Pulmonary vascular disease is a group of diseases,defined as the dysfunction of pulmonary artery,pulmonary vein and pulmonary capillary.Pulmonary vascular disease includes pulmonary hypertension,pulmonary vascular malformation,pulmonary vasculitis and pulmonary vascular thrombosis,et al.The manifestations of pulmonary vascular disease vary from recurrent wheezing,respiratory tract infection,short of breath and hemoptysis,et al.With the development of radiography investigations,the diagnosis of pulmonary vascular disease is improved.Pulmonary vascular disease in children is not uncommon therefore we should focus on it.

Hemoptysis,defined as the expectoration of blood or blood-tinged sputum from the lower respiratory tract has to be differentiated from hematemesis and other anatomic site of bleeding.In pediatric patients with hemoptysis,no definite classification correlating severity with blood loss exists.Thus,clinical judgment is the primary tool that clinicians have in assessing the severity of hemoptysis in children.Infection is one of the most common etiologies for hemoptysis in children; however,cystic fibrosis was the most common cause of pediatric hemoptysis in the European countries.Hemoptysis is not a common chief complaint in pediatric patients unless massive hemoptysis.The causes of massive hemoptysis in children are bronchial adenoma,bronchial foreign body and vascular abnormalities.Vascular abnormalities is rare cause of hemoptysis,but one of the common cause of massive hemoptysis,including pulmonary arteriovenous malformation,absent pulmonary valve,aberrant systemic artery supplying.As one of aberrant systemic artery supplying,bronchial artery-pulmonary artery malformation cause life-threatening hemoptysis.The aim of imaging evaluation is to identify the source of bleeding along with determination of the primary cause of hemoptysis.The initial management option for bronchial artery-pulmonary artery malformation is bronchial artery embolization.Surgery is alternative option.The patients with bronchial artery-pulmonary artery malformation usually have massive hemoptysis,which can quickly progress to acute respiratory distress and shock.Therefore these children require emergency procedures to stabilize.

Objective To explore the clinical promise of CT 3D reconstruction of tracheobronchial tree(TBT) by analyzing 73 cases retrospectively. Methods All the 73 cases were collected from October 1997 to February 2000, who were scanned by EBCT with 130 kV and 630 mA. The scanning method was continuous volume scan, the slice thickness were 3 mm or 1.5 mm. All cross-sectional images were transmitted to the INSIGHT workstation and reconstructed with SSD (shaded surface display), and the threshold setting were -500 to -300 HU. Results 3D reconstruction of TBT with EBCT could reveal the abnormal changes of TBT by many kinds of diseases including central cancer, inflammation, bronchiectasis, saber-sheath trachea, trachea cancer, congenital disorders, post-surgical changes of lung cancer, and stenoses by adjacent benign or malignant diseases. It could be used to locate the stenoses and measure stenostic extent. Of the 35 central cancer cases with 3D reconstruction, 6 cases were pestle obstructed, 15 cases cone obstructed, 5 cases interrupted irregularly, 8 cases with eccentric stenoses, and 1 case with right stem destroyed and right upper lobe bronchus obstructed. Conclusion 3D reconstruction of TBT has characteristic sign in the diagnosis or differential diagnosis of central airway′s benign or malignant stenoses, and it is of instructional value in clinical use.

Objective To study the relationship between bacterial translocation,endotoxemia and nitric oxide(NO) in portal hypertensive rats.Method Portal hypertension was induced by portal vein stenosis(PVS) in 30 rats subdividing into 3 groups:group B (Model),group C in which L arginine was given,and group D receiving L NAME.10 additional normal rats served as control (group A).Two weeks after, mesenteric lymph nodes (MLN),spleen and blood samples were collected for bacterial cultures.Portal pressure,endotoxin and NO 2 - levels were measured.The permeability of intestinal mucosa was assayed using Lanthanum as tracer and the mucosa ultrastructure in ileum was observed.Results[WT5”BZ] The bacterial translocation rates in MLN in the PVS groups was higher than in control.The endotoxin levels elevated in the PVS group.NO 2 - level and portal pressure were lower in group D than in group B.In the PVS group,the tracer was observed in the lamina properia and epithelium layers.[WT5”HZ] Conclusions Bacterial translocation and endotoxemia in portal hypertension were in response to enhanced permeability of intestinal mucosa,which are responsible for the increased NO level.

After primary EB virus(EBV) infection there are expansions of EBV-specific CD8~+/CD4~+ CTLs responses against lytic peptides and latent peptides in order to control EBV infection. Clinical manifestations of EBV infection are diverse.Its pathogenesis is not clear. The surveillance of EBV specific-immunity plays an important role to control viral replication.There are differences between the CTL responses against lytic peptides and latent peptides. And the migration and activation of EBV specific CTLs with different cell surface molecules play an important role in EBV infection .

Breast ; surgery ; Breast Neoplasms ; drug therapy ; pathology ; surgery ; Chemotherapy, Adjuvant ; Female ; Humans ; Lymph Node Excision ; Mastectomy, Segmental ; Neoplasm Recurrence, Local ; Treatment Outcome

Doing a good job of guarding against medical risks can effectively improve medical safety and reduce waste of medical resources. In recent years, marked results have been attained in the US in studies on the use of FMEA, a prospective quality analysis tool, to minimize medical risks. Similar studies, though not many, have been made in some other countries, such as Italy and Australia. No reports, however, have been published at home on studies in this field. The paper gives an account of the use and theoretical studies of FMEA in medical risk management in the US, illustrates cases wherein it was used to lower risks in prescribing drugs to patients and ensure the safe use of hospital software and hardware, and puts forward issues that shouldn't be ignored in using FMEA so as to arouse the attention of domestic hospital management departments.

Objective To study the 2-4 years intermediate-term clinical effects of bone-patellar tendon-bone (B-PT-B) autograft plus interface screw method and quadruple semitendinosus tendon autograft plus endobutton plate fixation method in anterior cruciate ligament (ACL) reconstruction after ACL injury and to estimate the correlation of various implants and fixation techniques with clinical effect. Methods A retrospective analysis was done on 104 cases with ACL injury as well as detailed clinical data from October 1998 to October 2000. ACL reconstruction with bone-patellar tendon-bone autograft (PT group) and kurosaka interface screw fixation were performed in 55 cases and quadruple semitendinosus tendon autograft and endobutton plate fixation (ST group) in 49 cases. The average follow up was 38.5 months in the PT group and 35.7 months in the ST group. We compared the intermediate myodynamic recovery, ROM, lachman test, pivot shift test, IKDC score, lysholm score, Werner score and X-ray view of tunnul enlargement between two groups. Results In the PT group, the circumference of thigh was (1.097?0.079) cm, shorter than that of normal side, and (0.896?0.126) cm in the ST group. The cases accounting for 82% (45/55) in the PT group and 88% (43/49) in the ST group had extension limitation less than 3?. Knee flexion limitation of 0?-5? accounted for 87% (48/55) in the PT group and 86% (42/49) in the ST group. Bilateral comparison of Lachman test less than 5 mm accounted for 93% (51/55) in the PT group and 96% (47/49) in the ST group. Negative rate of pivot shift test was 89% (47/55) in the PT group and 92% (45/49) in ST group. Bilateral comparison of AP knee laxity with 20Ib KT-1000 in laxity with less than 3 mm accounted for 53% (29/55) in the PT group and 57% (28/49) in the ST group. Lyoholm score in the PT group was increased from preoperative 69.2?6.4 to postoperative 86.7?4.3 and that in the ST group from 68.3?7.5 to 88.4?8.6. Knee motion standard of IKDC score in the PT group was 78%(43/55), which was found normal or nearly normal, and 82%(40/49) in the ST group. Patellar femoral pain Werner score was 43.0 ?6.1 in the PT group while 45.0?6.3 in the ST group. The X-ray showed that tunnel enlargement phenomena was 53% (29/55) in the PT group while 43% (21/49) in the ST group. Conclusions From 2-4 years intermediate-term follow up, there is no significant difference in ACL reconstruction using patellar tendon autograft plus interface screw method and quadruple semitendinosus tendon plus endobutton plate fixation method. Bone grafting in the donor site can reduce the incidence of anterior knee pain. Twisting technique is beneficial to overcome of the postoperative laxity caused by viscular elasticity of quadruple semitendinosus.

Objective To explore the correlation between gratitude and turnover intention of nursing staff.Methods A total of 660 clinical nurses from three general hospitals in Hangzhou city were subject to questionnaire survey for the correlation.Results The multidimensional gratitude totaled 128.33±32.67,at a medium or low level; their turnover intention totaled 14.59 ± 2.26,at a medium level.The multiple factor variance analysis showed statistically significant negative correlations between the three dimensions of gratitude(a sense of rich,simple thanks,and thanks to others)and turnover intention.Conclusion Related departments are recommended to pay close attention to nurses' gratitude and carry out gratitude education,so as to decrease their turnover intention,and keep the career stability of nurses.

Objective To introduce a method of arthroscopie treatment of purulent knee arthritis, and to evaluate its clinical value. Methods Twenty-seven cases of knee pyarthrosis were treated by de-bridement and subtotal synovectomy under arthroscope and combined with intravenous antibiotics and systematic postoperative rehabilitation. The clinical results were evaluated through examination of the temperature, joint effusion and range of motion of the knee joint. Results The temperature resumed to normal at an average of three postoperative days. All the knees regained the normal extension and more than 120 degree of flexion at six weeks after operation. 85. 2% of the knee flexion function resumed to normal in 3 months. Lysholm knee function score was 89. 4 ? 4. 1 in average and there is a significant statistical difference ( P