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.

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 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.

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.

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.

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 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.

Child ; Cryptosporidiosis ; complications ; Cryptosporidium parvum ; Cyclospora ; Cyclosporiasis ; complications ; Diarrhea ; complications ; Humans ; Hypoproteinemia ; complications ; Male

Objective To explore the effect of mosapride combined with polyethylene glycol electrolyte powder on cleaning intestinal tract before colonoscopy in patients with chronic constipation.Methods A total of 127 patients with chronic constipation for colonoscopy were randomly divided into observation group of 64 cases,oral administration of mosapride 10 mg and polyethylene glycol electrolyte powder; control group of 63 cases,oral polyethylene glycol electrolyte powder for bowel preparation for colonoscopy.The intestinal cleanness,first defecation time and adverse reaction was compared between two groups.Results The Boston bowel preparation score was (8.32 ± 0.86) scores in observation group,and (7.69 ± 0.95) scores in control group,and there was significant difference between two groups (t =3.918,P＜ 0.05).The first defecation time after taking the medicine was (45.69 ± 13.57) min in observation group and (54.63 ± 11.78) min in control group,and there was significant difference between two groups (t =3.966,P ＜ 0.05).After taking the medicine,5 cases of nausea and vomiting and 11 cases of abdominal distension in observation group,13 patients of nausea and vomiting and 23 cases of abdominal distension in control group,and there was significant difference between two groups (x 2 =4.29,6.04,P ＜0.05).Conclusion Mosapride combined with polyethylene glycol electrolyte powder can improve the intestinal tract cleaning quality,shorten the time of first defecation time,and reduce adverse reaction.

Objective To reconstruct the three-dimensional images of normal liver using 256-slice intelligent CT (iCT)and to measure the volume of liver and its segments.Methods 48 healthy adults underwent abdominal contrast enhancement iCT,and the images in portal venous phase were transmitted to a workstation (EBW4.5)to obtain the three-dimensional images of the liver.The total liver volume was measured,and a scatter plot was gotten between body surface area and liver volume.According to the Couinaud classification of hepatic segment ofⅠ-Ⅷ,the volume of each segment was also measured.Results The mean total liver volume in 48 adults was (1 343.2±238.3)mL,which was positively correlated with body surface area with a correlation coefficient of 0.87 and a regression equation of LV(mL)=763.0×BSA-28.6.The volume of SegmentⅠ-Ⅷ was(24.5±4.3)mL,(148.6±31.6)mL,(110.4±24.9)mL, (222.3±43.0)mL,(212.8±36.5)mL,(186.7±34.7)mL,(164.3±30.8)mL and (273.4±56.1)mL,and their percentage was (1.8±0.2)%,(11.0±1.1)%,(8.2±1.1)%,(16.6±1.4)%,(15.9±1.0)%,(13.0±1.0)%,(12.2±0.7)% and (20.3±1.5)% respec-tively.Conclusion The three-dimensional images of liver and hepatic segments can be well reconstructed by 256 slice iCT.