.9％,significantly higher than that of the ≤50 Gy group (46.2％,x2 =10.72,P ＜ 0.05 ).There was no grade 3 or 4 acute toxicity,and two patients (3.84％) developed gastric or duodenal ulcer.Conclusions Conventional fractionaled 3D-CRT evokes a rather effective response for unresectable HCC with acceptable toxicity.Radiation dose seems to be a significant prognostic factor in RT response for HCC.

Objective To purify Shiga toxin Ⅱ (STX Ⅱ) of enterohaemorrhagic Escherichia coli (EHEC) O157: H7 by affinity chromatography, and characterize its biological function. Methods The immno-affinity chromatography column was prepared by STX Ⅱ A subunit-specific antibody S1D8 coupling to Sepharose 4B matrix. The purity and specificity of STX Ⅱ molecule secreted by EHEC O157:H7 were detected by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western blot, respectively. The purified toxin was serially diluted and the toxic activities to Vero cell line and mice were observed. The 50% cytotoxic dose (CD50) for Vero cell line and 100% lethal dose (LD100) for mice were calculated. The protection effect of anti-STX Ⅱ polysera to the mice against the purified toxin challenge was also observed. Results STX Ⅱ was successfully purified from culture supernatant of EHEC O157:H7 using affinity chromatography scheme. The relative molecular weights of STX Ⅱ A and B subunits were 32 000 and 7 500 confirmed by SDS-PAGE, respectively. The purified toxin could react with monoclonal antibodies against STX Ⅱ A and B subunits, respectively.The toxin was cytotoxic to Vero cell with CD50 of 20 ng/L and lethal to mice with LD100 of 5 ng.The toxin could be neutralized by anti-STX Ⅱ polysera in vivo. Conclusion STX Ⅱ is successfully purified and its toxic effects are confirmed in both cell line and mouse model.

OBJECTIVETo analyze the complications of percutaneous kyphoplasty except bone leakge for the treatment of osteoporotic thoracolumbar vertebral compression fractures.

METHODSFrom October 2008 to October 2012,178 patients with 224 osteoporotic vertebral compression fractures were treated with percutaneous kyphoplasty under local anethsia. There were 72 males and 106 females,ranging in age from 58 to 92 years old,with an average of 75.3 years,including 93 thoracic vertebrae and 131 lumbar vertebrae. The complications except bone cement leakage were analyzed during operation and after operation.

RESULTSAll operations were successful and all patients were followed up from 12 to 60 months with an average of 26.2 months. No death was found. Bone cement leakage occurred in 27 cases, about 15.1% in 178 cases; and complications except bone cement leakage occurred in 15 cases. There was 1 case with cardiac arrest,was completely recovery by cardiopulmonary resuscitation (CPR) immediately; and 1 case with temporary absence of breathing,was recovery after treatment. There were 3 cases with fall of blood pressure and slower of heart rate; 1 case with intestinal obstruction; 2 cases with local hematoma and 1 case with intercostal neuralgia. Vertebral body fractures of 2 cases were split by bone cement and the fractures of adjacent body occurred in 4 cases.

CONCLUSIONIt's uncommon complication except bone cement leakge in treatment of osteoporotic thoracolumbar vertebral compression fractures with percutaneous kyphoplasty. The complication of cardiopulmonary system is a high risk in surgery; and cytotoxicity of bone cement,nervous reflex,fat embolism and alteration of intravertebral pressure may be main reasons.

Aged ; Aged, 80 and over ; Female ; Fractures, Compression ; surgery ; Humans ; Kyphoplasty ; adverse effects ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Osteoporotic Fractures ; surgery ; Postoperative Complications ; etiology ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; surgery

OBJECTIVE: To seek a precise method for estimating postmortem interval (PMI) in forensic medicine practice. METHODS: This study detected the concentration of 21 elements in the vitreous humor of rabbit within 96 hours after death and explored the relationship between their concentration and PMI using the method of ICP-MS. RESULT: It was shown that the concentration of 9 elements in vitreous humor of rabbit within different intervals after death were correlated to PMI available as a reference indicator to estimate PMI. CONCLUSION The changes in the concentration of certain elements in vitreous humor of vitreous humor are correlated with PMI and determination of such changes can be used to estimate the time of death.
Animals ; Calcium/analysis* ; Forensic Medicine ; Iron/analysis* ; Magnesium/analysis* ; Postmortem Changes ; Potassium/analysis* ; Rabbits ; Time Factors ; Vitreous Body/chemistry*

OBJECTIVE: To seek a exact method of estimating postmortem interval (PMI). METHODS: This study detected the concentration of zincum(Zn) and nickel(Ni) in vitreous humor of rabbit at hour 96 after death and explored the relationship between their concentration and PMI using a method ICP-MS. RESULTS: The concentration of Zn and Ni in vitreous humor of rabbit at hour 24 after death were related to PMI significantly; The formulae of the relationship between PMI and Zn concentrations is y = 0.1404x2 - 1.3351x + 3.8298 (within 24 h; R2 = 0.9202). The formula of the relationship between PMI and Ni concentrations is y = 0.0043x2 - 0.0596x + 0.2665(within 24 h; R2 = 0.9103). CONCLUSION The concentration of Zn and Ni in vitreous humor of rabbit may be a reference indicator to estimate early PMI.
Animals ; Female ; Forensic Medicine ; Male ; Nickel/analysis* ; Postmortem Changes ; Rabbits ; Time Factors ; Vitreous Body/chemistry* ; Zinc/analysis*

Objective To investigate the clinical features and neuroimaging features of patients with osmotic demyelination syndrome (ODS).Methods The clinical features and examination results ,including the clinical manifestations,the data of cranial MRI/CT,changes of EEG,treatment and prognosis,were analyzed in 4 patients with ODS.Results All the 4 patients had the history of hyponatraemia.The common clinical manifestations included psychiatric disorder,altered consciousness,dysphasia,dysphagia,quadriplegia and dystonia.Severe transient abnormal EEG was found in these patients,and all the brain CT scanning and CSF were negative.MRI features could only be noted 10 d after the appearing of clinical manifestations and all the first time MRI was negative in these 4 patients.Four patients were diagnosed as having extrapontine myelinolysis,showing symmetrical low T1-weighted signal and high T2-weighted signal within the pons,the basal ganglia,the thalami,the insular cortex and the hippocampal head.Three patients were also diagnosed as having central pontine myelinolysis,showing symmetrical T1 low signal and T2 high signal in the basilar part of pons; much clear imaging could be noted with the help of weighing the abnormal signals.Three patients got improvement with 1 having dystonia sequel.Conclusion ODS is correlated with chronic hyponatraemia,and both hypokalaemia and hypochloremia may be the 2 possible triggers; when they appear,quick correction is not needed.MRI features may be significantly delayed,thus,repeated imaging study is necessary.

Objective To discuss the microsurgical treatment of anterior communicating artery (ACoA) aneurysms at acute stage vit the supffontal approach. Methods Thirty-two patients with ruptured ACoA aneurysms,admitted to our hospital from January 2007 to October 2010 and underwent mierosurgery through supfrontal approach, were chosen in our study; their clinical manifestations,surgical methods and treatment efficacy were retrospectively analyzed. Results All 32 ACoA aneurysms in these 32 patients were clipped successfully.Forty-two aneurysm clips were used during the surgery; intraoperative aneurysm rupture occurred in 7 patients (21.88％). According to scores of Glasgow Outcome scale after 6-12 months of follow-up,26 patients (81.25％) enjoyed good results,5 (15.63％) had moderate disability and 1 (3.13％) had severe disability; no patients died,and no patients were having intracranial infection, having cerebrospinal leak or under vegetative state. Conclusion Microsurgical operation of anterior communicating aneurysms via subfronal approach was an effective and rapid method with minimal exposure and reliable neck clipping.

OBJECTIVETo investigate an effective method to facilitate the physical and mental recovery of drug abusers in detoxification restoration period.

METHODSIntegrated interventions were adopted to observe the changes in the physical and mental conditions of female drug abusers who had withdrawn drugs.

RESULTSComparing behavioral changes between the two groups before and after intervention, we found that changes of score in the intervention group were all higher than those in the control group in terms of their physical symptoms or state of anxiety.

CONCLUSIONIt is necessary to help drug abusers understand the harm of drug-abuse, build up self-confidence and improve EQ through interventions. It will be beneficial for the drug addicts to refrain from drug-taking and regain a normal life. Our study has proved that positive results can only be obtained from integrated intervention projects.

Adult ; Anxiety ; Counseling ; Female ; Humans ; Self Concept ; Substance Abuse Treatment Centers ; Substance-Related Disorders ; psychology ; therapy

Objective To find out the relationship of ecological environment protection and the transmission of Lyme disease under economic development of western regions in China.Methods Both scene molecular and traditional epidemiological methods were used to assess the effects of environmental protection on the transmission of Lyme disease.Results Among areas as protected natural forests,semiprotected nursery forests and farmland,the vector tick species and reservoir rodents from protected natural forests area had the highest quantity of population and diversity index and followed by semi-protected nursery forests.Vector competence of reservoir hosts and value of natural foci from protected natural forests area were also remarkably higher than those areas of semi-protected nursery forests and farmland. Staff working in the areas who were bitten by ticks from protected natural forests areas had higher serological Dositive rate(66.7%)than those from semi-protected nursery forests areas(2.5%),and both showed remarkable difference(P=6.45,E-11＜0.01,df=1).The difference of genetic divergence among these subpoPulations from different habitats being surveyed showed that the biggest genetic divergence index (Fst)of 0.557 42 was between protected natural forests area and farmland area.The index between semiprotected nursery forests area and farmland area was also bigger than zero with statistical significance.The genetic divergence index of 0.108 02 between semi-protected nursery forests area and protected natural forests area was the lowest which showed that genetic divergence between the subpopulations of the two sampling areas was not obvious.The genetic distance among these subpopulations had similar change along with their habitats.Conclusion Under economic development of western regions in China,when programs as natural forests protections,recovery prairie and grassland from farmland were actively performed,vectors insects and reservoir hosts of Lyme disease might also be protected to some degree but the risk and value of natural foci on Lyme disease might increase.Data suggested that people entering these areas should be told to strengthen their awareness on individual protection against the disease.