Objective To investigate major causes of chronic diseases and death from 2004 to 2006 in Gang Za district of Nan Tong city. Methods According to ICD-10, the data of diseases were coded and classified. Mortalities were accounted. Results The crude mortality of the whole crowd was for 754.26 / 100 000, and standardized mortality was for 419.47 / 100 000. The crude mortalities of chronic diseases (malignant tumor, cerebrovascular disease, respiratory system, cardiac disease and endocrine system disease) were for 208.97 / 100 000, 151.79 / 100 000, 114.17 / 100 000, 101.38 / 100 000, 16.55 / 100 000, and standardized mortalities were for 77.73/ 100 000, 56.14 / 100 000, 50.28 / 100 000, 9.19 / 100 000. The percent of death was 78.60%. The standardized mortalities of malignant tumor, cerebrovascular disease and endocrine system disease were in the up trend. Conclusions It is clear that malignant tumor, cerebrovascular disease,respiratory system, cardiac disease were the most important causes of death. Health education and effective prevention should be strengthened in order to reduce the mortality of chronic diseases.

Objective: Through treatment based on differentiation of symptoms and signs and classification of defi nited patients of maternofetal blood group incompatibility, detecting anti-A or Anti-B antibody and erythrocyte immune complex chaplet rate(RICR) and erythrocyte receptor chaplet rate(RC3bR) , etc, to observe the therapeutic effect and mechanism of prescriptions mainly with Yinchenhao Decoction. Methods: Patients definited maternofetal blood group incompatibility were divided into control group and observation group according to random principle in 1:3 ratio. Then, observation group was divided into moist heat group(SRG), moist heat and defi ciency of spleen qi group (SR+PQXG) and moist heat and defi ciency of kidney qi group(SR+SQXG) according to syndrome differentiation. Corresponding prescriptions were used, every 30 doses 1 course. Before and after treatment, the anti-A or anti-B antibody and RICR, RC3bR were detected in peripheral blood. Results: In Yinchenhao Decoction group with 21 cases, the anti-A or anti anti-B antibody decreased, including 5 case (1:64) and 4 case (1:32). In group of syndrome differentiation with 63 cases, the anti-A or anti anti-B antibody decreased, including 33 case(1:64) and 20 case (1:32). Before and after treatment, RICR of control group and observation group were(19.43?5.29), (19.57?6.50)and (20.59? 7.96), (23.77?5.12), respectively. RC3bR were(11.62?4.16), (12.42?6.60)and(11.93?4.10), (13.96?6.40)respectively. There was signifi cant difference of before and after treatment in obserbation group(P0.05). Conclusion: In cutting down anti-A and anti-B antibody, and increasing RICR and RC3bR fi eld, the observation groups were better than control group.

Objective To evalute the value of spiral CT in diagnosis and treatment of chronic suppurative otitis media.Methods Sixty-five cases including seventy-nine ears underwent the direct axial plane and coronal multiplanar reformation and three-dimensional reconstruction of auditory ossicular chain in chronic suppurative otitis media spiral CT imaging of temporal bone. Results The direct axial plane and coronal multiplanar reformation in diagnosing of the chronic suppurativeotitis media were correspondent,but in showing of the most middle ear structure were difference. Three-dimensional images was superior to axial and coronal MPR images in showing of the change of malleus and incus,the contrary situation in showing stapes. Only 3D image may not select application for definition.The rate of agreement between spiral CT diagnosis by combination of three different imaging methods and definition of chronic suppurative otitis media and operative findings(89.9%～97.5%) were higher, false positive rate(2.9%～6.0%) and false negative rate(0～14.6%) of the CT diagnosis were lower.Conclusion Combination of three different imaging methods(axial images, coronal MPR images and three-dimensional images of the ossicular chain) can improve the value of the spiral CT diagnosis and therapy of chronic otitis media.

Objective To evaluate the application value of 256 slice spiral CT angiography (CTA)in the bridge vessels lesions af-ter grafts operation in lower extremity arteriosclerosis obliterans patients.Methods Taken DSA as the gold standard,using 256 slices spiral CTA to analysis the post-processing image of 76 article Bridge vascular which can be assessed in 65 cases patients with lower extremity arteriosclerosis obliterans,and to evaluated the diagnosis accuracy,sensitivity,specificity,positive predictive rate and negative predictive rate of postoperative bridge intravascular lesions.Results Using 256 slices spiral CTA,the bridge vascular of grafts operation patients can be clearly displayed,stenosis or unobstructed,and the anastomosis of the bridge vascular.5 graft occlu-sion,22bridge intravascular plaque were diagnosed correctly,3 vascular lesions were undiscovered.The accuracy,sensitivity,speci-ficity,positive predictive rate and negative predictive rate were 98.15%,96.15%,97.90%,92.59% and 97.96% respectively. Conclusion Using 256 slices spiral CTA can clearly show the endovascular lesions of lower extremity arteriosclerosis obliterans after grafts operation,and has high accuracy and specificity.It can be safely used as one of noninvasive follow-up means after grafts oper-ation.

Objective To study the effect of early mechanical ventilation in treatment of patients with severe acute pancreatitis(SAP).Methods Fifty-two patients with SAP admitted in the First People's Hospital of Zhaoqing from January 2010 to January 2015 were randomly allocated into two groups (n =26),early mechanical ventilation group(observation group) and conventional mechanical ventilation group(control group).Patients in the observation group treated with early lung protective ventilation when PaO2 ＜ 13.3kPa.Patients in the control group treated without mechanical ventilation untill PaO2 ＜ 8kPa.The symptoms,the extent of inflammatory reaction,the severity of lung lesions and the mortality of two groups were compared through monitoring vital signs,abdominal circumference,APACHE Ⅱ score,bladder pressure,oxygenation index (PaO2/FiO2),C reactive protein (CRP),procalcitonin (PCT),hospital stay and mortality.Results No statistically significant differences in the APACHE Ⅱ score,bladder pressure,oxygenation index,CRP and PCT in two groups before treatment were observed(P ＞ 0.05).The APACHE Ⅱ score (12.8 ± 7.6) points,bladder pressure (14.9± 7.9) cmH2O,CRP (48.8 ± 30.1) rmg/L,PCT (1.25 ± 0.55) μg/L,mortality (3.84％) of the observation group after treatment were significantly lower than those of the control group (t =2.057,2.091,3.252,2.697,x2 =4.305,all P ＜ 0.05),while the oxygenation index in the observation group [(300.0 ± 34.9) mmHg] was significantly higher than that in the control group [(278.1 ± 32.8) mmHg],the difference of the two groups was statistically significant (t =3.322,P ＜ 0.05).Conclusion Early lung protective ventilation is safe and effective for treatment of the patients with SAP.

Objective To observe continuous venous-venous hemofiltration (CVVH) for treatments and cares of severe acute pancreatitis(SAP). Methods From August 2004 to August 2006, 15 cases with SAP were in conventional treatment (the control group), from September 2006 to August 2010, 20 cases with SAP were nursed with CVVH(the observation group). We surveyed patients' vital signs (including body temperature, heart rate, breathing and blood pressure),mental symptoms, abdominal signs and monitored liver and kidney functions. Additionally we executed APACHE Ⅱ scores. We analyzed them retrospectively. Results The afore - mentioned indexes of two groups were significant in statistics, the observation group had lower incidence of MODS、MOF than the control group after 10 days caring. Conclusions The CVVH could correct systemic inflammatory reaction of SAP and prevent complications. Standard technical operation and intensive nursing can ensure smooth process of CVVH and decrease complications caused by CVVH.

Background Our previous study showed that the expression level of glial fibrillary acid protein (GFAP) increases in astrocytes and Müller cells of retina in chronic hypertensive eye,and this change was clarified to be associated with the damage process of the retinal ganglion cells (RGCs).Aquaporin 4 (AQP4) exists in neural glial cells,so we conjecture AQP4 plays a role in the regulating GFAP expression in glaucomatous eye.Objectives This study was to investigate whether AQP4 gene can regulate the expression of GFAP in retina and explore the effect of AQP4 on RGCs damage of glaucoma.Methods Chronic ocular hypertensive eye models were established by cauterizing the scleral venous in the left eyes of 30 male AQP4-/-mice and 30 male wild type (WT) mice with the same background,and the right eyes served as control eyes.The intraocular pressure (IOP) was measured with Icare rebound tonometer at 1 day,3,7,14 and 28 days respectively and the retinas were isolated from 6 of each types of mice at the corresponding time points.The expression of GFAP in the retina was detected by Western blot.The use and care of the experimental animals followed ARVO Statement.Results The IOP was significantly higher in the model eyes than that of the control eyes 1 day,3,7,14 and 28 days in both AQP-/-mice (t =15.29,16.02,13.77,14.34,12.40,all at P＜0.05) and WT mice (t =17.65,14.91,15.97,13.41,12.53,all at P ＜0.05).GFAP was expressed in the control eyes both of the AQP4-/-mice and the WT mice.The expressing level of GFAP (GFAP/β-actin) in retinas was 1.00±0.00,1.99±0.29,4.05±0.69,4.47±0.48,3.21±0.35 and 3.25±0.53 in the control eyes and 1-,3-,7-,14-,28-day model eyes of WT mice; and those in the AQP4-/-mice were 1.00±0.00,1.69±0.31,2.27 ±0.55,2.79 ± 0.39,1.93 ± 0.31 and 1.54 ± 0.40,with a significant difference in the expressing level of GFAP in various time points (F =9.54,P＜0.05).In addition,significant gradually elevation of GFAP expression were seen in the WT mice and gradually decline of GFAP expression was found in the AQP4-/-mice with the lapse of time (all at P＜0.05).No significant difference was seen in the expression of GFAP in the control eyes between the WT mice and AQP4-/-mice (P＞0.05).However,the expression level of GFAP in retina was significantly higher in the WT mice than that of A QP4-/-mice 3,7,14 and 28 days after operation (t =4.51,7.95,6.12,5.76,all at P＜0.01).tonelusions In chronic high IOP mice,AQP4 gene plays an important role in retinal damage by upregulating the expression of GFAP in retina and promoting the activation of RGCs.AQP4 probably is a new target of treatment of glaucoma.

Background Long-term administration of glucocorticoid drugs induces ocular hypertension in susceptible individuals probably.It has been verified that 1 1β-hydroxysteroid dehydrogenase type 1 (11β-HSD1),glucocorticoid receptor (GR) and mineralocorticoid receptor (MR) can affect the generating of aqueous humor,but how they play the role in glucocorticoid-induced ocular hypertension is unclear.Objective This study was to investigate the relationship of expressions of 11β-HSD1 and steroids receptors in ciliary body and steroid-induced ocular hypertension.Methods Thirteen 12-16 week-old New Zealand albino rabbits were randomized to control group (5 rabbits) and experimental group (8 rabbits).Steroid-induced glaucoma models were induced by administration of subconjunctival injection of 5 mg dexamethasone solution(1 ml) and 0.5％ dexamethasone eye drops on alternate days in the left eyes for consecutive two months in the experimental group,and the equal volume of sterile normal saline solution was used in the same way in the control group.The successful criteria of model eyes was defined as rising of intraocular pressure (IOP) to ≥ 18 mmHg for over one week.Then,the animals were sacrificed by excessive anesthesia and the ciliary tissues were isolated for the assay of expressions of 1 1β-HSD1 protein by immunochemistry,and the expressions of 11β-HSD1 mRNA,GR mRNA and MR mRNA in ciliary body were semi-quantitatively detected by reverse transcription-PCR (RT-PCR).The experimental results were compared between the two groups.Results The IOP was normal in the first two weeks after administration of drugs,and no significant difference was found in IOP between the first week and the second week in the experimental group (q =0.469,P ＞0.05).From 3 through 5 weeks after injection,the IOP was gradually elevated,with the highest value of (18.87±0.77) mmHg in the fifth week.Significant differences were seen between the two groups at mentioned-above time points (q =10.535,20.353,28.681,all at P ＜ 0.01).11β-HSD1 protein was positively expressed in nonpigmented epithelial cells of ciliary tissue of rabbits in both groups,however,the expression intensity was weaker in the experimental group compared with the control group.The relative expressional values of MR mRNA,GR mRNA and 11β-HSD1 mRNA in the ciliary tissue were 2.22±0.78,0.64±0.11 and 0.47±0.16 in the experimental group,and those in the control group were 0.94±0.27,1.88±0.74 and 2.68±1.28,with significant differences between the two groups (t =6.070,P =0.004 ; t =5.170,P =0.007 ; t =5.540,P =0.005).Conclusions Corticosteroidinduced glaucoma probably is associated with the up-regulation of MR level and down-regulations of GR and 11β-HSD1 in ciliary body.

Objective To evaluate the value of diffusion.weighted imaging(DWI)in the differential diagnosis of benign and malignant breast lesions with Meta.analysis.Methods English and Chinese articles published from 1997 to 2007 were searched in Cochrane library,Pubmed,Ovid.Elsevier.Springer databases and Chinese National Knowledge Infrastructure(CNKI),and selected according to the criteria for diagnostic research recommended by Cochrane Method Group.The characteristics of selected articles including the study background,design,results and diagnostic indicators were analyzed.Statistical analysis was performed with Meta-test version 0.9.Results Six articles were included with a total of 479 lesions.The sensitivity and specificity of DWI for breast 1esions ranged from 64.0% to 92.8% and from 45.8% to 96.7% respectively. All groups had homogeneity.and a fixation effects regression Was developed.The pooled weighted sensitivity and specificity with 95% CI and Az Was 86%(76%-92%).80%(61%-91%)and 92.19% respectively.Sensitivity analysis demonstrated no remarkable change on heterogeneity.Condnsion The value of ADC in DWI can help to differentiate the benign breast lesions from the malignant with good sensitivity and specificity.The further study is needed to assess the clinical aplication of the b-value and diagnostic threshold.

Objective To increase the ability to recognize the characteristic MRI features of multiple sclerosis (MS) in the spinal cord. Methods Fifteen patients with MS underwent MR examination of the cervical spine. The MS plaques were evaluated for lesion location, length,size on cross-section and lesion enhancement. MRI features of intraspinal tumor of spinal cord, cervical spondylopathy of myeloid form and transverse myelitis were analyzed and compared. Results The lesion mainly developed in cervical cord in the 15 patients. The lesions were less than five vertebra body in length. MRI features showed that involved cord segment was mild swollen with smooth periphery in sagittal section;the plaques showed iso-mild hypointense on T 1WI and hyperintense on T 2WI; the plaques were located peripherally and occupied less than 50%of the cross-sectional area of the cord; the lesions in active stage were enhanced by Gd-DTPA or no enhancement, the enhanced size of plaque was smaller than the extent showing hyperintense on T 2WI. The case of several onset showed various enhancement. Conclusion MS of spinal cord has characteristic feature on MRI, this can provide reliable proof for clinical diagnosis.