Objective To investigate the serum procalcitonin (PCT),interleukin-6 (IL-6 ),hypersensitive C-reactive protein (hs-CRP)and white blood cells (WBC)joint detection in the value of early clinical diagnosis of neonatal sepsis.Methods Choose 84 cases with sepsis and 140 cases of mormal newborn in children between 2013.6.1~2013.8.31.Used the electro-chemical luminescence method and scattering turbidimetric method to detect levels of serum PCT,IL-6 and hs-CRP respec-tively,at the same time test whole blood white cells with XE-2100 instrument.Results There were significant difference be-tween serum levels of PCT,hs-CRP and IL-6 of the patients with sepsis and normal newborns (t=6.37~10.58,P<0.01) and no statistically significant difference for WBC (t=3.15,P>3.15).But joint detection of PCT,IL-6 and hs-CRP for neo-natal sepsis,the sensitivity was 98.81%,specificity was 90.24%,higher than any of them a detection sensitivity and special-ity degree.PCT in detection of neonatal sepsis,when 0.5 ng/ml≤PCT≤2 ng/ml,it was priority to with gram-positive bac-terium infection,and when PCT>2 ng/ml,was priority to with gram-negative bacteria infection,compared G+ bacteria infec-tion and G- bacteria infection,the difference was statistically significant (χ2=4.646.37~35.05,P<0.05).Conclusion PCT,hs-CRP and IL-6 detection has high sensitivity,strong specificity,they can provide evidence for early diagnosis and treatment of neonatal sepsis.

Objective:To evaluate the impact of atorvastatin and rosuvastatin at different doses on liver function in the patients with coronary artery disease. Methods:A retrospective study was used, and the patients with coronary heart disease hospitalized in the first hospital of China medical university from January 2013 to March 2014 were selected. According to the drug variety and dosage, the patients were divided into four groups: A (atorvastatin, 20 mg·d-1), B (atorvastatin, 40 mg·d-1), C (rosuvastatin, 10 mg· d-1 ) and D ( rosuvastatin, 20 mg·d-1 ) . The basic information of patients, the indices of liver function( ALT,AST,ALP and TBIL) , the time of abnormal liver function, treatment strategies and prognosis were recorded. The incidence of abnormal liver function in the groups was compared, and the rationality and effectiveness of the intervetion strategies were evaluated. Results:A total of 269 patients were collected. Among them, 149 cases were with abnormal liver function in varying degrees, and 21 patients were with ALT>3?ULN. The incidence of ALT>3?ULN in atorvastatin high dose group was much higher than that in atorvastatin low dose group( P<0. 05). Conclusion:The patients treated with high dose atorvastatin (40 mg·d-1) have a high risk of liver injury.

This article was aimed to study potential functions of Mori Cortex. Through the investigation of Mori Cortex in ancient herbal literatures, ancient prescriptions, the 2010 edition of the Chinese Pharmacopoeia, current pharmacodynamics and clinical studies, potential functions of Mori Cortex that had been lost were analyzed through comparative analysis. The results showed that the confirmed core functions of Mori Cortex recorded in ancient materia medica were in consistent with its applications in ancient prescriptions and its records in theChinese Pharmacopoeia. The functions summarized from the materia medica literatures contained potential functions such as supplementing qi, promoting blood circulation to remove blood stasis, encouraging production of body fluids to extinguish thirst, removing phlegm, hemostasis, relieving stranguria, analgesia, expelling wind, and deworming. Mori Cortex compound prescription recorded in thePu-Ji-Fangdatabase were used in the treatment of consumptive disease, sore, typhoid, traumatic injury, stroke, diabetes, stranguria, arthralgia syndrome, phlegm, bleeding, various types of pain, parasitic diseases, poisonous insect bites, itching, and pox. All these potential functions of Mori Cortex were not included in theChinese Pharmacopoeia. It was concluded that combined with experimental researches and current clinical applications, potential functions such as supplementingqi, promoting blood circulation to remove blood stasis, encouraging production of body fluids to extinguish thirst, removing phlegm, and relieving stranguria of Mori Cortex were confirmed.

Objective To study the reliability and feasibility of video-assisted thorascopic lymphadenectomy for complete resection of non-small cell lung cancer(NSCLC).Methods From May 2007 to October 2008,31 patients with NSCLC underwent video-assisted thorascopic radical lobectomy combined with systemic lymphadenectomy in our hospital.The patients were divided into video-assisted thorascopic surgery(VATS) group(n=14) and video-assisted mini-thoracotomy(VAMT) group(n=17).The numbers of removed and metastatic lymph nodes were counted.The results and the follow-up outcomes were compared between the two groups.Results No patient dead or showed serious perioperative complications in both the groups.No significant differences were found between the VATS and VAMT groups in the operation time [(193?92) min vs(188?101) min,t=0.143,P=0.887],blood loss [(592?123) ml vs(648?120) ml,t=-1.297,P=0.211],number of removed lymph nodes [(14.6?7.5) vs(15.2?4.5),t=0.262,P=0.795],or 1-year rate of recurrence or metastasis [21.4%(3/14) vs 13.3%(2/15),P=0.651].Conclusion For patients with NSCLC,no significant difference exists between the outcomes of video-assisted thorascopic surgery and video-assisted mini-thoracotomy.

Objective To retrospectively review the mortality and morbidity after orthopedic surgery for aged patients with reference to orthopedic version physiological and operative severity score for the enumeration of mortality and morbidity (O-POSSUM) and Portsmouth POSSUM (P-POSSUM) and validate the score' s accuracy in operative risk prediction.Methods O-POSSUM and P-POSSUM for mortality and morbidity were applied to 839 aged patients who had undergone orthopedic surgery between January 2008 and December 2011.Observed mortality and morbidity were compared with the expected values.Results O-POSSUM predicted 230 morbidities,but the observed value was 182 (x2 =2.718,P ＞ 0.05).O-POSSUM predicted 46 deaths,higher than the observed 3 deaths (x2 =38.870,P＜0.01).P-POSSUM predicted 16 deaths,higher than the observed 3 deaths (x2 =8.997,P ＜ 0.01).Conclusions O-POSSUM accurately predicts postoperative morbidity in aged orthopedic patients.However,O-POSSUM and P-POSSUM overpredicts the mortality and should be used with caution.

OBJECTIVETo explore clinical characteristics and treatment of posterior Pilon fracture.

METHODSFrom January 2011 to January 2013,18 patients with posterior Pilon fracures were treated. Among them, 13 were male and 5 were female, aged from 22 to 63 years old, with an average age of 46. All the patients were closed fractures. Open reduction and internal fixation were performed after swelling subsided, lateral malleolous and posterior Pilon fracture were exposured through lateral approach on healthy side, plates were used to fixed,screws or small plates were used to fix the posterior prominence of medial malleolus after changed to supine position. AOFAS scoring were applied to evaulate clinical effects.

RESULTSAll patients were followed up with an average of 22(ranged, 12 to 48)months. All patients obtained satisfactory reset except one patient. All factures were recovered well with an average healing of 11 weeks. According to AOFAS score at the final following up, 7 cases were excellent,2 cases were moderate, and the total score was 86.8±9.2.

CONCLUSIONPosterior Pilon fracture is not rare in clinical, its mechanism of injury, traumatic anatomy, surgical procedure and prognosis are different from that of classical ankle fracture and Pilon fracture.

Adult ; Ankle Injuries ; surgery ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tibial Fractures ; surgery ; Treatment Outcome ; Young Adult

Objective To investigate the relationship between interleukin (IL)-28B gene polymorphisms (rs12979860 and rs8099917) and treatment response in patients with chronic hepatitis C in China.Methods Taqman probes single nucleotide polymorphism genotyping methods were used to detect the genotypes of rs12979860 (C/T) and rs8099917 (T/G) located at IL-28B gene in 105 included patients.The patients were treated with standard doses of pegylated interferon plus ribavirin and were followed up regularly for therapeutic response and adverse reaction.The relationship between IL-28B gene polymorphism and antiviral treatment response of patients were analyzed.Categorical data were analyzed using Pearson chi-square test or Fisher exact test.Results Totally 105 cases were included in our study and 2 cases lost to follow-up because of moving away.Eight-one cases (78.6%) of the remaining 103 patients were CC/TT genotype (CC/TT group) at rs12979860 and rs8099917, 19 cases (18.4%) were CT/TG (CT/TG group) and 3 cases (2.9%)were TT/TG (TT/TG group).No other genotypes were detected and linkage disequilibrium was discovered at the two polymorphism loci (r2=0.11).After 4 weeks of treatment, 35 cases (43.2%) in CC/TT group, 3 cases (15.8%) in CT/TG group and non in TT/TG group achieved rapid virological response (RVR).There were statistically significant differences among three groups (P=0.033).After 12 weeks of treatment, 45 cases (55.6%) in CC/TT group, 6 cases (31.6%) in CT/TG group and none in TT/TG group achieved early virological response (EVR).There were statistically significant differences among three groups (P=0.025).At the end of the treatment, 68 cases (83.9%) in CC/TT group, 10 cases (52.6%) in CT/TG group and only 1 case (33.3%) in TT/TG group achieved end-of-treatment response (ETR).There were significant statistical differences among the three groups (P=0.003).After 24 weeks of follow-up, 62 cases (76.5%) in CC/TT group, 9 cases (47.4%) in CT/TG group and 1 case (33.3%) in TT/TG group achieved sustained virological response (SVR).There were statistically significant differences among the three groups (P=0.014).One hundred and one cases in CC/TT group developed adverse events, among them 19 cases needed clinical treatment.There were 43 cases in CT/TG group developed adverse events and 9 cases needed treatment.Seven cases in TT/TG group developed adverse events and only 1 case needed treatment.There were no statistically significant difference among three groups (χ2=0.139,P>0.05).Conclusions The genotype of rs12979860 (C/T) and rs8099917 (T/G) at IL-28B gene could affect the treatment response in patients with chronic hepatitis C.RVR and SVR are higher in patients with genotype CC/TT, which might help to guide HCV treatment.

Objective To study the pattern of cerebral gray matter and white matter volume changes among smokers with differ-ent level of nicotine dependence (addition)using voxel-based morphometry (VBM).Methods The current case-control study recrui-ted 53 healthy male smokers and 53 healthy non-smokers from outpatients of our hospital during January 2013 to May 2014.Personal information (including for example age,sex and addition dependence of subjects)was collected using a questionnaire.3D-T1 images of whole brain structure were collected and were analyzed using DARTEL toolbox of SPM8.Smokers were divided into mild to mod-erate nicotine dependence group (n=23)and severe nicotine dependence group (n=30)based on Fagerstr?m Test for Nicotine De-pendence (FTND)score.Independent sample t-test analyses were performed to compare the volumes of gray matter and white mat-ter between smokers with different levels of nicotine dependence and non-smokers.Results Compared with non-smokers,gray and white matter volumes of smokers were smaller in multiple brain areas,mainly in the middle occipital gyrus,posterior cingulate,cer-ebellum anterior lobe,precuneus,caudate body and insula,which however,had larger number and scope of focal areas with gray and white matter atrophy in the mild to moderate nicotine dependence group than that in the severe nicotine dependence group.Conclusion Smokers with mild to moderate nicotine dependence have more pronounced gray and white matter atrophy than that smokers with severe nicotine dependence have.

Objective To explore the management,curative effect and safe of superficial bladder tumor(BT)by greenlight photoselective vapontion per urethra(GPVPU). Methods 32 patients of BT were treated by GPVPU,and operation time,postoperative complications,relapse rate and so on were observed. Results All cases were completed successfully. No complication happened in operations. Urinary canal was detained 2 ～4 days and bladder washout(BW) did not need after operation. Follow-up average time was 16 months. Irrigation chems of bladder and cystoscopy were applied routinely. Conclusion GPVPU was safe and effective in treatment of superficial bladder tumor.

OBJECTIVE:To establish an overall teaching evaluation system for clinical pharmacology with PBL(problem-based learning) mode. METHODS:The teaching evaluation system was established by“Delphi”method,and it has been applied to 270 students at China Medical University in 2013-2014. RESULTS:According to the result of test score,PBL method can improve abil-ity of analyzing medical records,while formative evaluation indicates most of the students are satisfied with class response.And PBL method also can enhance student’s skill of clinical practice,broaden the knowledge an so on. CONCLUSIONS:The evaluation sys-tem was comprehensive with contents,systematic and objective,and it also can provide an effective feedback in teaching,which can accelerate the optimization of the teaching mode and improve the quality of education.