Objective:To explore the clinical value of dual-source CT direct method lower extremity deep vein CT angiography (DSCTV) and Doppler ultrasound (DUS) in the diagnosis of thrombosis in inferior vena cava and bilateral lower extremities deep venous.Methods: 40 suspected patients with lower extremities deep vein thrombosis (DVT) were enrolled to accept DSCTV, and the every original image data of this detection was analyzed by using multi- mode image reconstruction analysis. One week before and after DSCTV, all of patients need carried out DUS detections for inferior vena cava and bilateral lower extremities deep venous. 22 cases of these patients were detected by lower extremity deep vein X-ray digital subtraction angiography (DSA).Results: There was better consistency for diagnosis results between DUS and DSCTV, and their Kappa value was 0.784. The sensitivity, specificity and accuracy of DUS for lower extremity DVT, respectively, were 93.4%, 86.7% and 91.6%, and each result of DUS was lower than that of DSCTV (sensitivity with 97.2%, specificity with 91.1% and accuracy with 95.6%). By drawing ROC curve, the AUC value of DUS was 0.897, and that of DSCTV was 0.936, while the difference between them was no significant (Z=1.143,P>0.05).Conclusion: DSCTV possesses unique scanning and post-processing technique, which has a good reference value in the diagnosis for DVT

0.05). It was significantly related to tumor differentiation, lymph node metastasis,Dukes staging(P

By reviewing the research situation of the acupuncture therapy for mild cognitive impairment(MCI) in recent decade,we has analyzed, concluded and reviewed the clinical effect of different acupuncture methods on MCI, in order to provide reference for acupuncture therapy becoming an important invention measure in protecting against dementia.

Objective To compare the treatment effects between minimally invasive transthoracic device closure and traditional surgery on ventricular septal defect (VSD) in infants. Methods Data of 91 infants of VSD, who were less than 6 years old, were retrospectively analyzed from October 2013 to February 2015 in the department of cardiac surgery in Tianjin Chest Hospital. According to the operation mode, patients were divided into minimally invasive transthoracic device closure of VSD (closure) group (n=13) and traditional VSD repair under cardiopulmonary bypass (CPB, repair group, n=78) group. The preoperative cardiac ultrasound was used to determine the type of VSD, the distance from the margin of VSD to aortic and tricuspid valve, pulmonary artery pressure and other cardiac malformations. The intraoperative and postoperative monitoring included blood transfusion volume, valve regurgitation, mechanical ventilation time, intensive care unit (ICU) residence time, hospitalization time and hospitalization cost. The patients were followed up regularly after surgery to collect data including arrhythmia, hemolysis, valve regurgitation and residual shunt of VSD. Results There was no operative mortality in 91 patients. In closure group 1 case was converted to traditional repair surgery under CPB. There were significantly less values in ICU residence time and hospitalization time in closure group than those of the repair group[(13.2±11.7) h vs. (77.2±55.8) h, and (10.0±3.2) d vs. (15.8± 6.7) d, P<0.05]. In closure group 1 case (7.7%) underwent median sternotomy and CPB. All cases in repair group underwent median sternotomy and CPB. The infusion amount of suspended red blood cells, plasma and the time of mechanical ventilation were less in closure group than those in repair group (P < 0.05). There were no significant differences in the incidence of complications during early postoperative and the follow-up period, including arrhythmia, VSD residual shunt, valve regurgitation, hemolysis, and the cost of hospitalization between two groups (P>0.05). Conclusion In the comparison of the recent or short-term clinical curative effect of VSD treatment in infants, the minimally invasive transthoracic VSD device closure is better than the traditional VSD repair treatment. Long term effects need to be further observed and followed up.

Objective To understand the gene distribution and drug resistance rate of integron gene of extended spectrumβ‐lac‐tamases(ESBLs) producing Klebsiella pneumonia infection in ICU elderly patients in order to provide the basis for rational use of antimicrobial agents .Methods The BioMerieux VITEK‐2 Automated Microbes Identification System was adopted to conduct the bacteria identification and drug susceptibility test on various clinical specimens of ICU elderly patients in our hospital from January 2013 to December 2015 .The integron gene in 167 strains of ESBLs‐producing Klebsiella pneumoniae was analyzed by PCR ,and the gene was identified by sequencing .Results Among 386 strains of Klebsiella pneumoniae ,the detection rate of ESBLs‐producing strains was 43 .26% ;the positive rate of integron was 50 .89% ,the detected integron was class Ⅰ integron;aadA2 ,aadA1 ,aada16 , dfra27 and arr‐3 genes were amplified from integron variable region;the drug resistance rate of ESBLs‐producing integron gene pos‐itive strains was significantly higher than that of integron gene negative strains .Conclusion the ICU elderly patients with ESBLs‐producing Klebsiella pneumoniae infection is closely related to the integron gene and integron plays an important role in bacterial drug resistance .

Evidence-Based Practice ; Humans ; Practice Guidelines as Topic

Evidence-Based Medicine ; Evidence-Based Practice ; Humans ; Practice Guidelines as Topic

Evidence-Based Practice ; Practice Guidelines as Topic

Objective To develop a portable analyzer which can rapidly detect antigen of type B hepatitis,antibody of HIV and H5N1 in blood samples.Methods The micro-processor of STC89C52 was adopted as the controlling core in the system.Based on an embedded technology,the analyzer can rapidly detect the antigen of type B hepatitis,antibody of HIV and H5N1 by processing the synchronic frequency of quartz crystal micro-array and by sensitivity of quality on the surface of quartz crystal with special identification between antibody and antigen.Results The system has the advantages of high sensitivity,better sample-specific characteristics,convenient portability and multi-parameter simultaneous detection.Conclusion The piezoelectric analyzer exceeds the traditional reagent method and serves for institution of scientific research and hospital widely.

Objective To investigate the influence of Bupivacaine injection speed on blood pressure of patients undergoing cesarean section.Methods 90 patients(ASAⅠ-Ⅱ)who underwent cesarean section were selected with combined spinal-epidural anesthesia were divided randomly into three groups(20 for each).0.5% bupivacaine 1.4ml(7mg),the speed of injection in group A,group B and group C is 10 seconds,20 seconds,30 seconds.Systolic blood pressure(SBP),Diastolic blood pressure(DBP)and Heart rate(HR)were recorded before anesthesia and 5min,10min,15min and 30min after anesthesia.Cases need to be added epidural drug were all recorded.Results The age,body length and body weight in the three groups has no significant difference,location of injection and posture were same.The best effect of anesthesia was founded in group B,blood pressure(BP)and HR was stable.The effect of anesthesia was better but BP and HR were obviously descent in group A.The block level of anesthesia was unsatisfactory and need to add epidural drug in group C.Conclusion The injection speed of 0.5% bupivacaine 1.4ml in combined spinal-epidural anesthesia is suitable of 20 seconds when patients underwent cesarean section.