HC is very common in international classification of diseases. ICD-9 and ICD- 10 differ in their hypothesis. HC refers to the way of coding according to the occurrence of the most frequent clinical cases. Since the most frequent clinical cases are determined in accordance with the clinical cases in Western countries, they may often be contradictory to the diagnoses by clinicians in China. Thus it is imperative to understand and grasp the definition, identification and evolution of HC in intemational classification of diseases so as to arrive at more exact coding.

Anemia, Hemolytic ; complications ; Child ; Humans ; Pneumonia ; complications

Credit system is suitable for all-round development of students and teaching personality and it is an important component of the modern university system.The paper mainly studies the credit system as a learning management system and explores the form of the examination and assessment patterns.It also puts forward some specific measures and ideas about how to improve and perfect examination and assessment modes.

Objective To investigate the application value of combination of ambroxol and fluidmicronized ipratropium bromide in full dose and frequency in treating senile refractory pneumonia.Methods From January 2010 to November 2013,84 cases of elderly patients with refractory pneumonia were divided into 3 groups.On the basis of anti-inflammatory and symptomatic treatment,the control group (n=28) received routine sputum suction and normal saline irrigation;the routine dose group (n=28) received the intravenous ambroxol 15 mg twice daily and the inhalation of 2.5 ml of nebulized ipratropium bromide once daily plus treatment in control group while full dose group (n=28) received intravenous ambroxol hydrochloride 30 mg three times a day and the inhalation of 2.5 ml of nebulized ipratropium bromide four times a day.The severity of pulmonary infection was described by clinical pulmonary infection score (CPIS) and C reactive protein (CRP),and therapeutic efficiency was evaluated by clinical symptom remission time,average hospitalization days and effective rate.Results At the 5 day and 10 days after treatment,the CPIS in full dose group was (4.82 ± 1.21) scores and (4.39± 1.03),respectively,C-reactive protein (CRP) was (58.11 ± 11.12) mg/L and (57.57±12.69) mg/L respectively,and these CPIS and CRP values at the 5 day and 10 days were significantly lower than those in the control group (6.10 ± 1.10) scores and (5.36 ± 0.95) scores,(74.50± 12.79)mg/L and (68.46± 13.77) mg/L (all P＜0.05).The above Values were lower as compared with those [(5.43±0.84) and (5.21 ±0.83),(65.11 ±834) mg/L and (59.11± 13.77) mg/L (P＜ 0.05)] in routine dose group.The CPIS and CRP concentration in full dose group and routine dose group were lower at the 10 days than at the 5 days (P＜0.05).Besides,clinical symptom remission time (4.43 ± 1.75) days,average hospitalization duration(26.32 ± 4.92) days in full dose group,clinical symptom remission time (5.68 ± 2.29) day,average hospitalization (32.21 ± 5.63) days in conventional dose group were significantly lower than in the control group (7.79±2.74) and (36.71 ± 11.78) days (P ＜ 0.05).Clinical manifestation,time of remission,and average hospitalization days of the full dose group were also reduced as compared with the conventional dose group (P＜0.05).The efficiency rates in the three groups of control,conventional dose and full dose were 42.9％ (12/28),71.4％ (20/28),92.9％ (26/28),among which the efficiency of full dose group was significantly higher than those of the control group and the conventional dose group,(x2 =16.047,6.788,P＜0.01).The conventional dose group showed a higher efficiency than the control group (x2 =4.667,P ＜ 0.01).Conclusions Combination of ambroxol and fluid-micronized ipratropium bromidet in full dose and frequency for treating senile refractory pneumonia is a useful managemen in the elderly patients.

Objective To study the possibility and value of double-catheter-balloon technique for embolization of high-flow carotid cavernous fistula (CCF).Methods Three high-flow CCFs, which can't be completely occluded by 1 detachable balloon, were treated with the technique. By the way of bilateral femoral arteries approach, 2 detachable balloons were advanced to the internal carotid artery (ICA). After passing through the fistula, both balloons were inflated on the venous side in order to occlude the fistula. Results All CCFs were occluded completely and the ICAs remained patent. This procedure was easy and safe without increasing the risk of interventional therapy.Conclusions The application of double-catheter-balloon technique for high-flow CCF should be an effective method of choice during failure of 1 balloon procedure and simultaneously maintainning the patency of ICAs completely.

AIM: There are many active components of tonifying kidney to strengthen the bone in Kanggu Zengsheng capsule, but there are few reports about its effect in treating bone fracture. CR molybdenum target X-ray is often used in mammary gland examination and disease diagnosis. This study detected the callus density during fracture healing in rats by CR molybdenum target X-ray to explore the promoting effects of Kanggu Zengsheng capsule on fracture healing. METHODS: The experiment was performed at the Laboratory Centre of Second Hospital of Hebei Medical University from July 2005 to March 2006. Sixty Wistar rats with an equal amount of males and females, 170-200 g, aged 9-10 months were randomly divided into experimental group and control group (n =30). After the tibial fracture model was made, the rats in the experimental group were given 1 mL Kanggu Zengsheng capsule suspension, 14.00-15.75 mg for each, once daily, while the rats in the control group orally took matching normal saline (9 g/L) once daily. All animals were executed under anesthesia by batch on the 3rd, 10th, 17th, 24th, and 33rd days after the operation, separately. The diameter of callus was measured with vernier caliper. The values of callus density were calculated by image analysis system in the CR molybdenum target X-ray. RESULTS: Sixty rats were all included in the final analysis. The photo of CR molybdenum target X-ray showed clear bone lines, and bone and soft tissue were evident. During the process of fracture union, there were significant differences in callus density between the two groups (P

Experiments in vitro demonstrated for the first time that an EtOAc extract of roots of Rubus crataegifolius Bge.can markedly inhibit the for mation of lipid peroxide in rat brain,heart. liver and kidney tissucs. When administered intragastrically for 15 successive days,the EtOAc extract markedly inhibited the formation of lipid peroxide in plasma and tissues of liver and brain of mice. The above results showed that the EtOAc extract from roots of R. crataegifolius Bge.had anti-lipid peroxidation effect.

Objective To study the pain relief effectiveness of the combined spinal epidural analgesia(CSEA) and the inhalation of nitrous oxide, and the influences on the mothers and infants Methods The 300 cases of pregnant women were randomly divided into 3 groups: CSEA group,nitrous oxide group and control group The nitrous oxide group was that pregnant women inhaled nitrous oxide premixed with oxygen (50%∶50%),the pregnant women of the CSEA group were injected fentanyl and bupivacaine in the subarachnoid and epidural space,analgesic was not used in the control group The degree of labor pain, duration of the labor,way of delivery, bleeding volume, rate of anoxia of newborn,blood gas analysis to maternal radius artery and fetal umbilical blood among 3 groups were observed Results The effect for analgesia labor of the CSEA group was much better than that of the nitrous oxide group ( P 0 05) In the second stage of labor,the 3 groups were alike to each other The bleeding volume of caesarean section (373?77) ml in the nitrous oxide group was much more than the other 2 groups, there was no difference between the CSEA group (259?78) ml and the control group (239?89) ml The rate of obstetric forceps of CSEA group was higher than the control group ( P

Objective To discuss the technique of supraorbital transeyebrow keyhole approach microsurgery for sellar tumors. Methods A total of 33 cases of sellar tumors were treated in this hospital from July 2001 to June 2004. The resection of the tumor was achieved by way of a supraorbital eyebrow minicraniotomy through a 2.0 cm ? 3.0 cm keyhole approach. The surrounding cisterns of the sellar area were opened to expose underlying structures under microscope at proper angles. Results Of 26 cases of hypophysoma, a total resection was performed 19 cases, and a subtotal resection in 7 cases. Of 4 cases of craniopharyngioma, a total resection was performed 3 cases, and a subtotal resection, 1 case. One case of meningioma received a total resection, and 1 case of optic chiasm glioma underwent a partial resection. Postoperatively, transitory diabetes insipidus was observed in 5 cases, and grand mal epilepsy occurred in 1 case. There were no infection or bleeding after the operation. All the 33 cases were followed for 4~36 months (mean, 27 months). No recurrence of tumors was seen in the 24 cases of total resection. Postoperative radiotherapy was given in 7 cases of subtotal resection of hypophysoma, 1 case of craniopharyngioma, and 1 case of optic chiasm glioma, and no apparent enlargement of tumors was found. Conclusions Supraorbital transeyebrow keyhole approach microsurgery minimizes the unnecessary exposure of the brain and postoperative complications.

[Objective]To report the polyaxial locking plate and its primary clinical results in the treatment of the tibial plateau fractures.[Method]From July 2006 to August 2007,38 patients with tibial plateau fractures,including 26 males and 12 females,were treated with surgical reduction and internal fixation with polyaxial locking plate.The mean age of the patients was 30.6 years(18-65 years).According to Schatzker classification,there were 3 of type Ⅰ,5 of type Ⅱ,5 of type Ⅲ,6 of type Ⅳ,16 of type Ⅴ,3 of type Ⅵ,of which 34 were closed fractures and 4 open fractures.The follow-up period ranged from 7 to 18 months with a mean of 13.7 months.Function of the knees were assessed according to HSS system and radiological examination.[Result]Solid arthrodesis were obtained in all patients at 3-6 months after operation.Skin flap necrosis and incision infection happened respectively in 2 cases of type Ⅴ and type Ⅵ fractures.The score of HSS system was 92.8(range 78-98) averagely half year after operation and no reduction loss was observed.[Conclusion]The polyaxial locking plate is an effective fixation technique for the surgical treatment of the tibial plateau fractures because of its convenience and stability.The locking screws can be implanted in various directions and reduction loss is avoided post-operation.