Child ; Drinking ; Drinking Water ; Feeding Behavior ; Humans ; Recommended Dietary Allowances

Objective To investigate the indication,feasibility and clinical effectiveness of stage management of Budd-Chiari syndrome(B-CS). Methods From Feb 2007 to June 2009,32 cases of Budd-Chiari syndrome(9 cases of type Ⅰ,17 cases of type Ⅲa,6 cases of type Ⅲ b)were admitted.Inferior vena cava hypertension(IVCHT)and portal hypertension(PHT)co-existed in all the patients.According to the clinicopathologic classification and hemodynamic compensation,these patients underwent single stage treatment(snrglcal procedure or radioactive intervention)or two-stage management(one.stagesurgical procedure/radioactive intervention plus two-stage surgical procedure/radioactive intervemion).Results Recovery was achieved in all patients without mortality.The main complications were Dleural effusion in 3 cases,acute heart failure in 2 cases and celiac lymphatic leakage in 1 case respectively.which were cured after medical treatment.In 4 months to 2 years follow-up,no recurrent cases were identified and all the patients were in good condition. Condusions Stage management of Budd.Chiari svndrome canalleviate the perioperative risk and clinical effectiveness can be achieved.The hemodynamic compensation is the basis on which stage management is adopted.

Drinking ; physiology ; Humans

Objective To evaluate covered stent placement in the treatment of iliac artery rupture in the process of iliac artery angioplasty.Methods Clinical data of 9 patients' iliac artery rupture in the process of iliac artery angioplasty were retrospectively reviewed.Results Covered stent was successfully placed in all cases.The patency of involved iliac artery was identified in 8 cases by angiography and there was no contrast extravasation.Type Ⅰ endoleak occurred in one patient in the proximal end of the stent graft and iliac artery graft replacement was done by open surgery immediately.Postoperatively clinical symptoms were relieved in all these 9 patients.One case lost to follow up.8 patients were followed up for 14 to 45 months,average (22 ±9) months.Stenosis on the distal end of the covered stent (external iliac artery)was found in one patient who underwent external iliac artery balloon-expandable stent angioplasty.One patient with artificial vessel placement was symptoms free with patency of the involved artery as reviewed by ultrasonography on 18 month followed up.Conclusions When iliac artery rupture in the process of iliac artery angioplasty should develop,the first choice is immediately covered stent placement therapy,while open surgery remains as the last resort.

Objective To study the relationship between salt consumption and hypertension in Chinese people,and provide basic information for developing intervention strategies.Method The data of 45 349 chinese residents aged 15 yrs and above from 2002 China National Nutrition and Health Survey was used.Results The hypertension prevalence was 18.2%.The prevalence of residents with high blood pressure value was 36.0%,which was 20.4% and 16.2% among men and women,respectively. Hypertension prevalence among people living in urban was higher than their counterparts living in rural.The prevalence of hypertension increased with salt consumption.As compared to people who consumed less than 6 g salt per day,after relative confounding factors adjusted,the prevalence ratio was 1.09,1.14 and 1.28 times,respectively,among people who averagely consumed 6～12 g,12218 g,and≥18 g salt per day,which was 1.13,1.11 and 1.30 times,respectively,among employment population.Conclusion The hypertension prevalence of chinese residents is quite high.There is significant relationship between salt consumption and hypertension.It is very important to strengthen the health education for preventing and controlling hypertension in Chinese residents.

Humans ; Image Processing, Computer-Assisted ; Lung ; diagnostic imaging ; Pneumoconiosis ; diagnostic imaging ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; methods

Background and purpose: Sorafenib hepatocellular carcinoma assessment randomized protocol (SHARP) and sorafenib in patients in Asia-Pacific region with hepatocellular carcinoma (ORIENTAL) had indicated that multi-kinase inhibitor sorafenib could prolong overall survival (OS) and time to progression (TTP) as well as improve progress free survival (PFS) in patients with advanced stage hepatocellular carcinoma. Drug-related adverse events in the course of treatment restricted its clinical application to a certain degree. This study was aimed to summerize the adverse events as well as the management of sorafenib in our clinic. Methods: Twenty-five cases clinically diagnosed as advanced hepatocellular carcinoma were enrolled from January 2008 to October 2009. All the patients who received sorafenib treatment met inclusion criteria as followed: (1) Progression of disease after trans-hepatic arterial chemoembolization therapy; (2) Extensive portal vein cancerous thrombus formation; (3) Portal zone or retroperitoneal lymph node metastasis or multiple remote metastasis, such as lung or bone; (4) Diffused poor blood supply to tumor; (5) Inform consent was obtained. All adverse events with different grade were observed during the beginning 12 weeks, and clinical treatment were carried out relatively. Results: Total of 25 cases were enrolled. Nine patients died of the disease, 3 of them died during the first 12 weeks, 3 patients abandoned sorafenib treatment, among them 2 died before the finish of 12 weeks treatment and 1 patient discontinued 5 months after the sorafenib treatment. Twenty cases finally assigned. Number of patients encountered drug-related adverse events were: HFSR (hand-foot-skin-reaction) 4(4/20), diarrhea 4(4/20), alopecia 5(5/20), rasb 4(4/20), fatigue 8(8/20), leukopenia and Thrombocytopenia 4(4/20), elevated blood pressure 1(1/20) and abdominal pain 1(1/20). After clinical management, 20 patients' sorafenib treatment were eventually not affected by adverse events. Conclusion: Sorafenib was well-tolerated and is a safe option of treatment for patients with advanced hepatocellular carcinoma.

Objective To differential the biologic characteristics and multiple differentiation potential of mesenchymal stem cells in nucleus pulposus in (NP-MSC) scoliosis patient and patient with degenerative interverthral disc.Methods The human nucleus pulposus-mesenchymal stem cells were isolated and cultured with enzyme digestion from 2 patients of scoliosis and 2 patient with degenerative intervertbral disc separately.Cellular proliferation was detected with MTT assay and trypan blue.The immunophenotype expression of NP-MSC was detected by flow cytometry in scoliosis and degenerative group.The multiple differentiation ability of cells was assessed respectively using alizarin red dye,Oil red O dye and immunohistochemical staining.Results The primary cell morphology of scoliosis NP-MSC was the shape of spindle,while the degenerative NP-MSC was inhomogeneous.However,both of them became spindle shape after passages.The scoliosis NP-MSC was stronger than degenerative one in metabolic activity and proliferation.The percentage of positive antigen expression of CD44,CD105 and CD29 was 97％-100％ in scoliosis NP-MSC group,but 88.7％-97％ in the degenerative group.The expression of mature cell marker CD24 was negative in both groups.Furthermore,the MSC i.isolated from both groups differentiated along the osteogenic,chondrogenic but not adipogenic lineages.Conclusion The scoliosis and degenerative NP contains mesenchymal stem cells.Moreover the scoliosis NP-MSC had stronger ability of cell metabolic activity and proliferation.These cells have multiple differentiation potential with the exception of their adipogenic differentiation ability.

Objective To evaluate interventional therapy in the treatment of interposition graft stenosis or occlusion after mesocaval shunts.Methods The clinical data of 19 cases of artificial vessel stenosis or occlusion after mesocaval shunts for portal hypertension at our department from march 2009 to march 2012 were retrospectively analyzed.Results In the 19 cases with artificial vessels stenosis or occlusion developed after mesocaval interposition shunts for portal hypertension,there were 5 cases in which acute thrombosis occurred within a week after the surgery.Catheter directed thrombolysis was successfully conducted.In 6 cases in which shunt stenosis developing 1 to 8 years after surgery were managed by balloon dilatation or stent angioplasty successfully.The shunt graft occlusion occurred in 8 cases after 1 to 4 years of surgery was successfully managed and the shunt was reopened by balloon dilatation or stent angioplasty in 6 cases,and in 2 the procedure was failed for the guide wire can't go through the anastomotic site of artificial vessel-superior mesenteric vein.In 11 cases embolization of the esophagogastric varices was successfully carried out for postoperative standard anticoagulation.During a period of 3 months to 3 years follow-up,stenosis recurred 1 year after balloon dilatation in one case,and stenosis was managed by angioplasty successfully.Conclusions Interventional radiological techniques by percutaneous puncture through femoral vein-inferior vena cava-artificial vessel-portal vein (including catheter directed thrombolysis,balloon dilatation,stent placement,etc) are less traumatic,highly successful in the treatment of shunt stenosis or occlusion after mesocaval shunts in portal hypertension.

OBJECTIVE:To provide the scientific evidence and reference for improving medical reform. METHODS:Based on background ofSanming Medical Reform,self-designed questionnaires were used to investigate the cognition and satisfaction of local patients. The results of investigation were analyzed statistically. RESULTS:A total of 275 paper questionnaires were sent out and all were collected;345 electronic questionnaires were sent out by Wechat and all collected. Among 620 questionnaires,372 valid questionnaires were collected with effective rate of 60.00%. More patients(31.45%)thought the cost of treatment decreased, and less (22.31%) thought the cost increased. The proportion of high-income people who thought cost reduced was significantly higher than the proportion of low-income people (P=0.018). 27.42% of patients believed shortage of drugs,and tertiary hospi-tals were more prone to drug shortage than other medical institutions(P=0.062). The patients'satisfaction with medical staff and healthcare reform were both high(86.56% and 79.03%),but the satisfaction of rural patients was lower than that of urban patients (P=0.051). Understanding of patients onSanming Medical Reformwas in low level. Only 20.70% of the patients fully under-stood or generally understood ofSanming Medical Reform. The patients who thought the skills of medical staff were improved (40.32%)were more than those who thought the skills of medical staff were reduced(5.91%). CONCLUSIONS:Most patients are satisfied withSanming Medical Reform,and agree the achievements;but some problems are not solved,such as the shortage of some drugs,lack of grass-roots medical personnel,not understand medical policy.