Objective To investigate the clinical significance of serum lipids level changes in patients with acute leukemia.Method Serum total cholesterol(TC),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C),triglyceride(TG),apolipoprotein A1(apoA1),apolipoprotein B(apoB)were determined by using enzymatic methods before treatment and in complete remission period.Results The level of TC,LDL-C,HDL-C,apoA1,apoB before treatment were significantly lower than that in control group and in period of complete remission (P

Objective To investigate the therapeutic effect and safety of micro-dosage heparin therapy for acute leukemia with pre-diffuse intravascular coagulation (pre-DIC).Methods 36 cases of acute leukemia with pre-DIC were divided into two groups,18 cases were treated with micro-dosage heparin therapy (group A),18 cases were treated with conventional therapy(group B).Results Within the first 10 days,the cases which transformed to diffuse intravascular coagulation (DIC) in group A were significantly lower than group B(P

Objective To discuss the feasibility of estimation on intracranial pressure of patients withbrain injury by measuring optic nerve sheath diameter (ONSD) with uhrasonography.Methods From July 2008 to December 2011,90 patients with brain injury were selected.According to the admission Glasgow Coma Scale (GCS),they were divided into experimental group 1 (60 cases with light and medium brain injury,GCS 9-15 scores) and experimental group 2 (30 cases with severe brain injury,G CS 3-8 scores).The conventional physical examination 50 cases and volunteers 50 cases in neural surgical outpatient were selected as control group.ONSD of all groups were measured 3 mm behind the globe through orbital by ultrasonography with different time after admission.The intracranial pressure was measured at 0.5-1.0 h after ultrasonography by lumbar vertebra puncturing in different groups and analyzed statistically.Results After admission 1,3,7,14 d; ONSD in experimental group 1 respectively was (4.49 ± 0.31),(4.45 ±0.28),(4.41 ±0.32),(4A3 ±0.25) mm;ONSD in experimental group 2 respectively was (5.69 ±0.32),(6.30 ± 0.47),(5.71 ± 0.26),(4.77 ± 0.36) mm.After admission 1,3,7,14 d ;the intracranial pressure in experimental group 1 respectively was (78 ± 16),(83 ± 17),(90 ± 15),(82 ± 14) mmH2O (1 mmH2O =0.0098 kPa) ;the intracranial pressure in experimental group 2 respectively was (230 ± 22),(269 ± 21),(228 ± 13),(147 ± 22) mumH2O.ONSD and the intracranial pressure was (4.58 ± 0.41)mm and(88 ± 10) mmH2O in control group.ONSD and the intracranial in Experimental group 1 and control group had no difference (P ＞0.05); those of control group and experimental group 2,experimental group 1 and experimental group 2 had difference (P＜ 0.05).Conclusions ONSD and the intracranial pressure in light,medium brain injury patients have no change.In patients with severe brain injury after different time,the intracranial pressure change differently,ONSD enlargement with the intracranial pressure rising,examination of ONSD by ultrasonography can reflect the changes of the intracranial pressure,it is a new method to evaluate the intracranial pressure,has the certain application value.

ObjectiveTo study the expression changes of peripheral blood monocyte human leukocyte antigen DR (HLA-DR) in patients with severe craniocerebral injury,and investigate the correlation between HLA-DR expression and infection and prognosis.MethodsNinety patients with craniocerebral injury were selected as experimental group and were divided according to the Glasgow coma scale (GCS) score after hospitalization into experimental group 1 (GCS score 13-15 scores ),experimental group 2 (GCS score 9-12 scores) and experimental group 3 (GCS score 3-8 scores) with 30 patients each,which were moderate,medium,severe craniocerebral injury,respectively.Thirty healthy people were chosen at the same period as control group.The HLA-DR expression of experimental group was detected after 1,3,7 and 14 d of admission by flow cytometry,and the HLA-DR expression of control group was detected on the day they got physical examination.The rates of infection,cure,disability,vegetative state and mortality were counted after 30 d of admission.ResultsThe HLA-DR expressions in experimental group 1 and experimental group 2 after 1,3,7,14 d of admission were (28.11 ± 2.37),(26.45 ± 1.63),(27.75 ± 1.83),(27.15 ± 2.17) MCF and (29.34 ±2.07),(27.55 ± 1.63),(28.42 ± 1.94),(29.46 ±2.12) MCF,which had no statistical difference compared with that in control group [(29.18 ± 1.91 ) MCF](P＞ 0.05).The HLA-DR expressions in experimental group 1 and experimental group 2 after 1,3,7 d of admission and control group had statistical differences compared with those in experimental group 3 after 1,3,7 d of admission [(18.02 ± 1.78),(16.05 ± 1.97 ),(20.76 ± 1.65) MCF ] (P ＜ 0.05).The HLA-DR expressions in experimental group 1 and experimental group 2 after 14 d of admission and control group had no statistical significance compared with that in experimental group 3 after 14 d of admission [ (26.13 ± 2.15) MCF](P＞ 0.05).The infection rates of experimental group 1,experimental group 2 and experimental group 3 were 0,3.6％(1/28),82.8％(24/29),respectively,while the cure rates were 100.0％ (30/30),100.0％ (28/28),10.3％ (3/29),the disability rates were 0,0,41.4％ (12/29),the vegetative state rates were 0,0,20.7％ (6/29),and the mortality were 0,0,27.6％ (8/29).There was no statistical significance in the rates of infection,cure,disability,vegetative state and mortality between experimental group 1 and experimental group 2 (P＞ 0.05 ).While there was statistical differences in the rates of infection,cure,disability,vegetative state and mortality among experimental group 1,experimental group 2 and experimental group 3 (P ＜ 0.05).ConclusionsThe HLA-DR expression changes of patients with moderate and medium craniocerebral injury after 1,3,7,14 d of admission are not significant.The HLA-DR expression of patients with severe craniocerebral injury begins to decline from 1 d after injury,declines obviously at 3 d,increases from 7 d,returns to normal level at 14 d.The decline of HLA-DR expression in patients with severe craniocerebral injury is correlated with the infection,and predicts poor prognosis.

Objective To explore the clinic application value of ultrasonography examination of optic nerve sheath diameter(ONSD) in brain injury.Methods From July 2008-June 2011,90 cases of brain injured patients were chosen as experimental group including light (A group),medium (B group),and heavy (C group) brain injured patients according to the admission GCS score ;50 cases of conventional physical examination and 90 cases of volunteers 50 in neurosurgical outpatient were chosen as control group.The ONSD of both groups were measured 3 mm behind the globe through orbital using color sonographic with different time after admission.3 times measurements were carried out for every optic nerve sheath.All client's ONSD mean and standard deviation were calculated.In 0.5 h after color dopplar ultrasound examination,lumbar vertebra puncturing measured intracranial pressure in different groups.Results After admission (1d,3 d,7 d,14 d),the ONSD of A group was (4.54 ±0.32)mm,(4.42 ±0.30)mm,(4.44 ±0.32) m,and (4.43 ± 0.25) mm,respectively; The ONSD of B groups was (4.48 ± 0.28) mm,(4.52 ± 0.24) mm,(4.46 ±0.28)mm,and (4.38 ±0.22)mm,respectively; The ONSD of C group was (5.67 ±0.35)mm,(6.36 ± 0.42) mm,(5.65 ± 0.23) mm,and (4.76 ± 0.35) mm,respectively.After admission (1 d,3 d,7 d,14 d),the intracranial pressure (IP) of A group was (82 ± 11) mmH2O,(79 ± 12) mmH2O,(90 ±15) mmH2O,and (86 ± 14) mmH2O,respectively; The IP of B group was (78 ± 15) mmH2O,(85 ± 10)mmH2O,(78 ± 16) mmH2O,(80 ± 11) mmH2O,The IP of C group was (225 ± 26) mmH2 O,(288 ± 23)mmH2O,(256 ± 23) mmH2O,(122 ± 18) mmH2O,respectively.Group D had the ONSD average of (4.58± 0.41)mm and IP of (88 ± 10)mmH2O after eyeball 3-mm place.No difference was found between A and B,A and D,or B and D (P＞0.05) ; A difference was found between A and C,B and C,or D and C (t =12.24～24.67,P＜0.01).Conclusions The ONSD and IP in light medium brain injured patients had no change.In patients with severe brain injury,IP changed with the time after injury,the ONSD increased with the IP,the ultrasonography examination of ONSD with the important value in the diagnosis and treatment can respond the IP increase,which is a non-invasion,convenient,fast,and feasible method for evaluation of cranial high pressure.

OBJECTIVETo investigate the clinical efficacy of ligation of intersphincteric fistula tract (LIFT) in the treatment of simple anal fistula, including transphincteric anal fistula and insphincteric anal fistula.

METHODSClinical data of 52 patients with anal fistula receiving surgery treatment in Beijing Anorectal Hospital from January to October 2014 were analyzed retrospectively. Adoption of surgical procedure was based on rectal endoluminal ultrasound and patients' decision. Patients were divided into LIFT group and seton group. The two groups were compared in terms of operation time, blood loss, postoperative pain score, incidence of urinary retention, wound healing time, cure rate, recurrence, and the anal incontinence score.

RESULTSThere were 52 patients in the entire cohort including 28 cases of transphincteric anal fistula (14 cases of LIFT and seton placement groups) and 24 cases of intersphincteric anal fistula (12 case of LIFT and seton placement). The operation time was shorter in seton placement group in patients with two simple anal fistula [(23.9±5.0) min vs. (46.3±7.7) min, P<0.05]. LIFT postoperative pain score [(1.6±0.6) vs. (6.1±1.3)], wound healing time [(7.9±2.0) days vs. (30.0±5.1) days], postoperative hospital stay [(10.3±3.1) days vs. (20.7±7.1) days], and anal incontinence scores [(1.1±0.4) vs. (4.9±1.1)] were better than that of anal fistula seton (all P<0.05). There was no statistically significant difference in intraoperatie blood loss [(23.1±4.7) ml vs. (23.3±4.7) ml, P>0.05]. The cure rate of intersphincteric anal fistula was 83.3%(10/12) in LIFT group, and 100%(12/12) in the seton group. The cure rate of transphincteric anal fistula was 78.6% (11/14) in LIFT and 92.9%(13/14) in anal fistula seton group. There was no statistically significant difference (P>0.05).

CONCLUSIONIn the treatment of transphincteric fistula tract and intersphincteric fistula tract, LIFT procedures should be considered.

Digestive System Surgical Procedures ; Fecal Incontinence ; Humans ; Length of Stay ; Ligation ; Operative Time ; Pain, Postoperative ; Postoperative Period ; Rectal Fistula ; Recurrence ; Retrospective Studies ; Wound Healing

OBJECTIVE: The large sample retrospective cohort study were used to compare the diagnostic efficiency of PET/CT with conventional work-up (CWU) for evaluating nasopharyngeal carcinoma (NPC) distant metastasis. METHOD: Five hundred and fourteen patients with NPC were divided into PET/CT group and CWU group according the method of detecting distant metastasis. Chest film, abdominal ultrasonography, and bone scan were used in CWU group. Then the diagnostic efficiency of the two groups was compared. RESULT: Two hundred and sixteen patints were enrolled in PET/CT group and two hundred and nineteen-eight ones in CWU group. There were 28 out of 412 suspicious patients in CWU group were confirmed, another 3 patients confirmed without positive findings, compared with PET/CT group that all 32 suspicious patients were confirmed. The sensitivity and specificity of PET/CT were 100.0% (32/32) and 100.0% (184/184), as compared to 90.3% (28/31) and 94.8% (253/267) with CWU respectively, while there was no statistical significance. Further research found out that the percentage of patients with multiple distant metastatic sites and multiple organ metastases was higher in PET/CT group (P < 0.05), and similarly of patients with distant metastasis in N2-3 stages (P < 0.01). CONCLUSION Our results suggest that PET/CT appears to be slightly superior to conventional work-up in assessment of distant metastasis in NPC patients, but CWU is still a cheap and practical method.
Aged ; Carcinoma ; Cohort Studies ; Female ; Fluorodeoxyglucose F18 ; Humans ; Male ; Middle Aged ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; diagnosis ; secondary ; Positron-Emission Tomography ; methods ; Radiopharmaceuticals ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Ultrasonography

Objective:To investigate the relationship between CBCT imaging changes of condyle and clinical features,and related risk factors in patients with temporomandibular disorders(TMD).Methods:453 patients with TMD were enrolled and underwent CBCT scan for bilateral temporomandibular joints(TMJ),3D reconstruction of the TMJs was analyzed.Logistic regression analysis was performed to investigate the relationship between condylar bone changes and TMD clinical features.Results:Patients＜18 years old were more likely to have condylar bone changes than the adults.The symptoms of pain and restricted mouth opening were more likely to be detected in the condylar bone change group(n=133)than in the normal condylar bone group(n=320).The incidence of brux-ism in the normal condylar bone group was higher than that in the condylar bone change group.Univariate logistic regression analysis showed that only bruxism(OR=0.550),pain(OR=1.844)and mouth restriction(OR=2.024)were included in the regression equa-tion.Multivariate logistic regression analysis showed that,due to the protective effect of bruxism,the OR value of pain decreased from 1.844 to 1.791,and the OR value of mouth restriction decreased from 2.024 to 1.847.Conclusion:The condylar bone change in TMD patients more likely occur in puberty or patients with pain and restricted mouth opening.Bruxism may be a protective factor in the occurrence of condylar bone changes in TMD patients.