Objective To evaluate the values of computer tomography in differential diagnosis of parotitis and tumors.Methods CT findings of the 18 parotitis cases and 25 parotid tumors cases proved by pathology was analysed retrospectivety statistically.Results Most of parotitis appeared in both side(10/18),all of the parotid tumors were in unilateral parotid(25/25)(?0.05)).The border of the unilateral and local parititis was clear(2/5),mixed tumors were well-defined(5/6)(?

BACKGROUND: Ischemic reperfusion syndrome occurs in early donor liver reperfusion after orthotopic liver transplantation. It is the most important cause for liver function failure and patient death. Ischemic reperfusion severity is closely related to blocking of inferior vena cava period. Some studies demonstrate that inferior vena retrograde perfusion can shorten the blocking time during liver transplantation. OBJECTIVE: To observe the effect of retrograde perfusion on the hemodynamics in orthotopic liver transplantation without venovenous bypass during neohepatic reperfusion phase. DESIGN, TIME AND SETTING: Case comparison was performed at Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from December 2006 to June 2007. PARTICIPANTS: Thirty-nine patients underwent orthotopic liver transplantation without venovenous bypass under general anesthesia. METHODS: According to perfusion methods, the patients were divided into two groups: retrograde perfusion through inferior vena cave (n=19), and perfusion through portal vein (n=20). MAIN OUTCOME MEASURES: The systolic blood pressure, diastolic blood pressure, heart rate, central venous pressure and other hemodynamic parameters were measured before operation, and at anhepatic phase and primary neohepatic phase. The rewarming ischemia time of grafted liver was also recorded. RESULTS: The rewarming ischemia time of grafted liver in the retrograde perfusion through inferior vena cave group was significantly less than that in the perfusion through portal vein group (P

OBJECTIVE:To optimize the technics for the extraction of Qiangliyanhou mixture.METHODS:The physico-chemical properties of the compositions in the formula medicinal substances were analyzed,the obtained quantity of aqua aromatica was used as an investigation index of distillation technics;The preparation technics was optimized by orthogonal experiment in which the extraction ratio of the water extractives and the content of chlorogenic acid were used as the indexes to investigate the influence of the amount of water added,the soaking time before decoction,decoction time and times of decoc?tion on the extraction result.RESULTS:The optimized amount of aqua aromatica in the distillation procedures was collecting distillate that is3times the amount of the medicinal substances;The optimum water extraction condition was:the medicinal substances was soaked for2hours by adding15times amount of water before decocting for total3hours(3times?1hour/time).CONCLUSION:The preparation procedure is reasonable and reliable.

Objective To investigate the relationship between the serum uric acid (SUA) levels and the short-term clinical outcome in patients with spontaneous intracerebral hemorrhage.Methods Consecutive patients with spontaneous intracerebral hemorrhage admitted within 24 hours after onset were prospectively included.SUA levels was measured on the next morning after admission.Modified Rankin Scale (mRS) was used to ascertain clinical outcome at 30 days.The patients were divided into a good outcome group (mRS＜2) and poor outcome group (mRS≥3).Results A total of 92 patients with spontaneous intracerebral hemorrhage were included,and 46 of them (50％) were men,the mean age was 63 ± 12 years.At 30 days after onset,22 patients (23.9％) had a good outcome and 70 patients (76.1％) had a poor outcome.Univariate analysis showed that the Glasgow Come Scale (GCS) score in the good outcome group was significantly higher than that in the poor outcome group (13.85 ± 2.80 vs.11.21 ± 2.51; t=4.186,P=0.000),while hematoma volume (25.65 ±5.33 cm3 vs.34.60± 8.97 cm3,t=4.430,P=0.000) and SUA levels (324.90± 86.02 μmol/L vs.458.63 ±72.77 μmol/L; t =7.193,P =0.000) were significantly lower than those in the poor outcome group.Multivariate logistic regression analysis showed that the lower GCS score (odds ratio [OR]1.810,95％ confidence interval [CI]1.382-2.382; P =0.001),larger hematoma volume (OR 1.156,95％ CI 1.045-1.280; P=0.005) and higher SUA levels (OR 2.127,95％ CI 1.055-4.287; P=0.035) were the independent predictive factors for the short-term clinical outcome in patients with spontaneous intracerebral hemorrhage.Conclusions The increased SUA levels may predict the poor short-term clinical outcome in patients with spontaneous intracerebral hemorrhage.

Objective To investigate the serum levels of procalcitomn (PCT) and high mobility group box chromosomal protein-1 ( HMGB1 ) in patients with acute pancreatitis (AP) ; and study the relationship between the serum levels of PCT,HMGB1 and the severity and prognosis of AP.Methods The blood samples were collected from 80 AP patients,including 38 severe acute pancreatitis (SAP) patients and 42 mild acute pancreatitis (MAP) patients.The serum levels of HMGB1 were measured by ELISA kit,and the levels of PCT were measured by immunoassay chemiluminescent technique,then their relationship with other biochemical parameters,the severity and prognosis of AP was analyzed.30 healthy adults were treated as the control group.Results The serum PCT and HMGB1 levels were ( 8.18 ± 3.24) μg/L and ( 11.79 ± 3.98 ) μg/L in SAP group,and the corresponding values were (5.67 ± 2.43) μg/L and ( 5.38 ± 2.06) μg/L in MAP group,and both were significantly higher than those in control group [ ( 1.85 ± 0.86) μg/L and ( 1.87 ± 1.47) μg/L,P ＜0.01 ].The serum level of PCT was positively correlated with serum 1evel of HMGB1 ( r =0.276,P =0.014),and both were positively correlated with Ranson score,APACHE Ⅱ score,Balthazar CT score (P＜0.05 or ＜0.01 ).The HMGB1 levels were significantly higher in patients with organ dysfunction than those in patients without organ dysfunction (P ＜0.05).Conclusions In AP patients,serum PCT and HMGB1 levels were significantly increased,and they were positively correlated with disease severity.These results suggest that PCT and HMGB1 may act as potential serum markers for AP severity evaluation.

Objective To evaluate the impact of acute hyperglycemia on the short-term prognosis in patients with primary intracerebral hemorrhage (ICH) with meta-analysis. Methods The prospective or retrospective cohort studies or case-control studies of the relationship between baseline blood glucose levels and short-term prognosis (at least were followed up to discharge or 1 month) in patients with ICH within 24 hours were searched and reported. A meta-analysis software package (RevMan 4. 2) was used to pool data for the literatures in accordance with the inclusion criteria. The publication bias was analyzed and the sensitivity analysis was used to evaluate the stability of the results. Results The risk of mortality at the end of the follow up in the normoglycemia group was significantly lower than that in the hyperglycemia group (odds ratio 0. 24,95% CI 0. 19-0. 30; P <0. 000 01); the baseline plasma glucose level was significantly lower than that in the survival group (weighted mean difference -2. 30,95% CI -2. 36- -2.23; P< 0.000 01). Conclusions Acute hyperglycemia can significantly increase the risks of short-term mortality in patients with primary ICH. It is necessary to conduct a prospective randomized trial in order to investigate the effect of intensive glucose control on the prognosis of the patients with ICH.

Objective To identify the correlation between doctors' job burnout and medical errors.Methods In stage 1,a cross-sectional retrospective survey on doctors' job burnout and medical errors was conducted for 300 doctors serving in the First Affiliated Hospital of Fujian Medical University,who were randomly sampled in June 2013.The survey covered basic demographic information,self-assessed job burnout and medical errors.In stage 2,231 doctors without medical errors in stage 1 were selected for a prospective study focusing on a follow-up on their medical errors within half a year.Results Medical errors were found to influence job burnout of doctors significantly.Multiple logistic regression analysis was made based on the three independent variables of A-emotional exhaustion,B-depersonalization,and C personal sense of accomplishment,and the dependent variables Y1 and Y2 indicating the occurrence or non-occurrence of common medical errors or serious medical errors,respectively.The calculation aims to identify if there is line relationship among the three independent variables.Conclusions This study suggests that all kinds of medical errors influence job burnout;scores of the three dimensions of job burnout may be predictors of occurrence of different medical errors.

Objective:To investigate the prognosis of patients with liver metastasis or local recurrence after radical resection of rectal cancer,in order to provide reference for the further screening of high-risk patients for the precise therapeutic methods.Methods:The clinicopathological factor and follow-up data of 485 patients who underwent surgical treatment for rectal cancer from March 2005 to January 2016 were retrospectively analyzed.Including 75 liver metastasis and 32 local recurrence.The prognosis were compared between the patients with liver metastasis and with local recurrence.Results:The difference was statistically significant in CEA level,primary tumor position,surgical methods,tumor cell differentiation,tumor infiltration depth between liver metastasis and local recurrence after radical resection of rectal cancer (P＜0.05).The 1-,3-and 5-year overall survival rates were 76.6％,53.1％ and 18.8％ respectively of patients with liver metastasis,The 1-,3-and 5-year overall survival rates were 81.3％,62.5％ and 37.5％ respectively of patients with local recurrence,the difference was statistically significant(P＜0.05).Conclusion:There were different clinicopathological characteristics of patients between liver metastasis and local recurrence.The prognosis of patients with local recurrence was better than patients with liver metastasis.

Objective To investigate the relationship betweenthe stability of carotid artery plaque and cystatin C,homocysteine. Methods A total of 1 50 cerebral infarction patients with carotid artery plaque treated in Hospital of the First Electricity Authority in Guangdong were selected as the research subjects.According to Color Doppler ultrasound scanning,the patients were divided into the observation group (86 unstable plaque patients)and control group(64 stable plaque patients).Peripheral venous blood from the patients of both groups were collected for the detection of cystatin C,homocysteine,serum total cholesterol and fibrinogen levels and the results of detection were compared between the two groups.Results The levels of cystatin C,homocysteine,serum total choles-terol and fibrinogen in the observation group were significant higher than those of the control group(t =48.760,20.530,29.860, 33.720,P <0.05).The level of cystatin C was weak positive correlated with homocysteine(r =0.21,P <0.003).Multivariate lo-gistic regression analysis showed cystatin C,homocysteine,serum total cholesterol and fibrinogen were independent risk factors for carotid artery plaque instability in patients with cerebral infarction.Conclusion Cystatin C,homocysteine,serum total cholesterol and fibrinogen are important risk factors for carotid plaque instability,the cerebral infarction is closely related to the carotid artery plaque stability,so controlling the risk factors is the focus of prevention and treatment of cerebral infarction.

Objective To evaluate the feasibility and safety of early appendectomy in appendicular abscess. Methods Fifty patients with appendicular abscess who received early appendectomy in our hospital from January 2009 to June 2012 were considered as the abscess group,50 cases patients received acute appendicitis surgery were regarded as the control group. The postoperative hospital stay,cost of hospi-talization,operative time,the amount of bleeding in operation and complications were retrospectively analyzed. Results The operative time of abscess group was (68±23) min,and the control group was (49±14) min (P<0. 05). There were significant differences in operating time between two groups. But there was no significant difference in intraoperatve blood soss,length of stay,the average hospitalization charge and surgical complications (P>0. 05). All patients were cured. Conclusion Early treatment of appendiceal abscess is safe and alternate to conventional conservative treatment followed by interval appendectomy. It is not only to avoid the secondary hospitalization and treatment fail-ure,but also save the cost of hospitalization and minimize the medical expenses.