Acute Disease ; Female ; Humans ; Infant ; Infant, Newborn ; Propionates ; blood ; Pyruvate Carboxylase Deficiency Disease

[Summary] A total of 108 cases of endoscopic thyroidectomy via thoracic approach were conducted in our department between January 2012 and January 2015.The comfortable nursing was applied during the operation.The patients’ body position was adjusted properly according to requirements of the operation at different periods of pre-operation, intra-operation and post operation.No complications due to nursing mistakes or improper position occurred in the 108 patients. Follow-up checkups on the second postoperative day found 2 patients with vomiting.According to the Wong-Banker Faces Pain Scale to evaluate the head and back pain, there were 46 cases of 0 point, 51 cases of 1 point, 11 cases of 2 points.We got the conclusion that the application of comfortable nursing for proper position of patient not only reflects the nursing principle of Patients First, but also improves the entire quality of nursing services.

Objective To investigate the health-related quality of life (HRQOL), demographic characteristics, and health behaviors of the Chinese elderly to find out high-risk population and behaviors. Methods Data was collected from a cross-sectional survey performed in Jiangsu, Anhui, Gansu,Qinghai, Fujian, Beijing, Jilin, Jiangxi, and Henan province. MOS SF-36 was used for HRQOL assessment, t test was used for HRQOL comparison between the elderly and the general population. Multiple stepwise linear regression analysis was used to evaluate the affecting factors. Results The HRQOL among the Chinese elderly were PF ( Physical Functioning) 79 ± 21, RP ( Role-Physical ) 68 ± 40, BP ( Bodily Pain) 72 ± 23, GH ( General Health) 57±22, VT ( Vitality ) 69 ± 20, SF ( Social Functioning) 79 ± 23, RE ( Role-Emotional ) 72 ±40, M H ( Mental Health)76 ± 18, which were lower than Sichuan Norm on 7 dimensions ( P ＜ 0. 05 ; except on M H dimension) and lower than Hangzhou Norm on 5 dimensions (P ＜ 0. 05 ;except on GH, VT, and MHdimensions). The important affecting factors included physical exercise, education level, medical history of chronic disease, age, race, marriage, body mass index ( BMI ), sleeping habits, and gender. Conclusions Compared with the general population, the HRQOL in the elderly might be lower. The health policy and community heahhcare services should focus on the elderly individuals with insufficient exercise, lower education level, chronic disease history, and ethnic minority, or widows. Health education should encourage them to improve physical exercise and sleeping behavior.

Objective To analyse the sonographie characteristics of thyroid nodules after injection and investigate the contrast enhanced ultrasonography. Methods Analysed the sonographic characteristics in 32 cases and observed the dynamic enhancement pattern of nodules by the time-intensity curve(TIC). The evaluated parameters were arrival time (AT), time to peak(TTP), peak intensity(PI). Results Thyroid cancer (12 cases) showed early wash in an early wash out in comparison with the adjacent thyroid parenchyma, and the enhancement intensity [AT(7.49 ± 4.45), TIP( 17.41 ± 2.84), PI( 18.56 ± 5.24) s] were lower than nodular goitre (20 cases) [ AT ( 13.22 ± 3.30), TIP (20.92 ± 2.59), PI ( 19.15 ± 5.47 ) s ] (P < 0.05 ). Conclusion The contrast enhanced ultrasonography may provide a useful method for the diagnosis of thyroid cancer.

Objective To investigate the expression of monocyte chemoattractant protein-1(MCP-1)and CCR2 in peripheral blood and pleural fluid of tuberculous pleurisy patients.Methods Flow cytometry was used to detect the expression of CCR2 in the peripheral blood mononuclear cell and pleural fluid cell of tuberculous pleurisy patients;ELISA was used to detect the content of MCP-1 in serum and pleural fluid.Results MCP-1 in surem and pleural fluid and CCR2 in the peripheral blood mononuclear cell and pleural fluid cell of tuberculous pleurisy patients was significantly higher than that of the healthy normal controls[MCP-1:(340.8±220.8)and(9.0±3.8)ng/L,P＜0.01;CCR2(18.2±10.1)%and(6.9±3.5)%,P＜0.05];Both MCP-1 and CCR2 were detected in pleural fluid and both of them were positivley correlated(r=0.227,P＜0.05).Conclusion The expression of MCP-1 and CCR2 in peripheral blood of tuberculous pleurisy patient are significantly elevated which are significance molecule participating in the pathogenesis of tuberculous pleurisy.

Objective:To investigate the number and distribution of macrophages (Mφ) and natural killer(NK) cells in hepatocellular carcinoma (HCC), paraneoplastic,cirrhosis and normal liver tissues and their relationship with the prognosis of HCC patients.　Methods:Surgical specimens from 60 cases of HCC, 62 cases of cirrhosis and 23 cases of normal liver tissues were investigated by immunohistochemical staining of CD68 and CD57 with a streptavidin-horseradish peroxidase detective system.The correlation of the number of Mφ and NK cells in different tissues with the clinical tumor parameters was also studied.　Results:①The order of the number of Mφ from the highest to the lowest was:paraneoplastic,cirrhosis, normal, HCC(P<0.05)；and the number of NK cells from the highest to the lowest was:HCC, paraneoplastic, normal, cirrhosis(P<0.05).②The number of Mφ decreased successively with the decrease of the HCC differentiation(P<0.05)；There was no relationship between the number of NK cells in HCC and histological grade. ③There was no relationship between the number of Mφ in HCC and clinical TNM stage ；The number of NK cells in HCC had degressive tendency with the clinical TNM stage(P<0.05). ④The number of Mφ and NK cells in HCC in the cases with metastasis in 15 months was significantly lower than that without metastasis(P<0.05, 0.01）.⑤There was a linear positive correlation between the number of Mφ and NK cells in HCC (r＝0.344, P<0.05).　Conclusion:The number of Mφ and NK cells in HCC in the cases with metastasis is significantly lower than that without metastasis；The number of Mφ has a close correlation with the HCC differentiation, and positive correlation with the number of NK cells；The number of Mφ and NK cells might be important markers to estimate the immune status and useful factors to predict the prognosis of HCC patients.

Objective:To investigate the number of CD+68 cells in hepatocellular carcinoma (HCC),paraneoplastic tissues,cirrhosis tissues and normal liver tissues and their clinical significance.Methods:Surgical specimens from 60 cases of HCC,62 cases of cirrhosis and 23 cases of normal liver were investigated by immunohistochemical staining of CD+68with streptavidin-horseradish peroxidase detective system.Results:(1)The order of the mean number of CD+68cells in the tissues from the highest to the lowest was:paraneoplastic,cirrhosis,normal liver and HCC tissues(P〈0.01);(2)The number of CD+68cells in the tissues decreased successively with the decrease of HCC differentiation (P〈0.05);(3)There was no relationship between the number of CD+68cells in HCC and its clinical TNM stage;(4)The number of CD+68cells in the cases with metastasis within 15 months was significantly lower than that without metastasis (P〈0.05).Conclusion:The number of CD+68cells might be an important marker to estimate the immune status and a useful factor to predict the prognosis of HCC patients.

Objective To investigate the imaging differentiation between high-grade and low-grade limb of long bone chon-drosarcoma.Methods The MRI imaging features in 23 cases of pathologically proven limb long bone chondrosarcomas were retro-spectively analyzed,including 13 cases of low-grade and 10 cases of high-grade.The MRI imaging features including endosteal scal-loping lesion,cortical thickening,cortical destruction,bone expansion,soft tissue mass,bone marrow edema,soft tissue edema,calci-fication,hemorrhage,tumour maximal radial line and enhancing features were performed the statistical analysis.Results 13 cases were the low-grade chondrosarcomas,including atypical cartilaginous tumour and grade 1 chondrosarcomas,10 cases were high-grade chondrosarcomas (8 cases of grade Ⅱ chondrosarcomas,1 case of gradeⅢ chondrosarcomas and 1 case of dedifferentiated chondrosarcomas).Cortical destruction,soft tissue mass and soft tissue oedema had statistical differences between the low-grade and high-grade.Bone marrow had statistically significant difference.Calcification +(SC<1/3ST)had statistical difference between the low-grade and the high-grade.Calcification ++(1/3 ST

Objective To investigate the clinical value of medical image-three dimensional visible system (MI-3DVS) in percutaneous transhepatic cholangioscopy lithotripsy (PTCSL) for the treatment of hepatolithiasis.Methods The clinical data of 66 patients with hepatolithiasis (55 were from the First People's Hospital of Shunde City and 11 were from the Zhujiang Hospital) were retrospectively analyzed.The images of computed tomography were three-dimensionally reconstructed with MI-3DVS.The location,number,size,shape of the stones were figured out,and the operation strategies of PTCSL were designed according to the types of the disease.The clinical value of MI-3DVS was evaluated according to the operation results and postoperative recovery of patients.All the patients were followed up via telephone or out-patient re-examination.Results Liver,biliary system,stones and blood vessels were three-dimensionally reconstructed with the MI-3 DVS,and the size,number,shape,location of the stones and location,degree,length of the biliary stricture and its anatomical relationship with adjacent blood vessels were clearly displayed.The coincidence rate of planned and actual operations was 95.5％ (63/66).The mean operation time,intraoperative blood loss,rate of stone clearance,complication rate and duration of hospital stay of 63 patients were (117 ± 9) minutes,(18 ± 1) ml,92.4％ (61/66),6.1％ (4/66) and (15 ± 4) days,respectively.All the patients were followed up till September 2012,the median survival time was 16 months (range,1-69 months),and the recurrence rate of hepatolithiasis was 9.1％ (6/66).One patient died of tumor metastasis and multi-organ dysfunction syndrome postoperatively.Conclusion MI-3DVS could effectively improve the safety and efficiency of PTCSL for patients with hepatolithiasis.

Three viewpoints have been refined from the research on present situation of Medical Ethics teaching,and are probed out as followed:①The position of Medical Ethics in medical education has been underestimated and even ignored;②Dull teaching means、rigid teaching content and informal testing pattern were the drawbacks of Medical Ethics teaching model;③Compared with its external counterpart,the internal medical ethics teaching model requires to be improved.This article aims to provide direction and foundation for the optimizing research of Medical Ethics teaching model.