Objective To evaluate the correlation of the baseline clinical and laboratory test index with death,and to discuss the independent risk factors for long-term prognosis in elderly HIV/ AIDS patients who had accepted highly active antiretroviral therapy (HAART).Methods 1671 cases of HIV/AIDS patients were included in retrospective cohort study,divided into death group (183 cases) and non-death group (1488 cases) according to HIV/AIDS related death event,and followed up for 2 days to 120 months,an average of 427 days.Results During the period of followup,the proportion of male (12.45％) was higher than that of women (6.9％) in death group(x2 =10.42,P＜0.01).The mortality ratio of the WHO stage Ⅲ and Ⅳ was higher than that of the WHO stage Ⅰ and Ⅱ (x2 =18.67,P＜0.01).The mortality ratio was significantly higher in HIV/AIDS patients with baseline CD4+ T lymphocyte cell ＜100 cells/mm3 than ＞100 cells/mm3 (x2 =52.59,P＜0.01).The platelet (PLT),hemoglobin (HB),and blood glucose levels were lower in death group than in non-death group (P ＜ 0.05),but serum creatinine (SCR) and AST (aspartate aminotransferase) levels were higher than that in the non-death group (P＜0.05).There was no significantly differences between the death group and the non-death group in the index of white blood cell (WBC),blood urea nitrogen (BUN),total cholesterol (CH),triglyceride (TG),alanine aminotransferase (ALT) and total bilirubin (TB) levels (all P＞ 0.05).Multiple logistic regression analysis revealed that the WHO stage (OR=0.777,95％ CI:0.612～0.987,P＜0.05) and the baseline level of CD4+ T lymphocytes cell (OR=1.345,95％ CI:1.089～1.662,P＜0.01) were independent risk factors for long-term outcomes in elderly HIV/AIDS patients.Conclusions The WHO stage and baseline CD4+ T lymphocyte cell level are the independent risk factors for long-term prognosis in HIV/AIDS patients over 60 years of age.Early discovery and early beginning HAART can effectively improve the prognosis of elderly HIV/AIDS patients.

Objective To explore value of two-dimensional speckle tracking imaging (2D-STI) strain parameters in assessment of left ventricular (LV) dyssynchrony and its relationship with cardiac function in patients with dilated cardiomyopathy (DCM).Methods Totally 25 patients with DCM and 25 age-matched normal controls were enrolled.The LV time to peak longitudinal strain (Tls) and time to peak circumferential strain (Tcs) were measured by 2D-STI,from which the standard deviations and maximal differences of the Tls in all 18 segments,6 segments at apical 4-chamber,3-chamber and 2 chamber views (Tls-SD,Tls-SD-4,Tls-SD-3,Tls SD-2,Tls dif,Tls-dif-4,Tls-dif-3,Tls-dif-2) were calculated,as same as the standard deviations and maximal differences of Tcs in all 18 segments,6 segments at mitral valve,papillary muscle,apical short-axis views (Tcs-SD,Tcs-SD-M,Tcs-SD-P,Tcs-SD-A,Tcs-dif,Tcs-dif-M,Tcs-dif-P,Tcs-dif-A) were calculated.Results Compared with the control group,the global and segmental strain parameters of the DCM group increased significantly (all P＜0.05).Except for Tcs-dif-P and Tcs dif,the residual strain parameters were negatively correlated with LV ejection fraction (all P＜0.05).Except for Tcs-dif-M,Tcs dif-P and Tcs-dif,there was a positive correlation between strain parameters and E/e in DCM group (all P ＜0.05).Conclusion In patients with DCM,LV dyssynchrony exists both in global and regional,which may aggravates the LV function damage.2D-STI strain parameters can objectively evaluate LV dyssynchrony and its relationship with cardiac function in patients with DCM.

One hundred and sixteen patients with lower limb fracture were screened by Doppler ultrasound for deep vein thrombosis(DVT) of bilateral lower extremities within the first 72 h, d7 and d21 after fracture. Results showed that DVT was detected in 31 (26. 7% ) out of 116 cases within 72 h; at d7 and d21 DVT was detected in 3 and 1 patient respectively with a cumulated DVT rate of 30. 2% in 3 weeks.Serial Doppler ultrasonography is of value in screening for DVT of the lower extremities in patients with lower limb fracture at early stage.

Objective To isolate enterovirus 71 from a death children,and analyze whether the neurovirulence was related to the variation of nucleotide and amino acid. Methods Enterovirus 71 was isolated from throat swabs which were colleted from Shandong Linyi People's Hospital. The full length genome was sequenced by amplification with RT-PCR and sequencing of 9 overlapped gene fragments covering full length of the genomes. The nucleotide and amino acid sequenced was aligned by BLAST, Bioedit and MEGA 4. Results A strain of enterovirus 71 was isolated and named as SDLY107. The full length was 7405 bp. The results of homology analysis of overall nucleotide sequence showed that strain Fuyang. Anhui. P. R. C/17.08/2 had highest homology (98.6%)with strain SDLY107, and the homology was 80.0% between strain SDLY107 with prototype strain BrCr/70,and 86. 5% between strain SDLY107 with nerve strain MS/87. Phylogenetic analysis showed that the phylogeny was close between SDLY107 with some isolated strains from Chinese Mainland, such as Beijing, Henan, Guangxi, Sbenzhen, Lanzhou, Fuyang, Chongqing and Zhejiang strains, which was clustered for C4 subtype. The results of amino acid sequence analysis showed that there were 2 mutations, E947D and K1873R, for strain SDLY107. Conclusion SDLY107 belonged to C4 subtype, amino acid mutations E947D and K1873R of which may be relevant to the pathogenicity of EV71.

Objective To construct MIA3 psicheck2 wild-type and mutant vectors targeting miR-374b,and provide the previous guarantee for the dual luciferase reporter assay.Methods The amplification primer was firstly designed according to mice MIA3-3'UTR sequence information,mice whole blood genomic DNA was taken as the template for PCR amplification of MIA3-3'UTR sequence,and the PCR product was cloned into psicheck2 dual luciferase reporter vector.Then,mutant primer was designed to mutate the MiR-374b seed sequence target TATTATA into AAATTAT so as to construct mutant vector.At last,the vector enzyme digestion evaluation and sequencing method was used to evaluate the constructed vectors.Results It could be seen from the analysis of agarose electrophoresis that the PCR amplification size of vector was consistent with the theoretical size.DNA sequencing evaluation showed that the MIA3-3'UTR-WT vector had been constructed successfully.The construction of mutant vector has successfully mutated the MiR-374b seed sequence target TATTATA into AAATTAT.Conclusion The successful construction of the vector will lay a foundation for the further evaluation on whether there is an actual binding site between the miR-374b and the chondrogenic differentiation-related target gene MIA3.

Objective To evaluate the clinical efficacy of transcatheter super-selective hepatic artery embolization (TAE) in treating symptomatic polycystic liver disease (PLD). Methods A total of 8 patients with PLD, who were admitted to authors’ hospital during the period from 2009 to 2013 to receive TAE, were enrolled in this study. The patients included 6 females and 2 males with a mean age of 59.5 years (54-65 years). The used embolic agents were polyvinyl alcohol (PVA) microspheres and micro spring coils. Both plain and contrast-enhanced CT scans of the upper abdomen were performed before TAE as well as at 12 months after TAE; the total volume of the hepatic cysts was measured and the changes of the cystic volume were determined. Statistical analysis was conducted using paired t test. Results The technical success rate was 100%. After TAE, the patients developed fever and different degrees of discomfort at liver area, which were disappeared after active symptomatic medication, and no serious complications occurred. The patients were followed up for 12 months , the mean total volume of the intrahepatic cysts decreased from preoperative (5 794±2 066) cm3 (range 3 120-8 935 cm3) to postoperative (3 832±1 525) cm3 (range 2 019-5 925 cm3), the difference was statistically significant (t=6.971, P<0.001). The reduction ratio of total volume of intrahepatic cysts was 34.6%±11.3%(24.3%-60.4%). Conclusion For symptomatic polycystic liver disease, transcatheter super-selective hepatic arterial embolization is a newly-developed treatment. This technique is safe and effective with reliable response and fewer complications. Therefore, it should be recommended in clinical practice.

Objective To explore the diagnostic value of needle stereotaction marking by steel wire(NSMSW) under mammography for nonpalpable early stage breast carcinoma (BC). Methods 29 patients with nonpalpable breast lesions were performed NSMSW under mammography,and the lesions were removed for biopsy to make the diagnosis. Results Nine patients(31.0%) were definited as early stage BC and twenty(69.0%) benign disease.The pathologic results in freezing sections and in parafin sections were the same. Conclusions NSMSW under mammography can resolve the problem of accurate location of nonpalpable breast lesions during operation .It is a credible, useful and practical method for diagnosis of nonpalpable early stage BC.

The clinical data of 4 children with congenital absence of tracheal cartilage ring in Qilu Children′s Hospital of Shandong University from November 2017 to August 2019 were retrospectively analyzed.The age of the 4 cases was from 2 months to 1 year.One case had no obvious symptoms after birth, and then had repeated wheezing attacks for 3 times.Another 3 cases had symptoms after birth, such as throat ringing, repeated cough and asthma.Bronchoscopy in 4 cases indicated that the local lumen of trachea was round and centripetal stenosis, but the body of bronchoscope could pass smoothly, and no cartilage structure was found in the wall of trachea.Among them, 3 cases of chest enhanced CT examination displayed local and hourglass-like tracheal stenosis, without vascular ring malformation.All the 4 cases were treated by operation, of which 3 cases recovered well and 1 case died of severe infection after operation.

Forensic toxicology is a specialized subject which forensic medical appraisers and students must learn and master. As a new teaching mode,problem based learning method is attrcting a lot of attention. Applying "case" based PBL teaching method is an important method to train innovative and high technical ability forensic talents.

AIM:To observe the effects of cholecystokinin octapeptide (CCK-8) and its receptor antagonists on cAMP response element binding protein ( CREB) and phosphorylated CREB ( pCREB) expression in frontal cortex and hippocampus of morphine withdrawal rats , which aim to explore the post-receptor mechanism through which CCK-8 regu-lates morphine withdrawal .METHODS: After the morphine dependence and naloxone-precipitated withdrawal animal models were established, the effects of CCK-8, L-364718 (CCK1 receptor antagonist) and LY-288513 (CCK2 receptor an-tagonist) pretreatment on CREB and pCREB expression in frontal cortex and hippocampus were observed by Western blot -ting and immunohistochemistry .RESULTS:In rat frontal cortex neuron , CREB was expressed in both cytoplasm and nu-cleus, but pCREB was only highly expressed in the nucleus .In the pyramidal cell layer of hippocampal CA 1 region, CREB showed high expression in the cytoplasm and low expression in the nucleus , while pCREB was only expressed in the nu-cleus.No obvious change of CREB was observed after either chronic morphine treatment or naloxone withdrawal .The pCREB expression was increased after chronic morphine treatment and further increased after naloxone withdrawal .Com-pared with the withdrawal group , chronic pretreatment with CCK-8, L-364718 and LY-288513 had no effect on CREB expression in the frontal cortex , but obviously decreased the pCREB expression .In the hippocampus , pretreatment with L-364718 and LY-288513 decreased CREB and pCREB expression , but only the pCREB expression was decreased after CCK-8 treatment.CONCLUSION:CCK-8 and CCK receptor antagonists may alleviate morphine withdrawal symptoms by regulating CREB , with specificity in different brain regions .