Objective To explore and evaluate the predictive value of the coagulopathy in patients with community-acquired pneumonia (CAP).Methods A retrospective study was carried out for investigating the prothrombin time (PT),activated partial thromboplastin time (APTT),plasma fibrinogen (FIB),thrombin time (TT),plateslets (PLT),D-dimer in 385 patients with CAP and 146 patients without infection,tumor,trauma,thrombosis as controls.All the patients were admitted to the Respiratory Medical Department from June,2010 to May,2011.The results of the aforementioned biomarkers were analyzed and compared between two groups.The Pneumonia Severity Index (PSI) was calculated to evaluate the correlation between coagulopathy and PSI.Results The comparisons of the abnormal rates of PLT,PT,APTT,Fib,D-dimer between the patients with CAP and the controls were 92/385 vs.9/146,39/385 vs.1/146,108/385 vs.7/ 146,331/385 vs.47/146,348/385 vs.5/146,respectively.The differences were statistically significant (x2 =21.608,13.557,33.747,149.280,365.619,respectively,P ＜ 0.01),while difference in TT was not statistically significant (8/385 and 0/146,x2 =1.839,P ＞ 0.05).The differences in abnormal rate of PLT,PT,D-dimer between high-risk group of CAP and the low-risk group of CAP were 45/148 vs.47/237,26/148 vs.13/237,146/148vs.202/237,respectively,and the differences were statistically significant (x2 =5.602,14.609,23.442,respectively,P ＜0.05),while there were no differences in TT,APTT,FIB between two groups (6/148 vs.2/237,47/148 vs.61/237,123/148 vs.208/237,x2 =4.614,1.635,1.638,respectively,P ＞0.05).D-dimer in patients with CAP was (3.8 ±6.1) mg/L,compared with the controls (0.3 ±0.1) mg/L,and D-dimer in high-risk patients with CAP was (7.5 ±8.3) mg/L compared with the low-risk group (1.6 ±2.0) mg/L (P ＜ 0.001).Rank correlation existed between D-dimer and PSI (r =0.798,P ＜ 0.01),while there was no correlation between PLT and PSI (x2 =6.040,P ＞0.05).Conclusions The coagulopathy commonly occurs in patients with CAP.D-dimer was significantly higher in patients with CAP.D-dimer level is positively correlated with severity of CAP.D-dimer can be an ideal biomarker to assess the severity of patients with CAP.

Objective To probe the effects of the size and location of cranial defect on the neurological symptoms of patients with skull bone defect.Methods The patients were classified into the following groups according to the influence to symptoms by changes in body position and changes of symptoms before and after craniectomy: True syndrome of the trephined(ST,Ⅰ), partial ST patients(Ⅱ), other patients or symptom-free patients (Ⅲ).Results The group I consisted of 33 cases, their defects were located in the parieto-occipital region in 23 cases, frontoparietal in 10 cases. All these patients had flaccid skin flaps that became concave while in the upright position. The group Ⅱ was composed of seven cases, their defects were located in frontoparietal and parieto-occipital region in three respectively. All these patients had flaccied skinflap in defects pars.Group Ⅲ included twelve patients, flat and rigid skin flaps were usually demonstrated , predominantly in the tempora and parietal regions.Conclusions The size and location of the cranial could play an important role in the development of the neurological symptoms.

Objective To evaluate the efficacy of a new micro-bubble contrast agent of C_3F_8 in the opacification of the left ventricle. Methods Seven pigs received a bolus injection of C_3F_8 (0.002) and (0.02) (ml/kg) intravenously. Left ventricular opacification grades and number of endocardial border delineation segments were observed and left ventricular ejection fraction(LVEF) were measured using modified Simpson method after each intravenous contrast injection. Heart rate and respiration rate were recorded before and after each injection. Results There was a significant improvement for every measurement of contrast enhancement in each intravenous injection. In addition, part of myocardial tissue could be enhanced after contrast injection. There was no difference in heart rate and respiration rate between pre- and post-injection. Conclusions This new contrast agent is safe and helpful in delineating endocardial border of the left ventricle.

AIM To study the effects of neferine on gastric car cinoma apoptosis induced by vincristine in vitro. METHODS Cytotoxicity assay was tested by MTT method. The influence of neferine to affect vincristine to induce gastric carcinoma apoptosis was detected by PI staining flow cytometry, AO/EB double fluorescence stain and terminal deoxynucleotidyl transferase mediated nick end labeling (TUNEL). RESULTS 2 5, 5,10 ?mol?L -1 neferine enhanced vincristine to inhibit the proliferation of SGC7901 cells; 10 ?mol?L -1 neferine enhanced vincristine (0 1, 0 5, 2, 4 mg?L -1 ) to induce SGC7901 cells apoptosis. CONCLUSIONS Neferine enhanced vincristine to induce gastric carcinoma cells apoptosis. It is inferred a kind of low poisonous and high effective chemosenstizers.

Objectives To evaluate the clinical effect of one-stage reconstruction of dorsal hand softtissue defects using tendon allograft and free anterolateral thigh flaps.Methods From July 2006 to July 2011,fifteen cases of complex soft-tissue defects in dorsal hands were repaired using tendon allografts and anterolateral thigh flaps,sizing from 9 cm ×5 cm to 14 cm× 11 cm,in one stage.Two to 4 digital extensor tendons were reconstructed.With a brace on,early finger exercises were started after 2 weeks postoperatively when the flaps had survived.Results All the 15 flaps survived uneventfully.Twelve of the 15 patients were available for follow-up from 12-24 months (averaged 16 months).Two cases received tendolysis due to poor finger movement 6 moths postoperatively.At the end of follow-up,the range of wrist joint active flexion is from 40 to 70degrees and extension is from 25 to 50 degrees.The motion range of the related metacarpophalangeal joints was from 60 to 85 degrees,that of the interphalangeal joints from 80 to 90 degrees.The overall effective rate was 92 percent.Conclusion Simultaneous composite repair using tendon allografts and skin flaps proved to be reliable and cost-effective for complex dorsal hand soft-tissue defects.Allograft tendon reconstruction can not only obliterates new morbidities of autografting but also facilitates timely rehabilitation,avoiding extension loss of hand joints.

Purpose:To study the reversal of multidrug resistance (MDR) and its mechanism by neferine which is a new calcium channel blocker in human gastric carcinoma cell line SGC7901/VCR. Methods:The cytotixic effect was tested by MTT assay. The expression of multidrug-resistance-associated protein in human gastric carcinoma cells was examined by SP immunocytochemical and flow cytometry. Results:Neferine at the concentration 10 ?mol/L was not of significant cytotoxicity to SGC7901 and SGC7901/VCR cells. Neferine at the concentration of 2.5,5,10 ?mol/L decreased the IC_(50)value of VCR to SGC7901/VCR cells from 2.32 ?g/ml to 0.340,0.128 and 0.053 ?g/ml, respectively and with the increase by 6.8-,18.1-and 43.8-fold in the chemosensitivity, respectively. It had more potent reversal action on SGC7901/VCR cells than Verapamil at the concentration of 10 ?mol/L(P

OBJECTIVERNA interference was applied to knockdown the Dhcr7 gene in mouse embryonic palatal shelves to facilitate understanding of the function of Dhcr7 gene variants in the fusion of palatal shelves.

METHODSThe pAdTrack-CMV-siDhcr7 was constructed using the specific siRNA sequence of Dhcr7 from C57BL/6J mouse. The pAdTrack-CMV- siDhcr7 of positive clones was reconstructed in vitro, and the recombinant adenovirus pAdEasy-1-siDhcr7 of kanamycin resistance was screened. The adenovirus vector DNA was then prepared for transfecting the embryonic palatal shelves. Thirty pairs of embryonic palatal shelves at 13.5 d gestational age were harvested and then randomly divided into the following three groups: normal control group (n = 10), which included palatal shelves inculture medium without cholesterol; blank adenovirus control group (n = 10), which included palatal shelves in culture medium without cholesterol and blank adenovirus; and experimental group (n = 10), which included palatal shelves in culture medium without cholesterol and adenovirus encoding Dhcr7 siRNA. At 48 h after in vitro cultivation, the mRNA and protein of the palatal shelves were obtained for scanning electron microscopy (SEM), reverse transcription polymerase chain reaction (RT-PCR), and Western blot analyses.

RESULTSSEM showed that the palatal shelves of the normal control and blank adenovirus control groups fused and formed continuous palates, whereas those of the experimental group was almost undeveloped but exhibited large gaps between the two palatal shelves. RT-PCR and Western blot analyses showed that the mRNA and protein of Dhcr7 in the experimental group decreased compared with those in the normal control group with a significant difference (P < 0.05).

CONCLUSIONResults indicate that Dhcr7 gene silencing affects the fusion of palatal shelves. Thus, Dhcr7 gene may serve a function in the normal development of palates.

Animals ; Cleft Palate ; Gene Silencing ; Mice ; Mice, Inbred C57BL ; Microscopy, Electron, Scanning ; Organ Culture Techniques ; Oxidoreductases Acting on CH-CH Group Donors ; Palate ; growth & development ; RNA, Messenger

Aneurysm, Dissecting ; classification ; surgery ; Aortic Aneurysm ; etiology ; Dilatation, Pathologic ; Humans ; Stents ; adverse effects

Adult ; Endoscopy ; Eye Foreign Bodies ; surgery ; Humans ; Male ; Orbit

Objective To investigate the CT characteristics of anaplastic thyroid carcinoma and evaluate the diagnostic value of CT in this disease.Methods The CT findings of 10 patients with pathologically proved anaplastic thyroid carcinoma were retrospectively reviewed.The patients included 7 females and 3 males.Their age ranged from 25.0 to 78 years with median of 61 years.Multi-slices plain and post contrast CT scans were performed in all patients.Results Unilateral thyroid was involved in 6 patients.Unilateral thyroid and thyroid isthmus were both involved in 2 patients due to big size.Bilateral thyroid were involved in 2 patients.The maximum diameter of anaplastic thyroid carcinoma ranged from 2.9-12.8 cm with mean of (4.5 ± 1.4) cm.All lesions demonstrated unclear margins and envelope invasion.The densities of all lesions were heterogeneous and obvious necrosis areas were noted on precontrast images.Seven lesions showed varied calcifications,and coarse granular calcifications were found in 5 lesions among them.All lesions showed remarkable heterogenous enhancement on post-contrast CT.The CT value of solid portion of the tumor increased 40 HU after contrast media administration.The ratios of CT value which comparing of the tumor with contralateral sternocleidomastoid muscle were 0.69-0.82 (0.76 ± 0.18)and 1.25-1.41 (1.33 ± 0.28)on pre and post CT,respectively.Enlarged cervical lymph nodes were found in 6 cases (60.0％).It showed obvious homogeneous enhancement or irregular ring-like enhancement on post-contrast images and dot calcifications were seen in 1 case.Conclusions Relative larger single thyroid masses with coarse granular calcifications,necrosis,envelope invasion,remarkable heterogeneous enhancing and enlarged lymph nodes on CT are suggestive of anaplastic thyroid carcinoma.