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Sleep Wake Disorders*

Pancreaticoduodenal anastomotic dehiscence complicated with peritoneal hemorrhage following pancreaticoduodenectomy is a serious complication which threatens patients'life.Prevention and mangement of pancreaticoduodenal anastomotic dehiscence and peritoneal hemorrhage is the focus in the surgical treatment.Operation is the most reliable treatment for bleeding.While reoperation is difficult for most surgeons and the risk of fistula and rebleeding after reoperation exist.Some procedures will affect the endocrine and exocrine function of pancreas.We applied pancreaticojejunal bridge drainage for most patients with hemorrhage after pancreaticoduodenectomy.This procedure is easy,safe,and can protect the pancreatic function.

Objective To investigate the efficacy of intravenous iron sucrose combined with psychological intervention in the treatment of gynecological anemia. Methods A total of 76 patients with gynecological anemia admitted in our hospital from September 2000 to March 2017 were randomly divided into study group and control group, 38 cases in each group.The control group and gynecological anemia patients were treated with intravenous sucrose iron, the study group was treated with intravenous iron sucrose, and the corresponding psychological intervention measures were used. Results There was no significant difference in HGB and SF between the two groups before treatment., the study group after treatment HGB, SF detection value is higher than that of control group (P<0.05); study group increased to HGB for normal values of time required significantly less than the control group (P<0.05); two gynecological patients with anemia treatment in the process of research the rate of adverse reactions was 13.16%, the control group is as high as 28.95% (P<0.05). Conclusion Intravenous iron sucrose based treatment combined with psychological intervention can significantly improve the index of gynecological patients with anemia effect, reduce adverse drug reactions, to ensure the effectiveness and safety of patients are of positive significance.

Objective To evaluate the value and limitation of CTA, MRI and DSA in the diagnosis of the cerebral venous malformation. Methods CT angiography in 8 cases and MRI in 10 cases were performed among 12 cases of cerebral venous malformation confirmed by carotid angiography . Results All cases had typical DSA appearance and it could be seen both the number and the direction of the guide vein. The typical “Medusa-head” sign could be seen on MRI and could be more obvious after contrast enhancement.The other complications might be seen on the postcontrast. On CTA,both the lesion itself and the “caput medusae”sign could be displayed.Conclusion In diagnosis of cerebral venous malformation,DSA is the gold standard,CTA is the significant method in diagnosing and following up,while MRI is the most useful method.

OBJECTIVE:To standardize and improve the package inserts of Traditional Chinese medicine injections,and to guide clinical rational drug use and reduce incidences of adverse drug reactions(ADRs).METHODS:The package inserts of 34 kinds of traditional Chinese medicine injections commonly used in the clinic were subjected to an analysis.RESULTS & CONCLUSION:Part of the package inserts were not standard in writing contents in that they are unscientific and incompact,which thus remain to be improved.

3 d) were noted.CONCLUSION:The Clindamycin should be used in line with the perioperative preventive medication principle by strictly following its indications to ensure the safety and rationality of its clinical use.

Objective To study the operative method for severe duodenal trauma.Methods The clinical data of 38 cases of severe duodenal trauma complicated with pancreatic injury who underwent different operations between 1992—2006 year were reviewed.Results In 8 cases duodenal diverticulization was performed,of which 5 cases were cured,2 cases developed intestinal fistula,and one died.Of 9 cases who underwent panceaticoduodenectomy(PD),3 were cured but 6 had pancreatic leakage,and 3 of them died.Of 16 cases who had primary repair of ruptured duodenum with simple suture or patch suture,13 cases cured,2 cases developed intestinal fistula and one patient died.Five patients underwent duodenal repair and excision of head of pancreas plus pancreaticojejunostomy(PD with preserved duodenum),4 cases recovered and 1 had pancreatic leakage,but 3 with wrap-type pancreaticojejunostomy had no complications.Conclusions The repair of ruptured duodenum with simple suture plus duodenostomy and jejunostomy is preferential option for majority of cases of duodenal trauma.This procedure plus removal of head of pancreas and pancreaticojejunostomy(PD with preserved duodenum) can be used for severe pancreatic injury with excellent result,but duodenal diverticulization or panceaticoduodennectomy must not be undertaken lightly.

OBJECTIVETo investigate the clinical value of pleural biopsy in the etiological diagnosis of pleurisy in children.

METHODTotally 213 cases with pleurisy, who underwent pleural biopsy and hospitalized in Children's Hospital of Chongqing Medical University from January 2007 to April 2014 were enrolled into this study. Clinical symptoms, imaging manifestations, pleural fluid characteristics, the results of pleural biopsy and postoperative complications were retrospectively analyzed to evaluate the clinical value and security of pleural biopsy in making the etiological diagnosis of pleurisy.

RESULT(1) Of the 213 cases, 144 were boys and 69 were girls, their mean age was (6. 5 ± 4. 1) years. (2) Two hundred and thirteen patients had a surgical pleural biopsy under general anesthesia, the cause of 97 cases (45. 5%) were made clear by histopathological examination, including 35 purulent pleurisy, 55 tuberculous pleurisy and 7 paragonimus infection. For the remaining 83 (41. 3%) cases a final diagnosis was made based on the full analysis of clinical data, including 63 cases of purulent pleurisy, 3 cases of tuberculous pleurisy and 17 cases of paragonimiasis pleurisy but for 33 patients no exact cause was found at the end. (3) The mean operating time of the biopsy was (1. 4 ± 0. 6) hours. Seventy one (33. 3%) patients required blood transfusion during or after the operation. Thirty one (14. 6%) cases used the ventilator after surgery, and the ventilator supporting time was (6. 6 ± 5. 8) hours on average. The wound healing reached grade A in 200 cases (93. 9%), grade B in 13 cases (14. 6%). Postoperative complications included pneumothorax in 92 cases (43. 2%), subcutaneous emphysema in 18 cases (8. 5%), bronchopleural fistula in 3 cases(1. 4%). The average days of hospitalization was (17. 7 ± 7. 1) d.

CONCLUSIONPleural biopsy is of great diagnostic value in the etiological diagnosis and differential diagnosis of pleurisy in children, and it is considered reasonable to be used in the clinical practice when appropriate.

Biopsy ; Child ; Diagnosis, Differential ; Female ; Humans ; Infection ; diagnosis ; Male ; Pleura ; Pleurisy ; diagnosis ; etiology ; Retrospective Studies ; Tuberculosis, Pleural ; complications ; diagnosis

Multidrug resistant genes are highly expressed in hepatocellular carcinoma that seriousty affects the effect of chemotherapy. Screening of resistant genes from HCC cells and studying its mechanism of drug resistance will be helpful to improve the effecacy of chemotherapy for hepatocellular carcinoma. Here we described an alternative method called cyclical packaging rescue (CPR). First we constructed a retrovirus cDNA library of hepatoma cells and used it to infect fibroblasts. Then we added drugs to screen survival cells. The survival cells, stably integrated helper-free retroviral libraries, were recovered rapidly after transfection with plasmids expressing retroviral gag-pol and env genes. Through this method, retroviral RNAs were directly repackaged into new infectious virions. Recovered retroviral supernatant was then used to reinfect fresh target cells. When performed in concert with selection using functional assays, cDNAs regulating functional responses could be identified by enrichment through multiple rounds of retroviral library recovery and retransmission. Using CPR, we obtained several cDNAs. After a preliminary detection, we found Ribosomal protein S11 (RPS11), Ribosomal protein L6 (RPL6), Ribosomal protein L11 (RPL11), Ribosomal protein L24 (RPL24) possibly had drug resistant function.
Carcinoma, Hepatocellular ; genetics ; pathology ; Cell Line, Tumor ; DNA, Complementary ; Drug Resistance, Neoplasm ; genetics ; Gene Library ; Genetic Vectors ; Humans ; Liver Neoplasms ; genetics ; pathology ; Plasmids ; Retroviridae ; Ribosomal Proteins ; genetics ; metabolism ; Transfection

Objects To establish a simple,rapid carrier detection and prenatal diagnosis system for hemophilia.Methods Thirty-eight HA families were tested for the intron 22 and 1 inversions in factor VIII gene by LD-PCR and PCR.The remaining inversion negative families,but with family history,were screened using linkage analysis with 8 combined polymorphic markers,including St14,F8IVS13,CA22,DXS15,DXS9901,G6PD,DXS1073,and DXS1108.For sporadic families,the whole gene sequencing was applied directly to detect the mutation.For HB families,linkage analysis with 6 STRs,including DXS1192,DXS1211,DXS8094,DXS8013,DXS1227 and DXS102,was applied to get quick diagnostic information.The whole gene sequencing was used to get the final diagnosis.The rapid fluorescent PCR combined with polymorphism markers were applied for linkage analysis in HA and HB families,respectively.As soon as the pregnancy was identified,additional Amelo site detection would be performed.Results In 38 HA families,introns 22 and 1 inversions were found in 10 and 1 probands,respectively.The diagnostic rates of St14,F8IVS13,CA22,DXS15,DXS9901,G6PD,DXS1073 and DXS1108 were 61.11%,76.67%,71.43%,70.59%,62.50%,10.00%,75.00% and 50.00%,respectively.Combining inversion detection and linkage analysis,the diagnostic rate of carrier detection and prenatal diagnosis of families with HA family history were both 100%.One intron 22 inversion and 3 mutations were detected in 4 sporadic families.The total diagnostic rate of 38 HA families was 94.81%.And 10 mutations were detected in the 12 HB families.Combined with the linkage analysis,the total diagnostic rate was 96.88%.Conclusions Introns 22 and 1 inversion screening combined with the linkage analysis,using the highly informative polymorphic markers,can be used for carrier detection and prenatal diagnosis in Chinese HA families.The direct sequencing of FⅨ with the linkage analysis can be successfully applied for carrier detection and prenatal diagnosis of HB families.