Objective: To evaluate feasibility of using European Nutritional Risk Screening 2002(NRS2002) for nutritional status assessment in primary hospital.Methods: 799 patients were enrolled in this study.697 patients who were according NRS request were assessed using NRS method in hospitalization day.The patient whose NRS scores were higher than 3 were justified under nutritional risk.102 patients who were not according NRS request were assessed by exeamining the serum albumin(ALB) in the next day.The patients whose serum ALB was lower than 35 g/L were justified malnutrition.Results: There were 697 patients could be evaluated by NRS method.Body Mass Index(BMI) was lower than 18.5 in 159(22.8%) cases and NRS scores were ≥3 in 240 cases(34.4 %) among 697 cases.Serum albumin was lower than 35 g/L in 31 (30.4%) cases among 102 cases who could not be evaluated by NRS method because of incapable of standing up(66/102,64.7%) and ascites or hydrothorax(17/102,16.7%) and concomitance of above-mentioned causes(11/102,10.8%) and coma(8/102,7.8%).Conclusion: Assessment of nutritional status of hospitalized patients in primary hospital using NRS2002 method is feasible.The patients who could not be evaluated by NRS 2002 method can be assessed by assaying serum ALB.

Objective:To observe the efficacy of contact lenses on a wide range of corneal epithelial shedding. Methods:The information has collected a wide range of corneal epithelium of thirty-six patients admitted to our hospital in the January 2010-December 2010, tracking observed in patients with epithelial wear contact lenses after the healing. Results:The patients wear contact lens immediate relief of symptoms with eye pain, foreign body sensation. Patients with continuous wear contact lenses after five to seven days, including twenty-eight patients with corneal epithelial fully restored, the remaining eight cases without contact lens continue to use eye drops of one to two days corneal epithelial fully restored in the ointment;thirty-six patients were followed up in three to six months, not fall off again. Conclusion:Therefore, use contact lenses to treat corneal epithelial shedding, the patients suffered less pain, treatment is easy to operate, low cost, the treatment effect is significant.

Objective To investigate effects of morning blood pressure surge (MBPS) on cardiac remodeling and cardiovascular events in patients with essential hypertension.Methods Totally,386 patients with essential hypertension were recruited into the study,146 with MBPS and 240 without it based on their dynamic blood pressure monitoring.All the patients were monitored by 24-hour ambulatory blood pressure measurements,24-hour Holter electrocardiography and echocardiography for dynamic blood pressure,left ventricular mass index (LVMI),left atrial dimension (LAD),atrial and ventricular arrhythmias and ST depression,and so on.Results Compared with non-MBPS group,patients with MBPS had significantly higher incidence of left ventricular hypertrophy (LVH),enlargement of left atrial dimension,cardiac arrhythmias and myocardial ischemia detected,with LVMI [( 119 ±21 ) g/m2 vs.(93 ±12) g/m2,P＜0.01],LAD [(46±11) mmvs.(38±10) mm,P＜0.05],LVH (67.1% vs.30.4%,P ＜0.01 ),atrial premature beats (98.6% vs.84.2%,P ＜ 0.05 ),atrial tachycardia ( 54.1% vs.20.8%,P ＜ 0.01 ),atrial fibrillations ( 24.0% vs.0,P ＜ 0.0l ); ventricular premature beats and ventricular tachycardia ( 79.5% vs.57.9%,P ＜ 0.05,and 6.8% vs.2.5%,P ＜ 0.05 ),ST-segment depression (33.6% vs.13.8%,P ＜ 0.01 ),respectively.And,53.2 percent of cardiac arrhythmia and 57.6 percent of ST-segment depression occurred at six to eight o'clock in the morning.Blood pressure early in the morning and MBPS associated with ST-segment depression at the corresponding time ( P ＜ 0.05 ).Conclusions LVH is more significant,cardiac arrhythmias is severer and myocardial ischemia is more common in hypertensive patients with MBPS than that in those of non-MBPS.

Objective To study the clinical features of complicated upper urinary tract infection in children,aiming to provide a reference for clinical diagnosis and treatment of the disease.Methods The clinical data of 68 cases with complicated upper urinary tract infection hospitalized at the Department of Urinary Surgery NO.1,Children's Hospital of Shenzhen between January 2013 and August 2015 were retrospectively analyzed.Results A total of 68 cases,in which 44 were male,24 were female,and repeated infections were found in 15 cases.Fever was the most common clinical manifestation(48 cases,70.59％),while frequent urination and odynuria were rare(9 cases,13.24％).A total of 57 strains had been cultured form the submitted specimens which were obtained from the 68 cases,including 41 strains of gram-negative bacteria,15 strains of gram-positive bacteria and 1 strain of fungus.Two different strains were cultured in 3 children.Fourteen strains of Escherichia coli had 11 extended spectrum beta lactamases (ESBLs)-positive strains.In the 11 strains of klebsiella pneumoniae,8 trains were ESBLs-positive.The drug resistant rates of gram-negative bacteria to Ampicillin and Cefuroxime sodium were both more than 90％.The sensitive rates to Piperacillin/Tazobactam was more than 90％.Thirty-one cases of complicated upper urinary tract infection were cured by administering Piperacillin/Tazobactam,while 15 cases were cured by changing Cefuroxime sodium to Piperacillin/Tazobactam according to the drug sensitivity results.Conclusions Clinical manifestations of complicated upper urinary tract infection are untypical,and fever is the most common symptom.Repeated infection is common.The gram-negative bacteria is the dominant pathogen causing the complicated upper urinary tract infection.ESBLs-positive bacteria accounts for high proportion.The drug resistance rate to penicillin and the first,second generation of the cephalosporin is high.The drug sensitive rate of piperacillin tazobactam is high,with good prognosis.

Objective To compare the efficacy of laparoscopic gallbladder bed dissection(LGBD)between retrograde plus anterograde and anterograde only manners.Methods All of 575 cases of laparoscopic cholecystectomy(LC)were randomly divided into two groups(group A and group B).Patients underwent LGBD with retrograde plus anterograde mannerin group A(297 cases)oronly with anterograde manner in group B(278 cases)respectively.The efficacy and safety were compared between two groups.Results The operative time were(10.0±3.7)min and(13.0±3.9)min in group A and group B respectively (P<0.05).There were 33 cases of bleeding volume more than 5 ml in group A with 85 cages in group B (P<0.05).Three cases of gallbladder rupture were found in group A compared with 10 cases in group B (P<0.05).Postoperative fluid collection in gallbladder bed occurred in 5 cases in group A compared with 19 cases in group B(P<0.05).The conversion rate was 3.70%(11/297)and 3.96%(11/278)in group A and group B respectively(P>0.05).One cage of abdominal fluid collection was observed in group A whichwas relieved after conservative therapy.No other complications occurred.Conclusions LGBD applying retrograde plus anterograde manner may shorten the operative time,decrease the bleeding during operation and minimize the postoperative complications.Surgeons might benefit from its advantage of easier manipulation.

Objective To study the skills of laparoscopy for hight difficulty eholecystectomy.Method Forty-eight cases of hight difficulty laparoscopic cholecystectomy from July 2005 to July 2007 were analyzed retrospectively. Result In 48 cases, 5 cases were converted to open surgery, 2 cases suffered in-cision infection, all the patients recovered. Conclusion According to the operating status and experience of the performer, Calot triangle dissection and judge good opportunity to change open surgery are the key faetora to the successful operation for difficult and complex laparoscopie cholecystectomy, which is safe and feasible.

Objective　In a RCT study, the safety and efficacy of sabot (a slow-release salbuteral) and volmax (controlled-release salbuterol) were compared in bronchial asthma. Methods　40 patients with moderate to severe asthma were randomly divided into two groups and treated by sabot or volmax for 2 weeks. The FEV1%, peak expiratory flow (PEF), symptom score and use of rescue ventolin were measured to evaluate the effect of treatment. Results　After treatment FEV1%, PEF and symptom score improved and the need for inhaling short-acting beta 2-agonis in both groups reduced significantly. There was no difference of these improvement between two groups. Conclusion　The safety and efficacy of sabot for treatment of asthma was similar to volmax.

OBJECTIVE To investigate the epidemic situation of vertical dissemination of the Escherichia coli(ECO) and Klebsiella pneumoniae(KPN) isolates producing extended-spectrum beta-lactamases in the hospital.METHODS The fingerprints of the isolates were obtained by pulsed-field-gel-electrophoresis(PFGE),and were analyzed with software Quantity One.RESULTS The similarity of 10 isolates and 7 isolates among the 21 ECO(isolates) from ICU was more than 90%,and 100%,respectively;the similarity of 3 KPN isolates was 100%.The similarity of 9 isolates among the 20 ECO(isolates) was more than 90% and the similarity of 4 isolates among the 6 KPN isolates was more than 90% in the neurosurgery ward.The similar coefficients of 3 isolates and 2(isolates)(among) the 10 ECO isolates from the ward for cadre were more than 90% and 100%,(respectively.) The similar(coefficients) of 2 isolates among the 7 ECO isolates from the gastroenterology ward and 2(isolates)(among) the 18 ECO isolates from the respiratory ward were more than 90%.The isolates whose similarity was more than 90% were also found in other wards.CONCLUSIONS There are vertical disseminations of single clone of ESBL-producing organisms in several wards,especially in the ICU.It is necessary to strengthen the management of(infection)-control.

Objective To investigate the value in distinguishing benign and malignant vertebral fractures with MR diffusion-weighted imaging(DWI).Methods 31 patients with 58 vertebral fractures were underwent routine MRI scanning and echo-planar DWI(EPI/DWI).The materials were divided into benign group(n=32,20 cases),malignant group(n=18,8cases),tuberculosis group(n=8,3cases) and normal vertebral body group(n=31). Signal intensities on DWI were compared and apparent diffusion coeffient(ADC) values of normal and abnormal vertebral bodies were calculated. ADC values among the benign,malignant,tuberculosis vertebral bodies and normal ones were quantitatively analyzed and compared.Results The ADC values of benign,malingnant,tuberculosis and normal vertebral bodies were (1.44?0.41)?10 -3 mm2/s,(0.94?0.17)?10 -3 mm2/s,(0.98?0.13)?10 -3 mm2/s and(0.42?0.16)?10 -3 mm2/s ,respectively. The ADC values of the three abnormal groups were higher than normal group ( all P0.05). The sensitivity and specificity of ADC for the diagnosis of malignant lesion were 72.2% and 90.6% if the upper bound of 95% confidence interval was set as a differential level.Conclusion DWI provides an important supplement to the routine MRI in the differentiation of benign with malignant vertebral fractures.

Objective To improve the recognization of bilateral adrenal tumors from different tissues and to discuss the treatment.Methods One case of bilateral adrenal tumors from different tissues:pheochromocytoma in one side and adrenocortical adenoma in the other side was reported and the data of syptoms,physical features,auxillary examination,diagnosis and treatment were retrospectively reviewed.Results The patient was diagnosed as adrenocorticotropic hormone (ACTH) -independent Cushing's syndrome in other hospital and received laparoscopic adrenalectomy for right adrenal tumor.During the operation the blood pressure fluctuated seriously and was even more than 200 mm Hg.The pathological report showed the mass was pheochromocytoma.After the operation,the patient's clinical manifcstation was not changed.Half a year later the lab test showed blood ACTH was still less than 5 pg/ml,24 h urinary-free cortisol (UFC) was 571.32 μg,and 24 h urinary catecholamines (U CA) was:noradrenalin (NE) 22.80 μg,epinephrine (E) 2.55 μg,dopamine (DA) 92.92 μg.CT detected a mass in left adrenal gland.The patient received laparoscopic adrenalectomy for left adrenal tumor after being transferred to Peking Union Medical College Hospital.The tumor was proved as adrenocortical adenoma by postoperational pathology.One week after the operation,the 24 h UFC was 56.2 μg.Conclusions Bilateral adrenal tumors from different tissues are very rare in clinic.Adrenalectomy for tumors from both sides and remaining the normal adrenal glands are recommended.