Adolescent ; Anti-Bacterial Agents ; therapeutic use ; Child ; Child, Hospitalized ; statistics & numerical data ; Child, Preschool ; Drug Utilization Review ; statistics & numerical data ; Female ; Hospitalization ; statistics & numerical data ; Humans ; Infant ; Male ; Respiratory Tract Infections ; drug therapy

Purpose To investigate clinicopathological features, immunohistochemical findings and differential diagnosis of papillary glioneuronal tumor ( PGNT) . Methods The clinical features, imaging, histological and immunohistochemical findings were analyzed in three cases of PGNT, along with review of the related literatures. Results Two patients were female adults, and the other was male adults. One presented with dizziness, and the other exhibited intractable seizures. Magnetic resonance imaging ( MRI) revealed a cyst-ic space-occupying mass in brain parenchyma of left temporal lobe or right parietal lobe. Microscopically, it was characterized by pseu-dopapillary structures composed of hyalinized vessels rimmed by cuboidal glial cells, oligodendrocyte-like cells and the proliferation of neuronal cells. On immunohistochemical staining, the perivascular cuboidal cells were GFAP-positive, the oligodendrocyte-like cells were Olig-2-positive, and the neuronal cells were synaptophysin-and nuclear protein-positive. Conclusion PGNT is a rare and new variant of mixed neuronal-glial neoplasm, the natural evolution of this tumor is one of low malignant potential and it has a good progno-sis. The distinctive pathologic features help to differentiate this entity from other neoplasm of the central nervous system which has pa-pillary structures.

Developments in science and technology include the use of laser as an auxiliary device in treating oral diseases. Nd:YAG laser is convenient and safe to use. Nd:YAG laser irradiation leaves no scabby area on the wound surface, causes a mild reaction postoperation, and promotes high comfort. Therefore, this treatment has attracted increasing attention in the clinical setting. This review enumerates the applications of water-cooled pulsed Nd:YAG laser in hard and soft tissues in oral medicine. Nd:YAG laser in hard tissues can be applied in cavity preparation, acid etching, root canal preparation and sterilization, and dentin desensitization therapy. Meanwhile, the applications of this laser in soft tissues include adjunctive therapy in basic periodontitis treatment, gingival aesthetic treatment, and resection. This review suggests the importance of Nd:YAG laser as an auxiliary device in the clinical diagnosis and treatment of oral diseases.
Dental Cavity Preparation ; Dentin ; Humans ; Lasers, Solid-State ; Oral Medicine ; instrumentation ; methods ; Root Canal Preparation

Objective To analyze the differences in symptoms spectrum,lifestyle,diet and psychological features among different age groups with reflux esophagitis.Methods From June 2011 to October 2013,332 outpatients with reflux esophagitis (RE) were collected and divided into youth group (18 to 40 years),middle-aged group (41 to 64 years) and aged group (≥65 years).Symptoms and risk factors of patients were investigated.The severity of the symptoms was evaluated with reflux diagnostic questionnaire (RDQ).The anxiety and depression of patients were assessed with self-rating anxiety scale (SAS) and self-rating depression scale (SDS).The distribution of symptoms spectrum,the severity of symptoms,lifestyle,diet and psychological features of three groups were compared.Mann-Whitney U tests or Chi-square test were used for comparison between two groups.Pearson test was performed for correlation analysis.Results There were 96 cases,192 cases and 44 cases in youth,middle-aged and aged group,respectively.Compared with youth group and middle-aged group,the incidence of chronic cough and asthma (extra-esophageal symptoms) was higher in aged group (1.0％ (1/96),13.5％ (26/192),20.5 ％ (9/44);and 3.1％ (3/96),9.4 ％ (18/192),15.9 ％ (7/44)),and the differences were statistically significant (x2 =15.10 and 6.91,both P＜0.05).The scores of extra-esophageal symptoms in youth group,middle-aged group and aged group were 7.0(2.0,14.0),9.5(4.2,17.0) and 12.0(7.0,19.7),respectively,and the difference was statistically significant (F=3.93,P =0.02).Comparison with aged group,the incidences of youth group and middle-aged group were higher in irregular meals (4.5 ％ (2/44),28.1％(27/96),14.6％ (28/192)),overeating (29.5％(13/44),50.0％(48/96),34.9％(67/192)),dinner time after 19 o'clock (2.2％(1/44),27.1％(26/96),20.3％(39/192)),lying down in 30-minute post-meal (40.9％(18/44),63.5％(61/96),49.5％(95/192)),high fat diet (52.3％(23/44),84.4％ (81/96),69.3％(133/192)),spicy food (13.6％(6/44),43.8％(42/96),30.7％(59/192)),and the differences were statistically significant (x2 =13.93,7.90,11.71,10.36,16.22 and 12.99,all P＜ 0.05).Compared with the youth group and middle-aged group,the incidence of aged group was higher in exercise times ＜two times/week (15.6 ％ (15/96),40.1％ (77/192),50.0％ (22/44)),preference of tea (36.5％(35/96),36.5％(70/192),59.1％ (26/44)) and poor sleep quality (13.5％ (13/96),19.3％ (37/192),31.8％(14/44)),and the differences were statistically significant (x2 =22.52,8.18 and 6.47,all P＜ 0.05).The median SAS scores of youth group,middle-aged group and aged group were 30.0 (27.5,33.7),32.5 (28.7,37.5) and 30.0(27.5,36.2),respectively;and the median SDS scores were 32.5(27.5,39.7),36.2(30.3,45.0),37.5(35.0,45.0),respectively;and the differences in SAS and SDS scores among three groups were statistically significant (F=6.37,6.75,both P＜0.01).The SAS and SDS scores were not correlated with extra-esophageal symptoms in youth group.The SAS score was positively correlated with extra-esophageal symptoms in middle-aged group (r =0.19,P =0.009).The SAS and RDQ scores were positively correlated with extra-esophageal symptoms in aged group(r=0.26 and 0.23;P=0.005 and 0.003).Conclusions The incidence of extra-esophageal symptoms in middle-age group and aged group is high,the symptoms are severe and with anxiety and depression possibility.While unhealthy lifestyle and diet habits are more common in young patients.According to different age groups,risk factors should be adjusted.

Objective To observe and compare the efficacy and safety between propofol-fentanyl and propo- fol-ketamine for anesthesia of artificial abortion.Methods 450 ASA physical statusⅠandⅡpatients scheduled for elective artificial abortion were randomized into three groups:P group were given intravenous normal saline 2ml be- fore propofol(n=150) ;PF group were given intravenous fentanyl 1?g/kg then propofol(n=150);PK group were given intravenous ketamine 0.4mg/kg then propofol(n=150).Total dose of propofol,extinction time of lash reflex, heart rate(HR),mean arterial pressure(MAP),pulse oxygen saturation(SpO_2),time to open the eye when called, time of full recovery(answering correctly and walking unaided),discomfort,awareness during operation,self-feeling were recorded.Analysis of date was with SPSS 12.0.P＜0.05 was considered significant.Results No episodes of nausea,vomiting,cardio-cerebral syndrome or awareness were noted in all patients;Total dose of propofol,and extinc- tion time of lash reflex in P group were significantly more than those in PK or PF group(P＜0.05),but there was no difference between PK and PF group;MAP,minimum HR and SpO_2 during operation were obviously lower than preoperation or postoperation in those in P or PF group,minimum HR and SpO_2 during operation in P group were significantly lower than in PF or PK group;Minimum HR and SpO_2 during operation in PK group were lower than preoperation,but its decrease extent was less than that in P or PF group(P＜0.05);Time to eye opening in PF or PK group was significantly less than that in P group(P＜0.05);Time to full recovery were not different in three groups;Incidence of pain on injection in PF group(10%)or PK group(8%)was obviously lower than P group (80%);Incidence of coughing and moving during operation in PF group(8%)or PK group(6%)was obviously less than P group(30%);No difference were noted with respect to degree of comfort,time of full recovery,bleeding vol- ume during operation,time to operation.Conclusion Painless artificial abortion can be preformed effectively and safely with propofol-fentanyl or propofol-ketamine,propofol-ketamine especially fits for painless artificial abortion compared with propofol-fantanyl.

0.05)respectively,when the whole radiotherapy was finished,the CR was 53.3% and 25.8%(P

Carrier State ; virology ; Female ; Hepatitis B ; complications ; Humans ; Lymphoma, Large B-Cell, Diffuse ; virology ; Male ; Middle Aged

Objective To refrain the medical costs from out-of-control increase, and identify a per-disease payment mode suitable for New-CMS.Methods Case studies were conducted on all the data of five diseases in the course of three years, in a field study of the pilot counties for NRCMS in Anhui Province.Results This system of per-disease "pay by segmentation and quota" is composed of five parts: choice of diseases, measurement of payment criteria, method of settlement, method of compensation, and methods of supervision.Conclusion This system is an effective way to keep the medical costs in the NRCMS under control, given an effective play of the five supportive measures including the clinical pathways for individual diseases.

Objective To investigate the incidence and risk factors of acute kidney injury(AKI)after different types of cardiac valve replacement surgery. Methods A single cohort of 1113 patients who received cardiac valve replacement surgery from April 2009 to March 2010 in Zhongshan Hospital,Fudan University were prospectively analyzed.Multivariate Logistic regression analysis was used to evaluate possible risk factors associated with post-operative AKI.Akl was defined as a relative 50% increase or an absolute increment of 26.4 μmol/L in Scr within 48 hours and/or urine volume <0.5ml·kg-1·h-1 up to 6h.Results Of the 1113 patients, the incidence of AKI was 33.24%.In-hospital mortality of AKI patients was 6.49%,which was 5.373 times higher than that of non-AKI patients(P<0.01).The incidence of AKI in patients who simultaneously received cardiac valve replacement and coronary artery bypass grafting was 75.00%,which was significantly higher as compared to other types of valve replacement surgery(P<0.01).Unconditional multivariate Logistic regression analysis revealed that male,old age,long extracorpeal circulation (CPB)time(≥120 min)and combined with coronary artery bypass grafting surgery were the independent predictors of AKI episodes,and the corresponding OR values were 1.455,2.110,1.768 and 2.994 respectively. Conclusions AKI is a common and serious complication after cardiac valve replacement surgery.Patients who received combined cardiac surgery as valve replacement and coronary artery bypass grafting have higher incidence of AKI.Old age,male,long CPB time(≥120 min)and combined with coronary artery bypass grafting surgery are the independent risk factors of post-operative AKI for patients undergoing cardiac valve replacement surgery.

Foreign Bodies ; surgery ; Humans ; Oropharynx ; Punctures ; methods ; Ultrasonography