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Objective:To investigate the gait characteristics of patients with early Parkinson′s disease (PD) under cognitive dual task, and to provide sensitive kinematic indicators for the early diagnosis, timely treatment and reasonable rehabilitation of PD.Methods:A total of 62 outpatients and inpatients with early non-tremor Parkinson′s disease in Shijingshan Branch of Beijing Chaoyang Hospital Affiliated to Capital Medical University from September 2021 to August 2023 were selected as experimental group (PD group), and 62 healthy controls with comparable age composition ratio were selected as control group. The baseline data, Montreal Cognitive Assessment Scale scores, and the gait assessment scores of the motor part of the Unified Parkinson′s Disease Rating Scale were compared between the 2 groups. The wearable gait analysis device was used to collect the gait parameters of the 2 groups of subjects under single task and dual task, and the foot kinematic characteristics of the patients with early PD were quantified. Independent sample t test and Mann-Whitney U test were used to analyze the gait parameters of the 2 groups. The statistically significant variables were included in Logistic regression analysis to explore the association between gait parameters and PD. Finally, the diagnostic value of the variables was estimated by receiver operating characteristic (ROC) curve analysis. Results:Gait spatio-temporal parameters (per gait cycle): (1) The gait speed of the PD group was slower than that of the control group [(1.01±0.12) m/s vs (1.22±0.18) m/s, t=-7.526] during single task walking. The bipedal support time in the PD group was significantly longer than that in the control group [(0.29±0.05) s vs (0.22±0.06) s, t=6.659]. The differences were both statistically significant (both P<0.001). (2) During dual-task walking, PD patients showed slower gait speed [(0.88±0.11) m/s vs (1.19±0.16) m/s, t=-12.158, P<0.001]. The bipedal support time in the PD group was longer than that in the control group [(0.36±0.05) s vs (0.22±0.05) s, t=12.828, P<0.001]. PD patients had shorter stride length [(109.20±6.21) cm vs (112.77±5.87) cm, t=-3.203, P=0.010]. Stride frequency in the PD group was higher than that in the control group [(114.45±7.10) steps/min vs (110.87±7.16) steps/min, t=2.724, P=0.020]. The single leg support time was longer than that of the control group [(0.49±0.12) s vs (0.45±0.06) s, t=2.643, P=0.020] , and the differences were statistically significant. Gait kinematics parameters: (1) During single task walking, the maximum angle of foot movement in the sagittal plane in the PD group was smaller than that in the control group (17.19°±2.37° vs 19.71°±2.92°, t=-4.691, P<0.001). The minimum angle of movement in the sagittal plane was smaller than that in the control group (-67.08°±4.63° vs -70.10°±3.94°, t=0.395, P=0.001). The minimum horizontal angle of the foot during exercise in the PD group was lower than that in the control group (9.08°±4.02° vs 11.80°±3.60°, t=-3.461, P<0.001). The minimum angle of the foot coronal plane in the PD group was smaller than that in the control group (-10.55°±2.87° vs -12.04°±2.31°, t=2.831, P=0.030; the negative sign only represents the movement direction). The touch angle of the foot in the PD group was significantly lower than that in the control group (11.14°±2.78° vs 12.78°±3.57°, t=-2.779, P=0.030). (2) During dual-task walking, the maximum sagittal angle (15.44°±2.54° vs 18.99°±2.71°, t=-6.673, P<0.05), the minimum angle of sagittal plane (-65.68°±4.73° vs -70.02°±4.04°, t=-4.747, P<0.001; the negative sign only represents the direction of movement), the minimum coronal movement angle (-11.15°± 2.99° vs -13.18°±2.50°, t=3.642, P=0.020), the touch angle (11.01°±3.10° vs 12.83°±4.01°, t=-2.438, P=0.010), the minimum horizontal angle (8.83°±4.04° vs 11.83°±3.63°, t=-3.776, P<0.001), and the change of the angle from the ground (-65.00°±3.54° vs -67.06°±3.61°, t=3.133, P<0.001) in the PD group were all smaller than that in the control group. The differences were all statistically significant. Logistic regression analysis showed that step frequency was positively correlated with PD ( OR=1.124,95% CI 1.040-1.201, P=0.001), minimum angle of coronal plane was positively correlated with PD ( OR=1.501, 95% CI 1.040-2.151, P=0.030). Stride length was negatively correlated with PD ( OR=0.902, 95% CI 0.830-0.978, P=0.010). ROC curve was used to evaluate the diagnostic value of step frequency, stride length and minimum angle of coronal plane. For step frequency, when the maximum Youden index was 0.880, the best cut-off value to distinguish the PD group from the control group was 115.000, the sensitivity was 0.577, the specificity was 0.710, and the area under the curve was 0.656. For the minimum coronal angle, when the maximum Youden index was 0.251, the best cut-off value was -12.575, the sensitivity was 0.728, the specificity was 0.531, and the area under the curve was 0.670. For stride length, when the maximum Youden index was 0, the best cut-off value was 100.91, the sensitivity was 0.950, the specificity was 0.050, and the area under the curve was 0.300. Conclusions:Some gait parameters such as step frequency and minimum angle of coronal plane can be used as kinematic markers to reflect the gait characteristics of early PD, which may be helpful in tracking and evaluating the gait disorder characteristics of early PD patients and predicting the risk of PD. Some gait parameters of PD patients are significantly different from those of healthy people during cognitive-motor dual-task walking.
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@#Objective To evaluate the effect of postural restriction in preventing recurrence of Benign Paroxysmal Positional Vertigo(BPPV). Methods A total of 217 unilateral posterior semicircular canal BPPV patients were diagnosed clearly and divided into two groups randomly:104 caes(observation group) were demand postural restriction(head up 45 degrees for 72 hours,but did not restricted sleeping posture or departure from bed) after Epley maneuver,while 114 case(control group) could freely sleep. Demographic data,concomitant diseases and betahistine mesylate treatment were recorded. All patients were follow-uped at 72 hours after the Epley maneuver at outpatients of our hospital. A induced vertigo by position change or positional nystagmus were defined as recurrence of BPPV. Results There was no statics defferrence between two groups for base line data. After 72 hours of Epley maneuver,BPPV recurrence rates was 21.2% and 41.6% for observation group and control group,respectively(P<0.01). Odds ratio of postural restriction for BPPV recurrence was 0.377(95%CI 0.207~0.687). Conclusion Head up 45 degrees for 72 hours after Epley maneuver was helpful for preventing BPPV early recurrence.
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Silent mating type information regulation 2 homolog-3(Sirt3) has a close relationship with neurodegenerative diseases. As researches developing, more and more abnormal proteins have been found depositted in neuron, and these abnormal proteins could induce mitochondrion oxidative stress injury. But Sirt3 could resist abnormal protein′s oxidative stress injury by deacetylation. So Sirt3 may delay the progression of neurodegenerative diseases.
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A 33 years old male patient who suffered from a flame burn of 88% total body surface area was admitted to our hospital on November 28th, 2016. During his hospitalization, we repeatedly performed central vein catheterization in internal jugular veins, subclavian veins, or femoral veins for fluid transfusion. We incidentally found bilateral internal jugular vein thrombosis by performing a point-of-care ultrasound examination before catheterizing sometime. We treated the patient by avoiding catheterization in the affected internal jugular veins, anticoagulating with low molecular weight heparin, closing the wounds with skin autografting, and guiding the patient to practice functional exercise. The thrombus disappeared in the end. The patient was cured and discharged 3 months post burn.
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Objective To investigate the prevalence of anxiety and depression one month before idiopathic benign paroxysmal positional vertigo (BPPV) episode. Methods Patients from Vertigo Clinic of Department of Neurology, West Campus, Chaoyang Hospital, were enrolled from January 2014 to June 2016. For patients with first visiting idiopathic BPPV, Hamilton Anxiety Scale and Hamilton Depression Scale were used at the consulting room by an experienced neurologist to reflect the emotional state one month before idiopathic BPPV episode. The occurrence rate of mood disorders was compared with usual model. Results One hundred and eighty five patients with idiopathic BPPV, aged 28 to 82 (57.6±12.0) years, 19.5% (36/185) being male, 80.5% (149/185) being female, were enrolled into this research. No anxiety, probable anxiety, definite anxiety and severe anxiety accounted for 15.1% (28/185), 33.0% (61/185), 47.6% (88/185) and 4.3% (8/185), respectively;no depression, probable depression, definite depression and severe depression accounted for 18.4% (34/185), 48.6% (90/185), 29.2% (54/185) and 3.8% (7/185), respectively;no mood disorders, probable mood disorders, definite mood disorders and severe mood disorders accounted for 11.4% (21/185), 33.5% (62/185), 49.2% (91/185) and 5.9% (11/185), respectively;total definite mood disorders and severe mood disorders accounted for 55.1% (102/185), higher than usual model (14.4%)Conclusion Anxiety and depression is common before idiopathic BPPV episode.
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BACKGROUND AND PURPOSE: It is unclear whether postthrombolytic antiplatelet (AP) therapy after thrombolytic-related hemorrhage without extensive parenchymal involvement (THEPI) affects the clinical outcome. This study explored whether AP administration in patients with THEPI affects short- and long-term outcomes. METHODS: All of the data for this study were collected from the Thrombolysis Implementation and Monitor of Acute Ischemic Stroke in China (TIMS-China) registry. Patients with THEPI were assigned to either the AP (AP therapy should be commenced 24 h after intravenous thrombolysis) or AP-naive groups. THEPI was defined according to European-Australasian Acute Stroke Study II criteria. The 90-day functional outcome, 7-day National Institutes of Health Stroke Scale (NIHSS) score, and 7-day and 90-day mortalities were compared between the AP and AP-naive groups. Logistic regression analysis was used to evaluate the effects of AP therapy on the short- and long-term clinical outcomes. RESULTS: Of the 928 patients enrolled from those in the TIMS-China registry (n=1,440), 89 (9.6%) had nonsymptomatic intracerebral hemorrhage (ICH) within 24-36 h after thrombolysis; 33 (37%) of these patients were given AP therapy (AP group) and 56 (63%) were not (AP-naive group). No significant differences were found for the risk of 7-day aggravated ICH (p=0.998), 7-day NIHSS score (p=0.5491), 7-day mortality [odds ratio (OR)=3.427; 95% confidence interval (95% CI)=0.344-34.160; p=0.294], 90-day mortality (OR=0.788, 95% CI=0.154-4.040, p=0.775), or modified Rankin score 5 or 6 at 90-days (OR=1.108, 95% CI=0.249-4.928, p=0.893) between the AP and AP-naive groups after THEPI. CONCLUSIONS: Early administration of postthrombolytic AP therapy after THEPI does not worsen either the short- or long-term outcome. AP therapy may be a reasonable treatment option for patients with THEPI to reduce the risk of ischemic stroke recurrence.
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Humanos , Hemorragia Cerebral , China , Hemorragia , Modelos Logísticos , Mortalidade , Recidiva , Acidente Vascular CerebralRESUMO
It is important to meet the need of modern high-technology war during the new period in which our army change the modes of generating combat capabilities .How to more scientifically and effectively improve the soldiers′physical quality and reserve ability will play a key role in soldiers′operations training .Therefore,the metabonomic analysis will pro-vide a new idea for the military physical training monitoring .The application of metabonomics to military fitness training monitoring is described in this paper .
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BACKGROUND AND PURPOSE: Treatment with atorvastatin (80 mg) in stroke secondary prevention for patients with prior intracranial hemorrhage (ICH) has been associated with a higher frequency of ICH. The aim of this study was to determine whether 20 mg/day atorvastatin is linked to stroke recurrence in Chinese ischemic stroke patients with prior ICH. METHODS: A single-center retrospective cohort study was conducted, involving 354 cases from 395 Chinese in-patients who had ischemic stroke with prior ICH history in Beijing Chaoyang hospital from May 1, 2005 to October 31, 2010. Survivors were followed by telephone interviews for 12-60 months. Cox regression and Kaplan-Meier plot analysis were used to evaluate the effect of 20 mg/day atorvastatin on cerebral infarction and ICH recurrence. RESULTS: The overall rate of stroke recurrence was lower in the 20 mg/day atorvastatin group (chi2=6.687, p=0.022) than in the control group. The incidence of cerebral hemorrhage was increased by 20 mg/day atorvastatin for ischemic stroke cases with a history of ICH compared to those not receiving the drug, but the difference was not significant [hazard ratio (HR)=1.097, 95% confidence interval (CI)=0.800-1.243, p=0.980]. The incidence of ischemic stroke recurrence was significantly reduced in subjects receiving atorvastatin (HR=0.723, 95% CI=0.578-0.862, p=0.028), and the mean duration of all stroke recurrences was significantly prolonged, compared with those not exposed to the drug (chi2=5.351, p=0.021). The mean duration of ICH recurrence appeared to have shortened with atorvastatin, but the difference was not significant (chi2=0.680, p=0.480), and the mean duration of cerebral infarction recurrence was significantly prolonged (chi2=8.312, p=0.004). CONCLUSIONS: Medication with 20 mg/day atorvastatin may be beneficial in reducing ischemic stroke recurrence in ischemic stroke patients with a history of ICH and is not associated with an increased risk of ICH recurrence.
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Humanos , Atorvastatina , Povo Asiático , Hemorragia Cerebral , Infarto Cerebral , Estudos de Coortes , Ácidos Heptanoicos , Incidência , Entrevistas como Assunto , Hemorragias Intracranianas , Pirróis , Recidiva , Estudos Retrospectivos , Prevenção Secundária , Acidente Vascular Cerebral , SobreviventesRESUMO
ObjectiveTo research collateral pathways and collateral grading through digital subtract angiography(DSA) and their relation to clinical prognosis.MethodsCollateral pathways and collateral grading of 49 cases suffered from severe internal carotid artery (ICA) stenosis (70% -99% ) were assessed through DSA.Incidence of stroke,TIA or cerebral hemorrhage were observed in the following 12 months.Results①In all the subjects,no collateral pathway exist in 9 cases(18.9%),and primary and secondary collateral pathways occurred in 39(79.6% ) and 25(51.0%)cases.Pathway is not related to clinical prognosis.②There were 9 ,15 and 25 cases in 0 grade,1 -2 grade and 3 -4 grade collateral circulation and the complication ratio is 44.4%,50.66% and 24.00% respectively.Incidence of ischemic cerebrovascular disease is significantly higher in 3 - 4 grade patinets than those in 0 and 1 - 2 grade pation(x2 =4.856,3.242;all P < 0.05 ).ConclusionsCollateral levels but not pathway were correlated with clinical prognosis in patients with severe stenosis of internal carotid artery.
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Objective To investigate the usage of antiplatelet drugs(APD)therapy in ischemic stroke with a history of intracranial hemorrhage(ICH)and impact of APD therapy in recurrences of the ICH and the ischemic stroke. Methods In a retrospective study, all survivors of ischemic stroke with ICH who visited our hospital previous to this study were followed by clinic visit or by telephone interview and recurrent ICH, ischemic stroke, and APD use were recorded. Kaplan-Meier plot and Logistic regression were used to assess the effect of APD on recurrent ICH and isclemic stroke. Results Recurrent ICH was more common in patients with lobar hemorrhage compared than patients with deep hemorrhage. APD use was more common for prevention of myocardial infarction and atrial fibrillation. APD use did not increase ICH recurrence (OR = 1. 149, 95% CI 0. 376-3.513, P=0.808)and did not shorten duration of ICH recurrence(X2=1.257, P=0.262); however, it did reduce ischemic stroke recurrence(OR=0.410, 95% CI0. 203-0.826, P=0.013)and prolonged duration(X2 =14.315, P=0.001). Conclusion APD use was not associated with ICH recurrence and was beneficial to recurrence ischemic stroke in this observation study.
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AIM: To investigate whether three-dimensional time-of-flight magnetic resonance angiography (3D TOF MRA) can be used as a reliable screening tool for evaluation of intracranial vascular stenosis and occlusive disease before stent implantation. METHODS: Thirty-three patients with suspected intracranial arterial stenosis received 3D TOF MRA and digital subtraction angiography (DSA) examinations in Chaoyang Hospital Affiliated to Capital Medical University between March 2007 and April 2008,and were included for this study. Two physicians blindly estimated stenosis,patient history,and clinical information of 363 vascular segments from 33 patients,including bilateral internal carotid artery (ICA),anterior cerebral artery (ACA),middle cerebral artery (MCA),posterior cerebral artery (PCA),vertebral artery,and basilar artery (BA). Stenosis was categorized as 30%-49%,50%-69%,70%-99%,and 100%. For each kind of stenosis,sensitivity,specificity,positive predictive value,negative predictive value,K and P values of MRA were calculated,respectively,as compared to DSA. RESULTS: A total of 42 diseased vascular segments were identified. Compared to DSA,for intracranial stenosis 50%-69%,3D TOF MRA showed sensitivity 100%,specificity 96.8%,positive predictive value 62.1%,negative predictive value 100%,K value 0.751,and P value 0.000; For intracranial stenosis 70%-99%,the corresponding value was 100%,98.6%,70.6%,100%,0.821,and 0.000,respectively; For intracranial stenosis 30%-49%,it was 25.0%,99.7%,66.7%,98.3%,0.356,and 0.000,respectively.CONCLUSION: For high sensitivity and specificity to intracranial stenosis 100%,70%-99%,or 50%-69%,compared to DSA,3D TOF MRA is a reliable screening tool for preoperational evaluation of intracranial vascular stenosis and occlusive disease.
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BACKGROUND: Gene chip of expression spectrum is used to make contrastive analysis of the changes of gene expression of histocytes derived from different individuals, tissues, cell cycles, developmental stages, differentiating stages, physiological and pathological status, and stimulating conditions.OBJECTIVE: To investigate gene expression changes of cerebral tissues of mice at different phases after ischemia/reperfusion injury, and screen out and understand genes related to cerebral ischemic/reperfusion injury.DESIGN: A randomized and controlled animal study.SETTING: Laboratory of the Department of Hyperbaric Oxygen, Beijing Chaoyang Hospital affiliated to Capital University of Medical Sciences;Laboratory of Shanghai Biostar Gene Chip Co., Ltd.MATERIALS: The experiment was performed in the Laboratory of Department of Hyperbaric Oxygen, Beijing Chaoyang Hospital affiliated to Capital University Medical Sciences, and the Laboratory of Shanghai Biostar Gene Chip Co., Ltd. from September 2002 to October 2003. Totally 20 male mice of C57BL/6 species were selected and randomized into 4 groups with 5 in each group: 48-hour and 10-day sham-operation groups and 48-hour and 10-day cerebral ischemia-reperfusion groups.METHODS: The bilateral common carotid arteries of mice in cerebral ischemia/reperfusion group were blocked with clamp for 20 minutes to establish models of cerebral ischemia/perfusion injury. The bilateral common carotid arteries of mice in sham-operation group were separated without clamp. We killed the mice by breaking off their necks at the 48th hour and 10th day after operation. Expression changes of cerebral tissues of mice were detected with BiostarM-20 s gene chip of expression spectrum.MAIN OUTCOME MEASURES: Changes of gene expression of cerebral tissues of mice in each group.RESULTS: A total of 20 mice were involved in the result analysis. ①Differential expression gene in 48-hour sham-operation group and 48-hour cerebral ischemia/reperfusion group showed that the number of up-regulated expression genes was 30. Among them the most obvious up-regulated gene was related to DNA synthesis, repair and transcription. The number of down-regulated expression genes was 119. Among them the most obvious down-regulated gene was protein phosphatase 1 (PP1) gene related to cellular signal and transferrin protein. ② Differential expression gene between 10-day sham-operation group and 10-day cerebral ischemia/reperfusion group showed no up-regulated gene, but 7 down-regulated genes, and the most obvious down-regulated gene was the one that related to cell apoptosis.CONCLUSION: At the 48th hour after cerebral ischemia/reperfusion, upregulated gene is the one that related to DNA synthesis, repair and transcription, which is helpful for cerebral tissue repair after cerebral ischemia/reperfusion. Genes related to cell signal and transferrin are down-regulated, and can level off barrier of endothelial cells and relieve cerebral ischemia/reperfusion injury. At the 10th day after cerebral ischemia/reperfusion, cell apoptosis-related gene is down-regulated, and can accelerate apoptosis and aggravate injury of cerebral cells, which may be related to delayed neuronal necrosis.
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To explore the causes of the postoperative complications of the penile elongation and the measures to prevent them in order to raise the success rate of the penile elongation. 1,000 patients who had received the penile elongation were reviewed and analyzed for the causes of postoperative complications, and the measures of prevention and treatment were discussed. Our results showed that, of the 1,000 cases, 64 had the postoperative complications, including 20 cases of edema of prepuce, 15 cases of flap necrosis, 12 hematoma, 9 infections, and 8 cases of fat and clumsy penis. It is concluded that correct operative manipulation, strict aseptic measures and necessary postoperative care and management could avoid or reduce the postoperative complications. When complications happened, a satisfactory result can be achieved with timely and correct treatment in the majority of the patients.
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Adolescente , Adulto , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Edema , Hematoma , Pênis , Anormalidades Congênitas , Ferimentos e Lesões , Cirurgia Geral , Complicações Pós-Operatórias , Terapêutica , Procedimentos de Cirurgia Plástica , Métodos , Retalhos Cirúrgicos , Infecção da Ferida Cirúrgica , Procedimentos Cirúrgicos Urológicos Masculinos , MétodosRESUMO
To explore the causes of the postoperative complications of the penile elongation and the measures to prevent them in order to raise the success rate of the penile elongation. 1,000 patients who had received the penile elongation were reviewed and analyzed for the causes of postoperative complications, and the measures of prevention and treatment were discussed. Our results showed that, of the 1,000 cases, 64 had the postoperative complications, including 20 cases of edema of prepuce, 15 cases of flap necrosis, 12 hematoma, 9 infections, and 8 cases of fat and clumsy penis. It is concluded that correct operative manipulation, strict aseptic measures and necessary postoperative care and management could avoid or reduce the postoperative complications. When complications happened, a satisfactory result can be achieved with timely and correct treatment in the majority of the patients.
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Edema/etiologia , Edema/prevenção & controle , Hematoma/prevenção & controle , Pênis/anormalidades , Pênis/lesões , Pênis/cirurgia , Complicações Pós-Operatórias/prevenção & controle , Complicações Pós-Operatórias/terapia , Procedimentos de Cirurgia Plástica/métodos , Retalhos Cirúrgicos , Infecção da Ferida Cirúrgica/etiologia , Infecção da Ferida Cirúrgica/prevenção & controle , Procedimentos Cirúrgicos Urológicos Masculinos/métodosRESUMO
ObJective To measure the level of MDA and SOD in cerebrospinal fluid from patients with cysticercosis indifferent stages and to investigate their effects on this dieases. Methods Forty-nine patients with a single cysticercus incerebral parenchyma and twenty normal controls parlticipated in the study. According to the magnetic resonance imaging(MRI) results, patients were divided into four stages. The level of MDA,SOD in CSF were tested. The data were analyzedwith the software of SPSS. Results The amount of SOD was significantly decreased in all stages except the fourth stage,while the level of MDA was increased in all the stages,and reached its peak in the second stage. There was a negative cor-relation between SOD and MDA. Conclusion The data suggested oxygen free radicals may be a main mechanism of para-site killing.
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Objective To examine the pathological changes in the liver of an AIDS patient with complicated infection of Pneumocystis carinii(PC). \ Methods\ A liver biopsy was made. The tissue was stained with HE, PAS, Giemsa, GMS, and acid\|fast staining, and examined under light microscope and transmission electron microscope. \ Results\ Granulomas (acid\|fast negative) in the tissue and numerous pathogens (PAS positive) in hepatic sinusoids were detected. Giemsa and GMS staining and electron microscopy all confirmed that the pathogen was Pneumocystis carinii. \ Conclusion\ The pathological findings revealed a diffuse extrapulmonary infection of Pneumocystis carinii in the patient of AIDS.