Objective　In order to explore the prevalence of hypophosphatemia in postoperative patients of general surgery,as well as the time and dosage of phosphate replacement and its effects.Methods　To serum phosphate levels of 45 patients with phosphate replacement begun on the second postoperative day and 45 without replacement were monitored at the preoperative day,and the first,third,fifth and seventh postoperative day.Results　The incidence of hypophosphatemia was 91.1%(41/45) in cases without phosphate replacement.While it was 57.8%(26/45) in those with replacement.The serum phosphate concentrations in cases with phosphate replacement were higher than those without replacement on the third(P<0.001),fifth(P<0.05) and seventh(P<0.01) postoperative day.The Apache Ⅱ scores in cases with phosphate replacement decreased on the third postoperative days compared with those on the first day(P<0.001).Conclusion　The postoperative replacement of phosplates can avert the occurrence of hypophosphatemia and improve the Apache Ⅱ score.

Objective To discuss the value of essential hypertension arteriosclerosis as a predictor of early renal damage.Methods 90 cases of essential hypertension with early renal damage were selected and statistical analysis to result of AASI,Scr,ACR and eGFR with SPSS17.0、Excel statistical analysis software were carried out.Group A was defined as AASI≥0.55 and group B was defined as AASI＜0.55.Compared the two groups with relevant analysis,and then built multivariate linear regression equation.Results ① The group A showed higher age(P＜0.01),24 h DBP(P＜0.05),ACR(P＜0.01),ACR(+) rate(P＜0.01)and lower eGFR (P＜ 0.01),compared with the group B.②AASI showed a positive correlation with age (r＝ 0.483,P＝ 0.000),24 h SBP (r＝ 0.350,P ＝0.001),ACR (r＝0.474,P＝ 0.000),and a negative correlation with eGFR (r＝-0.383,P＝ 0.000).Two multiple linear regressions showed that AASI was associate with eGFR (B ＝-0.001,P＝ 0.038) and ACR(B ＝ 0.025,P ＝ 0.000) independent of other factors.Conclusion ①Arteriosclerosis is closely related with age and blood pressure mutation rate day and night.②Arteriosclerosis has a closely relationship with essential hypertension early renal damage,and can predict early renal damage in hypertension patients.

Chronologicaol order of acupuncture,as one of the in uential factors of acupuncture therapeutic e ect,has been commonly ignored at present.This article is to explain the rationality and necessity of chronologicaol order of acupuncture through following aspects.One is based on TCM theory,such as the'branch'and the'root',gentleness and urgency,qi and blood,reinforcing de ciency and reducing excess.The other is ndings of modern clinical and experimental researches.

With well understanding of the ethical problems in ophthalmic clinical treatment, strategies were developed to help establish a credible relationship with children and then to avoid causing psychological harm to them. The informed consent given prior to treatment can effectively minimize potential medical risks.

AIM: To investigate therapeutic effects of recombinant human growth hormone(rhGH) on rat sepsis and its possible mechanisms. METHODS: Mean arterial pressure (MAP), levels of plasma TNF?,IL-1? and endotoxin,leukocyte count and survival rate within 1 week were determined after E. coli injection among control group,sepsis group and sepsis+rhGH group. RESULTS: (1)rhGH diminished the decrease of MAP, reduced plasma endotoxin and TNF? levels and increased neutrophil ratio in total leukocytes in sepsis rat. rhGH increased survival rate within 1 week on sepsis rat. (2)No changes were found in IL-1? level among the three groups. CONCLUSION: rhGH showed desirable beneficial effects on rat sepsis, which may attribute to: improving circulatory function; maintaining intestinal mucosa barrier, attenuating bacteria/endotoxin translocation and inhibiting the production and release of TNF?.

ObjectiveTo value fluorescent quantified PCR (polymerase chain reaction) technique to detect the DNA of Mycobacterium tuberculosis from clinical patients.MethodsDetect the DNA of TB from the sputum of 80 active tuberculosis and hydrothorax of 40 tuberculous pleuritis.At equal pace,make a comparison to proceed microscopic examination and cultivation.ResultsWith fluorescent quantified PCR,56.2％ (45/80),27.5％ (11/40)positive detection from active tuberculosis and tuberculous pleuritis respectively.16.2％ ( 13/80 ),0.0％ positive specimen were detected with microscopic examination in two group of patients.Cultivation got 37.5％ (30/80),2.5％(1/40) positive detection respectively.ConclusionFluorescent quantified PCR was more sensitive and specific than traditional methods,and valuable in the microscopic examination and cultivation negative patients especially.

Objective To evaluate the efficacy of transanal local resection for early low rectal cancer. Methods The clinical data of 72 patients with early low rectal cancer who had been admitted to Union Hospital of Fujian Medical University from January 1997 to April 2009 were retrospectively analyzed. Patients were divided into 2 groups, and they received transanal local resection (group A, n = 31) and radical resection (group B, n =41), respectively. Postoperative local recurrence and distal metastasis were analyzed by Fisher exact test, the survival was analyzed by life table method. The difference in survival between the 2 groups was analyzed by Wilcoxon test. Results Three patients were found to have surgical complications in group B, while no complication was detected in group A. The local recurrence was 6% (2/31) in group A and 0 (0/41) in group B (P < 0.05); the distal metastasis was 6% (2/31) in group A and 2% (1/41) in group B, with no significance difference between the 2 groups (χ~2 =0. 062, P >0.05). The 3- and 5-year survival rates were 93%, 87% in group A, and 95%, 91% in group B, with no significant difference between the 2 groups (χ~2 =0.099, 0.144, P >0.05). Conclusions The prognosis of patients with early low rectal cancer who received transanal local resection is similar to those who received radical resection. Transanal local resection is safe and feasible when the indications are strictly followed.

Objective To investigate the value of C-reactive protein (CRP),serum amyloid A (SAA) and CD64 in early diagnosis of sepsis in very low birth weight infants (VLBWI).Methods Fifty-four VLBWI suspected to sepsis and 20 VLBWI without infection in neonatal intensive care unit of the Second Hospital of Wenzhou Medical College from May 2010 to May 2012 were enrolled in this study.CRP,SAA and CD64 of sepsis group were measured at 0 and 24 hour after suspected bacterial infection; and those of control group were measured at corresponding age.CRP and SAA were detected by enzyme-linked immunosorbent assay,and CD64 was detected by flow cytometry.The difference between groups was compared by Mann-Whitney U test.Receiver operating characteristic curve was used to predict the sensitivity and specificity of the three biomarkers on sepsis.Results Fifty-four VLBWI were suspected with sepsis,and 37 patients were finally diagnosed.The levels of the three biomarkers in sepsis group were higher than those of control group not only at 0 h [CRP:13.3 mg/L(4.6-67.2 mg/L) vs 4.4 mg/L(1.6-11.2 mg/L),Z=-2.308; SAA:95.7 mg/L(4.5-265.9 mg/L) vs 7.3 mg/L(2.5-16.9 mg/L),Z=-2.425; CD64:7306 fluorescent antibody molecules/cell (2667-10 853 fluorescent antibody molecules/cell) vs 2502 fluorescent antibody molecules/cell (1839-3017 fluorescent antibody molecules/cell),Z=-3.704],but also at 24 h[CRP:35.4 mg/L (7.7 106.5 mg/L) vs 3.2 mg/L (1.1-7.8 mg/L),Z-5.501; SAA:359.3 mg/L (3.8-503.2 mg/L) vs 6.6 mg/L (3.0-12.7 mg/L),Z =-2.818; CD64:8304 fluorescent antibody molecules/cell (2819-11 758 fluorescent antibody molecules/cell) vs 2563 fluorescent antibody molecules/cell (1760-3154 fluorescent antibody molecules/cell),Z =-7.670],P＜0.05 respectively.The best cutoff value of CD64 was 2934 fluorescent antibody molecules/cell,with the sensitivity of 81.1％ at 0 h and 91.9％ at 24 h; and the specificity of 90.0％ at 0 h and 80.0％ at 24 h.Although SAA had similar sensitivity (0 h:83.8％; 24 h:86.5％) as CD64,its specificity was relatively low(0 h:65.0％; 24 h:55.0％).Both the sensitivity (0 h:62.2％; 24 h:70.3％) and specificity (0 h:70.0％; 24 h:70.0％) of CRP were low.Combination of the three infection biomarkers could increase the sensitivity (0 h:91.9％; 24 h:97.2％) and specificity (0 h:95.0 ％ ; 24 h:90.0％).Conclusions Combination of CRP,SAA and CD64 might improve the diagnostic accuracy of sepsis in VLBWI.

Objective To investigate the fall-related knowledge and behaviors and ways after injury by chief caregivers of inpatients with neurological disease.Method We designed a questionnaire of fall-related knowledge,behaviors and ways after injury and used it among 208 chief caregivers of inpatients with neurological disease.Results On fall-related knowledge,the three items with the lowest scores about fall-related knowledge included fall-related medicine,postural hypotension and abnormal excretion.Of fall-prevented behaviour score,the lowest 3 items were three steps for getting up,placing things correctly and using wheelchair protection derive.Of the inquiry and fall measures score,the lowest 3 item were helping the patient up,observation and prevention after fall.There were significant differences in the total scores on education,time for taking care of the patients,history of fall and health education on fall (P＜0.05).The scores of those with education of senior middle school,college or above were significantly higher than those with education of junior middle school or lower (P＜0.001).The following time for taking care of the patients were compared with statistics significant:＜1month and 3～6 month,＜1month and ＞6 months,1～3 months and 3～6 months (P＜0.001).Conclusion The caregivers of the patients with neurological disease are short of knowledge in fall-related knowledge,normal behaviors and should carry out individualized health education to them.

Objective To compare the clinical effect of different doses of methylprednisolone in the treatment of children with severe hand foot mouth disease research and analysis. Methods 100 patients in our hospital from January 2014 to August 2016 were selected and randomly divided into the control group and the experimental group, with 50 patients in each group. The control group were treated with small doses of methylprednisolone, 2 mg/ (kg?d), intravenous injection. The experimental group was treated with large dose of methylprednisolone, 10～15 mg/(kg?d) intravenous infusion. The therapeutic effects of the experimental group and the control group were compared and analyzed. Results after the corresponding treatment, the number of adverse reactions in the experimental group was 31, the adverse reaction rate was 62.0％, and the adverse reaction rate in the control group was 60.0％. There was no significant difference in the incidence of adverse reactions between the two groups. The upper respiratory rate and critical illness in the experimental group were 26.0％ and 32.0％, significantly lower than that of the control group (P<0.05). The average remission time of the patients in the experimental group was (2.19±1.01) days. The symptomatic remission time in the control group was (4.19±1.89) days. The remission time of the control group was significantly longer than that of the experimental group, with statistical difference (P<0.05). Conclusion The short term large dose of methylprednisolone in treatment of children with severe HFMD clinical effect is ideal, can be reduced to critical illness rate, less symptom remission time, with the further promotion of the clinical significance.