Objective To investigate the clinical epidemiology and clinical features of patients with rubella. Methods Data of clinical epidemiology, clinical manifestations, laboratory findings of patients with rubella hospitalized in Second Affiliated Hospital of Harbin Medical University from 2002 to 2004 were retrospectively analyzed. Positive rates were analyzed using chi square test. Results Of the 408 patients with rubella,90.0% had histories of contacting with patients with rubella, and 75.5% were students. The common clinical manifestations were fever(71.1%),rash(100.0%),lymphadenectasis(90.0%).Laboratory findings were liver dysfunction(10.3%),myocardial enzyme abnormality(11.8%),WBC decrease(60.0%)and lymphocythemia(70.1%).The differences between adult group(n=125)and children group(n=283)were compared. The numbers of patients with eruption time within 1-2 days were 102 and 264,respectively(X~2=12.823.P＜0.01);those with deflorescence time within 1-3 days were 43 and 129,respectively(X~2=4.447,P=0.035);those with sporadic rash were 108 and 263,respectively(X~2=4.487,P=0.034);those with erythroic rash were 99 and 247,respectively(X~2=4.392,P=0.036);those with eruption order of head to trunk were 104 and 256,respectively(X~2=4.402,P=0.036);those with thrombocytopenia were 10.4% and 2.5%,respectively(X~2=11.686,P＜0.01);those with liver dysfunction were 17.6% and 7.1%,respectively(X~2=10.416,P＜0.01);those with myocardial enzyme abnormality were 20.0% and 8.1 %,respectively(X~2=11.774,P＜0.01),those complicated with broncho pneumonia were 0.8 and 6.7%,respectively(X~2=6.505,P=0.011);those complicated with hepatitis were 17.6 % and 7.1 %,respectively(X~2=7.117,P=0.008);those complicated with myocarditis were 18.4% and 7.1%,respectively(X~2=11.811,P＜0.01) and those complicated with arthritis were 12.0% and 2.8%,respectively(X~2=13.715,P＜0.01).Conclusions Compared with children patients with rubella, the constitutional symptoms of adult patients are more severe, and the proportion of liver and myocardial enzyme abnormality is higher, which should be paid more attention.

Clinical teaching and studying is suffering increasing hardship.This article analysises the present condition of clinical education problems and causes,and researches whether patients are obliged to coorperate clinical teaching and studying when they protect their rights.It also researches how to practice clinical teaching and studying in educational hospital and looks for effective pathway to go out of the clinical education problem.

Objective:To explore the curative effect and adverse reactions of cisplatin combined with rIL-2 on malignant pleural effusion. Methods:Totally 60 cases of patients with malignant pleural effusion were randomly divided into the observation group ( 30 cases) and the control group (30 cases). In the observation group, 30 cases were given intrapleural injection of cisplatin and rIL-2 af-ter the pleural effusions were drained, and in the control group, the patients received intrapleural injection of cisplatin. Both of the two groups were observed of tumor response and drug adverse reactions, compared the quelity of life and immune function indicators before and after treatment. Results:The response rate in the observation group was 83. 3%, which was significantly higher than that in the control group (56. 7%) (P<0. 05). The improvement of Karnofsky score in the observation group was 86. 7%, which was also nota-bly higher than that in the control group(63. 3%) (P<0. 05). After the treatment, CD4 level and CD4/CD8 were significantly in-creased in the observation group(P<0. 05), while those in the control group were notably decreased (P<0. 05), and the difference was statistically significant (P<0. 05). The incidence of adverse reactions shew no significant difference between the two groups (P>0. 05). Conclusion:Cisplatin combined with rIL-2 shows confirmed effects in the patients with malignant pleural effusion.

OBJECTIVE To analyze the traits and the related factors of the injured patients who had hospitalized in ICU in order to make the corresponding strategies and decrease the incidence of hospital infection effectively. METHODS The hospital infection and the associated factors of 384 cases in ICU from Jan 2006 to Dec 2007,including the patients age,injuried severity,interventional manipulation,emergency operation before or after admission to ICU,the length of stay in ICU and the use of tranquillizer were investigated. RESULTS Of 384 cases,156 cases occurred in patients with nosocomial infection,with the infection rate 40.6%,infection site or respiratory tract was accounted for 63.3%,followed by urinary tract,skin and soft tissue.Gram-negative bacteria,were accounted for 71.7%,followed by Gram-positive cocci(15.2%) and fungi(13.1%),the severe level of diseases,interventional manipulation,emergency operation,the use of tranquillizer,the length of stay in ICU were related to the hospital infection. CONCLUSIONS The key measures to preventing hospital infection are strengthening the care of the injured patients before admission to ICU,establishing the nursing regulations of the interventional manipulation,performing sterile manipulation strictly,and enhancing the monitoring and administration about environment to control the cross-infection.

Objective:To investigate the effect of fibrinogenase combined with aspirin on blood viscosity and clinical efficacy in patients with acute cerebral infarction.Methods:Senventy patients with mild to moderate acute cerebral infarction from October 2016 to June 2020 were collected from the Third People′s Hospital of Dalian. Patients were divided into control group and treatment group according to the random number table method, with 35 cases in each group. The control group was given oral aspirin plus an intravenous drip of normal saline equal to the treatment group, while the treatment group was given aspirin plus fibrinogenase by intravenous drip. Both groups were given symptomatic treatment such as management of blood glucose, blood pressure, arteriosclerosis plaque stabilization and improvement of circulation for 10 d. Blood viscosity and neurological deficit score were measured before and after treatment.Results:Compared with baseline values, WBV showed a slight decrease in all shear rates in the control group after treatment compared with that before treatment, but the difference was not statistically significant ( P>0.05). In the treatment group, all shear rates decreased compared with that before treatment ( P<0.05), and the effect of WBV was significant compared with that of the control group ( P<0.05). The improvement of neurological function in the treatment group was better than that in the control group. The significant efficiency and the total effective rate in the treatment group were significantly higher than those in the control group: 34.3% (12/35) vs. 25.7% (9/35), 88.6% (31/35) vs.71.4% (25/35). Conclusions:Fibrinogenase combined with aspirin in the treatment of acute cerebral infarction patients can safely and effectively reduce blood viscosity and improve clinical symptoms.

OBJECTIVE An understanding of the complex anatomy of the anterior skull base is crucial for the surgeon doing endoscopic surgery. The anatomic data of the olfactory sulcus and adjacent structures in Chinese patients were defined using 3-dimensional reconstruction images. The surgeon is encouraged to develop a detailed pre-operative surgical plan by utilizing these dynamic anatomical observations to avoid intracranial injury. METHODS The paranasal sinus CT scanning images of 100 adults were reconstructed for observation using EBW2.0 software and multiplanar reformation. All data obtained were in the coronal plane from the anterior point of the olfactory sulcus. The cribriform plate depth as compared to the ethmoid roof and adjacent structures, was measured bilaterally. Data obtained on adjacent structures include the vertical height of the lateral lamella of olfactory sulcus, the horizontal distance between the cribriform plate and the orbital lamella, the length of the middle turbinate, the height of the orbit, and the vertical distance between the cribriform plate and the nasal floor. RESULTS The olfactory sulcus was classified into three types: platform type (60 %), sloping type (17 %) and mixed type(23 %), as distinguished from Keros classification. In this study the vertical height of the lateral lamella of olfactory sulcus was (5.03 ± 0.17) mm (R) and (5.39 ± 0.19) mm (L) in platform type, and (2.79 ± 0.49) mm (R) and (4.72 ± 0.49) mm (L) in the mixed type. There were statistically significant differences between the right side and the left side in these two types (P＜0.01). The horizontal distance between the cribriform plate and the orbital lamella on the same side was significantly different between the platform type and the mixed type of olfactory sulcus. A similar result was observed for the vertical distance between the cribriform plate and the nasal floor. Gender differences exist in the horizontal distance between the cribriform plate and orbital lamella on the same side and the vertical distance between the cribriform plate and the nasal floor. CONCLUSION Different types of olfactory sulcus have distinct characteristics, hence care which must be taken into account when doing endoscopic surgery.

Objective To compare the clinical efficacy of minimally invasive removal of intracranial hematomas and medical con-servative treatment for hypertensive cerebral hemorrhage .Methods A total of 75 patients with hypertensive cerebral hemorrhage were collected and randomly divided into two groups according to the treatments :38 patients treated with conservative medicine and 37 patients treated with minimally invasive removal of intracranial hematomas based on standard drug therapy .Neurological impair-ment and recovery of self-care ability of patients in both groups before and after three weeks and six weeks of treatment were scored by National Institute of Health Stroke Scale (NIHSS) .Changes of diffusion tensor imaging before treatment and after two weeks of treatment were evaluated by fractional anisotropy value (FA) .Results There was no significant difference between neurological im-pairments of the patients in two groups before treatment .But the recovery degree of functional impairment and muscle nerve in min-imally traumatic treatment group was more significant than those in the conservative medical treatment group after treatments . There was significant difference between two groups (P< 0 .05) .Conclusion Minimally traumatic of hematomas is an effective method of treating hypertensive intracerebral hemorrhage .

Objective To compare the changes of intraocular pressure (IOP) in 24 hours between obstructive sleep apnea syndrome(OSAS) and the non-obstructive sleep apnea syndrome(non-OSAS).Methods Sixty patients with OSAS were divided into two groups:OSAS group(n =30) and non-OSAS group (n =30).The following indicators were detected:(1) Awake oxygen saturation ((HSaO2) ％),(2) The lowest oxygen saturation (LSaO2) ％) ; (3) Mean oxygen saturation ((MSaO2 ％)) ; (4) Oxygen desaturation index ((DI4),time/h:number of times that the hourly oxygen desaturation ≥ 4％) ; (5) The percentage of the time that oxygen saturation ≤ 90％ accounts the total time ((SIT90)％) and 24-hour IOP.IOP was measured from early morning 5:00 and measured once every four hours.The measurement results were compared between two groups.Results There was no significant difference on age ((62.60 ± 12.44) years old vs (65.20 ± 10.66)years old,t =1.48),Course of disease ((22.40 ± 6.88) month vs (25.49 ± 7.22) month,t =1.97),gender (The ratio of male to female is(20/10)vs (17/13),x2 =0.007) between the OSAS and the non-OSAS(P ＞0.05).Value of AHI(h-1) ((27.9 ±6.0) vs (2.5 ±1.1),t =8.78),LSaO2 ((74.7 ±11.7)％ vs (91.8 ±5.9)％,t=3.44),SIT90((13.2±12.4)％ vs(0.2±1.1)％,t=9.92) and ODI4(h-1) ((28.9 ±13.9)vs (6.1 ±4.1),t =8.09) of OSAS was significantly higher than that of non-OSAS(P ＜0.05 or P ＜0.01).Value of IOP of 21:00 o'clock((20.61±4.15)mm Hg vs(19.60 ± 4.03)mm Hg,t =2.18),1:00 o'clock((23.12 ±3.11)mm Hg vs (20.60 ± 3.29) mm Hg,t =4.64) and 5:00 o' clock ((22.82 ± 2.99)mm Hg vs (17.21 ±3.55) mm Hg,t =4.23) of OSAS was significantly higher than that of non-OSAS (P ＜ 0.05 or P ＜ 0.01).The wave ((10.40 ± 2.85)mm Hg vs (8.40 ± 2.55) mm Hg,t =4.15) and maximal ((23.60 ± 3.29) mm Hg vs (21.23 ±3.43)mm-Hg,t =2.60) value of IOP of OSAS was significantly higher than that of non-OSAS(P ＜0.05 or P ＜0.01).There was no significant difference on minimum of IOP between the OSAS and the non-OSAS ((13.20 ± 4.08)mm Hg vs (12.70 ± 4.22) mm Hg,t =0.54,P ＞ 0.05).Conclusion There are higher wave and maximal value of IOP in the patients of OSAS during the night.It is important to pay attention to IOP in order to protect those patients' visual function.

Objective To investigate the corelation between neutropenia (ANC) incidence and infection during treatment with peginterferon alfa and ribavirin for chronic hepatitis C.Methods A retrospective cohort study of 399 patients treated with peginterferon and ribavirin derived from database of Department of Infectious Diseases, the Second Affiliated Hospital, Harbin Medical University was conducted.The incidence of infections and their relation with ANC were investigated.Potential risk factors for infection were identified by multivariate analysis.Results During treatment,neutropenia (ANC ＜ 1.50 ×109/L) occurred in 251 patients.Among which,mild neutropenia [ANC: ( ＞ 0.75-＜ 1.50) x 109/L],moderate neutropenia [ANC: ( 0.50-0.75 ) × 109/L]and severe neutropenia ( ANC ＜ 0.50 × 109/L)occurred in 132 patients,103 patients and 16 patients,respectively.A total of 80 infections (20.1％ )occurred,among which,14 infections were defined as severe.There was no significant difference in infection rate between patients with and without neutropenia ( 19.9％,50/251 vs 20.3％,50/251 ; x2 =0.007,P =0.933).There was no significant difference in infection rate between patients with and without peginterferon dose reduction ( 21.5％,31/144 vs 19.2％,49/255 ; x2 =0.307,P =0.580 ).In multivariate logistic regression analysis,the independent factors associated with infection were age (P =0.021),diabetes (P =0.004) and cirrhosis (P =0.012).Conclusions Infections during treatment with peginterferon alfa and ribavirin for chronic hepatitis C are irrelevant to neutropenia.The independent factors associated with infection are age,diabetes and cirrhosis.

Objective To investigate the changes of epidemiological and clinical features of patients with hemmorrhagic fever renal syndrome (HFRS) over past 10 years in Harbin region. Methods The epidemiological, clinical and laboratory data of patients with HFRS in 1995 and 2005 in The Second Affiliated Hospital of Harbin Medical University were retrospectively analyzed. The genotypes of Hantaan virus of patients in 2005 having an onset within 5 days were examined by reverse transcriptase polymerase chain reaction (RT-PCR). Positive rates in different groups were compared using chi square test. Results One hundred and sixty-five cases were collected, including 78 in 1995 and 87 in 2005. There were significant differences in epidemiological area (X2=10. 483, P<0.05), clinical classification (X2=7. 907, P<0.05), clinical stage (X2=10.500, P<0.05), the variance of total white blood cells (X2=20. 315, P<0.01) and blood sugar changes (X2=9.958, P<0.01) between two groups of patients. Bases on clinical manifestations, there were significant differences in two groups (1995 and 2005): headache, 70.5% and 50.6% (X2=6.812, P<0.01); lumbago, 60.3% and 40.2% (X2=6.598, P<0.05); fossaorbitalis pain, 50.0% and 19.5% (X2=17.019, P<0.01); melena, 60.3% and 40.2% (X2=6.598, P<0.05); bleeding point and eeehymosis, 50.0% and 33.3% (X2=4.715, P<0.05) ; flush of faee, neck and upper chest, 59.0% and 40.2% (X2=5.782, P<0.05); membrane-like object in urine, 44.9 % and 29.9% (X2=3.964, P<0.05) rates of thrombocytopenia, 79.5% and 64.4% (X2=4.615, P<0.05) ; rates of liver dysfunction, 50.0% and 80.5% (X2=17.019, P<0.01); rates of cardiac muscle enzymoiogy dysfunction, 50.0% and 92.0% (X2=36.003, P<0.01). The genotypes of patients in 2005 were Hantaan virus (34.8%) and Seroul virus (65.2%). Conclusion The differences in epidemiological and clinical feature of patients with HFRS over past 10 years may be related with the change of virus genotypes, and further study should be done.