Objective To investigate the diagnostic significance of synchronous observation on bone marrow biopsy,bone marrow smear and peripheral blood smear in stubborn hematonosis.Methods Thirty-seven patients with difficult and complicated hematologic diseases were detected by peripheral blood smear,bone marrow smear and bone marrow biopsy.Those slides and smears were observed.Results The 37 cases with blood disease was diagnosed of aplastic anemia in 3 cases,5 cases of myelodysplastic syndrome,6 cases of primary myelofibrosis,13 cases of secondary myelofibrosis,7 cases of lymphoma with bone marrow infiltration and 3 cases of metastatic carcinoma of bone marrow.In the diagnosis of aplastic anemia,myelodysplastic syndrome,primary and secondary myelofibrosis,lymphoma and metastatic carcinoma of bone marrow diagnosis,bone marrow biopsy is superior to smear.Conclusion Bone marrow biopsy,bone marrow smear and peripheral blood smear synchronous observation can effectively increase the diagnostic rate,decrease misdiagnosis rate,and correctly identify the stage of the disease.

Thirty-six cases of delayed tramatic intracranial hematomas are reported in this paper. Among them 9, 5, 10 and 12 cases were epidural, subdural, intracerebral and multiple hematomas, respectively. The initial CT scans showed normal or brain contusions accompanied by a Me hemorrhage in 23 patients, and delayed intracranial hematomas developed after the earlier neurosurgical operations for evacuations of another traumatic mass lessions for urgent decompressions in 13 patients. Delayed hematomas occurred mostly in the acute stage of head injuries and most patients were impacted occipitally. Deterioration of consciousness was the most important manifestation for diagnosis. The responsible mechanisms of delayed intracranial hematomas are investigated and the indications of repeat CT scans or surgery for its early diagnosis are Droposed.

This paper reports 17 cases of traumatic bilateral epidural hematomas. The incidence of these cases was 8.7% of all cases of epidural hematoma. The hematomas in 15 cases were across the midline, and in the other 2 cases were at different location on either side. The mechanism and clinical features of bilateral epidural hematomas were discussed. The indications for early diagnosis were stressed.

Objectives:To investigate the nutrition support in patients with severe neurosurgical disease. Methods:Enteral nutrition(EN) was used in early phase(48～72 h, postoperatively or after trauma) in 28 cases with severe neurosurgical disease.Parenteral nutrition was adopted when EN was insufficient.Dose of glucose was limited at early period(acute phase,5～7 days after occurrence). Results:23 cases were cured and 5 cases died.During the period of EN,glucose and lipid metabolic abnormality or liver enzyme change were not found.There was no complication such as severe diarrhea,belly bulge.All patients who were on respiration machine were all taken off successfully. Conclusions:Early EN can improve the rate of cure and reduce the complication and mortality.

Objective To evaluate the feasibility of active breathing control (ABC) in conformal radiotherapy (CRT) for patients with non-small cell lung cancer (NSCLC). Methods From Feb 2005 to Mar 2008, 29 patients with inoperable NSCLC (stage Ⅱ-Ⅳ) were evaluated. For each patient, two series of CT scans were obtained with free breathing (FB) and ABC system during simulation, respectively. Then two confonnal radiotherapy (CRT) plans were finished based on the two sets of reconstructed images. The pattern of post-inspiratory breath-hold was triggered at 80% of the peak of inspiration curve. The margin of clinical target volume (CTV) to planning target volume (PTV) was 0. 6 cm for lesions of the superior lobe, and 1.0 cm for the lesions of middle and inferior lobes. Three to five coplanar fields were performed in conformal radiotherapy. The gross tumor volume (GTV), CTV, PTV, volume of the bilateral lungs (Volume_(lung)), V_(20) and mean lung dose (MLD) of two plans were evaluated by dose-volume histogram (DVH). The World Health Organization criteria and National Cancer Institute Common Toxicity Criteria 3.0 (NCI-CTC3.0) scale were used to assess the immediate response and acute side-effect, respectively. Results Significant differences of GTV, CTV, FIN, Volum_(lung), V_(20) and MDL were observed between the two plans (36. 35 cm~3 vs. 31.40 cm~3, t = 9. 70, P <0. 001 ;82. 33 cm~3 vs. 70. 83 cm~3, t = 8. 19, P < 0. 001 ; 230. 73 cm~3 vs. 197.59 cm~3 ,t=5.72,P <0. 001 ;21.66% vs. 18. 76% ,t = 11.16,P <0. 001 ;1329. 07 Gy vs. 1143. 14 Gy, t = 13. 24, P < 0. 001). With ABC, all patients completed their treatment successfully except one patient for financial problems. The median radiation dose to the GTV was 64 Gy (60 -64 Gy). The overall immediate response rate was 64% (18/28). According to the NCI-CTC 3.0, grade 1 and 2 acute radiation-related toxicities occurred in 68% (19/28) and 18% (5/28) of patients for esophagitis, 82% (23/28) and 7% (2/28) for pneumonitis, respectively. Grade 1, 2 and 3 bone marrow suppression occurred in 57% (16/28), 25% (7/28) and 14% (4/28) of patients, respectively. Grade 1 and 2 acute cardiac injuries occurred in 86% (24/28) and 14% (4/28) of patients. Conclusions During CRT for patients with NSCLC, the use of ABC can decrease the radiation dose and acute complications of normal tissues.

Objective To investigate health literacy before and after the medical intervention and its influencing factors so as to provide evidence for public health promotion.Methods Stratified multi-stage random sampling method was applied for residents aged 15-69 years from 8 urban or rural communities of Taishun County of Lucheng District.The comprehensive health literacy promotion and intervention was carried out,and a unified citizen health literacy questionnaire was designed.Residents' health literacy,the three aspects of health literature and five categories of health literacy issues levels were compared before and after the intervention,and Chi-square test was used for data analysis.Results The overall rate of having health literacy was 11.8％ and 16.3％ in 2012 and 2013,respectively (x2=7.20,P＜ 0.01).The rate of basic health concept and knowledge,health lifestyles and behaviors,and medical skills were significantly raised from 18.5％,9.4％ and 23.5％ to 28.0％,14.6％ and 33.5％,respectively (x2 values were 21.60,11.07 and 20.85,respectively; all P＜0.01).As to the five issues of health literacy,the level of the scientific healthy literacy,the chronic disease literacy,the literacy of infectious disease,the safety and first aid literacy and the basic health literacy were significantly inclined (52.4％ vs.40.4％,39.3％ vs.31.8％,27.8％ vs.22.4％,74.0 ％ vs.58.2％ and 41.9％ vs.33.8％,respectively; x2 values were 27.79,34.95,8.10,43.07 and 13.61,respectively; all P＜0.01).Conclusion Health education was helpful in the promotion of healthy literacy.Healthy lifestyles and behavior literacy and chronic disease prevention literacy should be important for the rural,elderly,low-education level and low-income populations.

Objective To investigate the merit and feasibility of vasoactive drugs by the double atrial infusion in children with congenital heart disease combined with pulmonary hypertension.Methods Ninety cases of congenital heart disease combined with pulmonary hypertension were randomly selected.One group(45 cases) was infused by double atrialadministration,which left atrium for catecholamines,and right atrial infusion for highly targeted expansion of pulmonary vascular drugs,such as prostaglandin E1.Another group(45 cases) was infused through the right atrium by a central venous to catecholamines and pulmonary vascular dilatation drugs.Cardiac output(CO) and cardiac index were measured by thermal dilution method and systemic vascular resistance and pulmonary vascular resistance(PVR) were calculated.Results Three cases were dead in early postoperative period(1 week),which were central intravenous group.2 cases with total anomalous pulmonary venous drainage had low co after operation,include 1 case through the left atrium,and the other case through central venous administration,and were recovered.There was no long-term mortality.There was no significant difference in CPB time,blocking time,the amount and timing of vasoactive drugs in two groups (P ＞ 0.05).Conclusion Double atrial infusion of vasoactive drugs can significantly reduce the mean pulmonary artery pressure and pulmonary vascular resistance,and increase CO,which is better than the traditional central intravenous methods.The treatment method is of very important significance.Thus double atrial infusion is safe and feasible.

The high-affinity glucocorticoid binding sites (HAGS) and the low-affinity glucocorticoid binding sites (LAGS) with steroid specificity were demostrated in cerebral cytosol of rats by using the radioligand binding assay. The Kd of HAGS and LAGS were (178?0.71)?l0-8mol/L and (2.12?1.06)?10-6mol/L respecitively as estimated by Scatchard and Pseudoscatchard analysis. Glucocorticoid receptors (GR) in the traumatized(left) hemisphere cytosol were decreased more significantly than those in both the control (right) hemisphere cytosol at 6h postinjury and normal brain tissue (P

ObjectiveTo study the Electrocardiogram (ECG) changes in AIDS patients at different age grades. MethodsThe ECG of 400 AIDS patients at different age were analyzed retrospectively. Results(①)The rate of abnormal ECG in the age group of 46 ～50 years was significantly higher than 11 ～ 15(P =0. 008) ,21 ～25( P = 0. 041 ),31 ～ 35 ( P = 0. 022 ),41 ～ 45 ( P = 0. 001 ) and 51 ～ 55 ( P = 0. 047 ) years groups respectively. (②)The rate of bradyarrhythmia in the age group of 46 ～ 50 years was significantly higher than 31 ～ 35 (U = 2. 44) ,36 -40( U = 2. 18 ) ,41 ～ 45 ( U = 2. 57 ) years groups ( P ＜ 0. 05 respectively. (③)The rate of left atrial and ventricular hypertrophy in 11 ～ 15 years group was significantly lower than the age groups older than 46 (except for 51 ～ 55years group) ;those aged ＞60 had higher atrial and ventricular hypertrophy rate than 36 ～40,41 ～45 and 51 ～55years groups ( P ＜ 0. 05 respectively). ConclusionsAIDS patients at all ages may present abnormal ECG, which is positively correlated with age.

Objective To compare the efficacy of arterial stenting with that of traditional B -T shunt for neo-natal pulmonary atresia with intact ventricular septum.Methods Twenty -six cases of neonatal pulmonary atresia with intact ventricular septum were treated at Children′s Hospital of Zhengzhou from December 2005 to December 201 5,aged 3 to 23 days[(8.20 ±4.80)days],and weighted 2.80 -3.88 (3.41 ±0.27)kg.Accompanied with pulmonary hypo-plasia,all these patients were combined with PDA and ASD or PFO.Before operation,the peripheral oxygen saturation was kept in 61 % -75%,averaged at 67%.Among them,1 2 cases underwent arterial catheter stenting,and 1 4 cases re-ceived B -T shunt (including modified B -T shunt and central shunt)ductus ligation.After operation,the oxygen satu-ration in these children was observed,and they were examined by echocardiography and true lateral chest X -ray,blood flow situations in stents and shunts were assessed,and follow -up examinations were conducted in 1 ,3,6 and 1 2 months postoperatively.Results Stents were successfully inserted into these 1 2 cases.After traditional pulmonary shunt,pa-tients′peripheral oxygen saturation was (82.73 ±5.59)%,compared with that of patients after arterial catheter sten-ting (86.1 8 ±3.1 9)%,there was significant difference(t =1 0.71 ,P <0.05).In pulmonary shunt group,2 cases died,1 case died of postoperative heart failure,and the other case was complicated with pulmonary infection and died of respiratory failure;in catheter stent group,1 case was complicated with postoperative supraventricular tachycardia and recovered after drug intervention.For the follow -up examinations 1 ,3,6 and 1 2 months after the operation,1 case of B -T shunt in pulmonary shunt group was improved by central shunt due to slow blood flow,less shunt volume,and ox-ygen saturation decreased to 69%.For the catheter stent group,1 case was improved by stent balloon dilatation due to declined peripheral oxygen saturation 2 months postoperatively,and after the operation,transcutaneous oxygen saturation was improved.No patients died in the catheter stent group.Conclusions In traditional B -T shunts,the operation is extensive,and complications are common,and the recovery turns slowly.Arterial catheter stenting can be used as the preferred method of treatment for one -stage surgical pulmonary atresia with intact ventricular septum to reduce the weakness feasibly and effectively.