0.05).(2) After treatment for 7 days,APACHEⅡ score was decreased in the two groups(P

Medical science have two sides in its nature. It is not only a subject of science, but also a social science. Medical science need social science to nourish it. At present, unsuitable language is the main cause which lead to medical tangles. The medical workers' attitude towards patients is the key factor during the solving course. Most of the medical tangles do not lead to accusing in the beginning. Both patients and the hospital wish to solve the tangle by intercession or compromise instead of law ways. Appropriate language could avoid non-malpractice tangles. It also play an important role in solving the medical tangles.

This study was aimed to observe the effect of Tao-He Cheng-Qi Decoction (THCQD) on tissue injury of different organs among rats with sepsis. A total of 100 Kunming male SD rats of clean grade were randomly divided into five groups, which were the normal control group, model 6 h control group, model 12 h control group, THCQD 6 h group and THCQD 12 h group. The normal control group received no treatment. The classic CLP method was ap-plied in the establishment of sepsis rat model in other groups. Intragastric administration of saline 1 ml/100 g (weight) was given to each rat in the model group every day. Intragastric administration of THCQD 1 ml/100 g (weight) was given to each rat in the THCQD group every day. The model was established after 7 days. Tissue speci-mens of lung, heart, kidney, liver, and small intestine were collected at 6 h and 12 h after modeling, respectively. Pathomorphological changes of each group were observed by light microscopy and electron microscope. The results showed that compared with the model group at the same time point, pathomorphological changes of tissues of the lung, heart, kidney in THCQD group were not significant. However, pathomorphology of tissues of the liver and small intestine changed significantly in the THCQD 12h group. And there were statistical differences (P < 0.05) between two groups in the score of pathomorphology. It was concluded that THCQD had protective effect on tissues of the liv-er and small intestine among rats with sepsis. However, the mechanism is not clear and requires further research.

Liver tissues around hydatid from 8 patients with cystic echinococcosis were observed by transmission electron microscopy,normal hepatic tissues of 6 cases were used as control.The results demonstrated predominant atrophy and necrosis of hepatocytes.These changes seem to be the major hepatic lesion in cystic echinococcosis.

Objective To investigate the long-term effects and risk factors of arterial polyvinyl alcohol resin (PVA) embolization for ⅢB and IV non-small cell lung cancer(NSCLC) patient.Methods 126 patients with 1 B or V NSCLC were performed the perfusion with 5-FU,THP,DDP by PVA grain embolization under fluoroscopic control.All patients were followed up.Kaplan-Meier was used to calculate the survival rate and the median survival time,and Cox regression model was adopted to analyze related risk factors which affected curative effect.Results The median survival time was( 11.78 ± 3.24) months and 1 -,2-year survival rate was 39.1 ％,25.59％ in 126 patients with NSCLC.Cox model analysis showed that of the tumor staging,tumor size,location and combination chemotherapy were all independent risk factors of prognosis (all P ＜ 0.01 ).Conclusion Arterial embolization of PVA for treatment of NSCLC is effective.Tumor size,stage,location and combination chemotherapy are associated with prognosis of NSCLC.

OBJECTIVE: To build up a simple and effective comprehensive system for predicting difficult laryngeal exposure under suspension laryngoscopy. METHOD: One hundred and twenty cases of laryngeal tubor were selected. Using Logistic regression method to analyse relative factors, including weight, height, BMI, neck girth, neck upward degree, upper-lower incisor teeth distance, thyroid-mentum distance, thyroid-sternum distance, Mallampati test, Yamamoto test and Upper lip bite test. Build data-base to construct a comprehensive system for predicting difficult laryngeal exposure under suspension laryngoscopy. RESULT: The relative factors of difficult laryngeal exposure were BMI, neck girth, upper-lower incisor teeth distance, neck upward degree, thyroid-mentum distance, Mallampati test and Yamamoto test (P < 0.05). To build up a comprehensive system for predicting difficult laryngeal exposure under suspension laryngoscopy. The predicting standards included the seven relative factors, each factor has 1 score, 2 score, 3 score. Higher score means more risk. Eight score was designed as minimum, under the premise,the sensibility, misdiagnosis rate, missed misdiagnosis rate, specificity of the experiment were 95.5%, 5.3%, 4.5%, 94.7%. CONCLUSION The comprehesive system is an effective method for predicting difficult intubation. It can help to identify difficult cases according to the results of this predicting system.
Anthropometry ; Chin ; Humans ; Intubation, Intratracheal ; methods ; Laryngoscopy ; methods ; Larynx ; Lip ; Neck ; Thyroid Gland

ObjectiveTo evaluate the long-term therapeutic efficacy of muscle-region alignment needling plus dermalneedle therapy in treating post-stroke upper-limb spasticity.MethodTotally 488 patients with post-stroke upper-limb spasticity were randomized into a treatment group and a control group, 244 in each group. Besides theessentialrehabilitation treatment, the treatment group was intervened by muscle-region alignment needling plus dermal needle therapy, while the control group was given regular Western medication.Thetwo groups were intervened for 3 weeks and were followed up for 6 months. The neurologic function, Functional Comprehensive Assessment (FCA), and Stroke Speciality-Quality of Life (SS-QOL) were observed for the follow-up study.ResultThe total effective rate was 93.4% in the treatment group versus 61.5% in the control group, and the difference was statistically significant (P<0.05); the neurologic function, FCA score, and SS-QOL score in the treatment group were significantly superior to that in the control group at the end of the follow-up study (P<0.05).ConclusionMuscle-region alignment needling plus dermal needle therapycan produce a content long-term therapeutic efficacy in treating post-stroke upper-limb spasticity.

Objective To study the indications for extubation of percutaneous transhepatic gallbladder drainage(PTGD).Methods Between January 2009 and December 2013,PTGD were performed on 104 patients with acute cholecystitis.The clinical data were analyzed retrospectively.Results PTGD were performed on all 104 patients successfully.In all the patients,after drainage the abdominal pain was relieved within 0.5 to 8 hours and mean time was(2.3 ± 1.9) h.The temperature decreased to normal in 1 days after drainage.The time of drainage was from 7 to 49 days,(22.4 ± 10.3) days on average.Thirteen patients'tubes were accidentally off during 3 to 12 days,5 patients were performed PTGD again,and 8 patients were given anti-infection,fluid infusion and other symptomatic treatments and all these patients were back to normal in time.Re-intubation rate was 4.8％.In 78 patients laparoscopic cholecystectomy (LC) were performed 1 to 2 months after PTGD.Operation time was between 35 to 95 min and mean time was(52.7 ± 15.0) min.There were 6 patients done open operation and the conservation rate was 7.7％.A mount of blood during LC was 30 to 150 mL,(61.7 ± 31.0) mL on average.No operative deaths occurred during therapeutic session.Conclusions Patients who formed PTGD obey the indications can extubate in time and reduce retrograde infection and skin irritation,also shorten the time during hospital's,which will have a positive impact about LC.

Objective To explore the prognostic significance of p53 mutation protein in patients with diffuse large B-cell lymphoma for the purpose of individualized therapy. Methods Newly diagnosed 62 cases were randomly chosen from our hospital, p53 mutation protein and CD10, bcl-6, MUM1 were tested by immunohistochemistry. Correlation of p53 mutation protein with patients ' characteristics, genotype and survival were analysed in the study. Results p53 mutation protein was found in 48.4 % (30/62) of patients.Its expression was only related to initial treatment response (x2 =20.365, P =0.040), including complete remission rate of 33.3 % (10/30) in positive group and 59.4 % (19/32) in negative group, and non-germinal center genotype (x2=31.023, P =0.021) with 83.3 % in positive group and 56.2 % in negative group. No other correlation was not verified with clinical features. Multivariate survival analysis showed that p53 mutation protein was an independent predictor for shorter progress-free and overall survival in positive group (x2 =30.784, P =0.005 and x2 =35.276, P =0.006). Conclusion p53 mutation protein should be an independent predictor with poor prognosis and to direct personalized therapy.

Objective To explore the feasibility and effect of laparoscopic Ladd's surgery for the treatment of intestinal malrotation in infants.Methods The clinical data of 50 infants with intestinal malrotation who were admitted to the Wuhan Medical & Health Center for Women and Children from January 2011 to December 2013 were retrospectively analyzed.Of 50 infants, 27 infants receiving the open Ladd's surgery were allocated into the open surgery group and 23 infants receiving the laparoscopic Ladd's surgery were allocated into the laparoscopy group.The operation time, time to anal exsufflation, duration of hospital stay, postoperative incision infection and intestinal obstruction in the 2 groups were observed.All the patients were followed up by outpatient examination or telephone interview till March 2014.The measurement data with normal distribution were presented as x-± s and analyzed by the t test, and count data were analyzed using the chi-square test or Fisher exact probability.Results The operation time, time to anal exsufflation and duration of hospital stay were (69 ± 7)minutes, (41 ±9)hours and (10.4 ± 2.4)days in the open surgery group, which was significantly different from (92 ± 13)minutes, (28 ±5)hours and (6.4 ± 1.5) days in the laparoscopy group (t =6.21, 16.50, 6.34,P ＜ 0.05).Two infants had incision infection and 1 infant had intestinal obstruction in the open surgery group.There was no patient with complications in the laparoscopy group.All the patients were followed up for the median time of 13 months (range, 6-24 months), with a good survival and no other symptoms.Conclusion Laparoscopic Ladd's surgery is safe and feasible compared with open surgery, and it could be used as a prior operation method for treatment of intestinal malrotation in infants.