Hedging is an important component of vague language. This paper retrieves high frequency expressions of hedgingby using medical English corpus. Pragmatic functions of hedging are analyzed, which can be summarized as politeness principle, authors' self-protection, avoidance of the absolute, pursuit of objectiveness as well as conversational implication. To medical researchers, it is necessary to cultivate the awareness of hedging and learn how to adopt it in their research papers.

Objective:To explore the clinical application of permanent needle of deep venipuncture in early management of extensive burn.Methods:88 patients with extensively burn are analyzed.Results:The success rate of venipuncture was 96%.The effect was satisfactory,while the complication was less.Conclusion:The permanent needle of deep venipuncture shows an important role in early management of extensive burn.

Primary central nervous system lymphoma (PCNSL) is a rare type of extranodal lymphoma, and its incidence rate is increasing nowadays. Chemotherapy is the main means for treatment of PCNSL and the efficacy of high-dose methotrexate (HD-MTX) has been confirmed among those chemotherapeutics. Treatments of HD-MTX combined with other drugs have been studied extensively. Progress of HD-MTX and other drugs for PCNSL are reviewed in this article.

ObjectiveTo investigate the risk factors,prevention measures and treatment methods of the pulmonary fibrosis patients with nosocomial pulmonary fungal infection. Methods50 pulmonary fibrosis patients with nosocomial pulmonary fungal infection were chosen as the observation group. In the same time,50 pulmonary fibrosis patients without nosocomial pulmonary fungal infection were chosen as the control group. The following factors were compared: hospital stay, corticosteroid use, antibiotic use, invasive procedures, a merger of the underlying disease.ResultsThere were 46％ (23/50) patients had long-term use of antibiotics in the observation group, much more than the control group(26％ ,13/50) ,the difference was statistically significant( P ＜0.05) ;More than half of patients in both groups using glucocorticoids, the ratio in the observation group was 84％ (42/50), which was significantly higher than the control group( P ＜ 0.05) ; In the observation group, the rates of patients with long time hospitalization ( ≥30 days), received invasive procedures, and associated with underlying diseases were much higher than the control group( all P ＜ 0.05). ConclusionMultiple risk factors could lead to the occurrence of pulmonary fibrosis patients with nosocomial pulmonary fungal infection,and the positive and effective preventions and standard treatment should be taken.

Ear Diseases ; diagnosis ; therapy ; Humans ; Magnetic Resonance Imaging

Objective To investigate the metabolism of lipid,calcium and phosphorus in women with endometriosis.Methods Clinical data of 223 patients with endometriosis and 200 patients without endometriosis were retrospectively analyzed.Electrochemiluminoimmunoassay was used to detect the levels of serum luteinizing hormone(LH),follicle-stimulating hormone(FSH),testosterone(T),estradiol(E2)and progesterone(P),and photoelectric colorimetry was used to determine the concentrations of serum triglyceride ( TG), total cholesterol ( TC ), low density lipoprotein ( LDL), high density lipoprotein (HDL), calcium and phosphorus in the patients with and without endometriosis. Results The levels of serum P were 2. 0 nmol/L and 1.8 nmol/L in endometriosis patients with age≤35 years old (case group A)and ＞35 years old (case group B), and 1.6 nmol/L and 1.2 nmol/L in patients without endometriosis at age≤35 years old (control group A) and ＞ 35 years old (control group B), respectively. A significant difference was found between case group A and control group A, and between case group B and control group B. The levels of serum LH was significantly higher in case group B (7. 2 U/L) than that in control group B (6. 1 U/L), however, there was no significant difference between case group A (7. 0 U/L) and control group A (6. 5 U/L). Also no significant difference in serum FSH, T and E2 levels was found between case group A (respectively, 6.2 U/L,1.1 nmol/L and 269 pmol/L) and control group A (respectively, 6.3 U/L, 1.1nmol/L and 264 pmol/L), also between case group B (respectively, 6.6 U/L, 1.0 nmol/L and 345pmol/L) and control group B (6. 6 IU/L, 0. 9 nmol/L and 279 pmol/L). The concentrations of serum TG in case group A and B (0. 71 mmol/L and 0. 72 mmol/L) were significantly lower than in control group A and B (0. 92 mmol/L and 1.08 mmol/L), respectively. The concentrations of serum LDL in case group A and B [ (2. 2 ± 0. 5) mmol/L and (2.4 ± 0. 6) mmol/L]were also significantly lower than in control group A and B[ (2. 4 ± 0. 7) mmol/L and (2. 62 ±0. 63) mmol/L], respectively. However, the concentrations of serum HDL in case group A and B [ (1.62 ± 0. 31) mmol/L and(1.53 ± 0. 32) mmol/L] were significantly higher than in control group A and B [ ( 1.48 ± 0. 21 ) mmol/L and ( 1.37 ± 0.22) mmol/L], respectively.In addition, the concentrations of serum TC were not significantly different between case group A and control group A [ (4. 2 ± 0. 7) mmol/L and (4. 29 ± 0. 71 ) mmol/L], and between case group B and control group B [ (4. 4±0. 8) mmol/L and (4. 5±0. 7) mmol/L]. The levels of serum phosphorus in case group A and B [ (1.01 ± 0. 22) mmol/L and (0. 89 ± 0. 18 ) mmol/L] were significantly lower than in control group A and B [ ( 1.23 ± 0. 24) mmol/L and ( 1.10 ±0. 13 ) mmol/L ] , respectively. But the levels of serum calcium had no significant difference between case group A and control group A [ (2. 39 ± 0. 23 ) mmol/and (2.41 ± 0. 12) mmol/L], and between case group B and control group B [(2.40 ± 0.28) mmol/L and (2. 42 ±0. 20) mmol/L]. Conclusion The abnormal metabolism of lipid and phosphorus, and the higher levels of serum P may playing a role in the pathogenesis of endometriosis.

As the increasing of digital imagilag modalities,a close-at-hand challenge to deal with is the storage and transmission requirement of enormous data of medical images.Compression is one of the indispensable techniques to solve this problem.A comprehensive review and discussions are made in this paper over the medial image compression techniques applied in medical image domain,including the latest achievements in this field.Different compression algorithm including ROI-based coding,lossless compression,DWT,neural net are introduced and some quality evaluation methods are introduced.Foreground of the field is given from our point of view.

Objective To explore the correlative factors of hypotension among hemodialysis patients and to come up with nursing interventions.Methods The histories of 49 maintenance hemodialysis patients were retrospectively reviewed to find out the correlative factors of hypotension and summarize the nursing strategies.Results The major factors for hypotension included large volume of dehydration and fast speed of dehydration in 22 cases,malnutrition and hypoproteinemia in 8 cases,severe anemia in 6 cases,dysfunction of the autonomic nervous system in 5 cases,low concentration of sodium or high temperature of dialysate in 4 case and medication errors and eating too much before or during dialysis in 4 cases.Conclusion The nursing strategies including control of weight,correct assessment of dry weight,right performance of low temperature hemodialysis and sodiun profile hemodialysis as well as mental care to those with depression are critical for prevention of hypotension development in patients undergoing maintenance hemodialysis.

The prognosis of patients with pancreatic cancer is dismal, especially at the advanced stage of the disease. Surgery is considered as the only curative treatment modality for pancreatic cancer;however, less than 20% of patients are candidates for curative surgical resection. Multidisciplinary management, including radiation therapy with concurrent chemotherapy, followed by systemic chemotherapy, is the treatment of choice for locally advanced pancreatic cancer. An early phase Ⅲ clinical trial conducted by GITSG (GI Tumor Study Group) has demonstrated a survival benefit for concurrent chemoradiation as compared to radiation alone in locally advanced disease. 5-FU,capacitabine and gemcitabine are the most investigated chemotherapy agents used with radiation. Currently thecombined use of gemcitabine and radiation therapy is under active investigation, and may provide substantial clinical advantage over other regimens. Multi-agent chemotherapy regimen used in concurrence with radiation has not demonstrated any significant effect but with severe toxicities. Conformal radiotherapy should be routinely used to treat locally advanced pancreatic cancer with doses of 45-50.4 Gy. The target of locally advanced pancreatic cancer is focussed on the gross tumor with safe margins. The use of IMRT is highly recommended for unresectable tumor, and makes further dose escalation possible.

Objective To observe the effect of high flux hemodialysis (HFHD) combined with artificial kidney on fibroblast growth factor-23 (FGF-23) in patients with maintenance hemodialysis (MHD). Methods Eighty cases who regularly carried out long-term HFHD in nephrology blood purification center of NO.85 Hospital of PLA were enrolled. All the patients firstly received HFHD alone for 1 month, and then according to random principle, they could receive HFHD followed by hemoperfusion (HP) for treatment (HFHD+HP group) or HP followed by HFHD for treatment (HP+HFHD group). These two types of treatment were respectively carried out for 3 months, and then exchanged to proceed the procedure, the interval of exchange being 1 month (in this month, the two groups of patients all underwent simple HFHD treatment). The therapeutic course was 8 months including 2 cycles. The serum samples were taken from patients undergoing simple HFHD before and after the first month of blood purification, and patients in HFHD+HP group and HP+HFHD group before and after the last month for determination of serum creatinine (SCr), calcium, phosphorus, parathyroid hormone (iPTH), FGF-23 levels. Results The SCr level in HFHD + HP group before hemodialysis was significantly lower than that in simple HFHD group (μmol/L:773.45±212.23 vs. 803.27±192.47, P<0.05), there were no significant differences in blood calcium and phosphorus before hemodialysis between HFHD+HP group and HP+HFHD group (all P>0.05). After hemodialysis, the serum iPTH, FGF-23 were dropped significantly in HFHD + HP and HP + HFHD groups compared with those in simple HFHD group (P < 0.05 or P < 0.01). After hemodialysis, there were no statistically significant differences in SCr and calcium levels between the above two groups (both P>0.05). But the levels of serum phosphorus, iPTH, and FGF-23 in HFHD+HP group were significantly lower than those of HP+HFHD group [serum phosphorus (mmol/L):1.47±0.22 vs. 1.60±0.23, iPTH (μg/L):490.12±145.23 vs. 516.34±165.75, FGF-23 (μg/L): 802.11±92.58 vs. 822.39±107.23, P < 0.05 or P < 0.01]. Conclusions In the aspect of elimination of large and medium sized molecules, the effect of combined artificial kidney is much better than that of simple HFHD. The rates of toxin elimination in different types of combined artificial kidney treatment are different, and the HFHD+HP type has greater effect than HP+HFHD type on elimination of toxins with large or medium sized molecules such as iPTH, FGF-23, etc.