Adenocarcinoma ; diagnosis ; pathology ; surgery ; Adenocarcinoma, Mucinous ; diagnosis ; pathology ; surgery ; Adult ; Aged ; Carcinoma, Squamous Cell ; diagnosis ; pathology ; surgery ; Cholecystectomy ; methods ; Female ; Follow-Up Studies ; Gallbladder Neoplasms ; diagnosis ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Retrospective Studies ; Survival Rate

The term complication is defined as a secondary disease, an accident, or a negative reaction occurring during the course of an illness and usually aggravating the illness. It usually takes two forms: a secondary illness of a disease; or a complication resulting from medical treatments.Characteristic of being risky, predictable, uncertain, and relatively avoidable, complications are affected by a variety of factors. In the course of identifying medical malpractice, identification of complications should be achieved according to how complications occur and evolve in the entire course of treatment and care, whether staffs have followed standards and regulations for treatment and care, whether staff are well aware of their obligations to take precautions to avoid risks, and provide medical care once complications take place, whether malpractice exists in the practice of medical staff, whether a cause -effect relationship exists between complications in patients and harms caused to families and medical malpractice.

Objective To explore the levels of neuron-specific enolase(NSE)in serum and cerebrospinal fluid(CSF) of children with convulsion,and its significance to the diagnosis of neuronal damage was evaluated.Methods Sixty patients were enrolled,and they were divided into 4 groups:non-nervous system disease group,peripheral nervous system disease group,brief convulsion group,and prolonged/status convulsion group.The levels of NSE in serum and CSF were detected in 4 groups,and the electroencephalography(EEG) and computed tomography/magnetic resonance imaging(CT/MRI) examinations were taken to observe the changes in patients with convulsion.Results The levels of NSE in serum and CSF of children with convulsion increased significant,especially in the prolonged/status convulsion group.Changes of NSE levels in serum and CSF were similar.Meanwhile,significant changes were found in EEG between the brief convulsion group and prolonged/status convulsion group;but no significantly changes were found in CT/MRI between the 2 groups.Conclusions NSE detection might be valuable to the diagnosis for neuronal damage in early time.The changes of NSE levels are similar to those in EEG,which are more sensitive than the changes in CT/MRI.It is very important to combine the NSE detection in serum or CSF and EEG examination in early time after convulsion for judgement to the neuronal damage and prognosis.

Accidents, Occupational ; prevention & control ; Humans ; Occupational Diseases ; diagnosis ; Occupational Health Services ; organization & administration

Objective To investigate the emergency treatment and correlation factors of aqueous misdirection during glaucoma and cataract surgery in glaucoma patients.Design Retrospective case series.Participants 126 cases(132 eyes)of angle-closure glaucoma patients with aqueous misdirection during surgery,100 cases(100 eyes)of angle-closure glaucoma patients without aqueous misdirection during surgery and 100 cases(100 eyes)of senile cataract patients.Methods We performed pars plana vitreous water-bag aspiration or anterior vitrectomy on glaucoma patients with aqueous misdirection during surgery.All the factors in observation group and control groups were compared and analyzed by logistic regression.Main Outcome Measures Preoperative highest intraocular pressure(HIOP),intraocular pressure after maximum dose(IOP),anterior chamber depth(ACD),lens thickness(LENS),axial length (AXL),mean keratometry(K),intraocular lens diopter within-0.5D corrected by SRK-T formula(IOLD).Results Among all the 132 angle-closure glaucoma eyes whose posterior chamber pressures were increased during surgery,we performed pars plana vitreous water-bag aspiration in 123 eyes(93.18%),and anterior vitrectomy in 9 eyes(6.8%).Postoperative complications included shallow anterior chamber in 20 eyes(7 eyes with malignant glaucoma,9 eyes with choroidal detachment,4 eyes with delayed local suprachorodal hemorrhage),and vitreous local hemorrhage in 1 eye.Means of all the observation indexes on three groups showed significant difference(all P

The mechanisms of antidepressants are still unclear. There a re two classical theories on monoamine neurotransmitter or on neurotransmitter rec eptors, but both of them can not fully explain the delayed therapeutic action of antidepressants. Recently, many researches have focused on the postreceptor int racellular signal transduction as the mechanism of antidepressant action. G protein is the molecular basis of antidepressants. Neurotransmitter receptors and G protein are the two sectors of their therapeut ic action. They will ultimately influence intracellular signal transduction and result in relative effects such as phosphoration, the induction of neurotrophic factors and neurogenesis. This mechanism suggests a reasonable explanation for t he clinical delaying of antidepressants and it will do great help for the develo pment of antidepressants. It makes the design of novel, safe and more efficaciou s antidepressants possible and provides significant information for the elucidat ion of biology of depression.

BACKGROUND: It is very important to explore an optimal loading force that can both allow effective intrusion and cause no damage to the teeth.OBJECTIVE: To investigate the optimal loading conditions, including loading force values and directions, in the intruding mechanics of maxillary anterior teeth.METHODS: A three-dimensional finite element model (3D FEM) of the maxillary anterior teeth was constructed to include the periodontal ligament (PDL), alveolar bone, and appliance (brackets and wire). The initial stress distribution and force of the maxillary anterior teeth were analyzed when the 3D FEM was loaded with different intruding force values and directions. RESULTS AND CONCLUSION: The optimal value of the intruding force for 6 anterior teeth fell within the range from 0.5 N to 1.0 N. The maximum stress was detected at the distal cervical level of the lateral incisor, and a relatively even distribution of initial stress was observed at 20° palatal deviation to the Y axis. The results suggest that using mini-screw implants at the labial region between the canine and lateral incisor and a combined 0.5-1.0 N intruding force with a distal force could be an optimal intrusion force system by which patients with normal occlusion could obtain a pure intrusion of anterior teeth.

Objectives To validate the Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) in hospitalized pediatric patients, and to assess the nutritional status and nutritional risk using STAMP. Methods the nutritional status of hospitalized pediatric patients was investigated by adopting STAMP. The STAMP score≥4 was deifned as a high standard of nutritional risk. Results Among 1 506 hospitalized children, children with high nutritional risk accounted for 26.56%. The overall prevalence of malnutrition and stunting was 19.12%and 10.16%, respectively. There was signiifcant diffe-rence in stunting among each department (P<0.05), which was the highest in department of internal pediatrics. The proportion of patients receiving nutritional support was 10.09%. Among them, the rate of parenteral and enteral nutrition support was 7.84%and 2.92%, respectively. The ratio of parenteral nutrition to enteral nutrition was 2.68:1. After intervention to hospitalized pa-tients with high nutritional risk, the overall prevalence of high nutritional risk decreased from 26.56%at admission to 21.71%at discharge (P<0.05). Conclusions STAMP can objectively relfect the possible malnutritional risk in hospitalized pediatric patients. The nutrition condition of the pediatric patients can be improved through nutritional risk management.

Background The pathogenesis of dry eye has not been clearly established.There are more and more evidences to suggest that it is associated with ocular surface inflammation mediated by immunity.But how T helper cell 17 (Th17) plays its role in dry eye remains unclear.Objective The aim of this study was to investigate the expressions of Th17 related cytokines in ocular surface with dry eye.Methods A prospective cohortl study was designed.This protocol was approved by Ethic Commission of Peking University Third Hospital,and written informed consent was obtained from each subject prior to entering this cohort.Twenty female patients with Sjigren syndrome (SS group),20 patients with non-SS dry eyes and 20 normal volunteers were recruited in Peking University Third Hospital during 2011-2012 duration and all the subjects were menopausal female with the age 50 years old or more.The ocular surface disease index (OSDI)questionnaire designed by Schiffman was performed firstly,and then tear breakup time (BUT),corneal fluorescein staining and Schirmer Ⅰ test (S Ⅰ t) were carried out in the subjects.Expression of Th17 related cytokines mRNA were measured using PCR-Array.The correlation between IL-17A and ocular surface parameters was analyzed.Results The OSDI scores of the SS dry eye group,non-SS dry eye group and normal control group were 50.00 (33.50,66.50),45.00 (35.50,55.00) and 3.00 (0.00,5.00),the S Ⅰ t values were 2.50 (1.00,4.00),5.00 (2.00,5.00) and 15.50 (10.00,18.50),the BUT were 2.00 (1.00,4.00),4.00 (3.00,5.00) and 10.00 (10.00,12.00),the corneal fluorescein staining score were 8.50 (6.00,12.00),5.50 (4.00,7.00)and 0.00 (0.00,0.00),respectively,and significant differences were seen among the SS group,non-SS dry eye group and normal control group (x2=34.11,28.13,93.66,92.25,all at P＜0.01).The relative expression values of IL-17A mRNA,IL-6 mRNA,IL-8 mRNA,IL-22 mRNA and IL-23 mRNA in the ocular surface were 1.98±0.16,11.64±1.32,6.67±1.12,1.88±0.18 and 1.78±0.17 in the SS group patients,and 1.45±0.17,1.32±0.14,1.12 ±0.13,1.23 ±0.15 and 1.23 ±0.13 in the non-SS dry eye group patients,respectively,with significant differences between the two groups (all at P＜0.01).IL-17A level on the ocular surface was significantly negative correlated with BUT (r =-0.56,P＜0.01) and positive correlation with corneal fluorescein staining scores (r=0.44,P=0.01).Conclusions Expressions of Th17 related cytokines in the ocular surface increased in patients with dry eye,especially in those with SS.IL-17A level in ocular surface is associated with BUT and corneal fluorescein staining scores,suggesting that immune is involved in the pathogenesis and devlopment of dry eye.

ObjectiveTo analyze the craniocerebrum ultrasonographic images of the infants born by women with hypertension in pregnancy and investigate the effect of hypertension in pregnancy on neonate brain injury and brain development.MethodsTo assess the brain injury and brain development, 106 infants born by women with hypertension in pregnancy (study group) and 200 infants born by women without high risk factors during perinatal period (control group) in the neonatal intensive care unit of First Affiliated Hospital of Harbin Medical University between 2013 and 2014 underwent brain ultrasonography. The abnormal ultrasound images and the constitution of abnormal ultrasound images distribution in two groups were compared. The relationship between the abnormal ultrasound images and the degree of hypertension in pregnancy were analyzed.ResultsThe brain ultrasonographic result of the infants : (1) In the group with hypertension in pregnancy, the abnormal ultrasound images were found in 78 cases (73.6%). For the preterm infants, the solitary abnormality was found in 41 cases (25 cases of cerebral white matter injury, 14 cases of peri-intraventricular hemorrhage and 2 case of brain hypoevolutism) and multiple abnormalities were found in 15 cases; for the full-term infants, the solitary abnormality was found in 17 cases (12 cases of peri-intraventricular hemorrhage, 3 cases of hypoxic-ischemic encephalopathy and 2 case of brain hypoevolutism) and multiple abnormalities were found in 5 cases. (2) In the group without high risk factors, abnormalities were found in 73 cases (36.5 %). For the preterm infants, abnormal ultrasound images were found in 45 cases, including solitary abnormality found in 30 cases (24 cases of cerebral white matter injury, 4 cases of peri-intraventricular hemorrhage and 2 case of brain hypoevolutism) and multiple abnormalities found in 15 cases; for the full-term infants, the abnormal ultrasound images were found in 30 cases, including solitary abnormality found in 24 cases (10 cases of peri-intraventricular hemorrhage and 14 cases of hypoxic-ischemic encephalopathy) and multiple abnormalities found in 6 cases. (3) There were obvious statistical significances between the comparativeness of two groups (χ2=38.119,P<0.001), but there were no statistical significances in the constitution of the abnormal ultrasound images distribution between the two groups (χ2=0.552,P=0.759). (4) There were statistical significances between the comparativeness of the abnormal ultrasound images and the degree of hypertensive disorder complicating pregnancy (P<0.001). ConclusionCraniocerebrum ultrasonography is the first choice to detect and monitor brain abnormal and can provide basis for clinical diagnosis, treatment and intervention at early stage for the infants born by women with hypertension in pregnancy.