简介：AbstractBackground:The association between free triiodothyronine (FT3) and long-term prognosis in dilated cardiomyopathy (DCM) patients has not been evaluated. The purpose of this study was to determine whether the level of FT3 could provide prognostic value in patients with DCM.Methods:Data of consecutive patients diagnosed with DCM were collected from October 2009 to December 2014. FT3 was measured by fluoroimmunoassay. Other biochemical markers, such as free thyroxin (FT4), thyroid-stimulating hormone, red blood cell, hemoglobin, blood urea nitrogen, and serum creatinine, were tested at the same time. Follow-up was performed every 3 months. The primary endpoint was all-cause mortality. Pearson analysis was used to evaluate the correlation of FT3 and other lab metrics with DCM patients’ prognosis. The association of long-term mortality in DCM and FT3 was compared using Cox hazards model.Results:Data of 176 patients diagnosed with DCM were collected. Of them, 24 patients missed FT3 values and six patients were lost to follow-up. Altogether, data of 146 patients were analyzed. During the median follow-up time of 79.9 (53.5-159.6) months, nine patients lost, 61 patients died (non-survival group), and 85 patients survived (survival group). FT3 was significantly lower in non-survival group than that in survival group (3.65 ± 0.83 pmol/L vs. 4.36 ± 1.91 pmol/L; P = 0.003). FT3 also showed a significantly positive correlation with red blood cell and hemoglobin, negatively correlated with age, blood urea nitrogen and serum creatinine (P < 0.05), respectively. Patients in the group of lower FT3 levels (FT3 ≤ 3.49 pmol/L) suffered from a higher risk of all-cause mortality (P for log-rank = 0.001). In multivariate Cox regression analysis, FT3 level was significantly associated with all-cause mortality (hazard ratio: 0.70, 95% confidence interval 0.52-0.95, P for trend = 0.021).Conclusion:Low levels of FT3 were associated with increased all-cause mortality in patients with DCM.

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简介：Objective:ToinvestigatetherelationbetweennecrosisandapoptosisinthehippocampusofexogenousbFGFonthisprocess.Methos:WithMarmarou'smethodweproducedaseverediffusebraininjuryandstudiedthechangesinthehippocampusbyadaptingamodifiedTdT-mediateddUTP-biotinnickendlabeling(TUNEL)method.AtthesametimeweobservedtheeffectofexogenousbFGFonneuronalnecrosisandapoptosis.Results:WefoundthattogetherwithcellnecrosistherewasanincreaseinthenumberofapoptoticneuronsinthehippocampusCA2-3sectorsasearlyas4hafterinjury,withnumbersreachingamaximumat7d.ExogenousbFGFresultedinadefinitereductionintheamountofnecrosisandapoptosis.Conclusions:NeuronalnecrosisandapoptosisoccurincombinationafterbraininjuryandthatoneofthecausesmaybetheinsufficienceexpressionofthebFGFgeneinthehippocampusaftersevereinjury.ExogenousbFGFandsimilarsubstancemayproveclinicallyusefulafterbraininjurybyreducingcellnecrosisandapoptosis.

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简介：ObjectiveTrauma在在沙特阿拉伯的年轻年龄组之中是死亡和病态的领先的原因并且开发国家。这研究试图为临床的严厉作为一个潜在的预言者与创伤的大脑损害(TBI)在孩子评估血小板计数的秋天，outcome.MethodsTotally，有TBI的74个病人从开始2008年1月到目的进入我们的医院的小儿科的特别护理单位(PICU)2010年3月(27个月)。基线注册标准是很长时间12年，在在损伤事件以后的4个小时以内的承认，和缩短的损害规模(AIS)(或)，3.1；相对风险(RR)，2.15。接收装置操作特征(巨鸟)曲线和Youden索引证明PFP的最佳截止点在51.5%.ConclusionPFP与TBI的严厉被增加，它能也为它的结果作为一个重要独立预言因素被拿。

简介：总结介绍任琢珊教授治疗重症肌无力的临床经验。认为本病的病因病机为脾虚为本,涉及于肾,治法上在＂独取阳明＂同时,辅之补肾,填精壮骨,变＂独取阳明＂为脾肾双补。临床上运用健脾补肾法,以加味补中益气汤随证化裁治疗重症肌无力,取得了满意疗效。

简介：秋日里的南京中医药大学校园，瑟瑟秋风，落叶缤纷。走过长长的林荫道，眼前显现树木环绕的17号楼，登至二楼，“周仲瑛传承工作室”几个大字铁画银钧，挥洒于眼前。诊室内已有患者在看病，循眼望去，可隐约看到先生着白大衣的身影。守得先生看完病，我们见到了这位闻名遐迩的大家。老先生红光满面，说话抑扬顿挫，淡淡的乡音让我觉得异常亲切，也与这古朴风格的办公室陈设相得益彰，散发出一种祖国传统医学文化独有的儒雅风韵。

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简介：Thisarticleelaboratestheviewpointthathowtostrengthenqualitymanagementofcasetogivefullplaytoitsvalue,thepointsthattheauthorurgedareinfollowingaspects,includingraisingqualityconsciousnessofcasewriting,upgradingthewritingqualityofcase,payingattentiontothevalueofcaseandensuringthequalityofcase.1.Trainingdoctor's“basicskill”.2.Trainingsystemofdoctor,a.Inthefirstmonthaftercheck-in,arrangetwolecturesaboutwritingofcasetounifytherequirementandinformthemhowtowriteit.b.Givethemthewritingstandardofanamnesis,whichtheycanrefertowhenwriting.3.Thesystemthatthedirectorsspot-checktheanamnesis.TheAmericanqaulityadministrativepower,world-famousDoctorMilanprophesiedthat“21centuryiscenturyofquality”,havingentered21century,factsalsofurtherprovedthefacticityofthisprophesy.Thenewerainwhichthequalityissupreme,qualitydirectlyinfluenceswhetherthecasecanfullyplayitsvalue.

简介：Objective:Tostudytheexpressionofvascularendothelialgrowthfactor(VEGF)andmicrovesseldensity(MVD)inesophagealsquamouscellcarcinoma(ESCC)andclarifytheassociationofVEGFexpressionwiththeangiogenesisandprognosticvalueofthisdisease.Methods:Eighty-twocaseswithprimaryESCCtreatedwithradicaloperationinDepartmentofSurgeryfromJan1981throughMay1994wereenrolled.VEGFexpressionandMVDvaluewereexaminedbyimmunohistochemicalstaining,thestreptavidin-biotinperoxidasecomplexmethod(SPmethod),usinganti-VEGFpolyclonalantibodyandanti-Factor-VIIIantibody,respectively.WealsoanalyzedtherelationshipbetweenVEGFexpressionandMVDvalueandpostoperativesurvivalrateofpatients.Results:Ofthe82cases,63.4%casesshowedpositiveforVEGFintumorcellsandthemedianofMVDintumorwas37(9-150)·mm-2.TherewasaclosecorrelationbetweenMVDandVEGF(P=0.001).The5-yearsurvivalrateofpatientswithlowandhighMVDwas34.1%and12.2%,respectively.The5-yearsurvivalratewas46.7%inpatientswithVEGF-negativetumorand11.5%inpatientswithVEGF-positivetumor.Thesedifferenceswerestatisticallysignificant(P=0.017andP<0.001,respectively).Conclusion:InESCC,angiogenesisismediatedmainlybyVEGFandVEGFmaybeassociatedwithtumorprogressionandincreasedmalignancyviaangiogenesis.

简介：Objective:Toprovideanewmethodtoestimatetheeffectivenessofthoracolumbarvertebralfiniteelementmodel.Methods:amechanicalmodelofhumanthoracolumbarvertebraemotionsegmentwasmadeusingthree-dimensionalfiniteelementmethodandthestressdistributionofverticallycompressedthoracolumbarvertebraewasanalyzed,meanwhile,20patientswithburstfractureofthoracolumbarvertebraeweretestedbyCTtocalculatedaverageCTvalueatascertaineddifferentpointsofthoracolumbarvertebrae.Thecalculatedresultsandeffectivestressatthesamepositionwereanalyzedwithstraightlinecorrelation.Results:ThestresslevelofdifferentpositionofthoracolumbarvertebraeunderverticalcompressiveforcewaspositivelycorrelatedwiththecorrelativeCTvalue,andtheregressivestyle,Y-214.028±45.268x,r=0.7386,P<0.05(N=8)showedastatisticalsignificance.Conclusions:Tostudymechanismofthoracolumbarvertebraeinjuriesunderdifferentforceshasclinicalsignificance.

简介：AbstractPurpose:To establish a severe blast lung injury model of goats and investigate the feasibility of lung ultrasonic score in the evaluation of blast lung injury.Methods:Twenty female healthy goats were randomly divided into three groups by different driving pressures: 4.0 MPa group (n = 4), 4.5 MPa group (n = 12) and 5.0 MPa group (n = 4). The severe blast lung injury model of goats was established using a BST-I bio-shock tube. Vital signs (respiration, heart rate and blood pressure), lung ultrasound score (LUS), PO2/FiO2 and extravascular lung water (EVLW) were measured before injury (0 h) and at 0.5 h, 3 h, 6 h, 9 h, 12 h after injury. Computed tomography scan was performed before injury (0 h) and at 12 h after injury for dynamic monitoring of blast lung injury and measurement of lung volume. The correlation of LUS with PaO2/FiO2, EVLW, and lung injury ratio (lesion volume/total lung volume*100%) was analyzed. All animals were sacrificed at 12 h after injury for gross observation of lung injury and histopathological examination. Statistical analysis was performed by the SPSS 22.0 software. The measurement data were expressed as mean ± standard deviation. The means of two samples were compared using independent-sample t-test. Pearson correlation analysis was conducted.Results:(1) At 12 h after injury, the mortality of goats was 0, 41.67% and 100% in the 4.0 Mpa, 4.5 MPa and 5.0 MPa groups, respectively; the area of pulmonary hemorrhage was 20.00% ± 13.14% in the 4.0 Mpa group and 42.14% ± 15.33% in the 4.5 MPa group. A severe lung shock injury model was established under the driving pressure of 4.5 MPa. (2) The respiratory rate, heart rate, LUS and EVLW were significantly increased, while PaO2/FiO2 was significantly reduced immediately after injury, and then they gradually recovered and became stabilized at 3 h after injury. (3) LUS was positively correlated with EVLW (3 h: r = 0.597, 6 h: r = 0.698, 9 h: r = 0.729; p < 0.05) and lung injury ratio (12 h: r= 0.884, p < 0.05), negatively correlated with PaO2/FiO2 (3 h: r =－0.871, 6 h: r =－0.637, 9 h: r =－0.658; p < 0.05).Conclusion:We established a severe blast lung injury model of goats using the BST-I bio-shock tube under the driving pressure of 4.5 MPa and confirmed that ultrasound can be used for quick evaluation and dynamic monitoring of blast lung injury.

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简介：与女乳癌相比，男乳癌是稀罕疾病，并且在临床/病理学的特征和预后之间的关系争论，或甚至大部分未知。在这研究，我们从合用的男乳癌病人在天津医药大学癌症研究所和医院从1996年1月对待到2011年12月的109nonmetastatic用临床、病理学的数据执行了回顾的分析。木头等级测试证明那降低肿瘤舞台，没有淋巴节点参与，和积极雌激素/孕酮受体地位是没有疾病的幸存和外套的好预言者univariate分析上的幸存。然而，hormonotherapy仅仅是没有疾病的幸存，并且不全面幸存的一个好预兆的因素。另外，基于考克斯，比例的危险回归模型，仅仅淋巴节点参与，和雌激素/孕酮受体地位是multivariate分析上的统计上重要的预兆的因素。我们的结果证明尽管辅助全身的治疗在男乳癌广泛地被使用，病人和预后在最后几十年，淋巴节点参与，和雌激素/孕酮受体地位改善了仍然是最重要的预示的因素。有一种更大的样品尺寸的未来的多中心研究着急地被需要进一步理解男乳癌。

简介：Toprovidetheoreticalbasisforeffectandmechanismofpercutaneouslumbardiscectomyinclinic.Methods:Atotalof180patientswithlumbarintervertebraldischerniationwereevaluatedbyCTonthefifthdaybeforeandafteroperation.Meanwhile,CTvaluewasmeasuredinthedeterminedlevelandregion.Results:Afteroperation,CTvalueofthecentralandposteriordeterminedpointofherniatedintervertebraldiscwaslowersignificantlythanthatbeforeoperation(P<0.01),butCTvalueoftheanteriordeterminedpointwasdifferentinsignificantly.Theexcellentandgoodresultsofthepatientstogetherwere83%postoperatively.Conclusions:Thecurativeeffectofpercutaneouslumbardiscectomyisachievedthroughreductionoflumbarintradiscalpressure.

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简介：Objective:Noninvasivediffusion-weightedmagneticresonanceimaging(DWI)isawell-studiedMRimagingtechniqueforquantifyingwaterdiffusionespeciallyintumorarea.Thecorrelationbetweenapparentdiffusioncoefficient(ADC)valueandapoptosisorproliferationisnotclearbynow.ThisstudyaimedtoinvestigatewhetherDWI-ADCvaluecouldbeusedasanimagingmarkerrelatedwithpathologicindexesoftumors.Methods:Atotalof30Balb/cmicewithHT29colorectalcarcinomaweresubjectedtoDWIandhistologicanalysis.ThepercentageofADCchangesandtheapoptoticandproliferatingindexeswerecalculatedatpredefinedtimepoints.Kolmogorov-SmirnovdistanceswereconsideredtodeterminewhetherthepercentageofADCchanges,andtheapoptoticandproliferatingindexeswerenormallydistributed.Anindependent-samplest-testwasusedtoanalyzethedifferencebetweenapoptoticandproliferatingindexesinthetwogroups.Results:Therewasastatisticallysignificantdifferenceinproliferatingindexbetweentheradiotherapyandcontrolgroups(meanproliferatingindex:49.27%vs.83.09%),andtherewasastatisticallysignificantdifferenceinapoptoticindexbetweenthetwogroups(meanapoptoticindex:37.7%vs.2.71%).AsignificantpositivecorrelationwasfoundbetweenthepercentageofADCchangesoftheviabletissueandapoptoticindex.Pearson'scorrelationcoefficientwas0.655(P=0.015).AsignificantnegativecorrelationwasfoundbetweenthepercentageofADCchangesoftheviabletissueandki-67proliferationindex.Pearson'scorrelationcoefficientwas0.734(P<0.001).Conclusions:OurresultssuggestthatADCvaluemaybeusedinmeasurementofcellapoptoticandproliferatingindexesincolorectalcarcinoma.

简介：Objective:ToexploretherelationshipbetweenquantitativeTreponemapallidumDNA(TP-DNA)PCRtestingandtheToludineRedUnheatedSerumTest(TRUST)inpatientswithsyphilisbeforeandaftertreatment,andevaluatetheclinicalvalueofquantitativeTP-DNAtestinginthediagnosisandtreatmentevaluationofsyphilis.Methods:29patientswithprimary(12cases)orsecondary(17cases)syphilis,whometthecriteriasetforthisstudywererecruitedassubjects.Allpatientsweretreatedwith2.4millionunitsbenzathinepenicillinIMweeklyfor3weeks.QuantitativetestsofTP-DNAinthepatients'plasmawereperformedusingFQ-PCRbeforeandafterthetreatment.SerologictestsincludingTRUSTandTPPAwerealsoperformed.Results:Beforethetreatment,9outof12primarysyphilispatients(75%)andallsecondarysyphilispatients(17/17)testedpositiveforTreponemapallidum(TP)byTP-DNAtesting.TheaveragequantitativetestvaluesofTP-DNAinprimaryandsecondarysyphilispatientswere(3.38±2.34)×10^4and(5.73±1.33)×10^6copies/ml,respectively.Afterthreemonthsoftreatment,1ofthe9primaryand5outof17secondarysyphilispatientswerepositiveuponTP-DNAtesting,respectively.TheaveragequantitiesofTP-DNAwere2.01×10^2copies/mlinprimaryand5.87×10^2copies/mlinsecondarysyphilispatientswithpositiveTRUSTandTP-DNAtests,and3.09×10^2copies/mlforthosewithnegativeTRUST,respectively.Afterninemonthsoftreatment,alltheprimaryandsecondarysyphilispatientswerenegativeuponTP-DNAtesting,whileallprimaryand14of17(82.35%)secondarysyphilispatientsshowednegativeTRUSTresults.Conclusion:ThattheresultsofTP-DNAtestsarenotconsistentwiththoseofTRUSTbeforeandaftertreatmentindicatesthatquantitativeTP-DNAtestingmayhavevaluableclinicalsignificanceintheearlydiagnosisandevaluationoftreatmentregimensforsyphilis.

简介：Objective:Chemotherapyisthestandardtreatmentforsmall-celllungcancer(SCLC),andleukopeniaisacommonsideeffect.Thisstudyassesseswhetherchemotherapy-inducedleukopeniaisapredictorofefficacyandwhetheritisassociatedwiththesurvivalofSCLCpatients.Methods:Aretrospectiveanalysiswasconductedondatafrom445patientswithSCLCwhoreceivedstandardchemotherapyfor4to10cycles.TheWorldHealthOrganizationgradingsystemclassifiesleukopeniaduringchemotherapyasfollows:absent(grade0),mild(grades1and2),orsevere(grades3and4).Theprimaryendpointisoverallsurvival(OS).Results:Theassociationbetweenchemotherapy-inducedleukopeniaandOSwasassessed.AccordingtoamultivariateCoxmodelwithtime-varyingcovariates,thehazardratioofdeathwassignificantlyloweramongpatientswithmildleukopeniathanamongpatientswithsevereleukopeniaat0.687(0.506to0.943)and1.414(1.147to1.744),respectively.Themediansurvivalwas13months(95%CI:11to15months)forpatientswhodidnotexperienceleukopenia,17months(95%CI:14to18months)forthosewithmildleukopenia,and14months(95%CI:13to16months)forthosewithsevereleukopenia(absentvs.mildvs.severeleukopenia,P=0.047).Conclusion:LeukopeniaduringchemotherapyisassociatedwiththesurvivalofSCLCpatients.Mildleukopeniaisstronglyassociatedwithlongersurvivaltime.