Objective To investigate the pediatric intensive care unit (PICU) in critically ill children with pediatric critical score (PCIS) and pediatric death risk score (PRISM),comparing its value.Methods A total of 100 cases of matching children with acute respiratory distress syndrome (ARDS) to stay in our hospital during 2007.07 ～2012.07 was retrospectively analyzed.Check PICU most serious disease in this group of children,living PICU most severely ill when diagnosed with acute respiratory distress syndrome (ARDS),when it was suffering from ARDS most serious line PCIS with PRISM score,and then using the Logistic multiple regression to analyze the scores of the two scoring ability as predicting the ARDS death in children with risk factors,and using two-factor analysis of variance of the two scoring methods by judging linear correlation existence.Results (1)PCIS with PRISM score showed a negative correlation (r=-0.6031,P ＜0.01),the linear regression equation y =-0.2389x +74.816 (P＜0.01).(2) There was no statistical difference between the ARDS death group and survival group (P ＞ 0.05) ; By PCIS PRISM score LOGISTIC regression analysis of the risk of death in children,there was no statistical difference (P ＞ 0.05).Conclusions PCIS and PRISM score cannot be the standards to forecast the death of the ARDS patients,but can provide an objective referring standard of ARDS's treatment.

Adult ; Cerebrospinal Fluid Rhinorrhea ; surgery ; Endoscopy ; adverse effects ; Humans ; Male ; Pneumocephalus ; etiology

Adolescent ; Adult ; Child ; Child, Preschool ; China ; epidemiology ; Disease Outbreaks ; Female ; Herbicides ; poisoning ; toxicity ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Paraquat ; poisoning ; toxicity ; Risk Factors ; Time Factors ; Young Adult

Objective To investigate precipitants of epileptic seizure, and to explore the correlation between various precipitants and relationship between precipitants and clinical features of epilepsy.Methods Data were collected from 154 patients attending a tertiary-care epilepsy clinic of Nanjing Brain Hospital between April 2015 and April 2016.The patients with epilepsy were older than 16 years, had a clinical history of one year or more, and one seizure at least a year and one seizure at least in the latest three months.An enclosed questionnaire was combined with open interview to identify and characterize seizure precipitants and clinical characteristics of patients.Patients were asked respectively whether there were some precipitants three months before and during last three months.Correlation between seizure precipitants and relationship between precipitants and clinical characteristics, such as age, gender, course, seizure frequency and so on, were calculated.Results A total of 125 (81.2%) participants reported at least one precipitant.Common precipitants (in descending order) were as follows: emotional stress (56.0%), sleep disorder (38.4%), fatigue (27.2%), missed medication (20.0%).There were one to six different precipitants for one patient, and 60.8% of patients had two or more precipitants.There was a correlation between emotional stress and sleep disorders as well as fatigue (χ2=4.665, 8.668;P<0.05).Patients with idiopathic epilepsy were more sensitive to sleep disorders.There was no relationship between total precipitants and clinical features such as age, gender, age of onset, duration, type of seizure, seizure frequency, number of drug taking and so on.Conclusions Seizure precipitants were found widespread.The most common precipitants were found to be emotional stress, sleep disorders, fatigue and missed medication.There existed a correlation between emotional stress and sleep disorders as well as fatigue.There was no connection between total precipitants and patient′s demographic characteristics as well as clinical features.However, the type of seizure precipitants was different in patients with different demographic and clinical characteristics.

Holmium ; Humans ; Kidney ; Lithotripsy, Laser ; Shock, Hemorrhagic ; Ureteroscopy

Objective To investigate the effects of Zuogui Jiangtang Yishen decoction (ZGJTYS) on the expression of nephrin and podocin in podocyte of MKR mice with diabetic nephropathy (DN), and explore its mechanism. Methods Forty MKR mice (8 weeks old) were randomly divided into four groups as follows:negative control group (group A), DN model group (group B), ZGJTYS group (group C) and positive control group (group D, Gliquidone and benazepri). All mice from group B, C and D were received high-fat diet feed and unilateral nephrectomy. Four weeks after operation, all mice were received drug intervention, and four weeks later, all mice were put to death. The levels of UmAlb were observed by ELISA, the serum BUN and Cr by biochemical, and the FBG by electrochemical detection method. The nephrin and podocin mRNA expression were measured by RT-PCR and the protein expression by western blotting. The morphological structure changes of the podocytes were observed by transmission electron microscopes. Results As compared with group A, FBG, BUN, SCr and urine UmAlb in the mice of group B increased significantly (P<0.01), the expression level of nephrin and podocin mRNA and protein were markedly decreased (P<0.01). After intervention of drugs, all biochemical indicators above in the mice of group C and D significantly decreased (P<0.01), the expression level of nephrin and podocin mRNA and protein were markedly increased (P<0.01, P<0.05), compared with group B. The renal pathological lesions of group C and D were significantly improved compared with group B. Conclusion ZGJTYS decoction exerts reno-protective effect via reinstating nephrin and podocin expression to repair the damaged podocyte.

Dextroscope workstation is an advanced equipment developed in recent years and isused to make virtual reality model.We not only used it in surgical planning of thyroid disease,but also applied it in clinic teaching.Application of Dextroscope virtual reality system can help to improve students'capabilities of clinical thoughts and clinical techniques,stimulate their learning interest,enlarge the knowledge,shorten learning curve and release the conflict in practice.Dextroscope system will push forward the progress of education reform,so it is worth spreading.

Objective To assess the feasibility of ultrasmall superparamagnetic iron oxide (USPIO)-enhanced magnetic resonance imaging (MRI) for monitoring the phagocytic activity in the brain tissue of rats following focal cerebral ischemia-reperfusion (IR) injury. Methods Forty male SD rats were randomized into 5 groups, namely 2, 3, 5-triphenyltetrazolium chloride (TTC) staining group (n=4), sham-operated group (n=6), and 3 cerebral IR injury groups with reperfusion time of 24, 48, and 72 h (n=10). USPIO was intravenously injected after focal cerebral IR injury, and MRI was performed at 24, 48, and 72 h after the reperfusion. The rats were sacrificed at 24, 48 and 72 h, and frozen sections of the local brain tissues were prepared to observe the cell death with HE staining, iron particle distribution with Prussian blue staining and the activity of the macrophages by CD68 immunohistochemical staining and immunofluorescent labeling. Results The ischemic lesions were identified as hyperintense area on T2-weighted images (T2WI) after middle cerebral artery occlusion (MCAO). The accumulation of USPIO appeared as hyperintense areas on T1WI and hypointense area on T2WI. The maximum signal change was observed at 24 h on T1WI (1.60±0.28) and at 48 h on T2WI (0.92±0.17) (P<0.05), and at each of the time points, the enhancement was significantly greater on T1WI than on T2WI (P<0.05). No obvious signal changes were found in the control group. Prussian blue staining detected iron oxide particles in both the peripherals of the ischcmic region and the necrotic area. A similar distribution pattern of the macrophagcs or activated microglia was found by CD68 immunohistochemistry and immunofluorescent labeling. Conclusion USPIO-cnhanced MRI allows dynamic monitoring of the inflammatory reaction in the local brain tissues aftcr focal cerebral IR injury.

Thorough excavation and artful utilization of various kinds concrete and invisible learning resources contribute to the cultivation of excellent postgraduates.In postgraduate education of anesthesiology Xuzhou Medical College utilizes time,network,technique platform,research outcome,self-potentiality and clinical patients resources,which produces an active effect and has important instructional significance.