Hepatic eosinophilic granuloma is a rare benign liver lesion,which results from granuloma formation due to chronic inflammation.Two patients were admitted to the Yantaishan Hospital and Yuhuangding Hospital from July 2008 to April 2012,respectively.The results of laboratory examination showed the elevation of peripheral blood eosinophils,and ultrasound examinations revealed low-echo masses in the liver and no blood flow was detected.The results of computed tomography showed hypoattenuation lesions with well-demarcated boundary.After intravenous administration of contrast angent,the lesions demostrated delayed heterogeneous enhancement with internal grid.The results of magnetic resonance imaging of 1 patient showed the lesion had slight hyper-intensity to the surrounding liver parenchyma on T1-weighted images,and slight high signal with low signal separation strip inside on fat-suppressed T2-weighted images.An obvious high signal was detected in diffusion weighted imaging.Familiarity with the imaging characteristics and combination of the elevation of peripheral eosinophil can help surgeons to make a suggestive diagnosis.

Objective To evaluate the relevance and accuracy of fibrinogen (Fib) detection by using PT-der assay and Von-Clauss assay on Sysmex CA-1500 Automated Coagulation Analyzer .Methods PT-der assay and Von-Clauss assay on Sysmex CA-1500 Automated Coagulation Analyzer were employed to detect the plasma Fib concentrations of 755 blood samples .The dilution ratios of samples with high Fib concentration were 1∶8 ,2∶7 ,3∶6 ,4∶5 ,5∶4 ,6∶3 ,respectively .The dilution ratios were served as the abscissa ,and the Fib concentrations measured by two methods as the ordinate ,a simple linear regression analysis was per-formed .Results When Fib concentration was in 2 .0- <6 .0 g/L ,the Fib value obtained by Von-Clauss assay was higher than that by PT-der assay(P<0 .01) .When Fib concentration was below 2 .0 g/L or above 6 .0 g/L ,the Fib value obtained by PT-der assay was higher than that by Von-Clauss assay(P<0 .01) .The linear regression equations of PT-der assay and Von-Clauss assay were Y=4 .537 7X+1 .551 3(R2 =0 .897 3) ,Y = 7 .792 2X+ 0 .290 0(R2 =0 .980 5) ,respectively .Conclusion Von-Clauss assay can better reflect the Fib level of human body which has a blood clotting function .

Objective To investigate the distribution characteristics of serum hepatitis B virus (HBV) markers of population in hospital and to provide the basis for prevention and control of virus B hepatitis .Methods 11 210 people in hospital who had accepted HBV serological testing were enrolled ,and were divided into >0 -25-year old group(n=3 553) and >25 -50-year old group(n=7 651) according to their ages .Enzyme-linked Immunosorbent Assay(ELISA) and Roche Cobas E601 Automatic Electro-chemiluminescence immunoassay analyzer were employed to detect serum HBV surface antigen (HBsAg ) ,anti-HBV surface anti-body(HBsAb) ,HBV e antigen(HBeAg) ,anti-HBV e antibody(HBeAb) and anti-HBV core antibody(HBcAb) .Results HBsAg positive rates of subjects in > 0 -25-year old group and > 25 -50-year old group were 16 .16% and 21 .19% ,respectively .The overall positive rates of HBsAg and HBsAb and full-negative rate were 19 .59% (2 195/11 204) ,37 .02% (4 148/11 204) and 11 .84% (1 327/11 204) ,respectively .Conclusion Distribution characteristics of HBV markers of population in hospital may pro-vide a reliable basis for taking effective protective and control measures against virus B hepatitis .

Objective To evaluate the surgical effect of laparoscopic anterior resection of rectal carcinoma with or without the left colic artery.Methods Through computer searching PubMed,Cochrane Library,Embase,WanFang Date and CNIK Date.Handsearching the Gray literature simultaneously.The randomized controlled trails and clinical controlled trials comparing low ligation with high ligation the inferior mesenteric artery in laparoscopic anterior resection of rectal carcinoma were colected.Data were screened,extracted and evaluated by two reviewers independently.Meta-analyses were conducted using the sofeware STATE12.0.The standardized mean difference were calculated for continuous data and odds ratio for dichotomous and the point estimates of each effect quantity and 95％ confidence interval were calculated.TheI2 test was used to test the heterogeneity of the inchuded literature:if the heterogeneity was small,the fixed effects model was adopted.otherwise,the random effects models was adopted and explored the heterogeneity by sensitivity analysis or subgroup analysis.Results Forteen articles including 15 researches were met the selection criteria.The Meta-analyses showed that the grope of low ligation had lower rate of anastomotic fistula (OR =0.394,95 ％ CI:0.251-0.616,P =0.000) and longer opration time (SMD =0.361,95％CI:0.242-0.480,P =0.000).There is no statistical differences in the number of lymph node dissection besides the root of IMA (SMD =-0.017,95％ CI:-0.130-0.097,P =0.772) intraoperative biood loss (SMD =0.083,95 ％ CI:-0.048-0.214,P =0.213).Conclusions In spite of reserved the left colic artery had longer operation time it can reducedrate of anastomotic fistula effectively and there is no statistical differences in the number of lymph node dissection besides the root of IMA,intraoperative blood loss.It is possible to promote the use of reserved the left colic artery in laparoscopic anterior resection of rectal carcinoma.

Objective To examine the association between child-supporting from their folks and elder abuse in China so as to provide evidence for prevention and control of elder abuse.Methods Based on the third survey on the Status of Chinese women,organized by the All-China Women's Federation and the National Bureau of Statistics,7 159 residents aged 65 and older were included and general information on supporting child and elder abuse were gathered.Chi-square test and logistic regression were used to investigate the association between supporting child from elderly and elder abuse.Results The overall prevalence of elder abuse was 6.71％.Risks of elder people being abused by family numbers varied from different supporting child situations.After adjusting for potential confounding factors,ORs for the elderly appeared as follows:OR=1.99 (95％CI:1.56-2.54) for those who only providing support to male children;OR=2.07 (95％CI:1.51-3.79) for those only providing support to the female offspring and OR=2.32 (95％CI:1.72-3.13) for those who did not support their children regardless of their sex identity.Elderly who provided support to their children on both sexes were exposed to lower risk of being abused than those who only supporting their male offspring.There was no significant difference appearing on the risk of elder abuse between those elderly who only supporting the male (OR=1.00) or the female offspring (OR=1.04,95％ CI:0.63-1.71),among all the participants in our study.However,such associations were different in urban and rural areas.Conclusions High prevalence of abuse was seen in China.The pattem of supporting child was associated with risk of elder abuse.Elderly who showed poor support to their children were under higher risk of being abused by their family members.

ObjectiveTo assess the effects of constraint-induced movement therapy(CIMT) on sub-acute stroke patients with upper extremity motor dysfunction.Methods63 patients with hemiplegia after stroke were divided into two groups: control group(31 cases) and CIMT group(32 casese). The two groups received the regular rehabilitation training for 14 d. Then the control group went on the the regular rehabilitation training, while the CIMT group received CIMT for 14 d. All patients were assessed by the Action Research Arm Test(ARAT) and Fugl-Meyer(FMA) on the first day, the 15th day and the 30th day after the treatment.ResultsARAT score and FMA scores were higher in CIMT group than in the control group 30 d after the treatment and in CIMT group 15 days after the treatment(P<0.001).ConclusionCIMT is more effective to improve the upper limb motor function of the sub-acute stroke patients than the regular rehabilitation training.

Objective: To assess the relationship between hemoglobin A₁c (HbA₁c) and hemorrhagic cerebral infarction (HI) in patients with acute cerebral infarction. Methods: From January 2014 to June 2016, in the Lianyungang Hospital Affiliated to Xuzhou Medical University, 426 patients with acute anterior circulation infarction were included. The blood sugar status before stroke was expressed by HbA₁c. HbA₁c and fasting blood glucose (FBG) were measured on the second day after admission. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the severity of neurological function at admission. The modified Rankin scale (mRS) was used to evaluate the prognosis at discharge. CT or MRI/SWI examination was performed to determine whether there was HT. Logistic regression was used to evaluate the risk factors for HT and short-term prognosis after cerebral infarction. Results: Of the 426 patients enrolled, 93 (21.8%) appeared HT, 60 (14.1%) had hemorrhagic cerebral infarction (HI) and 33 (7.7%) had parenchymal hemorrhage (PH). Multivariate analysis showed that HbA₁c and infarct volume were independent predictor of HT. When patients were grouped according to fasting blood glucose (FBG<7.8 mmol/L or ≥ 7.8 mmol/L), the predictive effect of HbA₁c on HT was found in both groups. In multiple Logistic regression analysis, HbA₁c was also a predictor of poor prognosis after stroke (OR=1.482, 95% CI 1.228 -1.788). Conclusions In patients with ischemic stroke, elevated HbA₁c is independently associated with post-infarction HT, and this result doesn′t change even in patients with well-controlled blood glucose. HbA₁c is also a predictor of poor prognosis after stroke. These findings are important for blood glucose management in patients with diabetes and acute anterior circulation infarction.

Objective To investigate the target blood pressure level of restrictive fluid resuscitation in patients with traumatic hemorrhagic shock. Methods Sixty patients with traumatic hemorrhagic shock admitted to the First Affiliated Hospital of Bengbu Medical College from January 2016 to December 2018 were enrolled. All patients were resuscitated with sodium acetate ringer solution after admission. According to the difference of mean arterial pressure (MAP) target, the patients were divided into low MAP (60 mmHg ≤ MAP < 65 mmHg, 1 mmHg = 0.133 kPa), middle MAP (65 mmHg ≤ MAP < 70 mmHg) and high MAP (70 mmHg ≤ MAP < 75 mmHg) groups by random number table using the admission order with 20 patients in each group. Those who failed to reach the target MAP after 30-minute resuscitation were excluded and supplementary cases were deferred. The restrictive fluid resuscitation phase was divided into three phases: before fluid resuscitation, liquid resuscitation for 30 minutes and 60 minutes. The most suitable resuscitation blood pressure level was further speculated by monitoring the inflammatory markers and hemodynamics in different periods in each group of patients. Pearson correlation analysis was used to detect the correlation of variables. Results Before fluid resuscitation, there was no significant difference in hemodynamics or expressions of serum cytokines among the three groups. Three groups of patients were resuscitated for 30 minutes to achieve the target blood pressure level and maintain 30 minutes. With the prolongation of fluid resuscitation time, the central venous pressure (CVP), cardiac output (CO) and cardiac index (CI) were increased slowly in the three groups, and reached a steady state at about 30 minutes after resuscitation, especially in the high MAP group and the middle MAP group. The expressions of serum inflammatory factors in the three groups were gradually increased with the prolongation of fluid resuscitation time. Compared with the low MAP group and the high MAP group, after 30 minutes of resuscitation the middle MAP group was superior to the other two groups in inhibiting the expressions of pro-inflammatory factors tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and promoting anti-inflammatory factors IL-10 [TNF-α mRNA (2-ΔΔCt):0.21±0.13 vs. 0.69±0.34, 0.57±0.35; IL-6 mRNA (2-ΔΔCt): 0.35±0.31 vs. 0.72±0.39, 0.59±0.42; IL-10 mRNA (2-ΔΔCt): 1.25±0.81 vs. 0.61±0.46, 0.82±0.53; all P < 0.05], but there was no significant difference in promoting the expression of IL-4 mRNA among three groups. At 60 minutes of resuscitation, compared with the low MAP group and the high MAP group, the middle MAP group could significantly inhibit the expressions of TNF-α, IL-6 and promote IL-10 [TNF-α mRNA (2-ΔΔCt): 0.72±0.35 vs. 1.05±0.54, 1.03±0.49; IL-6 mRNA (2-ΔΔCt): 0.57±0.50 vs. 1.27±0.72, 1.01±0.64; IL-10 mRNA (2-ΔΔCt): 1.41±0.90 vs. 0.81±0.48, 0.94±0.61; all P < 0.05]. Compared with the high MAP group, the middle MAP group had significant differences in promoting the expression of IL-4 mRNA (2-ΔΔCt: 1.32±0.62 vs. 0.91±0.60, P < 0.05). There was no significant difference in serum cytokine expressions at different time points of resuscitation between the low MAP group and the high MAP group (all P > 0.05). Correlation analysis showed that there was a strong linear correlation between MAP and mRNA expressions of TNF-α, IL-6, IL-10 in the middle MAP group (r value was 0.766, 0.719, 0.692, respectively, all P < 0.01), but had no correlation with IL-4 (r = 0.361, P = 0.059). Fitting linear regression analysis showed an increase in 1 mmHg per MAP, the expression of TNF-α mRNA increased by 0.027 [95% confidence interval (95%CI) = 0.023-0.031, P < 0.001], IL-6 mRNA increased by 0.021 (95%CI = 0.017-0.024, P < 0.001), and IL-10 mRNA increased by 0.049 (95%CI = 0.041-0.058, P < 0.001). Conclusions When patients with traumatic hemorrhagic shock received restrict fluid resuscitation at MAP of 65-70 mmHg, the effect of reducing systemic inflammatory response and improving hemodynamics is better than the target MAP at 60-65 mmHg or 70-75 mmHg. It is suggested that 65-70 mmHg may be an ideal target MAP level for restrictive fluid resuscitation.

Objective:To investigate the relationship between serum uric acid (SUA) and 3-month outcomes in patients with acute ischemic stroke undergoing intravenous thrombolysis.Methods:A total of 386 patients with acute ischemic stroke received intravenous thrombolysis therapy from 1 January 2017 to 31 December 2019 in the Affiliated Hospital of Lianyungang, Xuzhou Medical University were enrolled prospectively. The National Institute of Health Stroke Scale (NIHSS) was used to evaluate the severity of stroke. The functional outcome was evaluated by the modified Rankin Scale at discharge or 3 months after onset. Pearson′s correlation was used to assess the relationship between SUA and NIHSS scores at baseline and discharge. Propensity score matching was used to balance confounding factors. Multivariate logistic regression model was used to identify the correlation between SUA and prognostic outcome after thrombolysis.Results:A total of 386 eligible patients were included. Two hundred and thirty patients (59.6%) had good outcomes in the follow-up after 3 months. The levels of SUA are negatively associated with the NIHSS score at discharge ( r=-0.171, P=0.003). A positive correlation was observed between the levels of SUA and the difference of NIHSS at baseline and discharge ( r=0.118, P=0.032). Patients were divided into three groups according to the quartile of SUA. Multivariate logistic regression analysis showed that high SUA levels were independently associated with good outcome three months after stroke ( OR=0.421, 95% CI 0.327-0.541, P<0.001). Conclusion:In patients with acute ischemic stroke, elevated SUA levels can predict better recovery and short-term outcomes in patients undergoing intravenous thrombolysis.

Objective:To evaluate the predictive value of anthropometric indicators in predicting cardiovascular risk in the population with metabolic syndrome(MS).Methods:A cross-sectional study was used to analyze the correlation between anthropometric measures and cardiovascular risk in subjects with MS. Cardiometabolic risk was assessed with cardiometabolic risk index(CMRI). Receiver operating characteristic(ROC) curve analysis was used to assess the predictive power of anthropometric measures for cardiometabolic risk.Results:(1) The anthropometric measures [body mass index(BMI), waist-hip ratio(WHR), waist-to-height ratio(WtHR), body fat percentage(BFP), visceral fat index(VFI), conicity index(CI), a body shape index(ABSI), body roundness index(BRI), abdominal volume index(AVI)] in the MS group were significantly higher than those in the non-MS group( P<0.05). Moreover, there were significant differences in CMRI score and vascular risk between the two groups( P<0.05). (2) Logistic regression analysis showed that the cardiovascular risk was increased with the increases of BMI, VFI, WHR, WtHR, CI, BRI, and AVI after adjusting for confounding factors in the overall population, the non-MS population, and the MS population( P<0.05). (3) In the ROC analysis, the AUC values of BMI, VFI, and AVI were 0.767, 0.734, and 0.770 in the overall population; 0.844, 0.816, and 0.795 in the non-MS population; 0.701, 0.666, and 0.702 in the MS population, respectively. For the overall population and non-MS population, the optimal cut points of BMI to diagnose high cardiovascular risk were 26.04 kg/m 2 and 24.36 kg/m 2; the optimal cut points of VFI were 10.25 and 9.75; the optimal cut points of AVI were 17.3 cm 2 and 15.53 cm 2, respectively. In the MS population, the optimal cut point as a predictor of high cardiovascular risk in young and middle-aged men with MS was 27.63 kg/m 2, and the optimal cut point of AVI in women was 18.08 cm 2. Conclusion:BMI, VFI, and AVI can be used as predictors of cardiovascular risk in the general population. BMI can be used as a predicator of high cardiovascular risk in young and middle-age men with MS. AVI can be used as a predicator of high cardiovascular risk in women with MS.