Objective To explore the value of early arterial blood lactate clearance rate and central venous oxygen saturation (ScvO2 ) monitoring in patients with severe pneumonia .Methods A total of 56 patients with severe pneumonia treated during the period from January 2012 to December 2013 were reviewed retrospectively .The arterial blood lactate concentration and ScvO2 were determined immediately after admission to hospital and 6 hours after admission to calculate the 6‐hour lactate clearance rate .APACHE II score was evaluated at the same time .The patients were divided into three groups according to APACHE II score:10 to ＜20 (group A) ,20 to ＜30 (group B) ,≥30 (group C) .The three groups were compared in terms of early arterial blood lactate clearance rate and ScvO2 and estimate their association with the prognosis of patients .Results The initial arterial blood lactate concentration did not show significant difference between the three groups (P>0 .05) .The early lactate clearance rate and ScvO2 at 6 hours in group C were significantly lower than in group B .The values in group B were significantly lower than in group A (P＜0 .05) .The mortality rate in group C was significantly higher than in group B ,and the mortality rate in group B was significantly higher than in group A (P＜0 .05) .The APACHE II score of the dead patients was higher than that of the suevivors ,but early lactate clearance rate and ScvO2 level were lower than those of the survivors (P＜0 .05) .APACHE II score was negatively correlated to early lactate clearance rate (r=0 .661 ,P＜0 .01) and early ScvO2 level (r=0 .579 , P＜ 0 .01) .Conclusions Early lactate clearance rate and ScvO2 level are good indicators to reflect the severity of disease and predict the outcome in the patients with severe pneumonia .

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; diagnostic imaging ; drug therapy ; Female ; Fluorodeoxyglucose F18 ; Humans ; Lung Neoplasms ; diagnostic imaging ; drug therapy ; Male ; Middle Aged ; Positron-Emission Tomography ; Small Cell Lung Carcinoma ; diagnostic imaging ; drug therapy ; Tomography, X-Ray Computed

One child was hospitalized because of repeated cough and sputum. The biopsy diagnosis in local hospital was cystic lymphangioma in retropharyngeal space. We carried out transoral incision and drainage by catheter under general anesthesia. Put into the surgical cavity a suction drainage tube, and injected 5 mg dexamethasone and 8mg Bleomycin. He had nasogastric liquid diet after operation. We removed the suction drainage tube two weeks later. No recurrence was found following up over two years.
Child ; Humans ; Lymphangioma, Cystic ; diagnosis ; surgery ; Pharynx ; pathology ; surgery

Objective To explore the optimal screw fixation of anterior column lag screw fixation in the treatment of acetabular anterior column fractures by finite element method.Methods Firstly,CT scanning images from one healthy adult volunteer (male 30),were transferred into Materialise Mimics Innovation Suite 16.0 software,then three-dimensional (3D) models of pelvic were reconstructed and stored in stereolithography format.Then Imageware 12.0 software (EDS,USA) was used to produce the optimal and safe channel of the screw for acetabulum anterior column fixation.Three types of screw fixation were generated,i.e.(1) geometric algorithm screw channel,(2) in-out-in channel,(3) free screw channel.Secondly,all model data were transferred into Ansys 12.0 software to establish the finite element model.Gravity load were defined as 600 N,1 200 N,and 2 400 N,and the Von Mises the parameters of peak stress and deformation were recorded.Results Respectively load of 600 N,1 200 N,2 400 N force to normal hip and geometric algorithm screw channel, in-out-inscrew channel,free screw channel,the comparison between groups of hip by stress and hip deformation,with a given loading force of hip by stress and hip deformation increase gradually,the two were positively correlated,including screw by stress at slightly higher than that of normal hip,while the stress of hip by geometric algorithm screw channel andin-out-inscrew channel were similar,and that by free screw channel increased significantly.There was no significant difference between groups in the hip deformation.With a given loading force (600 N,1 200 N,2 400 N) on geometric algorithm screw channel、 in-out-inscrew channel and free screw channel,the deformation is gradually increased,and there were positively correlated.With the stress on geometric algorithm screw channel,it was significantly reduced compared with the latter two,and in-out-in screw channel suffered the biggest stress.Conclusion Through the finite element analysis,the geometric algorithm screw channel can be used as a safe and effective way for acetabulum anterior column fracture.

Objective To examine the levels of serum adipaneetin in patients with incipient chronic kidney disease (CKD, GFR≥ 60ml/min, and identify the relationship between serum adiponectin and albumin (ALB), urinary protein excretion amount, blood lipid and renal function. Methods Forty-two CKD patients and twenty normal healthy persons were involved in this study. These patients were divid- ed into two groups: nephrotic syndrome and non-nephrotic syndrome. The level of serum adiponectin, serum ALB, urinary protein excretion amount, blood lipid, renal function were measured and compared. Results The level of serum adiponectin in nephritic syndrome patients [(21.9±11.3) mg/L] and non-nephrotic syndrome patients [ ( 11.0±7.0) mg/L] was significantly higher than that in normal healthy per- sons[ (5.6±3.3) mg/L] ( P<0.01 ), and the level of serum adiponectin in nephritic syndrome patients was higher than that in non-ne- phrotic syndrome patients( P <0.01 ). Correlative analyses revealed a negatively correlation between serum adiponectin and serum total pro- tein(TP, ALB, BMI( r=-0.5680, r = -0.6241, r = -0.4083,respectively), and a positive correlation between serum adiponectin and urinary protein excretion amount ( r =0.4083). Stepwise regression analyses showed that serum adiponoctin was highly influenced by BMI, ALB and urinary protein excretion amount. Conclusion Serum adipanectin was markedly increased in incipient CKD, especially in patients with macroalbuminura. The effect of high level adiponectin in CKD was still not clear.

Objective To detect the expression of genes Her-2/neu,DPC4 and P16 in pancreatic carcinomas and to investigate the role of their alterations in tumorigenesis and progression of pancreatic carcinomas.Methods We studied the immunohistochemical markers Her-2/neu,DPC4 and P16 in 34 adenocarcinomas and 12 nonmalignant specimens of the pancreas,and the relationship between DPC4 alterations and various clinicopathological parameters was evaluated.Results There was a significant difference between normal pancreatic tissues and benign pancreatic lesions and primary pancreatic carcinomas for frequency of Her-2/neu expression and loss of P16 expression(P

In order to carry out the training objectives ofexcellent doctor education training pro-gram implemented by the Ministry of Education and the Ministry of Health, an integrated organ-system oriented curriculum system of circulatory system was applied in five year clinical medicine education. The teaching contents of circulatory system from traditional Histology and Embryology, Physiology, Pathology, Pathophysiology, and Pharmacology were integrated and optimized to compile the integrated circulatory sys-tem textbook. problem-based learning (PBL) and comprehensive morphology experimental teaching were implemented into the integrated circulatory system curriculum. Diversified examination methods including continuous assessment of PBL were used to evaluate the learning effect of students. As a result, a new cur-riculum model of circulatory system teaching was constructed. And on the base of this curriculum model, an innovation course research experiment was performed, a digital network teaching platform with 4A (anybody, anything, anywhere, anytime) was set up, and diversified teaching methods were applied. This new developing curriculum system is helpful for students to relate what they have learned in the basic sci-ences to clinical medicine, gain clinical thinking competence, lifelong skills of self-directed learning, in-novative thinking, and ability of scientific research and practice.

Animals ; Gene Expression Profiling ; Gene Silencing ; Hematologic Neoplasms ; genetics ; metabolism ; Hematopoiesis ; genetics ; Humans ; MicroRNAs ; metabolism ; physiology ; Neoplasms ; genetics ; metabolism ; Oligonucleotide Array Sequence Analysis ; T-Lymphocytes ; metabolism

The cardiovascular and cerebrovascular diseases have become a main category of disease which affects human health today.It is helpful to search for its causes and main risk factors for scientific prevention and control of these diseases.Now,we have already paid close attention to effect of the airborne contaminant and meteorological factors on the cardiovascular and cerebrovascular diseases.Some reports about solo affect of two types factors have given a clear results;however,a little of unification evidences have been provided.This article reviews the solo and unification effects of pollutants and meteorological factors in the cardiovascular and cerebrovascular diseases.

Objective To evaluate the long-term effects and safety of an intense pulsed light (IPL) in the treatment of epilation.Methods 159 patients received treatment with a non-coherent IPL because of unwanted facial and body hair.116 cases were followed up by means of phone call or letters.The average follow-up time was 38 months.Results Overall,36 (31.0％) patients were very satisfied,53 (45.7％) were satisfied and 27 (23.3％) remained unsatisfied with the outcome of lightassisted hair removal.The non-coherent intense pulsed light satisfactorily removed unwanted dark hair.Hair-free periods from weeks to years could be observed.Besides,the satisfaction was not related with the colour of the skin.Conclusions Hair removal by a non-coherent intense pulsed light is an effective and safe method for long-term epilation of unwanted hair.