Objective To improve the awareness of the CT and/or MRI appearances and clinical presentations of Kasabach-Merritt syndrome(KMS),6 cases were reported.Methods The CT and/or MRI and clinical characters of 6 cases of KMS were reviewed and analyzed.Results Thrombocytopenia,and consumption coagulopathy were presented in all 6 cases.The paravertebral mass of posterior mediastinum, right pericardial lesion,skin and soft tissue of left arm were shown as iso-,hypointensity on T1-weighted image,iso-,hyper-intensity on T_2-weighted image,and with heterogeneous enhancement after contrast administration in three cases.Splenomegaly was presented in one case,it showed homogenous hypoattenuation on unenhanced CT,and diffused heterogeneous enhancement after contrast administration. On MRI,spleen was shown as hypointensity on T_1-weighted image,hyperintensity on T_2-weighted image, and with heterogeneous enhancement after contrast administration.There were lesions in both bones and spleen in one case.Osteopenia and thinned cortex were shown on the metaphyses of upper and lower extremities.Spleen enlarged and showed multifocal hypoattenuation lesions,the peripheral region enhanced on the early phase,and some of the lesions filled on the delayed phase after the contrast administration.One case showed huge hypoattenuation lesion in the left lobe of liver with gradually filling of the mass after peripheral enhancement.Conclusion Thrombocytopenia and consumption coagulopathy suggest the entity of extensive hemangioma.Splenomegaly with diffuse or focal hypoattenation or hypointensity in MRI infers the diagnosis of hemangioma.

Objective To evaluate laparoscopic appendectomy(LA) and open appendectomy(OA)in obese patients.Methods From January 2008 to November 2010,153 obese patients with appendicitis were operated on,92 cases were treated with initial LA and 61 cases with upfront OA.The operative time,intraoperative bleeding volume,intestinal recovery period,the rate of using acesodyne,major postoperative complications,the duration and hospital cost were studied.Results In LA group,4 cases were converted to open surgery.All the variables in LA group were better than those in OA group except the hospital cost and the differences were statistically significant (the operative time:t =14.0,P ＜ 0.001 ;intraoperative bleeding volume:t =19.7,P ＜ 0.00 1 ;intestinal recovery period:t =12.3,P ＜ 0.001 ;the rate of using acesodyne:t =21.01,P ＜ 0.001 ;main postoperative complications:x2 =40.138,P ＜ 0.001 ;the hospital stay:t=17.3,P＜0.001) except the in-hospital cost(t=1.434,P＞0.05).Conclusions Compared with OA,LA is a better choice for obese patients with appendicitis because of its advantages of minimal injury,early recovery,less complications and short hospital stay.

Objective To find out some possible risk factors of death postcardiac surgery undergoing cardiopulmonary bypass.Method Totally 36 patients,who underwent postcardiotomy undergoing cardiopulmonary bypass in Subei Hospital of Jiangsu Provience from March 2005 to June 2006,were retrospectively analyzed.The criteria for the selection of patients were as follow:(1)patients underwent on-pump cardiopulmonary bypass;(2)patients with heart function in Ⅰ-Ⅲ degree; (3)all patients didn't have organ dysfunction before operation;(4)patients died within 28 days postcardiotomy.Therefore,6 patients who died were admitted as death group,the other 30 patients were admitted as control group.The analysis included: (1)preoperative factors,including gender,age,diagnosis preoperative,NYHA grade,APACHEⅡscore,left ventricular end-diastolic diameter.(2)operative factors:operation time,block aorta time. (3)postoperation factors:hemorrhage volume,mechanical ventilation time,and factors of hemodynamics and oxygen metabolism 6 hour postoperative:heart rate(HR),central venous pressure(CVP),pulmonary arteria wedged pressure(PAWP),cardiac output index(CI),arterial blood lactic acid,partial pressure of oxygen(PaO2),mixed venous oxygen saturation(SvO2),oxygen delivery index(DO2I),oxygen comsume index(VO2I),oxygen extraction ratio (O2ext).Comparisons between two group was made with SPSSl0.0 for windows.Firstly,the data were analyzed with process of single variable analysis and Some parameters,which showed the significant difference,were sorted out from two groups.Then these parameters were put to the IDGISTIC regression analysis.Consequently,the independent risk factors of death of postcardiac surgery could be found.Results The single variable analysis showed that the parameters of APACHE Ⅱ score,left ventricular end-diastolic diameter,block aorta time,mechanical ventilation time,arterial blood lactic acid,SvO2 had significant difference betwen groups(P＜0.05).The LOGISTIC regression showed that left ventricular end-diastolic diameter and arterial blood lactic acid ale the two independent risk factors of death(P＜0.05).Conclusions Arterial lactatemia and left ventricular end-diastolic diameter can be used to predict the prognosis of postcardiotomy undergoing cardiopulmonary bypass.

Objective To evaluate the value of differential diagnosis on congenital biliary atresia(BA) and infantile hepatitis syndrome(IHS) by technetium-99m-diethyl-iminodiacetic acid(99Tcm-EHIDA)hepatobiliary scintigraphy with phenobarbitol sodium.Methods Fifty-eight infants with persistent jaundice were taken phenobarbitol sodium[5 mg/(kg?d)] ,bid ?7 d).Those who had not bowel and gallbladders radioactivity within 24 hours were diagnosed as the diagnostic criterion of BA.Those with bowel and gallbladders radioactivity within 24 hours were diagnosed as the diagnostic criterion of IHS,who then received 99Tcm-EHIDA hepatobiliary scintigraphy with single photon emission computed tomography(SPECT) instrument.The results of all children were analyzed and compared with pathology and clinical follow up results.Results 99Tcm-EHIDA hepatobiliary scintigraphy correctly diagnosed 24 infants with last diagnosis BA and 29 infants with last diagnosis IHS,5 neonates false positive in all 34 IHS patients.The sensitivity in the diagnosis of BA was 100%,the specificity and accuracy were 85.3% and 91.4%,restectively.The sensitivity was 85.3% in the diagnosis of IHS;the specificity and accuracy were 100% and 91.4%,respectively.Conclusions 99Tcm-EHIDA hepatobiliary scintigraphy with phenobarbitol sodium can accurately differentiate BA and HIS at early stage.

OBJECTIVETo investigate moisture content and hygroscopicity of spray dry powder of Gubi compound's water extract obtained at different spray drying conditions and laying a foundation for spray drying process of Chinese herbal compound preparation.

METHODIn the paper, on the basis of single-factor experiments, the author choose inlet temperature, liquid density, feed rate, air flow rate as investigated factors.

RESULTThe experimental absorption rate-time curve and scanning electron microscopy results showed that under different spray drying conditions the spray-dried powders have different morphology and different adsorption process.

CONCLUSIONAt different spray-dried conditions, the morphology and water content of the powder is different, these differences lead to differences in the adsorption process, at the appropriate inlet temperature and feed rate with a higher sample density and lower air flow rate, in the experimental system the optimum conditions is inlet temperature of 150 degrees C, feed density of 1.05 g x mL(-1), feed rate of 20 mL x min(-1) air flow rate of 30 m3 x h(-1).

Desiccation ; methods ; Drugs, Chinese Herbal ; chemistry ; Hydrophobic and Hydrophilic Interactions ; Particle Size ; Powders ; chemistry ; Temperature ; Water ; analysis ; Wettability

Objective To observe the effect of atorvastatin on mixed dyslipidemia in type 2 diabetic patients. Methods 39 patients of type 2 diabetic with mixed dyslipidemia were taken with atorvastatin for 6 months,and the change of total cholesterel(TC),triglyceride(TG),low-debsity-lipoprotein-cholesteral(LDL-C),high-debsity-lipopro- tein-cholesteral(HDL-C)were observed.The incidence of side-effect was recorded.Results TC,TG,LDL-C were obviously reduced and their extent of reduction were 26.17 %,54.97 %,38.92 %.HDL-C was obviously increased and it's extent of increase was 14.81%(P

Objective To investigate and analyze the nurses' critical thinking abilities and its related factors, and provide basic data for developing nurses' critical thinking. Methods 210 nurses accepted CTDICV and EPQ questionnaire investigation in a top hospital in Nantong. Results The total score of nurses' critical thinking was (276.41 ± 26. 107); Single factor analysis results revealed that the critical thinking scores of nurses were significant in different education background(266.5 ± 22.200,277.03 ± 25. 750,292.92 ± 24.841;F = 19. 168, P ＜ 0. 01 ), professional title, length of nursing working and different departments; The length of nursing service and the E scores were positively correlated with the scores of critical thinking; The P, N scores ( r =0. 292,0. 221 ,P ＜0. 01 ) were negatively correlated with the score of critical thinking( r = -. 0142, -0. 196,P ＜0. 05 or P ＜0. 01 ); Multivariate analysis showed that nurses' critical thinking abilities were correlated with the nurse education background, length of service, different departments and the E scores ( P ＜ 0. 01 or P ＜0. 05 ). Conclusions Nursing managers should pay attention on improvement nurses' critical thinking abilities.Nurses critical thinking abilities may be developed by individualized training according to their specific circumstances.

Adolescent ; Child ; Collagen Type I ; metabolism ; Extracellular Matrix ; metabolism ; Female ; Fibrillin-1 ; Fibrillins ; Heart Defects, Congenital ; metabolism ; pathology ; Humans ; Male ; Microfilament Proteins ; metabolism

OBJECTIVE To develop a non-paper,interactive,multiplex medium way,and to obtain the information disinfection protection on second level of time.METHODS Using the computer,the touchscreen,the personal digital assistant(PDA),the general packet radio service(GPRS),the pronounciation(man-machine conversation),the video frequency and the other advanced technology methods,to study and develop an electronic version of intelligent search engine system for disinfection protection.RESULTS Touching namely attained the applied and guided information,such as to fulfil exactly the disinfection technology standard for the medical workers in medical establishments,to provide the post work instruction;to correctly guide the disinfection protection for common family;and to build the communication platfrom with the enterprisers in order to meet the demand for disinfection protection appliances from the society,hospital and family.CONCLUSIONS The intelligent search engine system is feasible applying to use.

Objective To explore the clinical application of percutaneous endoscopic gastrostomy in gastroin- testinal nutrition among critically ill patients.Methods Twenty-two patients were undertaken percutaneous endo- scopic gastrostomy under the lead of gastroscope.The puncturatio site was located in anterior wall of stomach.Results All the procedures were performed successfully for one time.Intraoperational blood pressure was very steady.At the same time,intraoperational SpO_2 of the patients all exceeced 97%.The bleeding amount and operation time were respectively (3.8?1.9) ml and (15.5?2.3) min.Severe complications such as gastrostoma,gastrocolic fistula, pneumoperitoneum,refluxing or aspiration of gastric juice,inhalant pneumonia didn't occur after the operation.Con- clusion Percutaneous endoscopic gastrostomy was safe and feasible among critically ill patients who needed gastroin- testinal nutrition because of its slight injury,little bleeding and shorter operational time.