The changes of serum malondialdehyde, myeloperoxidase, total antioxidant capacity, superoxide dismutase activity, and glutathione peroxidase were observed in patients with Graves′ disease. The myeloperoxidase level increased in patients with Graves′ disease. The balance between oxidation and antioxidative defense was disrupted in patients with newly-onset Graves′ disease. Oxidative stress seems to be related to hyperthyroidism.

Objective To analyze the therapeutic effect and prognosis of peritoneal dialysis in patients with end-stage polycystic kidney disease.Methods A retrospective analysis was performed on patients with polycystic kidney disease who were treated with peritoneal dialysis for more than 3 months between July 2007 and September 2016 in the Second Hospital Affiliated to Soochow University.A total of 45 patients were enrolled in this study.Another 45 patients of non-diabetic nephropathy were selected as the control group matched by gender,age,and time of PD initiation.The information of the two groups such as general data,dialysis related complications,incidence of peritonitis,prognosis was recorded.Survival analysis was performed using the Kaplan-Meier method and Log-rank test.The risk factors affecting patients' survival were analyzed with Cox regression model.Results There were no significant difference in pre-dialysis age,sex ratio,blood pressure,urine volume,body weight,eGFR,biochemical data,and the proportion of hypertension and diabetes mellitus in the polycystic kidney group and control group.24 h ultra-filtration volume,4 h D/Pcr,Kt/V and Ccr between the two groups showed no significant difference (all P ＞ 0.05).The incidence of peritonitis and the time of the first peritonitis in the two groups respectively as one episode per 82.4 months vs one episode per 81.5 months,(35.8±22.8) months vs (34.5±20.9) months had no statistical difference.The ratio of hernia (6.6％ vs 2.2％),thoracic and abdominal leakage (4.4％ vs 2.2％),dialysate leakage (0 vs 0),catheter dysfunction (4.4％ vs 6.6％),exit-site infections (11.1％ vs 6.6％),tunnel infections (4.4％ vs 2.2％) and non PD related infections (11.1％ vs 13.3％) had no significant difference.The 1-year,3-year,5-year patient survival of two groups respectively were 95.2％ vs 93.3％,78.9％ vs 75.0％,67.6％ vs 64.9％ (P=0.475),and 5-year technique survival was 78.7％ vs 76.7％ (P=0.623),demonstrating no obvious difference.Cox regression analysis showed that age and serum albumin were risk factors for the survival of patients.Conclusions The effect and prognosis of peritoneal dialysis in patients with polyeystic kidney and non polyeystic kidney were similar.Peritoneal dialysis is not the contraindication of polycystic kidney.Peritoneal dialysis can be used as a routine renal replacement therapy in patients with polycystic kidney disease.

Geriatric falls presenting to the emergency department (ED) are rising due to our rapidly ageing population. As part of a group of geriatric-focused emergency medicine practitioners, we describe a multidisciplinary falls prevention tool using the acronym.
Accidental Falls/prevention & control* ; Aged ; Emergency Service, Hospital ; Geriatric Assessment ; Humans

Objective: To construct an index system for evaluating the effectiveness of dynamic pricing adjustment of medical services, for the purpose of providing a set of evaluation tools for price regulatory authorities to evaluate the effectiveness of pricing adjustment of medical services, to keep track of pricing trends, to implement dynamic monitoring and to guide decision-making. Methods: Oriented to public hospitals in Guangdong province, literature analysis and Delphi method were used to construct the index system for evaluating the effectiveness of dynamic adjustment of medical service price. Descriptive analysis, consistency test and index importance evaluation were applied to statistical analysis. Results: Thirty-two experts evaluated the importance of 41 alternative indicators. The index system for evaluating the effectiveness of dynamic adjustment of medical service price was finally constructed, including six structural indicators, six process indicators and six result indicators. Conclusions Experts are representative, authoritative and well-coordinated. The consultation results are reliable. The evaluation index system has high reliability and validity, and can be used to objectively evaluate the dynamic adjustment effect of medical service price.

OBJECTIVETo analyze the CT and MRI findings and pathological characteristics of retroperitoneal localized Castleman's disease and discuss the diagnostic and differential value of CT and MRI.

METHODSCT, MRI and clinical data of retroperitoneal localized Castleman's disease, proved by surgery and pathology, of 13 patients were reviewed. Among them, all the 13 cases received CT, and 4 cases received MRI examination.

RESULTSAmong the 13 cases, 12 cases were of hyaline vascular type, and one was of mixed type. All foci were single mass and most foci located in the periphery of the kidney. The maximum diameter was 4.2 cm to 8.6 cm and the mean diameter of all tumors was 5.9 cm. The outline of most tumors was clear and kidney-shaped. On unenhanced CT, 10 cases showed low density and 3 cases showed isodensity. On plain MRI, four cases showed iso-signal on T1WI, three cases showed slightly high signal on T2WI and one showed moderately high signal. The CT and MRI findings were similar on contrast enhanced scan. In arterial phase, 10 cases showed moderate enhancement, 2 cases showed significant enhancement and one case showed moderate enhancement. Five cases showed rather homogeneous enhancement and 8 cases showed heterogeneous enhancement.In venous phase, all the 13 tumors showed continuous enhancement. Eight cases showing heterogeneous enhancement in arterial phase showed expanded range, and among them two cases showed tending to be homogeneous enhancement. Six cases showed areas of low density without enhancement, and 9 cases were accompanied with single or multi-satellite punctuate or striped foci around the tumors.

CONCLUSIONDynamic contrast-enhanced CT and MRI combined with MR T2WI fat-suppression are of great importance in the diagnosis and identification of retroperitoneal localized Castleman's disease.

Adult ; Castleman Disease ; diagnostic imaging ; pathology ; surgery ; Female ; Humans ; Image Enhancement ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Radiographic Image Enhancement ; Retroperitoneal Space ; diagnostic imaging ; Retrospective Studies ; Tomography, X-Ray Computed

Objective:To develop an evaluation index system for dynamic adjustment effect of medical service prices in public hospitals, as a set of quantitative evaluation tools for management departments to keep track of the trend in time, implement dynamic monitoring and guide decision-making.Methods:Based on the evaluation system of price adjustment effect, through the importance assessment of expert consultation and multiple index percentile method, the scoring criteria were formulated and the empirical analysis was carried out.Results:The total scores of hospital A and hospital B were 71.31 and 77.94 respectively, classified as " average" . The evaluation could basically reflect the effect of dynamic adjustment of medical service price in public hospitals.Conclusions:The evaluation has the functions of displaying differences, witnessing achievements and tracing causes. It can be used to evaluate the effect of dynamic adjustment of regional prices, to assist the regulators to keep track of trends, monitor dynamically and guide decision-making in time, and be used by hospitals in self-evaluation to find problems, improve their own operation and promote the healthy development of hospitals.