Bacterial Infections ; epidemiology ; etiology ; Cerebral Hemorrhage ; diagnosis ; etiology ; therapy ; Craniocerebral Trauma ; diagnosis ; etiology ; therapy ; Female ; Fetal Membranes, Premature Rupture ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases ; diagnosis ; etiology ; therapy ; Pregnancy ; Risk Factors ; Tomography, X-Ray Computed

Objective To evaluate the application value of serum endotoxin combined with integrated model for end-stage liver disease (iMELD) in evaluating the short and medium term prognosis of patients with decompensated liver cirrhosis.Methods The clinical data of 68 patients with decompensated liver cirrhosis were retrospectively analyzed.The patients were divided into survival group and death group according to the result of follow-up at the 3,6 and 12 months.The iMELD score and Child-Turcotte-Pugh (CTP) score were calculated according to relevant indicators,and the serum endotoxin level was detected.The correlation between serum endotoxin and iMELD score was analyzed in the short and medium term prognosis in patients with decompensated liver cirrhosis.Results After 3 months' follow-up,5 patients died.The iMELD scores in survival group and death group were (39.26 ± 7.29) and (49.29 ± 8.63) scores,CTP scores were (9.32 ± 2.12) and (12.03 ± 2.75) scores,serum endotoxin levels were (9.21 ± 2.24) and (15.39 ± 5.12) ng/L,and there were statistical differences (P ＜ 0.05).After 6 months'follow-up,12 patients died.The iMELD scores in survival group and death group were (41.35 ± 8.03) and (52.18 ± 10.37) scores,CTP scores were (9.78 ± 2.05) and (12.93 ± 1.99) scores,serum endotoxin levels were (8.96 ± 2.41) and (16.43 ±6.03) ng/L,and there were statistical differences (P ＜0.05).After 12 months' follow-up,19 patients died.The iMELD scores in survival group and death group were (40.74 ± 6.38) and (52.29 ± 8.53) scores,CTP scores were (10.01 ± 2.23) and (13.27 ± 1.69) scores,serum endotoxin levels were (8.53 ± 2.34) and (16.52 ± 6.08) ng/L,and there were statistical differences (P ＜ 0.05).The area under curve of receiver operating characteristic (ROC) was 0.952,standard error was 0.048,and 95％ confidence interval was 0.790-1.022.The best critical value of iMELD score to predict death was ≥48.00 scores,and the risk of death would rise if iMELD score was increased.The best critical value of serum endotoxin to predict death was ≥ 11.00 ng/L.Conclusion iMELD score and serum endotoxin have important value in predicting prognosis in patients with decompensated liver cirrhosis.

Thyroid peroxidase antibody (TPOAb) play an important role in the diagnosis of autoimmune thyroid disease.Chemiluminescence immunoassay (CLIA) is a new method been strongly recommended in recent years.The definition of positive value of TPOAb is inconsistent.The definition of TPOAb positive value is important for exploring the development of autoimmune thyroid disease.TPOAb is significantly increased in Hashimoto's disease and the titer is associated with the degree of infiltration and destruction of thyroid follicular.It is essential to monitor TPOAb in postpartum thyroiditis and early pregnancy.The positive of TPOAb is closely related to the adverse pregnancy outcomes caused by various risk factors.Graves disease combined with Hashimoto's must to be considered.

Objective To investigate the efficacy of warfarin combined with urokinase in the prevention of deep venous thrombosis after hip replacement. Methods 58 patients undergoing hip replacement in our hospital from October 2014 to October 2016 were randomly divided into the observation group and the control group, 29 cases in each group. The control group were treated with oral warfarin, the observation group was treated with warfarin combined with urokinase, two groups of patients were treated for 14d, the incidence of lower limb deep vein thrombosis, follow-up statistics of two groups of patients within three months after operation, the diameter and blood rheology changes before and after weeks of treatment of lower extremity. Results During the treatment and follow-up of 14d patients in the control group, the incidence of deep venous thrombosis was 20.67% significantly higher than the observation group 3.45% (P<0.05); after treatment, the two groups of patients with lower limb circumference difference was significantly reduced (P<0.05), and the patients in the observation group the thigh circumference, calf circumference difference was significantly less than the control group (P<0.05); after treatment, the two groups of patients with high blood viscosity, low blood viscosity, plasma viscosity and hematocrit were significantly lower than those before treatment (P<0.05), and the indicators of the observation group were significantly lower than the control group (P<0.05). Conclusion Warfarin combined with urokinase can effectively prevent the formation of deep vein thrombosis of lower extremity after hip replacement, improve the hypercoagulability of patients and reduce the circumference of the lower extremity, so it is worthy of clinical application.

The authors give an account of the basic concept and classification of cytotoxic drugs. A center for compounding cytotoxic drugs has been set up in their hospital by using for reference the management experience of the US in this aspect. The center stresses centralized management in compounding cytotoxic drugs, strict operating rules and protective actions, and reduction of possible toxic damages resulting from cytotoxic drugs and infection caused by them in other sectors, thus guaranteeing the physical and mental health of the medical staff. At the same time, the authors call on all medical institutions to pay attention to the disposition of cytotoxic drugs and exert efforts to help a relevant national standard to come out as soon as possible.

Objective To develop a new type fusion apparatus for scaphoid-trapezium-trapezoid (STT) arthrodesis.Methods The apparatus was designed on the basis of the anatomic data of STT measured from Chinese cadaveric wrists.Simulated arthrodeses of STT joints were conducted to test the fixation performance of the apparatus made of titanium alloy on the STT joint specimens.Several modifications were made before the apparatus was made into a finished product.Results The fusion apparatus consists of a plate and screws.The fusion plate for STT arthrodesis is made into a taper one connected to a cylinder.On the plate are three screw holes through which the three carpal bones (STT) are fixed by three screws respectively.The hollow cylinder is designed for bone grafting,and its outer threads ensure a very tight contact between the fusion plate and the carpal bones.Auxiliary tools are also made.Conclusions As the novel design of the fusion apparatus improves the mechanical strength of fixation of STT and prevents the possible rotation and collapse of fused STT,the apparatus is a reliable internal fixation device for the limited intercarpal arthrodesis.

Objectives: To investigate the occurrence and risk factors of cerebral microbleeds on the cognitive function in patients with ischemic cerebrovascular disease and to investigate the effect of cerebral microbleeds on the cognitive function in patients with ischemic cerebrovascular disease. Methods: A total of 160 patients with ischemic cerebrovascular disease were divided into cerebral microbleed group (n =30) and control group (n = 130) according to MR T2 *-weighted gradient echo sequences. The demographic data of the patients, conventional risk factors, sites of microbleed, types of cerebral infarction, severity of white matter changes, and numbers of lacunar infarction were recorded in detail. The Montreal Cognitive Assessment was conducted in both groups. All the data were processed using SPSS 16.0 software. Results: Circled digit oneThe mean age of the microbleed group was older than that in the non-microbleed group (75 ±9 vs. 66 ±6, P = 0.000) ; the degree of white matter changes was higher (6.7 ±2.4 vs. 3.5 ±1. 8, P =0.003) ; and the numbers of lacunar infarction were larger (5.0 ±2. 3 vs. 2. 1 ±1.3, P= 0.000). Circled digit twoThe logistic regression analysis showed that the high blood cholesterol, the degree of white matter change ( WMC ) , and the numbers of lacunar infarction were the independent risk factors for CMB (OR =3. 880, 95% CI:0. 086 -0. 994; OR = 11.735, 95% CI; 1.340 -2.930; OR = 10. 160, 95% CI: 1.241 -2.475). Circled digit threeThere was no significant difference in the cognitive function scores between the two groups ( P > 0. 05 ). Circled digit fourThere was significant difference in the executive ability between the two groups (P =0.010). Conclusions: Circled digit oneCerebral microbleeds are closely associated with leukoaraiosis and lacunar infarction; Circled digit twothe patients with ischemic cerebrovascular disease accompanied by microbleeds has obvious executive dysfunction ; Circled digit threecontrolling the risk factors for microbleeds has a certain role for the control of the occurrence and development of cognitive impairment in patients with ischemic cerebrovascular disease.

Objective:To investigate the correlation between sarcopenia and post-stroke cognitive impairment(PSCI)in elderly patients with first-time acute minor ischemic stroke.Methods:This was a prospective study.Elderly patients over 60 years of age with first-time acute minor ischemic stroke admitted to the Department of Neurology of the General Hospital of Western Theater Command from October 2018 to June 2019 were continuously enrolled.Patients received the SARC-F score assessment within 24h after admission and were divided into two groups according to their SARC-F scores: the non-sarcopenia group(SARC-F score<4)and the sarcopenia group(SARC-F score≥4). Cognitive function was assessed by using the Mini-Mental State Examination(MMSE)within 24 h of admission and at 3-month follow-up.Results:A total of 211 patients were enrolled in this study, including 31 patients(31/211, 14.69%)in the sarcopenia group and 180 patients(180/211, 85.31%)in the non-sarcopenia group.The incidence of PSCI was higher in the sarcopenia group than in the non-sarcopenia group(83.87% or 26/31 vs.55.56% or 100/180, χ2=8.814, P=0.003). The total MMSE score, orientation, immediate memory, attention, calculation and language functions were lower in the sarcopenia group compared with non-sarcopenia group( P<0.05). Logistic regression analysis showed that sarcopenia was an independent risk factor for PSCI( OR=3.478, 95% CI: 1.039-11.642, P=0.043)in the elderly with first-time acute minor ischemic stroke. Conclusions:Sarcopenia is an independent risk factor for PSCI in elderly patients with first-time acute minor ischemic stroke.Sarcopenia assessment in the acute phase of stroke might help doctors to assess the risk of PSCI and reduce the incidence of PSCI in stroke patients.

Objective To explore the effect of trimetazidine, telmisartan and low molecular weight heparin (LMWH) on improving cardiopulmonary function, hemorheology and clinical symptom of chronic pulmonary heart disease in acute exacerbation. Methods A total of 96 patients with chronic pulmonary heart disease in acute exacerbation were randomly divided into group A (40 cases) and group B (56 cases ).The group A was treated with general method and the group B was treated with trimetazidine, telmisartan and LMWH besides general method. After 3 weeks' treatment, ca_rdiopulmonary functional parameters,hemorbeology parameters and clinical symptoms were observed. Results After treatment, the left ventricular ejection fraction (LVEF), and the ratio of forced expiratory volume in one second and forced vital capacity (FEV_1/FVC ) improved in group B (P<0.05 ), and there were significant difference in LVEF, FEV_1/FVC after treatment between two groups (P<0.05). The clinical total effective rate in group B (92.9%, 52/56 ) was significantly higher than that in group A (67.5%, 27/40 ) ( P<0.05 ). Conclusion Trimetazidine, telmisartan and LMWH is effective to improve patients' cardiopulmonary function, hemorheology parameters and clinical symptoms in the treatment of chronic pulmonary heart disease in acute exacerbation.

Objective To explore the value of trypsinogen activation pepfide (TAP) levels in blood plasma and urine in the diagnosis of acute pancreafitis at early stage and severity predicting combined with the CT results. Method Sixty-five patients with acute pancreatitis who scanned with enhanced CT were di-vided into mild acute pancreatitis (MAP) group and severe acute pancreatitis (SAP) group according to the CT results, 29 patients with acute abdomen except for acute pancreatitis were as control group. TAP levels in blood plasma and urine were measured in all patients. Results At the time of 6, 12 and 24 h after admis-sion, the level of blood plasma TAP in SAP group ( > 9.0 nmol/L) was significantly higher than that in MAP group(< 3.5 nmol/L), there were significant differences between SAP group and MAP group or control group (P<0.05). And the median urinary TAP in SAP group (102.8, 78.2, 52.3 nmol/L)was significantly higher than those in MAP group (32.5, 28.7, 25.6 nmol/L)and control group(12.6, 12.2, 11.5 nmol/L), there were significant differences among three groups (P<0.05). At the time of 3, 5 d after admission, there was no significant difference in TAP levels in blood plasma and urine among three groups (P>0.05). Conclusions Early dynamic detection of TAP levels in blood plasma and urine is of higher diagnostic value and predictive value for acute pancreatitis, which is of benefit in the early diagnosis and treatment of acute pancreatitis.