Objective To detect the distribution of cerebral microbleeds (CMBs) in patients with lacunar infarction (LI) and/or leukoaraiosis (LA) and to analyze the correlation between the CMB related risk factors and cognitive impairment.Methods Thirty-eight patients with LI and/or LA were divided into either a CMB group or a non-CMB group according to the findings of susceptibility weighted imaging.The number of CMB lesions was recorded.Mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) were used to conduct cognitive function tests,and the patients were also divided into a cognitive impairment group and a non-cognitive impairment group according to the MoCA scores.The demographic and clinical data in each group were compared.The independent risk factors for CMBs and cognitive impairment were identified.Results Thirteen patients had 58 CMBs in the CMB group.Their distributions were as follows:36 CMBs in basal ganglia and thalamus,14 in cortical and subcortical regions,3 in brain stem,and 5 in cerebellum.There were 25 patients in the non-CBM group,26 in the cognitive impairment group,and 12 in the non-cognitive impairment group.There were significant differences in age and the proportions of hypertension,taking antithrombotic drugs and the patients with LA between the CMB group and the non-CMB group (all P ＜ 0.05).Multivariable logistic regression analysis showed that only age was an independent risk factor for CMBs (odds ratio 1.103,95％ confidence interval 1.034-1.454; P =0.045).MMSE (26.92±2.87vs.29.00± 1.44; t=2.452,P=0.027) and MoCA (21.62±3.36vs.25.04 ± 2.59; t =-3.493,P =0.001) scores in the CMB group were significantly lower than those in the non-CMB group.There was only significant difference in the number of CMBs between the cognitive impairment group and the non-cognitive impairment group (2.08-± 3.64 vs.0.33 ±0.78; t =-1.629,P =0.010).Multivariate logistic regression analysis showed that only the number of CMBs was an independent risk factor for cognitive impairment (odds ratio,1.534,95％ confidence interval 1.100-2.576; P=0.046).Spearman rank correlation analysis showed that the number of CMBs was significantly negatively correlated with the MoCA language (r =-0.229,P=0.003) and the delayed recall (r =-0.332,P=0.042) scores.Conclusions In patients with LI and/or LA,CMBs were correlated with age.Their existence and number were associated with cognitive impairment.

Antineoplastic Agents ; therapeutic use ; Colorectal Neoplasms ; drug therapy ; genetics ; metabolism ; Genes, ras ; genetics ; Humans ; Lung Neoplasms ; drug therapy ; genetics ; metabolism ; Molecular Targeted Therapy ; methods ; Mutation ; Neoplasms ; drug therapy ; genetics ; metabolism ; Pancreatic Neoplasms ; drug therapy ; genetics ; metabolism ; Proto-Oncogene Proteins ; genetics ; metabolism ; Proto-Oncogene Proteins p21(ras) ; Receptor, Epidermal Growth Factor ; drug effects ; metabolism ; Signal Transduction ; ras Proteins ; genetics ; metabolism

Infection is an essential factor in chronic wound disunion. With the increasing number of patients with chronic diseases in the aging society, the number of patients with chronic wounds increases. It caused a heavy social burden. The proper cleaning method and cleaning fluid play a key role in chronic wound healing. In this paper, the concepts, classification, mechanism of different cleaning fluids, and their effects on chronic wounds were reviewed, which is expected to help health professionals to choose cleaning methods and cleaning fluids scientifically. It was supposed to provide significant guidance for chronic wound cleaning.

Objective To explore the intrinsic link between neuro-endocrine-immune (NEI) network and the viscera-state.Methods Using three databases namely TCM database, Chinese pharmacy database and combination of TCM and WM database in China Academic Journals Database, the authors searched and collected NEI-related indicators published on journals for the viscera-state researches. Then a related database was established for data mining. Through analysis of association rules, analysis of the relationship among diseases, syndromes, therapeutic principles, combination of disease and syndrome, and NEI network related indicators were performed for association rules and directional network diagrams.Results Through the association analysis, the authors drew 44 directional network diagrams of high-frequency disease positions, syndromes, therapeutic principles and NEI network related indicators, and obtained 19 association rules. Kidney and liver essence research focused on HPG axis, HPA axis, and HPT axis. Spleen essence research focused on brain-gut peptide related indicators. Heart essence research focused on vascular endothelium function indicators. Pulmonary essence research focused on humeral immunity, ET and TNF-α.Conclusion It was feasible to explore the intrinsic link between NEI network and the viscera-state by using data mining. Differences among study on NEI network of five-organs systems were found, which is of great significance for researches on the essence of the viscera-state.

Objective To analyze drug resistance of pathogenic bacteria from the blood culture and distribution in clinical departments,and to guide the rational clinical drug use.Methods We retrospectively analyzed 11 275 samples of blood cultures in The Central Hospital of Wuhan from 2012 to 2014.The blood specimens were cultured by VersaTREK(USA).The pathogenic bacteria were identified and their drug resistance was analyzed by BD-PHOENIX 100 automicrobiological identification systems(USA).Results Among the 11 275 blood cultures,636 bacterial strains were detected.The top four bacterial strains were Escherichia coli,Staphylococcus aureus,Klebsiella pneumonia and Enterococcus f aecium.A vancomycin-resistant Enterococcus faecium strain and a pandrug-resistant Klebsiella pneumoniae strain were detected.The top three clinical departments with distribution of pathogens were Gastroenterology Department,Nephrology Department and Intensive Care Unit (ICU).Pathogens isolated from ICU were evenly distributed.Conclusion Distributions of pathogenic bacteria in the blood culture are different in clinical departments.Identification of pathogenic bacteria and result of drug susceptibility can reduce use of broadspectrum antimicrobials and enhance antimicrobial de-escalation.

Adult ; Cerebrospinal Fluid Rhinorrhea ; Female ; Humans ; Sphenoid Sinus ; pathology

APACHE ; Adult ; Female ; Humans ; Male ; Organophosphate Poisoning ; Young Adult

Objective To explore the histopathological features of 850 patients with esophageal malignant tumor in 10 years.Methods From January 2002 to January 2012, 850 patients diagnosed with esophageal malignant tumor were enrolled.Tumor location, general type, pathological type and TNM stage were retrospectively analyzed.All the data were described as case number and percentage.Results Among the 850 cases of esophageal malignant tumor, 33 lesions (3.9％) located in the neck segment of esophagus, 119 lesions (14.0％) located in the upper segment, 44 lesions (5.2 ％) located in the upper-middle segment, 409 lesions (48.1％) located in the middle segment, 123 lesions (14.5 ％) located in the middle-lower segment, 122 lesions (14.4％) located in the lower segment.Among the 724 eases clearly diagnosed as esophageal malignant tumor by general type, the most cases were ulcer type (305 cases, 42.1％), followed by medulla type (260 cases, 35.9％), fungating type (80 cases, 11.0％) and constrictive type (70 cases, 9.7％), and the least cases were intraluminal type (nine cases, 1.2％).Among the 850 cases of esophageal malignant tumor, squamous cell carcinoma (794 cases, 93.4 ％) was the most common cytological type, followed by small cell carcinoma (19 eases, 2.2％), and the least common cytological type was adenocarcinoma (seven cases, 0.8 ％).Among the 724 cases with clear TNM staging, case number of Tis, T1, T2, T3 and T4 stage was eight (1.1％), six (0.8％), 271 (37.4％), 278 (38.4％) and 161 (22.2％), respectively.Among the 122 cases of distal esophageal carcinomas (104 cases with clear TNM staging), most cases were squamous cell carcinoma (112 cases, 91.8 ％), the others cases were adenocarcinoma (three cases, 2.5 ％), small cell carcinoma (three cases, 2.5 ％), basaloid squamous cell, adenosquamous, neuroendocrine carcinomas and carcinosarcoma (one case in each type, 0.8％).Conclusions Esophageal carcinoma was mostly located in the middle segment of in which squamous cell carcinoma was predominant while adenocarcinoma was less common.Esophageal cancer located at lower segment of esophagus is with a wide range of pathological spectrum, squamous cell carcinoma was still dominant, however, esophageal adenocarcinoma is rare.

Objective To explore the relation between clinical-pathological features,Siewert classification and prognosis of esophagogastric junction (EGJ) carcinoma,and to assess the applicability of the new edition of American Joint Committee of Cancer (AJCC) staging guideline on EGJ adenocarcinoma in China.Methods From 2002 to 2012,the clinical data,pathological features,treatment and prognosis of 218 patients with EGJ malignant tumor were retrospectively analyzed.The patients were typed according to Siewert classification criteria and each case was staged according to 7th edition of AJCC TNM staging criteria for esophagus adenocarcinoma and gastric cancer.Kaplan-Meier method and Log-rank test were performed for survival analysis.Results According to the Siewert classification,type Ⅰ was rare (nine cases,4.1％),type Ⅱ was the most common type (150 cases,68.8％) and followed by type Ⅲ (59 cases,27.1％).There was no significant difference in survival curve among the three types (P＞0.05).The survival curve was drawn according to 7th edition of AJCC TNM staging criteria for esophagus adenocarcinoma.In T staging,the prognosis of patients at T4b was better than that of patients at T4a,the prognosis of patients at ⅡB was better than that of patients at ⅡA.The survival curve of patients at Ⅲ C obviously crossed with that of patients at Ⅳ,which was not in conformity with clinical results.The survival curve was drawn according to 7th edition of AJCC staging criteria for gastric cancer.In T staging,the survival curve of patients at Tis was overlapped with that of patients at T1a.The survival rate of patients at ⅡB could not be accurately predicted by the overall staging.In general,the survival of patients with EGJ carcinoma was better predicted according to 7th edition of AJCC staging criteria for gastric cancer than 7th edition for esophagus adenocarcinoma.Conclusions Neither 7th edition of AJCC staging criteria for esophagus adenocarcinoma nor for gastric cancer could accurately predict its prognosis.In our country,EGJ malignant tumor was similar to gastric cancer and had specific clinical-pathological features.It is necessary to research and establish EGJ carcinoma staging criteria instead of applying the current staging criteria for esophagus adenocarcinoma or gastric cancer.

Purpose To establish Logistic regression model of gallbladder lesions of≥1 cm in diameter diagnosed by ultrasound, and to filter benign and malignant sonographic features. Materials and Methods The sonographic features were retrospectively analyzed in 165 patients with gallbladde apophysis lesions of≥1 cm in diameter which confirmed by pathology, including the number of lesions, size, shape and basal width, gallstones, continuous gallbladder wall continuous, blood flow signals detected by color Doppler flow imaging. Logistic regression model with bipartition was established by multivariate Logistic regression analysis, and the efficiency of Logistic regression model was evaluated to predict benign or malignant of these lesions. Results Three characteristic variables, including lesion morphology, basal width and flow signals, were took into the Logistic regression model by binary Logistic regression analysis, which was the sensitive indicators can differentiate the benign or malignant gallbladder lesions. The accuracy, sensitivity and specificity of this model were 97.0%, 93.8%and 97.3%for predicting the benign or malignant gallbladder apophysis lesions≥1 cm in diameter, respectively. Area under ROC was 0.979. Conclusion Binary Logistic regression analysis can filter the sonographic features which can differentiate the benign or malignant gallbladder apophysis lesions≥1 cm in diameter, and lesion morphology, basal width and flow signals are of important differential diagnosis value of benign lesions or malignant lesions.