Objective To investigate the accuracy of liver volume measurement in patients with primary hepatocellular carcinoma by using the 3D + medical imaging visualization processing system. Methods Thirty patients who were clinically diagnosed as primary hepatocellular carcinoma and underwent surgical resection before preoperative assessment were selected from January 2016 to November 2016. Preoperative thin-slice CT images were transferred into the 3D + medical imaging visualization processing system for hepatic volume measurement, the predictive resection volume were measured and statistically analyzed with that of intraoperative specimen according to water measurement method. Results All patients had complete resection of tumor, the average volume of predictive resection calculated by the 3D software was (408.84 ± 177.07) ml, the average volume of intraoperative specimen measured by the water test was (399.95 ± 176.15) ml, the difference was not statistically significant (t=1.502, P=0.144), and the average percentage error was (6.21 ± 4.73) %. Pearson correlation analysis showed that there was significant correlation between them (r=0.983, P<0.05). Conclusion 3D+medical image visualization processing system is a simple, intuitive and accurate method for liver volume measurement, which can provide the basis for the accurate measurement of liver volume and the implementation of complex hepatectomy, and guide the precise hepatectomy.

Objective To explore the correlation between hyperuricaemia and blood pressure, and blood lipid and glucose. Methods By using simple cluster sampling, 2 branch units from PetroChina Changqing Oilfield Company were selected, and all the 720 subjects with hyperuricaemia (HUA) were assigned to the HUA group; another 620 participants with normal uric acid (UA) level into the normal group. The correlation between blood uric acid and blood pressure,and blood lipid and glucose was assessed by Logistic regression. Results The odds ratio (OR) of those who had 1,2 or 3 abnormal status of hypertension,hyperlipidemia and impaired fasting glucose in the HUA group were much higher than the normal group (OR values were 4. 036,2. 562, and 4. 174, respectively). Logistic regression showed that male, systolic blood pressure ( SBP), GLU, total cholesterol ( TC), triglyceride ( TG), low-density lipoprotein cholesterol (LDL-C) were risk factors of H UA ( OR values were 7. 736,2. 309,1.721,2. 761 and 1. 411,respectively) ,while high-density lipoprotein cholesterol (HDL-C, OR = 0. 211 ) was a protective factor of HUA. Conclusions Gender,blood pressure and blood lipid may have correlation with blood UA. Multiple risk factors should be considered to improve the effectiveness of health education and health promotion.

Objective To investigate the prevalence of anti-endothelial cell antibody fAECA) in the sera of patients with connective tissue diseases(CTD)complicated with pulmonary arterial hyperten-sion (PAH)and to detect the specific antigens of AECA which may be related to clinical manifestations.Methods AECA was detected with Western blotting in 39 CTD patients with PAH.22 CTD patients without PAH and 30 healthy donors.Results The prevalence of AECA was 82%in CTD patients with PAH.73%in CTD patients without PAH and 20%in healthy donors.Anti-22 000 AECA was only detected in CTD patients with PAH(15%).Anti-75 000 AECA was more frequently detected in CTD patients with PAH than in thosewithout PAH(51%vs 23%.P＜0.05).In CTD patients complicated with PAH.anti-75 000 AECA was morefrequently detected in those with Raynaud's phenomenon or with positive anti-RNP antibody.Conclusion AECA can be more frequently detected in CTD patients with or without PAH.Furthermore,anti-22 000 and anti-75 000 AECA may play a special role in CTD patients with PAH.

OBJECTIVETo explore the effects of Feixin Decoction (FXD) on the hypoxia-inducible factor-1alpha (HIF-1alpha) and vascular endothelial growth factor (VEGF) in the rat model of hypoxic pulmonary hypertension (HPH), and to study its mechanisms for treating HPH.

METHODSForty healthy male SD rats were randomly divided into four groups, i. e., the normal control group, the HPH model group, the FXD group, and the Nifedipine group, 10 rats in each group. The HPH rat model was prepared using normal pressure intermittent hypoxia method. Except the normal control group, rats in the rest groups were fed in a self-made hypoxic plexiglass cabin, with the poor oxygen condition for 8 h daily for 14 successive days. Then the distilled water (at 30 mL/kg) was given by gastrogavage to rats in the normal control group and the HPH model group. FXD (at 28 g/kg) and Nifedipine (at 20 mg/kg) were given by gastrogavage to rats in the FXD group and the Nifedipine group respectively, once daily, for 14 successive days. Besides, hypoxia was continued for 14 days while medicating. The mean pulmonary artery pressure (mPAP) was detected on the second day after the last medication. The morphology of the pulmonary arteriole was detected. The ratio of pulmonary artery wall area and tube area (WA%) was determined. The protein and mRNA expressions of HIF-1alpha and VEGF were detected using immunohistochemistry and in situ hybridization technique.

RESULTSCompared with the normal control group, mPAP, WA%, and the protein and mRNA expressions of HIF-1alpha and VEGF significantly increased in the model group (P < 0.01, P < 0.05). Compared with the HPH model group, mPAP, WA%, and the protein and mRNA expressions of HIF-1alpha and VEGF significantly decreased in the FXD group (P < 0.01, P < 0.05).

CONCLUSIONSFXD down-regulated the expression of VEGF through decreasing the expression of HIF-1alpha. One of its mechanisms for treating HPH might be partially due to reversing the remodeling of pulmonary vascular smooth muscle.

Animals ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Hypertension, Pulmonary ; drug therapy ; etiology ; metabolism ; Hypoxia ; complications ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Male ; Phytotherapy ; Rats ; Rats, Sprague-Dawley ; Vascular Endothelial Growth Factor A ; metabolism

Objective To explore the changes of serum gastrin(GAS),plasma motilin(MTL) and somatostatin(SST) in critically ill children with gastrointestinal dysfunction(GID).Methods According to pediatric critical illness score,75 cases were divided into greatly critical group(score90).Fifty cases of greatly critical and critical group were divided into GID group and non-GID group.The levels of serum GAS,plasma MTL and SST were detected on an empty stomach at acute stage and convalescence stage,comparing with those of normal control group,and then,the relationship between the levels of serum GAS,plasma MTL,SST and GID,the severity of disease were analyzed.Results At acute stage,the levels of serum GAS and plasma MTL of greatly critical group and critical group were higher than those of normal control group,the levels of plasma SST of greatly critical group and critical group were lower than that of normal control group,the more severe condition of critical children,the higher level of serum GAS and plasma MTL,the lower level of plasma SST.At convalescence stage,the level of serum GAS and plasma MTL of the greatly critical group and critical group decreased and the level of plasma SST increased.The levels of serum GAS and plasma MTL of GID group were higher than those of non-GID group,but the level of plasma SST of GID group was lower than that of non-GID group.Conclusion The level of serum GAS,plasma MTL and SST can be used to assess the severity of illness and prognosis,judge the change of disease and determine the efficacy of treatment programs,and detect gastrointestinal functional lesion.

Objective To investigate the clinical features of the enterovirus 71 ( EV71 ) infection complicated with pulmonary edema or pulmonary hemorrhage as a fulminant and often fatal illness.Methods The medical records of three cases with EV71 infection were retrospectively reviewed for clinical manifestations, laboratory data, medications, and outcome.Results All the cases were infants and died of the infection. These infants had no skin or mucosal lesions, however, they had sudden onset of cyanosis and tachypnea 1 to 2 days after the onset of the febrile disease with vomiting. All these 3 cases were misdiagnosed and were treated for shock on admission. Pulmonary hemorrhage was not considered in any of the cases on admission. All the cases received tracheal intubation when foamy secretions were discharged from the mouth and nose of the patients and notable cyanosis occurred. After intubation, pink foamy fluid flew out from the endotracheal tube in all the 3 cases. The patients had hyperglycemia and limb weakness, two had tachycardia, and hypertension was found in one case. Chest X-ray showed bilateral or unilateral widespread air space opacity, but the cardiac size and shape were normal. All the patients had leukocytosis. Enterovirus 71 infection was confirmed by detection of specific nucleic acid sequences of the virus from throat swab and tracheal secretions samples and in one case in cerebrospinal fluid.Conclusions Pulmonary edema or pulmonary hemorrhage occurred in the 3 cases with EV71 infection. The initial presentation was nonspecific with fever and vomiting, and sudden appearance of cyanosis, tachypnea, tachycardia, hypertension or hypotension, limb weakness, which may suggest pulmonary edema or hemorrhage. Excessive fluid resuscitation may deteriorate the illness, on the contrary, fluid restriction and inotropic agents, and early intubation with positive pressure mechanical ventilation may be the proper treatment.

Background:The symptomatic bradyarrhythmia is Class Ⅰ indication for pacing therapy which is not a radical cure.The present study aimed to assess the feasibility and to present the initial results of the restricted ablation of the parasympathetic innervation surrounding sinus and atrioventricular (AV) nodes for treating patients with bradyarrhythmia.Methods:A total of 13 patients with cardiogenic syncope were included from May 2008 to June 2015.Under the guidance of fluoroscopy and/or three-dimensional geometry by 64-slice spiral computed tomography,atrial activation sequence in sinus rhythm was mapped.Chamber geometry was reconstructed manually or automatically using the Niobe Ⅱ magnetic navigation system integrated with the CARTO-remote magnetic technology (RMT) system.Cardioneuroablation was targeted at the high-amplitude fractionated electrograms surrounding the regions of His bundle and the site with the earliest activation in sinus rhythm.Areas surrounding the sinus node,AV node,and the phrenic nerve were avoided.Results:Thirteen patients completed the studies.Ablation was successfully performed in 12 patients and failed in one.The high-frequency potential was recorded in atrial electrograms surrounding the sinus or AV nodes in all the patients and disappeared in 15 s after radiofrequency applications.The vagal reaction was observed before the improvement of the sinus and AV node function.No complications occurred during the procedures.Patients were followed up for a mean of 13.0 ± 5.9 months.During the follow up ten patients remained free of symptoms,and two patients had a permanent cardiac pacemaker implanted due to spontaneous recurrence of syncope.The heart rate of post-ablation was higher than pre-ablation (69.0 ± 11.0 vs.49.0 ± 10.0 beats/min,t =4.56,P =0.008).The sinus node recovery time,Wenckebach block point,and atrium-His bundle interval were significantly shorter after ablation (1386.0±165.0 vs.921.0 ±64.0ms,t=7.45,P=0.002;590.0±96.0 vs.464.0± 39.0ms,t=2.38,P=0.023;106.0±5.0 vs.90.0 ± 12.0 ms,t =9.80,P =0.013 before and after ablation procedure,respectively).Conclusions:Ablation of sinoatrial and AV nodal peripheral fibrillar myocardium electrical activity might provide a new treatment to ameliorate paroxysmal sinus node dysfunction,high degree AV block,and vagal-mediated syncope.

This paper presents a novel monitor which uses ARM controller AT91SAM7S64 as its main processor, LCM (Liquid Crystal Display Module) for displaying ECG waves, SD (Secure Digital memory) card for data storage and RF module PTR8000 for radio data transmission. This portable monitor boasts alarm function for abnormality and can provide dynamic ECG monitoring for patients.
Computer Communication Networks ; Electrocardiography ; instrumentation ; Humans ; Monitoring, Physiologic ; instrumentation ; Signal Processing, Computer-Assisted ; instrumentation ; Telemetry ; instrumentation ; methods

ObjectiveTo study the early diagnosis and prevention of fungal infection in severe acute pancreatitis(SAP). Method 1.SAP patients from July 1998 to June 2002 were prospectively randomized into 3 groups: garlicin prevention group, fluconazole (low dosage) prevention group and control group, the incidence of fungal infection in SAP was compared between the groups. For fungal infection patients, the fungal clearance and mortality rate were observed. 2.Clinical data of SAP patients with fungal infection and with simple bacterial infection was compared by multivariate logistic regression, and clinical characters and risk factors of fungal infection were evaluated. Results 1.There were lower incidences of fungal infection in garlicin group (16% vs. 30%,P

OBJECTIVEThis study sought to analyze the clinical manifestations and intervention of fulminant septic shock in community-acquired Pseudomonas aeruginosa septicemia.

METHODSWe retrospectively reviewed the medical records for diagnosis, antibiotic therapy, clinical course of septic shock, respiratory support, laboratory data etc.

RESULTSEight of nine cases with P. aeruginosa septic shock died. Fever (nine cases) and cough (three cases) or diarrhea (3 cases) were the 2 most common initial symptoms, three cases developed skin gangrenosum later. Pseudomonas aeruginosa infection was not considered in any of the cases before death or blood culture showed positive result. Only 3 cases were initially treated with susceptible antibiotic regimen but no anti pseudomonas combination therapy was applied, susceptible antibiotic monotherapy was applied in 7 cases after transfer to the ICU. The mean latency of shock occurrence was 5.1 hours (range 0 to 21 hours) after admission, the mean duration from the occurrence of shock to death was 13.8 hours (range, 1 - 32 hours). All the patients were transfer red to ICU for shock, the appropriate resuscitation of shock patients was delayed by 49.3 minutes (range 25 - 80 minutes) by transfer. Only two cases were diagnosed and treated for shock on admission; after transferred to ICU, only 5 patients were diagnosed as having shock, and only 3 received anti-shock treatment. Eight of the patients died of persistent shock. In 6 patients who died, mechanical ventilation was not applied until cardiac arrest occurred. All the patients had hypoalbuminaemia, elevated serum C-reactive protein concentration, leukopenia and 6 cases had DIC.

CONCLUSIONThe initial presentation of the cases with community-acquired Pseudomonas aeruginosa septicemia was nonspecific with fever and cough or diarrhea. Clinicians often underestimated the severity of the infection, few patients received effective antimicrobial therapy. The authors suggest that an anti-pseudomonas antibiotic should be included in the initial empiric antibiotic regimen to cover P. aeruginosa high-risk patients; the front-line clinician should be educated for early recognition and aggressive resuscitation of P infection. aeruginosa septicemia.

Adolescent ; Child, Preschool ; Community-Acquired Infections ; Female ; Humans ; Infant ; Male ; Pseudomonas Infections ; Pseudomonas aeruginosa ; Retrospective Studies ; Shock, Septic ; microbiology