Research Status and Prospects of Non-Traumatic Fat Embolism in Forensic Medicine / 法医学杂志

In the practice of forensic pathology, fat embolism is one of the common causes of death, which can be divided into two categories: traumatic and non-traumatic. Non-traumatic fat embolism refers to the blockage of small blood vessels by fat droplets in the circulatory blood flow caused by non-traumatic factors such as underlying diseases, stress, poisoning and lipid metabolism disorders. At present, it is believed that the production of non-traumatic fat embolism is related to the disturbance of lipid metabolism, C-reactive protein-related cascade reaction, the agglutination of chylomicron and very low-density lipoprotein. The forensic identification of the cause of death of non-traumatic fat embolism is mainly based on the case, systematic autopsy, HE staining and fat staining, but it is often missed or misdiagnosed by forensic examiners because of its unknown risk factors, hidden onset, the difficulty of HE staining observation and irregular implementation of fat staining. In view of the lack of attention to non-traumatic fat embolism in forensic identification, this paper reviews the concepts, pathophysiological mechanism, research progress, existing problems and countermeasures of non-traumatic fat embolism, providing reference for forensic scholars.

Replacement Therapy for Hemophilia Patients Undergoing Cardiac Surgery: Report of Three Cases / 中国医学科学杂志(英文版)

Hemophilia is an X-linked recessive inherited bleeding disorder. Despite the improved treatment in recent years with the advent of replacement therapies, the progression of atherosclerosis is not slowed down after the reduction of clotting factors in hemophilia. As life expectancy increases, more hemophilia patients will suffer from age-related cardiovascular diseases. Since cardiac surgery needs heparinization and cardiopulmonary bypass (CPB), it is extremely challenging to balance hemostasis and coagulation in patients with hemophilia. Here we report three cases of hemophilia patients who underwent cardiac surgery successfully.

Mechanism of Salviae Miltiorrhizae Radix et Rhizoma and Carthami Flos Component Compatibility on Inflammatory Factor in Brain Tissue of Rats with Ischemic Stroke / 中国实验方剂学杂志

Objective:This study intends to study the regulatory effect and mechanism of the effective components of Salviae Miltiorrhizae Radix et Rhizoma and Carthami Flos on inflammatory factors related to cerebral ischemia-reperfusion injury in rats through multiple levels of neuropathology， molecular neurobiology and functional behavior. Method:The 32 male rats were randomly divided into four groups： sham group， model group， Danhong components compatibility group（720 mg·kg-1）， nimodipine （0.5 mg·kg-1）groups，each group of eight male rats.Cerebral ischemia was established by middle cerebral artery occlusion （MCAO） approach. The treatment was performed immediately and at 6 hour after MCAO.Hematoxylin-eosin （HE）staining was used to check the changes of brain histopathology， immunohistochemistry and Real time polymerase chain reaction （Real-time PCR） were used to check the expression of IL-1β and Nrf2 in brain tissue，Western blot was used to detect the protein expression of Nrf2 in brain tissue. The aim is to investigate the treatment mechanism of Salviae Miltiorrhizae Radix et Rhizoma and Carthami Flos components in a rat model of cerebral ischemic-reperfusion injury. Result:HE staining results showed， compared with sham group， the surviving neurons amount in the model group was significantly reduced（P<0.01），compared with the MCAO group，the number of surviving neurons in the brain tissue of Salviae Miltiorrhizae Radix et Rhizoma and Carthami Flos component compatibility group and nimodipine group was significantly increased（P<0.05，P<0.01）.The results of immunohistochemistry and Real-time PCR showed that，compared with normal group，IL-1β and Nrf2 expression in model group were significantly increased （P<0.01），compared with MCAO group， the expression of IL-1β and Nrf2 in Salviae Miltiorrhizae Radix et Rhizoma and Carthami Flos component compatibility group and the nimodipine group was significantly decreased （P<0.05，P<0.01）. Western blot results showed that， compared with sham group， Nrf2 positive expression in model group was much more increased （P<0.01）， compared with MCAO group， the expression of Nrf2 in Salviae Miltiorrhizae Radix et Rhizoma and Carthami Flos component compatibility group and the nimodipine group was significantly decreased （P<0.01）. Conclusion:The combination of effective components of Salviae Miltiorrhizae Radix et Rhizoma and Carthami Flos can significantly down-regulate the expression of IL-1β and Nrf2 proteins.The mechanism is to activate the protein expression of inflammatory pathways， reduce the apoptosis of nerve cells， and finally inhibit the inflammatory response in the process of ischemic stroke injury.

Liver histopathological diagnosis of autoimmune hepatitis / 临床肝胆病杂志

Autoimmune hepatitis may have various liver histopathological manifestations, with interface hepatitis with lymphoplasmacytic infiltration, rosette formation, and emperipolesis as relatively characteristic manifestations, but they are not specific. The above histological manifestations should be combined with clinical data to exclude hepatitis caused by other reasons. This article mainly elaborates on the characteristic histological manifestations of AIH and the histological manifestations of special types of AIH and discusses the value of histology in the diagnosis and differential diagnosis of AIH.

Characteristics and outcomes of primary angiosarcoma / 中华肿瘤杂志

Objective@#The study was designed to analyze the clinicopanthologic characteristics, treatments and outcomes of a series of patients with primary angiosarcoma.@*Methods@#The clinical, surgical and pathological data and treatment of 68 patients with pathologically confirmed angiosarcoma admitted to Peking Union Medical College Hospital from January 1990 to June 2017 was retrospectively analyzed. Kaplan-Meier method and Log rank test were used for univariate survival analysis and Cox regression model was used for multivariate survival analysis.@*Results@#A total of 68 patients were enrolled, 38 were male, 30 were female. The median age at diagnosis was 50.5 years. The time from symptom onset to diagnosis was (7.5±7.5) months. The primary sites included face and scalp, breast, chest wall, lung, heart, liver, spleen, extremities, bones and so on. At diagnosis, the mean size of tumors were (7.4±7.3) cm, 28 patients (41.2%) had localized disease (stage Ⅰ+ Ⅱ) and 40 patients had metastatic disease (stage Ⅲ+ Ⅳ). There were 37 patients treated with surgery alone, three receiving radiotherapy alone, five receiving chemotherapy alone and sixteen receiving comprehensive treatment with 5 underwent surgery plus radiotherapy, three treated by surgery plus chemotherapy, four had surgery plus interventional therapy, two had chemoradiotherapy, one had radiotherapy and interventional therapy and 1 had surgery plus chemoradiotherapy and targeted therapy. Five patients received only palliative treatment, and 2 patients lost follow-up after diagnosed. Fifty patients were followed up with a median overall survival time of 8.5 months. The median survival time of patients with metastatic angiosarcoma was 6.6 months, significantly shorter than that of patients with localized disease (15.0 months, P=0.020). The median survival time of patients with cardiac angiosarcoma was 3.0 months, significantly shorter than that of patients with angiosarcoma at other sites (11.5 months, P=0.010). The median survival time of patients receiving comprehensive treatment was 31.0 months, significantly longer than that of patients without comprehensive treatment (5.6 months, P=0.007). Multivariate analysis showed that staging, heart occurrence and comprehensive treatment were independent factors for the prognosis of primary angiosarcoma (all P<0.05).@*Conclusions@#Angiosarcoma is a rare malignancy, and patients with metastatic disease or cardiac occurence have poor prognosis. Comprehensive treatment can improve the prognosis of patients with angiosarcoma.

Clinical and radiologic characteristics as well as outcomes of patients with primary cardiac angiosarcoma / 中华心血管病杂志

Objective@#To analyze the clinical, radiologic characteristics, and outcome of consecutive patients with primary cardiac angiosarcoma.@*Methods@#The medical records of patients with primary cardiac angiosarcoma diagnosed through pathology at Peking Union Medical College Hospital between January 2001 and May 2018 were obtained. The results of echocardiography, coronary artery CT angiography (CTA), cardiac magnetic resonance (CMR), positron emission computed tomography (PET-CT), operation, postoperative treatment and prognosis of the patients were analyzed.@*Results@#A total of 16 patients were included, 9 were male, 7 were female, the median age was 42.5 years (31.7, 52.5). The interval from symptoms onset to diagnosis was 4.5 months (0.5-18.0 months). Eight patients were diagnosed at non-metastatic phase, while 8 patients were in metastatic phase. The main complaints were dyspnea, short breath, chest pain, hemoptysis, syncope, edema, fever, fatigue, and cough. Three patients (18.8%) had pericardial tamponade in the course of the disease. Echocardiography was performed on all 16 patients, cardiac mass was found in 12 patients, and pericardial effusion or pericardial thickening was observed in 4 patients. In 8 cases with results of coronary CTA, 5 cases presented signs of right atrium occupation, 1 case presented sign of right ventricle occupation, and 1 case presented isolated massive pericardial effusion. None abnormality was found in 1 case. Of the 7 patients who underwent CMR, 6 presented with right atrium mass occupation and 1 mediastinal mass. Four patients received PET-CT examination and results showed that all presented with hypermetabolic lesions: 2 in right atrium, 1 in pericardium, and 1 in mediastinum, and lung metastasis was found in 2 cases. Among the 16 patients, 13 received surgical treatment, 2 received adjuvant chemotherapy, and 1 received chemotherapy and radiotherapy after biopsy. The median overall survival was 3.0 months.@*Conclusion@#Cardiac angiosarcoma is a rare malignancy with poor prognosis, and echocardiography has only limited diagnostic value for angiosarcoma. CMR, CTA or PET-CT examinations could provide valuable clues for the diagnosis of this rare disease.

Clinicopathological analysis of anti-mitochondrial antibody negative primary biliary cholangitis-autoimmune hepatitis overlap syndrome / 中华肝脏病杂志

Objective@#To explore the clinicopathological features of anti-mitochondrial antibody (AMA) negative and positive patients with primary biliary cholangitis-autoimmune hepatitis overlap syndrome (PBC-AIH OS).@*Methods@#Seventy-four cases diagnosed as PBC-AIH OS from June 2017 to April 2018 were enrolled in this study. Among them, forty cases were AMA negative (negative group) and thirty-four cases were AMA positive (positive group). The clinical manifestations, serum biochemical indexes, immunological indexes and histological data of the negative group were compared with the positive group. Mann-Whitney U test and theχ 2test were used for statistical analysis.@*Results@#There was no significant difference in sex, age, clinical manifestations and major liver function indexes (ALT, AST, ALP, GGT, TB, DB) between the negative group and positive group (P> 0.05). The level of IgM in the negative group (1.68 ± 0.87) was significantly lower than positive group (3.77 ± 2.88)(P< 0.05). The positive rates of antinuclear antibodies (ANA) and gp-210 antibodies was lower than positive group (P< 0.05). There were no significant differences in the stages of inflammation and fibrosis between the two groups (P> 0.05), and the bile duct injury was more significant in the negative than positive group (P< 0.05).@*Conclusion@#The serum IgM level of AMA-negative PBC-AIH OS is low, and immunological antibody is often negative, which makes bile duct injury apparent in liver histology. A liver biopsy should be carried out as soon as possible for early diagnosis and treatment.

Experimental study of silybin-phospholipid complex intervention on amiodarone-induced fatty liver in mice / 中华肝脏病杂志

Objective@#To probe into the mechanism and interventional effects of silybin-phospholipid complex on amiodarone-induced steatosis in mice.@*Methods@#Eight-week-old male C57BL/6 mice were divided into three groups (5 mice in each group): a control group (WT) with normal diet, a model group with amiodarone 150mg/kg/d by oral gavage (AM), and an intervention group on amiodarone 150mg/kg/d combined with silybin-phospholipid complex(AM+SILIPHOS. All mice were fed their assigned diet for one week. Then, one week later, serum alanine aminotransferase, aspartate aminotransferase, triglyceride, total cholesterol and high-density lipoprotein were detected of each group. A liver pathological change was observed by oil red O and H&E staining. Ultrastructural pathological changes of hepatocytes were observed to evaluate the intervention effect by transmission electron microscopy. RT-q PCR was used to detect the expression of peroxisome proliferator-activated receptor alpha and its regulated lipid metabolism genes CPTI, CPTII, Acot1, Acot2, ACOX, Cyp4a10 and Cyp4a14 in liver tissues. Intra-group comparison was done by paired t-test. One-way ANOVA was used for comparison between groups and semi-quantitative data were tested using Mann-Whitney U test.@*Results@#Oil Red O and H&E staining results of liver tissue in the intervention group showed that intrahepatic steatosis was significantly reduced when compared to model group. Transmission electron microscopy showed that the model group had pyknotic nuclei, mitochondrial swelling, structural damage, and lysosomal degradation whereas the intervention group had hepatic nucleus without pyknosis, reduced mitochondrial swelling and slight structural damage than that of model group. RT-q PCR results showed that the expression of peroxisome proliferator-activated receptor alpha, CPTI, CPTII, Acot1, Acot2, ACOX, Cyp4a10 and Cyp4a14 were increased in the model group but the expression of CPTI, Cyp4a14, Acot1 and peroxisome proliferator-activated receptor alpha were decreased in the intervention group (P < 0.05).@*Conclusion@#Silybin-phospholipid complex can alleviate amiodarone-induced steatosis, and its mechanism may play a role in protecting mitochondrial function and regulating fatty acid metabolism. Thus, silybin-phospholipid complex has potential intervention effect on amiodarone-induced fatty liver.

Morphological analysis of cardiac rupture due to blunt injury, cardiopulmonary resuscitation and myocardial infarction in forensic pathology / 南方医科大学学报

OBJECTIVE@#To analyze the morphological features and forensic pathological characteristics of cardiac ruptures of different causes for their differential diagnosis.@*METHODS@#We analyzed the data of 44 autopsy cases of cardiac rupture from 2014 to 2017 in our institute, including 11 cases caused by blunt violence with intact pericardium, 4 caused by cardiopulmonary resuscitation (CPR), 9 by myocardial infarction, and 20 by aorta dissection rupture.The gross features and histopathological characteristics of cardiac rupture and pericardial effusion were analyzed and compared.@*RESULTS@#Cardiac ruptures caused by blunt violence varied in both morphology and locations, and multiple ruptures could be found, often accompanied with rib or sternum fractures; the volume of pericardial effusion was variable in a wide range; microscopically, hemorrhage and contraction band necrosis could be observed in the cardiac tissue surrounding the rupture.Cardiac ruptures caused by CPR occurred typically near the apex of the right ventricular anterior wall, and the laceration was often parallel to the interventricular septum with frequent rib and sternum fractures; the volume of pericardial blood was small without blood clots; microscopic examination only revealed a few hemorrhages around the ruptured cardiac muscular fibers.Cardiac ruptures due to myocardial infarction caused massive pericardial blood with blood clots, and the blood volume was significantly greater than that found in cases of CPR-induced cardiac rupture ( < 0.05);lacerations were confined in the left ventricular anterior wall, and the microscopic findings included myocardial necrosis, inflammatory cell infiltration, and mural thrombus.Cardiac tamponade resulting from aorta dissection rupture was featured by massive pericardial blood with blood clots, and the blood volume was much greater than that in cases of cardiac ruptures caused by blunt violence, myocardial infarction and CPR ( < 0.05).@*CONCLUSIONS@#Hemorrhage, inflammatory cell infiltration, and lateral thrombi around the cardiac rupture, along with pericardial blood clots, are all evidences of antemortem injuries.

Application of SDHB and SDHC immunohistochemistry in the differentiation of malignant and benign pheochromocytoma and paraganglioma / 中华内分泌代谢杂志

Objective To evaluate the expression profile of succinate dehydrogenase (SDH)B and SDHC in pheochromocytoma (PCC) and paraganglioma(PGL) (collectively abbreviated as PPGL), and their value in the early diagnosis of malignancy. Methods SDHB and SDHC immunohistochemistry were performed on 140 tumor specimens from 126 PPGL patients (PCC n＝62, PGL n＝61, PCC+PGL n＝3). Results (1) Germline mutation status of 67 patients were determined, of which, identifying 37(55.2%) patients with germline mutation: 2 (3.0%) SDHA, 18 ( 26. 9%) SDHB, 2 ( 3. 0%) SDHC, 5 ( 7. 5%) SDHD, 2 ( 3. 0%) VHL, 7 ( 10. 4%) RET, and 1(1.5%) NF1; and 30 (44.8%) individuals without known mutation. (2) Among 30 PPGLs from 27 patients with SDH-related (SDHx) mutations, 96.7%(29/30) stained negative for SDHB, 76.7%(23/30) stained negative for SDHC, while only 28.6%(14/49) and 18.4%(9/49) stained negative for SDHB and SDHC respectively in the 49 PPGLs without SDHx mutation (P<0.05). (3) The sensitivity of the SDH immunostaining in detecting the presence of germline SDHx mutation was 96.7%for SDHB and 76.7%for SDHC, while the specificity was 71.4%for SDHB and 81.6% for SDHC. ( 4 ) Among PPGLs without SDHB expression, 22. 9% were malignant. This percentage is significantly higher than that in PPGLs with preserved SDHB expression (3.8%, P<0.05). Conclusion SDHB and SDHC immunohistochemistry may serve as post-surgical screening tools to predict the presence of germline SDHx mutation in PPGLs. Negative SDHB expression calls for intense follow-up to rule out malignancy.

Pathological Features of Autoimmune Liver Diseases / 胃肠病学

Autoimmune hepatitis (AIH),primary biliary cholangitis (PBC,formerly known as primary biliary cirrhosis),primary sclerosing cholangitis (PSC),IgG4-related sclerosing cholangitis (IgG4-SC) and IgG4-related hepatopathy are the main categories of autoimmune liver diseases (AILDs),and liver biopsy is important for their diagnosis and management. The characteristic histological features of AIH are interface hepatitis with portal lymphoplasmacytic infiltration,hepatic rosette formation and emperipolesis. Chronic nonsuppurative destructive cholangitis and epithelioid granuloma are frequently seen in PBC. PSC is characterized by 'onion-skin'type periductal fibrosis,while storiform fibrosis with IgG4-positive plasmacytic infiltration usually indicates IgG4-SC. Closer cooperation between clinicians and pathologists may improve the diagnosis and management of AILDs.

Clinical observation of isolated immunoglobulin G4-related sclerosing cholangitis and immunoglobulin G4 sclerosing cholangitis combined autoimmune pancreatitis / 中华肝脏病杂志

Objective@#To compare and analyze patient’s general condition, laboratory testing and therapeutic responses of isolated immunoglobulin G4- related sclerosing cholangitis (IgG4-SC) and immunoglobulin G4 sclerosing cholangitis combined autoimmune pancreatitis (IgG4-SC/AIP).@*Methods@#A retrospective study was conducted on IgG4-SC patients who attended outpatient and inpatients department of our hospital from April 2014 to March 2018 and their demographic characteristics, laboratory testing, and therapeutic responses were statistically analyzed. Normal distribution of continuous variables was compared with t-test, non-normal distribution of continuous variables was compared using the Mann-Whitney U test, and the categorical variables were compared with χ 2 test.@*Results@#29 IgG4-SC patients were included, including 19-isolated IgG4-SC and 10 IgG4-SC combined AIP (IgG4-SC/AIP). The average age of onset in the isolated IgG4-SC group was (46.06±19.03) years which was lower than IgG4-SC/AIP group (62.60±15.11), t = -2.360, P < 0.05. The median IgG4 in IgG4-SC/AIP patients is higher than that in isolated IgG4-SC, respectively 10.87 (3.73 ~ 20.13) and 3.14 (2.37 ~ 4.78)g/L(U = 159.000, P < 0.05). IgG4/IgG ratio is higher in IgG4-SC/AIP, than that in isolated IgG4-SC, respectively 0.62(0.23 ~ 0.86) and 0.16(0.10 ~ 0.21), U = 130.000, P < 0.05. Liver cirrhosis was more common in isolated IgG4-SC group (47%) than the IgG4-SC/AIP group (0), χ 2 = 9.637, P < 0.05. The median biochemical response time of isolated IgG4-SC group was 3.00 (2.00 to 4.00) months, which was longer than 1.00 (1.00 to 1.25) months of IgG4-SC/AIP group, U = 30.000, P < 0.05. The biochemical recurrence rate of isolated IgG4-SC group was 32%, which was lower than that of IgG4-SC/AIP (χ 2 = 6.461, P < 0.05).@*Conclusion@#Serum IgG4 level and IgG4/IgG ratio were higher in patients with IgG4-SC/AIP group, and therapeutic responses in isolated IgG4-SC patients were worse than that of IgG4-SC/AIP patients. The efficacy of glucocorticoid monotherapy and immunosuppressive agents combined with glucocorticoid therapy demonstrated no considerable difference in IgG4-SC patients.

Study on commercial specification of Gardenia jasminoides / 中国中药杂志

Collecting different commodity grade Gardenia jasminoides of wild and cultivated varieties all over the country, obtaining color information from each batch of G. jasminoides by the standard D65 light source and image acquisition system, quantifing the gardenia plumpness information by the digital display vernier caliper, determinating 6 kinds of effective components of G. jasminoides by HPLC, classifing from ten indicators by two step clustering analysis and correspondence analysis method of statistics, clearing the importance of the traditional identification indexes, establishing multiple corresponding relation between the skin color and commercial specification of G. jasminoides,exploring the correlation of the skin color and chemical composition, to provide the reference for the reasonable division of commercial specifications and grades of G. jasminoides. Medicine is divided into two classes and has obvious distinguish meaning, The importance of the skin color is greater than the plumpness in traditional identification characteristics, it can accurately distinguish the specifications of G. jasminoides. We improve and rebuild the standard of commodity specifications and grades of Gardenia jasminoides Ellis and establish the rapid evaluation method by the study, it provide a new way and idea for the comprehensive evaluation of G. jasminoides quality.

Effect of Mesalazine Combined with Trimebutine on Mast Cell and Related Inflammatory Mediators in Colonic Mucosa in Patients with Irritable Bowel Syndrome / 胃肠病学

Background: Mast cell activation is a characteristic of irritable bowel syndrome (IBS).Study on mast cell and the related inflammatory mediators in colonic mucosa is helpful for the evaluation and treatment of IBS.Aims: To assess the effect of mesalazine combined with trimebutine on colonic mucosal mast cell and related inflammatory mediators in patients with IBS.Methods: Forty patients with diarrhea-predominant IBS (IBS-D) and 40 patients with constipation-predominant IBS (IBS-C) from Oct.2014 to June 2016 at Shanghai Jiading District Central Hospital were enrolled, 20 healthy volunteers were served as controls.Forty patients with IBS-D and 40 patients with IBS-C were randomly divided into mesalazine+trimebutine group and trimebutine group, the treatment courses were all 4 weeks.Number of mast cell was counted by modified toluidine blue staining.Score of related inflammatory mediators were evaluated by immunohistochemistry.Clinical efficacy was assessed.Results: Compared with healthy controls, number of mast cell at baseline was significantly increased both in IBS-D and IBS-C patients (P<0.05).After treatment with mesalazine+trimebutine, number of mast cell was significantly decreased (P<0.05).At baseline, immunohistochemical staining score of 5-HT, IL-1, TNF-α, histamine, tryptase were significantly increased in IBS patients than in healthy controls (P<0.000 1).After treatment with mesalazine+trimebutine, above-mentioned inflammatory mediators were significantly decreased (P<0.05).In IBS-D patients, the total efficacy rate in mesalazine+trimebutine group was significantly increased than that in trimebutine group (85.0% vs.45.0%, P=0.008).In IBS-C patients, no significant difference in total efficacy rate was found between mesalazine+trimebutine group and trimebutine group (55.0% vs.25.0%, P=0.053).Conclusions: Mesalazine combined with trimebutine is an effective and safe approach to reduce mast cell infiltration and release of related inflammatory mediators, and is more efficient for patients with IBS-D.

Clinical feature and post-operativeprognosis of infective endocarditis patients with acute kidney injury / 基础医学与临床

Objective To analyze the clinical features and prognosis of patients with infective endocarditis(IE) and acute kidney injury(AKI),and to evaluate the effect of timely operation on prognosis of renal function.MethodsClinical data of 45 IE and AKI cases in Peking Union Medical College Hospital from January 2010 to May 2016 were retrospectively reviewed;among them 8 cases underwent renal biopsy and the pathologies were analyzed.Patients were divided into Operation group(22 cases) and Non-operation group(23 cases),the clinical data and prognosis were compared.Results The ratio of male to female was 2.46:1 and the average age was 48.3±16.6.35.6% of cases were found with basic valve diseases,the congenital valve diseases were the most common type.The most frequently infected valves were mitral valve(46.7%),aortic valve(28.9%) and prosthetic valve(8.9%) ordinally.The most common pathogenic bacteria were streptococcus(46.7%) and staphylococcus(35.6%).Some rare and special pathogen could also be found in these cases.In 8 cases underwent renal biopsy,3 cases were diagnosed as crescentic nephritis,2 cases were diagnosed as focal proliferative glomerulone-phritis and mesangial prolif-erative glomerulonephritis respectively,1 case was diagnosed as acute interstitial nephritis.C3 sedimentation was the most common phenomenon found in immunofluorescence.There was no significant difference between the baseline data of Operation and Non-operation groups,and neither was the survival rate.However,renal function recovered better in Operation group(P<0.05): the serum creatinine declined remarkably in 7 days(P<0.05) and 30 days(P<0.01)post operation,compared with the peak valve before operation.Conclusions The underline valve diseases and pathogen have been changed in IE as compared with traditional description.Crescentic nephritis is common in renal pathologic manifestation when parenchymal lesion is developed after the onset of IE.Timely operation can improve the renal prognosis in patients with IE and AKI.

Surgical Treatment Strategies of Intravenous Leiomyomatosis withRight Cardiac Cavities Extension / 中国医学科学院学报

Objective To investigate the diagnosis and surgical treatment strategies of intravenous leiomyomatosis(IVL)extending through inferior vena cava into the right cardiac cavities. Methods Thirty patients of IVL extending through inferior vena cava into the right cardiac cavities were treated in Peking Union Medical College Hospital from November 2002 to January 2015.The following variables were studied: age,cardiopulmonary bypass time,deep hypothermic circulatory arrest time,origins of IVL,blood loss,duration of post-operative hospital stay,hospitalization expenses,edema of lower extremity,blood transfusion,postoperative complication,residual IVL,and re-grow or recurrence. Results Thirteen of 30 patients reported double lower limb edema. The cardiopulmonary bypass was applied in 27 cases,and the average duration of cardiopulmonary bypass was(106.9±53.7)min. Then,21 patients were treated with the deep hypothermic circulatory arrest,and the mean time was(28.2±11.6) min. The tumors originated from the genital veins in 9 cases,the iliac vein in 13 cases,and both veins in 8 cases. The average intra-operative blood loss volume was (2060.5±2012.3)ml,and 21 patients received blood transfusion. The average hospitalization time was(18.9±8.3)days and the average hospitalization expenses was (80 840.4±28 264.2)RMB yuan. While 14 patients had postoperative complications,there was no serious postoperative complication or death.All patients have shown a favorable outcome.Conclusions Tumor embolus extending through inferior vena cava into the right cardiac cavities should be suspected in patients with multiple hysteromyoma. Successful therapy for IVL with right cardiac cavities extension is dependent on reasonable surgical treatment strategies. Surgical removal of the ovaries is vital to avoid IVL re-grow or recurrence.

Study on ecological suitability of Gardenia jasminoides based on ArcGIS and Maxent model / 中国中药杂志

The application of ArcGIS and Maxent modelto analyze the ecological suitability of Gardenia jasminoides.Taking 85 batches of Gardenia as the basis of analysis, the selection of ecological factors for the growth of Gardenia. The results showed that the average precipitation in April, the average precipitation in November and the average precipitation in August were the most important factors affecting the growth of Gardenia. The relative concentration of Gardenia suitable growth region,north to the south of Shaanxi province, south of Henan, central Anhui, south to the north of Hainan province, west to central Sichuan province, east of Zhejiang coastal area, northeast of Taiwan.

Ascending to descending aorta extraanatomic bypass for coarctation of aorta / 国际外科学杂志

Objective To summarize the treatment of 10 aortic coarctation cases ,who receive the surgery from ascending aorta to thoracic descending aorta with the prosthetic graft, discuss the valuable and appliable of this method. Methods Cardiac surgery, Chinese Acdemy of Medical Sciences, Peking Union Medical College Hospital department treated 10 patients who got the aortic coarctation from Jan. 2006 to Dec. 2015 Seven male patients and 3 cases of female patients consist of the sample, aged from 14 to 35 years old, the median age was 27. One cases consolidated aortic valve deformity and aortic root expansion, the others were simple aortic coarctation. Their upper limbs blood pressure was 20 mmHg higher compared with the low limb. Meanwhile, there was no sign of surgery contraindication. Ten cases received this operation under cardiopulmonary bypass situation. And the patient who consolidate aortic valve deformity and aortic root expansion receive the Bentall surgery at the same time. Results There was no death during perioperative time, no spinal cord ischemic and other serious complications. Those patients went back to outpatient department after discharging from hospital 3 to 6 months. The differential pressure between upperlimbs and low limbs were less than 20 mmHg, and the CTA results indicated no aneurysms. Conclusion Using artificial blood vessels to make a graft from the ascending aorta to the descending aorta is an effective method for treatment of thoracic aorta.

Endoscopic Saphenous Vein Harvesting versus Open Vein Harvesting Techniques / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate whether endoscopic saphenous vein harvesting (EVH )reduces leg wound morbidity and improves rehabilitation of lower extremity as compared to open vein harvesting (OVH) in patients with coronary artery disease.</p><p><b>METHODS</b>The clinical data of 333 patients who underwent isolated coronary artery bypass graft surgery (CABG) between January 2007 and December 2011 were retrospectively analyzed.These patients were divided into EVH group (n=210) and OVH group (n=123). Parameters including age,sex,with/without diabetes mellitus,leg wound complications rate,postoperative hospital stay,hospitalization expense,and vein graft patency were analyzed.</p><p><b>RESULTS</b>The age,sex,with/without diabetes mellitus were not significantly different between two groups (P>0.05). However,the incidences of leg wound complications, poor wound healing, wound infections, wound pain,wound numbness, and edema of lower extremity were significantly lower in the EVH group than the OVH group (P<0.05). The ecchymoma and deep vein thrombosis incidences were not significantly different between these two groups (P>0.05). The postoperative hospital stay showed no significant difference (P>0.05), while the hospitalization expense was significantly higher in the EVH group than in the OVH group (P<0.05). There was no statistical difference of vein graft patency (P>0.05).</p><p><b>CONCLUSION</b>The EVH system is a safe and effective alternative to OVH because it can markedly reduce postoperative leg wound morbidity and the EVH vein graft has good patency.</p>

Fungistasis of nanometer silvers synthesized by different methods on Candida al-bicans / 药学实践杂志

Objective To explore the in vitro fungistasis of nanometer silvers made by different methods on Candida al-bicans .Methods The minimal inhibitory concentrations (MICs) of Candida albicans strains stimulated to silver nanoparticles were determined by microdilution method .The combination effects of silver nanoparticles with fluconazole were determined by chess board check assay .Results The inhabitation effect of two kinds of silver nanoparticles were different on the growth of Candida albicans .Silver nanoparticles had a synergistic effect with fluconazole on Candida albicans .Conclusion The two kinds of silver nanoparticles had various antifungal activities in vitro and had a synergistic effect with fluconazole on Candida albicans .