Arthroscopy ; methods ; Humans ; Knee Injuries ; surgery ; Shoulder Joint ; injuries

Chemical and Drug Induced Liver Injury ; Humans

Humans ; Myocardial Infarction ; diagnosis ; Takotsubo Cardiomyopathy ; diagnosis

Objective To evaluate the safety and therapeutic value of endoscopic sphincterotomy by endoscope to the patients with common duct stones after their gallbladders resected. Methods 158 patients with common duct stones after their gallbladders resected were given the treatments of endoscopic sphincterotomy and nasobiliary drainage in recent 4 years. Results 153 of 158 patients got succeed. The symptoms obviously improved such as jaundice and fever and epigastric distention and so on. As for the postoperative complications, the hyperamylasemia occurred in 85 patients of all patients,and active hemorrhage in 2 patients,and acute pancreatitis in 16 patients,and cholangitis in 5 patients,but no one occurred biliary fistula,no one died,too. Conclusion EST is the best way for us to treat the patients with common duct stones after their gallhladders resected by endoscope,and its curative effect is sure and its safety coefficient is higher.

The standardized resident training is an important and necessary way to cultivate high-quality medical talents.The goals between clinical and imaging residents in standardized training of ultrasound department are different.For clinical residents,the purpose is to understand the ultrasound images of various common diseases,combine clinical manifestation with ultrasound images,and improve the level of clinical diagnosis and treatment.For imaging residents,the goal is much higher and stricter;they need to master solid ultrasonic knowledge,independent operational and diagnostic ability,in order to provide reliable and accurate ultrasonic diagnosis.We individually design the teaching plan and methods in ultrasound department,in order to improve teaching efficiency and quality.

ObjectivesTo observe correlation between serum vitamin A status and prevalence or severity of NRDS. MethodsRecruited into this study were 166 preterm infants admitted to our neonatal department. The serum concentration of vitamin A was measured, and the prevalence of NRDS at different levels of vitamin A was compared. According to the clinical manifestation and X-rays, there were 30 infants diagnosed as NRDS. Another 30 patients from the rest 133 infants without NRDS were randomly selected as control group according to the gestational ages, then the difference between NRDS group and control group were observed according to gestational ages. The 30 preterm infants with NRDS were divided further into mild group (in-cluding stagesⅠandⅡ,n=18) and severe group (including stageⅢ andⅣ,n=12) according to ifndings chest X-ray, then the difference between these two groups were observed.ResultsIn the 166 preterm infants recruited, 65/166 had serum vitamin A lower than 0.35 μmol/L, in which 14/65 (21.54%) were NRDS patients. Another 93/166 patients had serum vitamin A ranged from 0.35 μmol/L to 0.7 μmol/L, in which 15/93 (16.13%) were NRDS patient. The rest 8/166 had serum vitamin A higher than 0.7 μmol/L, in which 1/8 (12.50%) were NRDS patient. However, the differences between each two groups were not signiifcant. When gestational ages ranged from 34 to 37 weeks, the serum concentrations of vitamin A of NRDS group were lower than that in controls (P<0.05). No signiifcant difference between the serum concentrations of vitamin A and the severity of NRDS were ob-served (P>0.05).ConclusionsThe prevalence of NRDS for those preterm infants lacking of vitamin A was tended to increase. And the late preterm infants (34 w≤ GA <37 w) with vitamin A deifciency are prone to NRDS.

Objective To investigate the relationship between gestational hypothyroidism and preeclampsia.Methods A retrospective study was conducted on 1 776 patients with gestational hypothyroidism,who gave birth in the International Peace Maternity & Child Health Hospital of China Welfare Institute,Shanghai Jiaotong University School of Medicine from January 2013 to December 2014.They were divided into three groups,including Improving Group (n=1 469),Progressing Group (n=133) and Remaining Group (n=174),based on their thyroid function at the first and third trimesters.Levels of thyroid hormones in the first and third trimesters were analyzed.Incidences of preeclampsia in those patients were calculated.And the correlation between thyroid function and incidence of preeclampsia was analyzed.T-test,Mann-Whitney U test,Chi-square test,variance analysis (SNK method) and Kruskal-Wallis H test or Logistic regression were performed for statistical analysis.Results (1) There were no statistical differences in age,gravidity and parity among the three groups.The pregestational body mass index in Progressing Group was lower than that in Improving group (21.1 ±2.9 vs 21.8±2.8,P＜0.05).(2) In the first trimester,the level of thyroid stimulating hormone (TSH) in Remaining Group was higher than those in Improving and Progressing Groups [(4.21 ± 1.69) vs (3.77±.3.03) and (2.00±0.57) mU/L,F=27.635,P＜0.01],and that in Improving Group was higher than that in Progressing Group (P＜0.05).The level of free thyroxine (FT4) in Progressing Group was higher than those in Improving and Remaining Groups [(16.18±9.67) vs (14.58± 1.71) and (14.54± 1.74) pmol/L,F=16.188,P＜0.01].In the third trimester,the TSH level in Remaining Group was higher than those in Improving and Progressing Groups [(5.07±0.86) vs (2.57±0.77) and (4.31 ±0.87) mU/L,F=28.986,P＜0.01],while the TSH level in Improving Group was higher than that in Progressing Group (P＜0.05).No statistical differences in FT4 levels (in the third trimester) and positive rates of thyroid peroxidase antibody (TPOAb) Were observed in the three groups.(3) Blood pressures (including diastolic and systolic blood pressures) in the first trimester and diastolic pressures in the third trimester showed no significant differences among the three groups.Systolic pressure of Improving Group in the third trimester was lower than that of Progressing Group [(119.4± 11.9) vs (121.8± 14.2) mmHg,P＜0.05,1 mmHg=0.133 kPa].(4) The incidence of preeclampsia in Progressing Group was higher than those in Improving and Remaining Groups [7.52％ (10/133) vs 1.29％ (19/1 469) and 3.45％ (6/174),x2=26.646,P＜0.01],and the incidence in Progressing Group was higher than those in Remaining and Improving Groups (both P＜0.05).The incidence of severe preeclampsia in Progressing Group was higher than that in Improving Group [6.02％ (8/133) vs 0.41％ (6/1 469),P＜0.05].There were no significant differences in incidences of mild preeclampsia among the three groups.(5) After adjusting for age,body mass index,gravidity and parity,the risk of severe preeclampsia in Improving Group was lower than that in Remaining Group (OR=0.233,95％CI:0.057-0.946,P＜0.05).Conclusions By improving thyroid function in pregnant women with hypothyroidism,the risk of preeclampsia,especially severe preeclampsia,could be reduced,which could improve maternal and neonatal outcomes.

The suprachoroidal space (SCS) is the potential space between the sclera and choroid.Drugs delivered through SCS can bypass the sclera,avoiding clearance by conjunctival and scleral blood vessels and lymphatic circulation,so that more drugs can reach the disease tissues such as choroid and retina.SCS drug delivery does not disrupt the ocular integrity,is safer than the intravitreal drug injection and more effective than trans-scleral drug delivery.In addition,SCS delivery only needs a very small volume of drug,which makes it possible to be carried out in multiple parts of the sclera,and the specific disease area can be more precisely targeted.SCS drug delivery is suitable for the treatment of choroidal and retinal diseases.However,currently SCS drug delivery is still a novel field and many aspects need to be more in-depth studied,including its safety,delivery methods,drug formulation and effectiveness.

Over the past decade , with the rapid increase of the incidence of idiopathic membranous nephropathy (IMN) in our country, the diagnosis and treatment of IMN has been paid more and more attention.IMN is an autoimmune disease.Two important podocyte autoantigens , PLA2R and THSD7A, have been indentified sine 2009.Subsequently , serum anti-PLA2R antibody test and anti-THSD7A antibody test have also been used in clinical .Preliminary applications show that these two tests can not only help IMN diagnosis and differential diagnosis , but also help IMN prognosis.

The principal role of neutrophils in tissue repair has long been thought to be confined to killing bacteria and clearing necrotic tissue. However, recent studies have shown that neutrophils are also one of the sources of pro inflammatory cytokines and growth factors, such as IL 1, TNF ?, bFGF, VEGF,TGF ? 1 that probably serve as the earliest signals to activate local fibroblasts, epidermal cells and vascular endothelial cells and initiate tissue repair. It was also reported that neutrophils improved the proliferation removal of injured epithelial cells in airway and corneal epithelial cells. It is very important for the successful tissue repair that the function of neutrophils is normal.