Childhood hypertensive crisis is a relatively rare emergency event,and is associated with a high risk of morbidity and mortality.Children in this situation need rapid,safe and effective treatment to release clinical symptoms,relieve injuries of target organs,improve quality of life,and reduce mortality.Many kinds of anti-hypertension drugs have been used in children for decades,but most data were extrapolated from studies in adult.There is limited number of randomized controlled trials in children.Therefore it is still difficult to choose drugs for pediatric hypertensive crisis based on evidence-based medicine.This paper sought to summarize the experience of medical management of childhood hypertensive crisis in children.

The paper gives an account of the concept and significance of the people-oriented principle and explores its practice in hospital management,including adopting patient-centered humane management,intensifying job dedication,and enhancing the hospital's cohesive force and development potential.Patient-centered humane management includes adopting the system of no companions for the inpatients,respecting the patients and safeguarding their rights and interests,providing friendly and comfortable medical environments for the patients,managing in a scientific,rational and whole-course manner the diets of the patients,and offering quality medical services to the patients.

It was undoubted that doctor-patient relationship was becoming more and more worse,and this condition lead the doctors,patients,governments feel ve ry awkward.Every related side would be Faliures.Nowadays,the tensional doctor patient relationsh i p is a result of improper value choice and institutional arrangement in the back ground of market economy and high technology development.Building a harmonious doctor patient relationship and become double win is a key issue to affect medical service.It needs government,hospital,doctor and patient to work together.Therefore,we should promote the harmony of doctor-patient relationship in the respects of value choice and institutional arrangement.The action of benefiting others at the medical market includes benefiting for others unselfish and benefiting for others for self under the condition of market economy.Seeking patients' interests even at the expense of the professionals' own interests is the most essential moral criterion and professional obligation.

Guidelines as Topic ; Humans ; Medical Oncology ; standards ; Neoplasms

Humans ; Neoplasm Recurrence, Local ; prevention & control ; therapy ; Rectal Neoplasms ; pathology ; Reoperation

Objective To study the effect of selection of indications in percutaneous laser disc decompression(PLDD).Methods Lumbar disc herniation treated by PLDD with satisfactory and unsuited indications in 34 cases respectively were matched studied.Results The curative effect was 85.3% and 55.9% in satisfactory indication group and unsuited indication group respectively (?~2=5.06,P

Objective To evaluate the diagnostic value of multi-slice spiral CT (MSCT)for traumatic spleen and liver rupture.Methods We made a retrospective analysis of 140 cases of liver and spleen injury with clinical manifestations confirmed by operation.MSCT examination results and clinical data were compared.Results Of the 140 cases,male patients outnumbered female ones,and the peak age was 10 - 30 years old.The injuries were most commonly attributed to traffic accident and falling.There were 69 (49%)cases of spleen injury,5 1 (36%) cases of liver injury,and 20 (14%)cases of both.Liver and spleen injuries showed on MSCT examination were liver and spleen laceration, hematoma within the liver and spleen as well as hematoma beneath the envelop. Conclusion MSCT has an important diagnostic value for traumatic liver and spleen rupture and thus can guide clinical treatment choice.

BACKGROUND: In recent years, percutaneous laser disc decompression (PLDD) has been developed gradually in China. But there have been fewer further studies on the indications and contraindications for the use of the therapy.OBJECTIVE: To analyze the therapeutic effect after the choice of the indications for PLDD.DESIGN: A case-paired observational analysis with the patients as the subjects.SETTING: The Department of Radiology and Department of Soft Injuries of the 474 Hospital of Chinese PLA.PARTICIPANTS: We recruited inpatients of the 474 Hospital of Chinese PLA after PLDD between August 1998 and December 2004 as subjects for this research. Totally 68 cases were involved. According to the same gender, the closeness in age, the cases were matched and divided into 2 groups (eg. If there were 2 or more than 2 cases with the same age, the case whose disease course is the closest one was chosen): poor indication group (n=34) and good indication group (n=34).METHODS: A pillow was put under the belly of the patient who lay face down on the angiographic bed with the side with serious symptoms near the outside of the bed (the side where doctor operated). Symbols were marked on the body surface under the fluoroscopy. The waist was subjected to conventional sterilization and was paved with a piece of sterile cloth. 5 Ml of lydocaine was used for anesthesia. 8-12 cm to the posterior central midline of the diseased side, an incision was made to insert the needle according to the fat and thinness of the patients, and attention to the angle adjustment was needed to enter the intervertebral disc through "the secure triangle"beneath the nerve root so that 5 mm of the exposed front segment covered the needle end completely. Cautery was made with 15 W laser for every 1s after an interval of 4 s. The total output power of laser was adjusted according to the area of intervertebral disc, which was usually 1 200-1 700joules. The gas produced should be drawn out during the cautery, and this was done at least for 3 times. If the patient felt the distending pain, drawing out gas should be performed at any time. The puncturing needle and fiberoptics were pulled out after the operation, and band-aid was applied to the local area. The patients lay at the supine position to let the doctor examine the remission and functional recovery. When the patients were discharged, modified Macnab standard was used to evaluate the therapeutic effect. Evaluation criteria: According to the modified Macnab standard, the therapeutic effect can be classified into the following types: excellent means disappearance of pain, no limitation in motor function, with complete recovery of normal working and movement; good means that the patients showed occasional pain, but were able to do light job; passable means that the patients showed partial improvement, but still felt pain, and were not able to work and move; poor means that the patients showed signs of nerve compression that further operation was needed. The therapeutic effect of being excellent and good was combined as good therapeutic effect,and that of being passable and poor was combined as poor therapeutic effect. X2test was performed to the paired numerative data by the author.MAIN OUTCOME MEASURES: ① General evaluation of the therapeutic effect of the poor indication group and good indication group according to modified Macnab standard when the patients were discharged from the hospital; ② Comparison of the curative effect between the group with intervertebral disc herniation ≥ 0.6 cm and the group with intervertebral disc herniation ＜ 0.6 cm; ③ Comparison of the therapeutic effect of the group complicated with spinal canal stenosis and the group with normal spinal canal; ④ Comparison of the therapeutic effect between the group with good indications and other groups with poor indications.RESULTS: All the 68 patients entered the result analysis. ①The therapeutic effect in the good indication group was obviously better than that in the poor indication group, with a significant difference [85%(29/34),56%(19/34) ,χ2=5.06,P ＜ 0.05]. ② The therapeutic effect was significantly better in the group with intervertevbral disc herniation ＜ 0.6 cm than in the group with intervertevbral discs herniation ≥ 0.6 cm, but without significant difference [75 % (6/8), 50% (4/8),χ2=0.25, P ＞ 0.05]. ③The therapeutic effects were close in the group complicated with spinal canal stenosis and the group with normal spinal canal, but without significant difference [80% ( 12/15 ), 73 ( 11/15 ) ,χ2=0,P ＞ 0.05].④ The therapeutic effect in the group with good indications was obviously better than that in other groups with poor indications, with a significant difference [100%( 11/11 ), 36%(4/11), χ2=5.14,P ＜ 0.05].CONCLUSION: It could improve the therapeutic effects of PLDD when indications were properly chosen.

Objective　To investigate the clinical significan ce of pelvic lymphadenectomy in advanced ovarian carcinoma. Methods　A total of 86 cases of advanced ovarian cancer with surgical treatment were assigned to 3 groups according to the size of residual focus and the performanc e of pelvic lymphadenectomy. Group A consisted of 42 cases with pelvic lymphaden ectomy and the diameter of residual focus smaller than 2 cm; Group B, 26 cases, underwent pelvic lymphadenectomy but with the residual focus larger than 2 cm; Group C con sisted of 18 cases without pelvic lymphadenectomy and the diameter of residual f ocus larger than 2 cm. All patients received CAP chemotherapy for 6 to 8 course of treatment and were in similar clinical stages and pathological grading. Results　The 5 year survival rate was 30.1% (13/42) in Group A, and 11.5% (3/26) in Group B with significant difference (P<0.05). Group C's 5 year survival rate was 11.1%(2/18). No significant difference was found betwee n Group B and C. Conclusion　Application of pelvic lymphadenecto my on those with residual focus less than 2 cm can apparently improve the patien ts' survival rate. But when the diameter of the focus is larger than 2 cm, pelvi c lymphadenectomy is not necessary.

Objective The aim of the study is to investigate whether the progressive incremental exercise can induce the change in bone maximum force.Methods One hundred and seventy healthy SD rats,aged 3 months,were used as samples after adaptive exercise for one week,and then they were divided to a basic control group(C_0),8 control groups and 8 exercise groups according to the training duration(2W,4W,6W,8W,9W,11W,13W and 15W).Based on Bedford and our pre-study.the longest training duration of the rats was 15 weeks.The maximum force(F) of femoral bone and the 2nd lumbar vertebrae(L_2)were tested by three-point bending test and compressive test separately.Results It was shown that there was no pronounced difference in F of femoral bone between con trol groups and exercise groups.But significant differences in F of L_2 were found between the control groups and exercise groups(P<0.001).Conclusions Changes in different degree were found in the F of femoral bone and L_2 during the process of growth.The differential effects of incremental exercise on F were caused by the difference in training intensities and in the bone types.