Objective To investigate the risk factors and predictors of poor outcome in full-term neonates with severe hyperbilirubinemia. Methods Data were retrospectively collected from 326 neonates with severe hyperbilirubinemia hospitalized between January 1, 2012 and December 31, 2012. Results A total of 326 full-term neonates with severe hyperbilirubinemia were included in this study (181 males and 145 females). The average gestational age was 39.12±1.17 weeks. Two hundred and sixty (260) cases were followed up successfully by phone while 66 cases were lost to follow-up. Infection (74.40%) and hemolytic disease (51.19%) were the main causes of severe hyperbilirubinemia. Multiple factors regression analysis found that threshold TSB was an independent risk factor of poor outcome (OR=2.02, 95%CI:1.13~3.62, P=0.018). The outcome of neonates with BIND scored between 0-6 had poor prognosis and some of them were reversible, and the outcome in those scored between 7-9 were of worse prognosis. Threshold TSB, USB and B/A ratio in group of poor outcome were signiifcantly higher than those in other groups and their area under the ROC curve evaluating the prognosis was 0.682, 0.671 and 0.698, respectively. With TSB at 474.5 μmol/L, UCB at 449.15 μmol/L and B/A at 0.923 mg/g, Youden index was the higest. The results of BAEP, OSE, MRI and NBNA were not signiifcantly different between groups with or without poor outcome. Conclusions Threshold TSB is an independent risk factor of poor outcome in full-term newborns with severe hyperbilirubinemia. BIND score is a very good predictor of outcome. TSB threshold, USB and B/A ratio are the predictors of outcome, but their diagnostic values are limited. NBNA, hearing screening and hyperintense globus pallidus on T1W1 in the acute phase of jaundice might not related with neurologic prognosis.

Objective To discuss which drainage method is more efficient in treatment of choledocholithiasis with obstructive jaundice. Methods Compared the difference of serum total bilirubin,direct bilirubin, the variation of serum total bilirubin and direct bilirubin before and after drainage and daily biliary drainage by endoscopic nasobil-iary drainage (ENBD) and endoscopic nasobiliary drainage with continuous negative-pressure suction after three days. Results The daily biliary drainage about the patients by ENBD with continuous negative-pressure suction is much more effective than the patients by ENBD. The serum total bilirubin and direct bilirubin about the patients by ENBD with continuous negative-pressure suction is less than the patients by ENBD after three days. The variation of serum total bilirubin and direct bilirubin before and after drainage about the patients by ENBD with continuous neg-ative-pressure suction is more than the patients by ENBD. Conclusion The ENBD with continuous negative-pres-sure suction is more effective for choledocholithiasis with obstructive jaundice.

Hazardous Substances ; Risk Assessment ; methods ; Workplace

Aged ; Antibodies, Monoclonal, Murine-Derived ; therapeutic use ; Antigens, CD20 ; metabolism ; Antineoplastic Agents ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cyclophosphamide ; therapeutic use ; Doxorubicin ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; metabolism ; pathology ; surgery ; Neoplasm Invasiveness ; Prednisone ; therapeutic use ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Proto-Oncogene Proteins c-bcl-6 ; metabolism ; Rituximab ; Uterine Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; Vincristine ; therapeutic use

Objective To assess the efficacy of different types of thymectomy for the treatment of myasthenia gravis(MG).Methods A retrospective analysis on 269 cases of MG,who were treated in our hospital from 1991 to 2006 by transsternal thymectomy(January 1991 to May 2002,n=161),thoracoscopic thymectomy(February 2002 to July 2005,n=67),or video-assisted thoracoscopic extended thymectomy(VATET,February 2005 to November 2006,n=41).Results The mean operation time of the transsternal group was significantly shorter than that in the other groups [transsternal group vs thoracoscopic and VATET groups:(97.5?17.5)min vs(130.3?31.5)min(q=12.991,P

Objective To evaluate the effect of tourniquet on incisional infection based on animal model,and evaluate the effect of ischemia preconditioning on incisional infection,so as to provide experimental basis for the ra-tional use of tourniquet in clinic.Methods 100 BALB/c mice were randomly divided into 4 groups,with 25 mice in each group.Group A:tourniquet+methicillin-resistant Staphylococcus aureus (MRSA)incisional infection;group B:ischemic preconditioning+ MRSA incisional infection ;group C :MRSA incisional infection;group D:blank control.The survival rates,temperature,routine blood testing,and change in soft tissue beside femoral incision were compared among 4 groups.Results During observation period ,the survival rate in group A was 68%,in group B,C,and D were all 100%,group A was lower than group B,C,and D (P <0.05).The temperature at each time point was significantly different among group A,B,and C (P <0.01 );temperature curves of 4 groups were significantly different (P <0.01 );except basal body temperature,temperature at the other time points among 4 groups were significantly different(all P <0.01);routine blood testing results (white blood cell count,total granu-locyte count,and total lymphocyte count)among 4 groups on the third,and seventh day were significantly different (all P <0.05);on the seventh day,routine blood testing results of 4 groups all returned to normal level,but group A was slightly higher than group B,C,and D.Section of epithelial tissue revealed that epithelial tissue in group A was not healed,inflammatory response of peripheral tissue was most serious;epithelial tissue in 10 mice in group B was healed,partial peripheral tissue revealed inflammatory response;epithelial tissue in 4 mice in group C was healed,most peripheral tissue revealed inflammatory response.Conclusion Mice incisional infection will be aggrava-ted by using lower limb tourniquet,incision healing and body function recovery time will be delayed,even lead to death.Ischemic preconditioning before making an incision model can reduce the severity of incisional infection,and shorten wound healing time.

The identification of the specific cause in every patient has important clinical implications, because ischemic stroke is an etiologically heterogeneous disease. The Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification can be used to define the etiology of stroke. However, TOAST classification can not be completed timely on admission of patients with acute stroke, which has impacted early guidance of clinical treatment. This article reviews the biological markers of early differential-diagnostic significance of the TOAST classification.

There is a high incidence of esophageal cancer(EC) in China.The survival and prognosis of EC is unoptimistic due to the lack of efficient early diagnostic markers.There is an urgent demand of novel biomarkers with more stability,sensitivity and specificity.miRNAs are a class of small non-coding single stranded RNAs consisting of 21-23 nucleotides,which are involved in the pathological and physiological process of life activities.miRNAs are stable not only in tumor tissues,but also in serum/plasma.There are significant differences in the expression patterns of circulating miRNAs between two main types of EC.They are closely related to the occurrence and progression of EC,which make circulating miRNAs a novel kind of biomarkers for differential diagnosis,early supervision of esophageal cancer,and prognosis.

Objective To study the directly injury effects of lipopolysaccharide(LPS) on human vascular endothelial cells(HVEC).Methods Lipopolysaccharide with different concentrations added into cultured vascular endothelial cells of human umbilical vein,at different phase after lipopolysaccharide being added,the concentrations of nitric oxide(NO),lactic acid dehydrogenase(LDH) were measured,and the adhesion of HVEC to polymorphonuclear leucocytes(PMN) were observed,the morphological changes of HVEC were detected by phase-contrast microscope.Results The NO content,LDH activity were obviously elevated with increase of LPS concentration(P

Infectious endophthalmitis refers to the acute suppurative inflammation of the uveal and retinal, with acute onset, severe symptoms, and poor prognosis.Early diagnosis and effective treatment is particularly important.Based on the way of intraocular infection, endophthalmitis can be divided into endogenous endophthalmitis and exogenous endophthalmitis.In the East Asian, liver abscess is the main source of endogenous endophthalmitis, and Klebsiella pneumoniae is the main pathogen.Liver abscess endophthalmitis is a serious cause of blindness caused by intraocular infection.A liver infection disseminated through hematogenous and the primary focus was hidden, which makes the disease was easy to be confused with immune related uveitis, causing high misdiagnosis rate, delaying the best time for diagnosis and treatment.In this article we reviewed the etiology, clinical features, diagnosis and treatment and prognosis of endogenous endophthalmitis caused by liver abscess.Clinicians should maintain a high index of suspicion to the endogenous endophthalmitis caused by liver abscess.