Objective To explore the influence factors of thrombocytopenia in patients with severe infection in ICU ,so as to provide a reference for clinic prevention and treatment and the judgment of prognosis .Methods 76 patients(39 male ,37 female) with severe infection from May 2014 to December 2014 were retrospectively analyzed in this hospital .Among them there were 40 cases with thrombocytopenia (Group A ) ,and 36 patients without thrombocytopenia (group B) .Influence factors and prognosis differences were investigated for thrombocytopenia combine with severe infection .Results There was correlation between the age , numeration of leukocyte ,neutrophil ratio ,gram negative bacteria infection ,respiratory infection and severe infection combine with thrombocytopenia(P < 0 .05 ) ,ICU dwell time and mortality differences between the two groups was statistic significance ( P<0 .05) .Conclusion Platelet count should be monitored in patients with severe infection ,especially in those with old age ,respiratory infections ,Gram negative bacteria infection ,we should give priority intervention and find the point in time in order to prevention and cure and improve its poor prognosis .

Objective:To investigate the expression of the collagenases MMP-13 and its inhibitor, tissue inhibitor metalloproteinase-1 (TIMP-1) in the rat lung of the experimental models of COPD.Methods:Male Wistar rats (10 weeks of age) were divided into two groups—model and control groups.The rat of model group were given intratracheal lipopolysaccharide (LPS),and then animals were exposed to cigarette smoke for 32 days.The lung function was measured,and pathological changes were also observed.Transcriptional levels of MMP-13 and TIMP-1 mRNA extracted from the lungs were assessed by semiquantitative reverse transcription-polymerase chain reaction (RT-PCR).Results:(1)In COPD model group,the pathological changes of bronchi and lung tissue,the changes of lung function were similar to those of the COPD patients.(2)The mRNA expression of MMP-13 and TIMP-1 in COPD model group were significantly increased compared with those in control group( P

Aim To determine the effect of phospholipase C(PLC) on the rabbit platelet triphosphoryl inositol(IP_3) induced by ADP,and then to explore the mechanism of anti-aggregation to platelet by PLC.Method PRP was made from rabbit blood by removing red cells,and then was parted to eight groups.The first group was treated with PSS.The second was treated with with ADP.The third was treated with ASP and then induced by ADP.Four to eight groups were treated with different dose of PLC respectively and then induced by ADP.IP_3 of rabbit platelet was made by trichloro-acetic acid method,and its content was tested by radioimmunological assay.Result IP_3 of rabbit platelet treated with PSS was 0.29 pmol/10~8 platelet.IP_3 of rabbit platelet treated with ADP was 0.39 pmol/10~8 platelet.IP_3 of rabbit platelet,which were treated with ASP 668 ?mol?L~(-1),5,10,15,20 and 25 U PLC?ml~(-1) respectively and then induced by ADP,were 0.29,0.19,0.08,0.15,0.25,0.04 and 0.18 pmoL/10~8 platelet respectively.IP_3 of ADP group was apparently higher than that of PSS group,but the IP_3 of ASP group and different dose PLC group were significantly lower than ADP group(P

Positive psychology focuses on enhancing individual positive emotion and promoting the development of individual positive personality.Introducing positive psychology into the first stage of internal medical resident standardized training will improve the resident ability to solve clinical problems.It's helpful for resident doctors to improve their clinical thinking ability,doctor education innovation ability and lifelong self-education ability.It inspires their creative thinking by motivating their positive emotions It would help them to avoid occupational tiredness.Using the idea of positive psychology could improve the comprehensive quality of residents.

Objective To investigate the ultrasonographic features corresponding to classification of peripheral neuropathies in neurofibromatosis type Ⅰ.Methods Thirty-six patients with peripheral neuropathies and diagnosis of neurofibromatosis type I were enrolled in this study.Ultrasound appearance of peripheral neuropathies was analyzed and divided into four groups according to their pathological classifications.There were 19 males and 17 females with age between 7-47 years.High frequency or board frequency ultrasound probes were used for scanning.Results The ultrasound findings were varied based on different pathological classifications.Multiple nodular class(n=5) was presented as multiple nodes.Ultrasound demonstrated that tumors were multiple,oval or lobulated,and had well defined margin,and the echogenic of lesions was mainly hypoechoic.Plexiform class (n=12) was presented as cluster nodes along the peripheral nerve trunk.Ultrasound showed trunk nerves in extremities became thicker in a long range and lost the normal structure,and catenular or racemosum in shape.The echogenicity was hypoechoic.Diffuse class (n=14) was diffuse subcutaneous disease.Tumors range was infiltrative.The subcutaneous soft tissue was thicken and echogenicity was increased.The structure of nerve bundle was disturbed and associated with multiple hypoechoic nodes.Mixture class (n=5) was defined as mixture of multiple nodular class and plexiform class.In this group,diffuse disorders were co-existed with multiple nodes disorder.Conclusions The ultrasonographic appearances of peripheral nerve disorders in neurofibromatosis type I was closely corresponded to their pathological characters.And the ultrasonic examination would be helpful to diagnosis and provide important information for therapy.

This paper summarized the effects of the treatment of chronic hepatitis B (CHB) by lamivudine combined with traditional Chinese medicine or western medicine in the past few years. Combined treatment of lamivudine and the other medicine had higher efficiency than lamvudine alone in the treatment of CHB. The Combined treatment should be a tendency of the treatment for chronic hepatitis B. The focal point is that the traditional Chinese recipe produces a multitarget effect in the treatment of CHB. The combined treatment of lamivudine and traditional Chinese recipe can reduce the treatment course and the recurrence rate. Combined treatment of traditional Chinese medicine and western medicine has notable superiority and broad developing prospect in the treatment of CHB.

The present preliminary study was to observe the feasibility of the use of polylactic acid gel (PLA-G) in modified radical mastectomy and the ability of the PLA-G in the prevention of flap adhesion after operation. Sixty-eight patients were diagnosed with breast cancer, and received modified radical mastectomy from Jan. 2004 to Dec. 2006. The patients were divided randomly into a treatment group and a control group (with 34 cases each). The PLA-G was used under the surface of the auxiliary operative wound in the treatment group, and nothing was used in the control group. The wound healing, the wound complication, the amount of drainage solution, the indwelling time of the drainage tube and the auxiliary skin adhesion were evaluated after operation in both groups. There were no statistical difference on wound healing between the first intension (29:27) and the second intention (5:7), and the wound dehiscence after taking the stitches out (0:0) between the two intensions, the hematoma (0:1) and the effusion of the wound (5:6), and the flap necrosis (1:2) between two groups. There were also no statistical difference on the amount of drainage solution per day (6 +/- 3) and indwelling time of the drainage tube (6 +/- 4) after operation between the two groups (P > 0.5). After the operation, the case load with no flap adhesion in the treatment group was significant higher compared with the control group (22:8). The case load with complete acquired skin flap adhesion in the treatment group was visibly lower than in the control group (3:19), which proved that there was a significant statistical difference between the two groups (P < 0.05). This study suggested that the using of PLA-G in the breast cancer modified radical mastectomy could prevent skin flap adhesion without any harmful effects in the wound healing.
Breast Neoplasms ; surgery ; Drainage ; Female ; Gels ; therapeutic use ; Humans ; Lactic Acid ; therapeutic use ; Mastectomy, Modified Radical ; Necrosis ; Polyesters ; Polymers ; therapeutic use ; Surgical Flaps ; Tissue Adhesions ; prevention & control ; Wound Healing

BACKGROUND: Not only can auditory evoked potential (AEP) reflect electric activities of cerebral cortex and subcortex, but also have dose-effect relationship with many sorts of anesthesia agents; it is a relatively good index for monitoring anesthesia depth at present.OBJECTIVE: To analyze target controlled infusion propofol by auditory evoked potentials index during anaesthesia.DESIGN: Patients with operations were taken as objects in the randomized controlled trial.SETTING: Department of Anesthesia of Southwest Hospital of the Third Military Medical UniversityPARTICIPANTS: A total of 16 patients, with selective simply laparoscopic cholecystectomy, admitted to Department of Anesthesia of Southwest Hospital from October to November 2003, were selected and randomly divided into normal control group and auditory evoked potential index monitoring group with 8 in each group. The baseline information of the patients, such as gender, age, weight and operating time etc., was similar between the two groups (P ＞ 0.05).METHODS: Same anesthesia induction method was conducted on the patients in both groups; anesthesia was maintained with propofol (10 g/L) according to ALARIS P6003 pump calculation in the two groups; age, weight and target concentration of propofol (4 mg/L) was regulated according to clinical experience, while, in auditory evoked potential monitoring group,the concentration value of propofol in effective site was regulated by maintaining auditory evoked potential index between 15 and 30. Non-invasive blood pressure, heart rate and AAI were monitored at the moment of reposing for 10 minutes after entering operating room (T0), eyelash reflex disappearing after anaesthesia induction (T1), trachea intubation (T2), 3 minutes after intubation (T3), boring abdomenal holes (T4), 30 minutes after aeroperitonia steady (T5), observer's assessment of alertness and sedation (OAA/S) ≥4 at the end of operation (T6).MAIN OUTCOME MEASURES: ① Comparison of dosages of anaesthetia agents between the two groups. ② Changes of hemodynamics and auditory evoked potential index at each phase point. RESULTS: According to intention to treat analysis, all the 16 patients entered results analysis. ①Comparison of dosages of anesthesia agents between the patients in each two: The actual dosage of propofol in auditory evoked potential monitoring group was significantly lower than that in normal control group [(247.25±37.11), (337.38±36.72) mg, P ＜ 0.05], while the dosages of fentanyl and vecuronium bromide were no differences between two groups (P ＞ 0.05). ② Changes of hemodynamics and auditory eyoked potential index at each phase points of the two groups: Changes of hemodynamics at each phase points were similar between the two groups (P ＞ 0.05). Compared with T0 phase, there was no significant difference in auditory evoked potential index between the two groups in T1, T2 and T3 phases (P ＞ 0.05), however, in T4 and T5 phases, auditory evoked potential index in auditory evoked potential monitoring group was remarkably higher than that in normal control group (28.50±6.19, 21.25±4.06; 28.00±5.66,20.75±3.41; P ＜ 0.05). All patients had no awareness during the operation. CONCLUSION: Auditory evoked potential index is a new indicator for monitoring anesthesia depth, which can be helpful to regulate and control depth of anesthesia so as to avoid awareness and recall during general anesthesia.

Amino acids (AA) as substrates of gluconeogenesis could promote endogenous glucose production.Some AA can enhance insulin secretion. Recently,many studies have found that some AA can also activate mammalian target of rapamycin-S6 kinase 1 ( mTOR-S6K1 ) pathway,resulting in maintaining pancreatic β cell function on one hand,and on the other hand,inhibiting insulin signal transduction of insulin-sensitive cells and thus causing insulin resistance.

Point of care testing (POCT) is a laboratory-medicine discipline that is evolving rapidly in analytical scope and clinical application.Medical-laboratory tests can be performed at the point of care,shortening the time caused by sample transportation and preparation.At present,POCT contains many items,ranging from blood-glucose measurement to coagulation assays.But,errors in results in POCT practical applications are usually caused by personnel and methodology.Management of POCT detection within the hospital should be strengthened to ensure the quality of POCT in order to provide better services for patients.