Objective To explore the measure to diminish the misdiagnosis of Budd-Chiari syndrome.Methods 46 cases of Budd-Chiari syndrome were analyzed.Results 33 cases had ever been misdiagnosed with average time of 5.3 years.One of the main clinical symptoms was the pathological process of lower limb(84.8%).Doppler color flow imaging examination showed positive rate of 100% in liver veins and inferior vena cava,,but none of the misdiagnosed cases received this examination.The viral marker test had a positive rate of only 4.3% that was not higher than that of general population.Conclusion Budd-Chiari syndrome has a variety of symptoms,so Doppler color flow imaging is considered an important means to diagnose this disease.

Objective To observe the effects of misoprostol on prevention of postpartum hemorrhage.Methods 200 cases of full-term pregnancy intravaginal labor were randomly divided into misoprostol groups (n=100) and control groups (n=100).The misoprostol groups were treated with misoprostol 400 μg PO after labor and control groups were treated with oxytocin 20 U IV after labor.Results The average time interval of the third stage was (6.10±3.35) min in misoprostol groups,whereas (10.00±3.45) min in controls.There was significant difference between two groups (P＜0.01).The average quantity of blood loss in 2 h after labor was (150.30±34.00) ml in misoprostol groups,whereas (240.60±57.30) ml in controls.Conclusion Better effects of misoprostol than oxytocin were proved on preventing postpartum hemorrhage.

Objective To investigate the changes of lipopolysaccharide binding protein(LBP) in serum and ascites in patients with liver cirrhosis and its clinical significance. Methods Ninety?six cases of liver cir?rhosis patients who were treated in the NO. 202 Hospital of People's Liberation Army from January 2013 to De?cember 2015 were selected as research subjects,and were divided into liver cirrhosis with spontaneous bacterial peritonitis(SBP) of 27 patients as SBP group,69 cases of patients with liver cirrhosis as non?SBP group accord?ing to the clinical diagnosis. The level of LBP in serum and ascites,routine blood test and liver function indica?tors of two groups were detected and comparative analyzed. Receiver operating curve( ROC) was drawn to select LBP diagnosis best critical value of SBP. Results The level of LBP in serum and ascites of SBP group were significantly higher than that of non?SBP group((43. 2±10. 6) μg/L vs. (19. 5±7. 5) μg/L,(280. 6±73. 9)μg/L vs. (127. 4±42. 0) μg/L),and the difference was statistically significant(t=12. 324,7. 892;P<0. 05) . ROC curve showed that the diagnosis of SBP sensitivity was 82. 30%,the specificity was 78. 36%,the area un?der ROC curve AUC value was 0. 821 when Cut?off value of LBP in ascites was 23. 5 g/L;the diagnosis of SBP sensitivity was 85. 59%,the specificity was 81. 24%,the area under ROC curve AUC value was 0. 856 when Cut?off value of LBP in serum was 152. 1μg/L. Conclusion LBP levels in serum and ascites in cirrhotic patients for the differential diagnosis of SBP has some clinical value.

Objective To investigate the changes of Treg cells,Th17 cells and related cytokines in pe?ripheral blood of patients with severe hand?foot?mouth disease( HFMD) in the initial stage of infection caused by Enterovirus 71 virus. Methods Thirty?five cases of severe HFMD children in the Fifth Hospital of Shijiazhuang from May 2013 to December 2013 were selected as the research subjects,including 27 cases of severe formed group and 8 cases of danger severe formed group. The frequencies of Th17 cells ( CD3+CD8?IL?17+) and Treg cells( CD4+CD25+Foxp3+) in peripheral blood were detected by flow cytometry in patients with severe HFMD and 31 healthy children(control group). Moreover the serum levels of interleukin 6(IL?6),interleukin 17(IL?17) ,interleukin 10( IL?10) ,interleukin 23( IL?23) ,and human transforming growth factorβ1 ( TGF?β1) were measured by ELISA. Results As compared with those in control group,the frequencies of Treg cells,ratio of Treg/Th17,serum levels of TGF?β1, IL?10 in severe HFMD groups were significantly decreased ( F=23. 23, 30. 88,10. 766,11. 680 respectively;P<0. 05) . However the frequency of Th17 cells,serum levels of IL?6,IL?17,IL?23 in severe HFMD groups were significantly increased( F=646. 81,5. 904,10. 557,3. 490 respectively;P<0. 05) . Conclusion The changes of Treg and Thl7 cells and related cytokines appear in peripheral blood of patients with HFMD in the initial stage of infection caused by Enterovirus 71 virus. The frequency of Treg cell is decreased,however,the frequency of Thl7 cells frequency is increased,as a result,which may spread inflammato?ry reaction and cause complication.

Objective To study the effect of the deferoxamine mesylate on the prognosis of patients with intracerebral hemorrhage(ICH) after one year. Methods From February 2013 to May 2014,spontaneous ICH patients diagnosed by computed tomography ( CT ) within 18 hours of onset in Mancheng District Hospital of Baoding were evaluated. Patients were randomly divided into experimental group and control group. The treatment of the two groups was similar except that the experimental group received deferoxamine mesylate. Patients were e?valuated by CT and neurology scale( NIHSS scale,GCS scale) at the time of admission and followed up for the first year by the RANKIN( mRS) scale. All clinical data of the two groups were compared. Results Forty?two patients were included in the study, including 21 cases in the experimental group and 21 cases in the control group,there was no significant difference in baseline data between the two groups at admission. There were 6 pa?tients with mRS ≥3 in the experimental group, and 6 patients with mRS ≥3 in the control group after one year. There was no statistically significant difference in the distribution of mRS score between the two groups after one year admission( P=1. 000) . Conclusion There may be no helpful on the prognosis of patients with intrace?rebral hemorrhage by intravenous infusion of deferoxamine mesylate,the further study is needed.

Objective To compare the clinical effects of different labor induction methods in the termination of intermediate pathological pregnancy. Methods From January 2015 to December 2016,ninety?two cases of intermediate ( 11-16 weeks ) pathological pregnancy were treated in Huangyan Hospital of Wenzhou Medical University. The patients were treated with different intermediate labor induction program to terminate their pregnancy. Among them,29 cases were treated with mifepristone combined with water bag abortion ( group A) ,47 patients with mifepristone and misoprostol induction( group B) ,16 cases with single rivanol ( group C) . The successful rate of labor induction and the labor induction related indexes ( the onset time of contraction,the total duration of labor,the total amount of bleeding in the hospital,the volume of bleeding in the perioperative period) , the rate of postpartum re?curettage and the adverse events after birth of the two groups were compared. Results The successful rates of labor induction in the three groups were 93. 10% (27/29),100%(47/47) and 87. 50% (14/16) respectively,the difference among the groups was statistically significant (χ2=8. 502,P<0. 05). The onset time in group A was (4. 61±2. 15) h,in group B it was (3. 68±2. 10) h,in group C it was (5. 85±2. 30) h,the difference among the 3 groups was statistically significant (F=6. 05,P =0. 025). The total duration of labor in group A was (10. 45±3. 21) h,in group B was (7. 50±3. 40) h,in group C was (14. 60±4. 89) h,the difference among the 3 groups was statistically significant (F=7. 48,P =0. 013). The total hospitalization time in group A was (4. 70 + 2. 33) d,in group B was (2. 80±1. 7) d,in group C was (6. 05±2. 50) d,the difference among the 3 groups was statistically significant (F=10. 23,P =0. 011). The perioperative bleeding volume in group A,B,C were (64. 88±20. 50) ml,(40. 10±15. 26) ml,(91. 50±31. 73) ml,respectively,the difference was statistically significant (F=8. 70,P=0. 020). The rate of postpartum re?curettage in group A was 7 cases (24. 10%),in group B was 6 cases (12. 80%),in the group C was 9 cases ( 56. 30%) ,the difference was statistically significant (χ2=20. 40,P=0. 003) . The incidence of adverse events in group A and group B were all 0,and in the group C,it was 3 cases ( 18. 75%) ,the difference was statistically significant (χ^2= 40. 00, P<0. 001 ) . Conclusion The pathological pregnancy should be terminated by induction of mifepristone combined with misoprostol, the operation is simple, safe and effective, and the implementation is feasible in the outpatient operation room of obstetrics and gynecology department.

Objective To analyze the curative effect of posterior internal fixation and fusion on patients with spinal fractures, and to provide the basis for clinical application. Methods A total of one hundred and eighty?eight patients with orthopedic incision treated in the First Affiliated Hospital of Xinxiang Medical University from March 2013 to December 2016 were divided into the observation group ( 98 cases with posterior internal fixation fusion ) and the control group ( 90 cases with anterior internal fixation fusion ) . The clinical curative effects of the patients ( including Cobb angle,spinal nerve function,complications and the success rate of surgery ) , postoperative visual analogue score ( VAS ) , hospitalization time, operation time were compared. Results In the observation group,the VAS score before operation was (6. 89±6. 89) points and reduced to (2. 70±1. 33) points after operation,the pain decreased significantly after treatment (t=26. 099,P<0. 001). The VAS score of the control group lowered from (6. 85±6. 85) points to (5. 05±1. 35) points,and the pain decreased significantly after treatment ( t=10. 704, P<0. 001 ) , and the postoperative pain in the observation group was significantly reduced than that in the control group ( t=12. 016,P<0. 001) . There were significant differences between the observation group and the control group in operation time,intraoperative blood loss,incision length and hospitalization time ( ( 141. 91 ± 35. 42 ) min vs. ( 198. 82 ± 38. 61 ) min, ( 509. 72 ±113. 65) ml vs. (823. 40±108. 54) ml,(10. 25 ± 0. 84) cm vs. (18. 83±1. 58) cm,(10. 59±12) d vs. (15. 37±1. 52) d,t=10. 541,19. 315,47. 015,24. 681,P<0. 001) . The total effective rate of the observation group was 86 cases ( 97. 96%) , and ineffective rate of the observation group was 2 cases ( 2. 04%) . In the control group, the effective and ineffective rates were 75 cases ( 83. 33%) and 15 cases ( 16. 67%) , the difference in effective rate between the two groups was statistically significant (χ2 = 12. 202, P<0. 001 ) . Conclusion Posterior internal fixation fusion is effective in the treatment of spinal fracture,which can reduce the postoperative pain,shorten the hospitalization time,less complication and high success rate. It is suitable for clinical promotion.

Objective To compare the effects and complications of lumboperitoneal shunt ( LP ) and ventriculoperitoneal shunt ( VP ) in the treatment of post?traumatic hydrocephalus. Methods Eighty patients with post?traumatic hydrocephalus treated in the neurosurgery department of Zhangjiagang Hospital of Traditional Chinese Medicine from March 2014 to March 2010 were retrospectively analyzed. The patients were randomly divided into two groups,40 patients treated with LP were assigned into the LP group and 40 patients undergone VP treatment were seen as the VP group. All patients were followed up for 1 year to investigate and compare the symptom improvement rate,neurological deficit score and the incidence of complication of the two groups. Results The total effective rate of hydrocephalus disappearance in the LP group was 41. 50% ( 37/40) and 87. 50%( 35/40) in the VP group. The difference between the two groups was not statistically significant (χ2=0. 556,P=0. 456);the neurological deficit scores before treatment in the LP group and VP group were (28. 35±8. 64) points and (29. 13±7. 98) points,there was no significant difference between the two groups (t=0. 419,P=0. 676) . The difference in the scores of neurological deficit after treatment in the LP and VP group was not statistically significant ( (19. 32±5. 34) points vs. (21. 62±4. 86) points,t=1. 480,P=0. 143),the average scores of neurological deficits in the two groups were significantly better than those before treatment ( t=5. 623, 5. 084,P<0. 001 ) . There was no significant difference in the average score of improvement of urinary incontinence between the two groups before and after treatment ( t=0. 376,1. 265,P>0. 05) ,the average score of urinary incontinence improvement after treatment in both groups were better than those before treatment ( t=4. 891,5. 370,P<0. 001) . In the LP group,the incidence of bleeding,infection,shunt related complications and shunt abnormality were all 2. 50% ( 1/40 ) , the overall complication rate was 10. 00%, the incidence of bleeding,infection,shunt related complications and shunt abnormality in the VP group were 7. 50% (3/40), 10% ( 4/40 ) , 5% ( 2/40 ) 10%, ( 4/40 ) , the overall complication rate was 32. 50%, there was significant difference between the two groups (χ2=6. 050,P=0. 014) . Conclusion LP and VP have significant curative effect on the treatment of post?traumatic hydrocephalus,but the overall incidence of LP complication after 1 year is significantly lower than that of VP,and is worth popularizing widely in clinical practice

Objective To investigate the clinical value of joint detection of six tumor markers in patients with colorectal cancer. Methods Eighty?six patients with colorectal cancer were included in the study group,86 healthy subjects were selected as the control group at the same period. The difference of tumor markers in different groups,tumor stages and prognosis were compared. Results The levels of carcinoembryonic antigen (CEA),carbohydrate antigen 19?9 (CA19?9),carbohydrate antigen 242 (CA242),carbohydrate antigen 72?4 ( CA72?4) , carbohydrate antigen 125 ( CA125 ) and carbohydrate antigen 50 ( CA50 ) in study group were significantly higher than those in the control group (CEA: (22. 5±6. 2)μg/L vs. (2. 2±1. 0)μg/L;CA19?9:(95. 7±27. 3) U/ml vs. (17. 1±9. 5) U/ml;CA242:(29. 5±8. 3) U/ml vs. (6. 0±2. 7) U/ml;CA72?4:(21. 6 ±5. 1) U/ml vs. (3. 6±1. 2) U/ml;CA125:(95. 4±32. 8) U/ml vs. (18. 9±8. 4) U/ml;CA50:(51. 8±20. 6)μg/L vs. (8. 3±3. 7)μg/L,t=29. 98,25. 22,24. 97,31. 86,20. 95,19. 27,P<0. 05). Among the single index detections,the sensitivity and negative predictive value of CA72?4 were the highest ( 61. 6%, 68. 3%) , the specificity of CA19?9 was the highest( 91. 9%) ,the positive predictive value of CEA was the highest ( 80. 4%) . The sensitivity,positive predictive value and negative predictive value of the joint detection were all higher than those in each single index detection (80. 3%,87. 3%,74. 1%). The levels of CEA,CA19?9,CA242,CA72?4, CA125 and CA50 in patients with stage III and IV were significantly higher than those in patients with stageⅠandⅡ(CEA:(32. 7±7. 1)μg/L vs. (15. 9±4. 4)μg/L;CA19?9:(127. 8±33. 7) U/ml vs. (52. 5±13. 8) U/ml;CA242:(40. 3±12. 7) U/ml vs. (23. 5±8. 6) U/ml;CA72?4:(37. 6±10. 2) U/ml vs. (13. 6±4. 1) U/ml;CA125:(128. 9±38. 4) U/ml vs. (59. 7±12. 8) U/ml;CA50:(88. 3±23. 7)μg/L vs. (41. 8±15. 6)μg/L,t=13. 04,13. 32,7. 11,14. 06,10. 99,10. 64,P<0. 05) . The levels of CEA,CA19?9,CA242,CA72?4,CA125 and CA50 in the recurrent metastasis group were significantly higher than those in the non?recurrent metastasis group ( CEA:( 37. 7 ± 8. 6 ) μg/L vs. ( 3. 8 ± 1. 7 ) μg/L;CA19?9:( 110. 5 ± 29. 4 ) U/ml vs. ( 25. 5 ± 13. 8 ) U/ml;CA242:( 33. 6 ± 10. 3 ) U/ml vs. ( 15. 5 ± 6. 6 ) U/ml;CA72?4:( 33. 1 ± 15. 3 ) U/ml vs. ( 9. 3 ± 3. 0 ) U/ml;CA125:(113. 4±31. 7) U/ml vs. (28. 7±7. 8) U/ml;CA50:(55. 4±14. 6)μg/L vs. (16. 8±9. 6)μg/L,t=29. 04,18. 31,9. 86,11. 47,19. 28,14. 65,P<0. 05) . Conclusion The joint detection of six markers can further improve the sensitivity, positive predictive value and negative predictive value of diagnosis, and can provide a more reliable basis for the auxiliary diagnosis of colorectal cancer.

Objective To compare the clinical effects of mini phalangeal external fixation and mini plate in the treatment of intraarticular fractures of the metacarpal bone head,and to provide a theoretical basis for clinical selection of surgical plan. Methods Seventy?four cases of metacarpal bone head intraarticular fractures treated in Huizhou People′s Central Hospital from March 2014 to March 2016 were selected as the research object. All cases were closed fractures and were randomly divided into the external fixation group and the mini plate group,37 cases in each group and treated respectively with the mini phalangeal external fixator and mini AO plate. The patients were followed up for 6 months to 1 year,the function of the metacarpophalangeal joint,the union of the fracture and the incidence of side effects were compared between the two groups. Results The excellent rates of the external fixation group at 6 months and I year after operation were 91. 9% ( 34/37) and 97. 3%( 36/37) respectively,which were significantly higher than those of the mini plate group ( 73. 0%( 27/37) ,81. 2%( 30/37 ) ) , the difference was statistically significant (χ2 = 7. 120, 7. 062, P<0. 05 ) . The complication rate of the external fixation group was 2. 7%( 1/37) ,which was significantly lower than that of the mini plate group ( 24. 3% ( 9/37 ) ) , the difference was statistically significant ( P=0. 014 ) . The average fracture healing time in the external fixator group was (2. 6±0. 4) months,which was significantly lower than that in the mini plate group (3. 1±0. 7) months,the difference was statistically significant (t=2. 40,P<0. 001) . Conclusion In the treatment of metacarpal bone head fracture,the external fixation has small trauma,can do cross joint fixation,and maintain a good fixation strength,and promote the healing of fracture and the recovery of metacarpophalangeal joint function. It is worthy of clinical application.