OBJECTIVETo investigate the clinical value of pleural biopsy in the etiological diagnosis of pleurisy in children.

METHODTotally 213 cases with pleurisy, who underwent pleural biopsy and hospitalized in Children's Hospital of Chongqing Medical University from January 2007 to April 2014 were enrolled into this study. Clinical symptoms, imaging manifestations, pleural fluid characteristics, the results of pleural biopsy and postoperative complications were retrospectively analyzed to evaluate the clinical value and security of pleural biopsy in making the etiological diagnosis of pleurisy.

RESULT(1) Of the 213 cases, 144 were boys and 69 were girls, their mean age was (6. 5 ± 4. 1) years. (2) Two hundred and thirteen patients had a surgical pleural biopsy under general anesthesia, the cause of 97 cases (45. 5%) were made clear by histopathological examination, including 35 purulent pleurisy, 55 tuberculous pleurisy and 7 paragonimus infection. For the remaining 83 (41. 3%) cases a final diagnosis was made based on the full analysis of clinical data, including 63 cases of purulent pleurisy, 3 cases of tuberculous pleurisy and 17 cases of paragonimiasis pleurisy but for 33 patients no exact cause was found at the end. (3) The mean operating time of the biopsy was (1. 4 ± 0. 6) hours. Seventy one (33. 3%) patients required blood transfusion during or after the operation. Thirty one (14. 6%) cases used the ventilator after surgery, and the ventilator supporting time was (6. 6 ± 5. 8) hours on average. The wound healing reached grade A in 200 cases (93. 9%), grade B in 13 cases (14. 6%). Postoperative complications included pneumothorax in 92 cases (43. 2%), subcutaneous emphysema in 18 cases (8. 5%), bronchopleural fistula in 3 cases(1. 4%). The average days of hospitalization was (17. 7 ± 7. 1) d.

CONCLUSIONPleural biopsy is of great diagnostic value in the etiological diagnosis and differential diagnosis of pleurisy in children, and it is considered reasonable to be used in the clinical practice when appropriate.

Biopsy ; Child ; Diagnosis, Differential ; Female ; Humans ; Infection ; diagnosis ; Male ; Pleura ; Pleurisy ; diagnosis ; etiology ; Retrospective Studies ; Tuberculosis, Pleural ; complications ; diagnosis

Objective To investigate the influence of lidocaine on systemic inflammatory response to cardiopulmonary bypass (CPB) in patients undergoing coronary artery bypass grafting (CABG) .Methods Twenty ASA Ⅱ or Ⅲ patients of both sexes (13 males, 7 females) aged 47-67 yrs weighing 62-82 kg undergoing CABG were randomly divided into 2 groups of 10 each: control group (C) and lidocaine group (L). In group L lidocaine infusion was started as soon as the pericardium was cut open and maintained at 4 mg?min-1 until the end of the surgery. Another dose of lidocaine (4 mg?kg-1) was added to the prime. In control group normal saline (NS) was given instead of lidocaine in the same volume and at the same speed. Blood samples were taken from radial artery before CPB (T0, baseline) and at 1, 10 and 60 min after release of the aortic cross-clamp (T1,2,3) for determination of plasma concentration of TNF-?, IL-6, IL-10 and PMN count. Plasma lidocaine concentration was determined at 10 and 60 min after initiation of CPB and at the end of surgery in 5 patients in group L. Results The two groups were comparable with respect to age, sex ratio (M/F), body weight, CPB time and aortic cross-clamping time. The mean plasma lidocaine concentration was (4.1?0.5)?g?ml-1, (4.6?0.7) ?g?ml-1 and (5.9?0.9)?g?ml-1 at 10, 60 min of CPB and end of surgery respectively in group L. Plasma concentrations of TNF-?, IL-6, IL-10 and PMN count were significantly increased at T1,2,3 as compared to the baseline values at T0 in both groups. The plasma concentrations of TNF-? and IL-6 were significantly lower while those of IL-10 were significantly higher at T1-3 in group L than in group C. Conclusion Lidocaine can inhibit the inflammatory response induced by CPB in patients undergoing CABG.

Objective:To find a short, neutralizing antibody-inducible, ORF2-encoded protein by means of comparing the immunogenicity of pN472-C617 and pN477-C613 which represent amino acids 472-617 and 477-613 of HEV ORF2-encoded protein of hepatitis E virus(HEV) genotype 4, respectively.Methods:The two recombinant proteins were expressed, purified, and then used to immunize BALB/c mice. Anti-HEV titers in the immune sera were detected by ELISA. Anti-HEV neutralizing activity was tested by a PCR-based in vitro neutralization assay.Results:Both of the two recombinant proteins were efficiently expressed in E.coli in soluble forms. The purified proteins induced mice to develop high levels of anti-HEV specific antibodies. However, only the immune sera obtained from the mice immunized with pN472-C617 showed the neutralizing activity to the homologous HEV strain by preventing the virus from absorption on PLC/PRF/5 cells surfaces and replication in the cells. The immune sera against pN477-C613, which was truncated five amino acids from both N- and C-terminal of pN472-C617, had no HEV neutralizing activity.Conclusion:The pN472-C617 is the shortest neutralizing antibody-inducible ORF2-encoded protein of HEV reported in literatures so far. It may be considered as a potential candidate for a novel HEV subunit vaccine in our future study.

Objective To construct a scientific and objective assessment to value nurse′s ability of scientific research in order to provide an objective unified standard and operable method to value nurse′s ability of scientific research and provide a standard for medical institutions to select nurses of scientific research. Methods After searching literatures and interviewing 7 experts, Delphi method was used to construct primary variables of nurse′s ability of scientific research. Then a second interview was given to each of 18 experts. The variables were weighted using analytic hierarchy process. Results Variables to assess nurse′s ability of scientific research included 2 first grade indices, 9 second grade indices and 35 third grade indices. Questionnaire return rates for two rounds of interviews were 84.00%(21/25) and 85.71%(18/21), respectively. Degree of authority Cr was 0.938. Scores of variables′importance ranged at 4.06-4.96. Ratios of full scores ranged at 33.33%-94.44%. Variable coefficients ranged at 0.05-0.25. The weight coefficients of 3 first grade indices (scientific research accumulation, explicit ability of scientific research, and intrinsic ability of scientific research) were 0.475 and 0.525, respectively. Conclusions The nurse′s ability of scientific research assessment system based on Delphi method and analytic hierarchy process is scientific and objective. This system combines quantitative and qualitative variables. It thus can calculate the ability of nurse′s scientific research according to the three grade indices. It is operable to be used to assess the ability of nurse′s scientific research.

Objective To explore the biomechanical characteristics of the pharynx in patients with aspiration after radiotherapy for nasopharyngeal carcinoma (NPC).Methods Clinical data on NPC patients with dysphagia admitted between July 2011 and June 2015 were retrospectively analyzed.Twenty-three patients were found who had received videofluoroscopic swallowing studies (VFSSs) and whose pharyngeal pressure and upper esophageal sphincter (UES) relaxing were tested using high-resolution solid-state manometry (HRM).The cases were divided into an aspiration group and a non-aspiration group according to the VFSS results.Differences in biomechanical parameters between the 2 groups when taking food of different viscosity were compared.Results Patients with aspiration had significantly higher UES residual pressure when taking thick liquids (20.1± 14.3 mmHg) and paste (18.0± 14.3 mmHg) than patients not aspirating (9.3±9.2 mmHg and 7.2±8.9 mmHg for thick liquid and paste respectively).But no significant difference in average pharyngeal pressure between the two groups was observed.Conclusion Aspiration after radiotherapy may be correlated with increased UES residual pressure.

With the public hospitals expanding,the nurses at age of marriage or bearing are enrolled and account for large part of all health care workers in China.A significant percentage of nurses in the period of pregnancy or lactation,especially abortion and sterility,deteriorate the shortage of nursing human resources and the nurses' health.It is essential to cope with the matter in order to maintain the nurses and contribute to the professional development.In this paper,we review the human resource management of the nurses during the periods at home and abroad from the human resources,occupational protection and management approaches,which is contributed to supplement the human resource.

Objective To investigate the effects of reactive oxygen species (ROS) inhibition on the down-regulation of adiponectin (ADPN) in mouse 3T3-L1 adipocytes by advanced glycation end-products (AGEs).Methods AGEs were prepared for incubating with cell.3T3-L1 preadipocytes were cultured in vitro and differentiated into mature adipocytes.Cell differentiation and lipid accumulation were determined by oil red O staining.After being intervened with AGEs,2',7'-dichlorofluorescein diacetate (DCFH-DA) was used as a reactive oxygen species (ROS) capture agent and the fluorescent intensity of 2',7 '-dichlorofluorescein (DCF) was detected by flow cytometry.Adiponectin expression under AGEs in 3T3-L1 adipocytes pretreated with N-acetyl-L-cysteine(NAC) or not was detected by real-time fluorescent PCR and ELISA.Results The level of ROS in 3T3-L1 adipocytes treated with AGEs was increased.mRNA and protein of ADPN were down-regulated.After inhibition with ROS,mRNA and protein expressions of ADPN injured by AGEs were ameliorated.Conclusion Exposure of 3T3-L1 adipocytes to AGEs induces oxidative stress in vitro,which decreases the expression of ADPN,and causes functional impairment of adipose cells and insulin resistance.

BACKGROUND:Hyaluronic acid has antioxidant, immune regulation, anti-inflammatory roles as wel as promotes wound healing. Hyaluronic acid is more and more applied in the treatment of chronic periodontitis and achieves a significant effect. OBJECTIVE: To observe the clinical effects of local application of sodium hyaluronate in the treatment of chronic periodontitis. METHODS:Sixty cases of chronic periodontitis (300 teeth) were selected. According to self-control method, the teeth in district A, 150 premolars or molars, were as experimental group, and other 150 teeth in district B served as control group. In the experimental group, periodontal scaling, subgingival scaling, and local application of Gengigel gel (0.2% hyaluronic acid) in the gingival sulcus were employed; in the control group, the treatment was same to that in the experimental group except local application of Gengigel gel. During 8-week folow-up, dental plaque index, sulcus bleeding index, probing depth, and clinical attachment loss were changed dynamicaly. RESULTS AND CONCLUSION:After treatment, al the measurement indexes were improved remarkably in the two groups. However, there was no difference in the dental plaque index between the two groups at 1, 4, 8 weeks after treatment. The sulcus bleeding index was lower in the experimental group than the control group at 1, 4, 8 weeks after treatment (P < 0.05). The periodontal probing depth of the experimental group was lower than that of the control group at 4 and 8 weeks (P < 0.05). The clinical attachment loss was lower in the experimental group than the control group at 8 weeks (P < 0.05). These findings indicate that periodontal treatment with local application of sodium hyaluronate in the gingival sulcus is significantly effective for the treatment of chronic periodontitis.

Objective To observe the efficacy and toxicity of thermotherapy plus chemotherapy in treatment of retroperitoneal lymph node metastasis after radical gastrectomy and sequential radiochemotherapy. Methods Sixty patients with retroperitoneal lymph node metastasis after radical gastrectomy and sequential radiochemotherapy were randomly divided into of microwave hyperthermia combined with chemotherapy group (experimental group, 30 cases) and chemotherapy group (control group, 30 cases) by using random number table method. The control group: oxaliplatin 130 mg/m2, intravenous drip (2 h), d1; S-1: 80 mg·m-2·d-1, P.O 2 times/d (after breakfast and after dinner), d1-14. 3 weeks was 1 cycle, a total of 4 cycles. The experimental group: chemotherapy on the basis of control group combined with microwave hyperthermia, d1, 8. the efficacy and toxicity of two groups were evaluated. Results The efficacy rate of the experimental group was higher than that of the control group, and the difference was statistically significant [66.7 % (20/30) vs. 33.3 %(10/30), P< 0.05]. The improvement of Karnofsky score in the experimental group was better than that in the control group, and the difference was statistically significant [73.3%(22/30) vs. 23.3%(7/30), P<0.05]. The improvement of pain score in the experimental group was better than that in the control group, and the difference was statistically significant [75.0 % (15/20) vs. 17.6 % (3/17), P< 0.05]. There was no significant difference in gastrointestinal reactions of two groups [30.0%(9/30) vs. 26.7%(8/30), P>0.05]. There was no significant difference in bone marrow suppression of two groups [33.3%(10/30) vs. 30.0 % (9/30), P> 0.05]. Conclusion Microwave thermotherapy plus chemotherapy has a good efficacy for retroperitoneal lymph node metastasis after radical gastrectomy and sequential radiochemotherapy, and the patients can well tolerated, it is worthy of clinical promotion.