Objective To explore the new method for the differential diagnosis of malignant and non-malignant ascites. Methods 126 patients with ascites including 39 cases of liver cirrhosis,15 cases of tuberculous peritonitis,33 cases of hepatocellular carcinoma and 39 cases of other malignant tumors were enrolled in this study.The levels of serum C-12 tumor markers were measured. Results The levels of serum CEA, AFP, CA19-9 and CA242 were remarkably higher in malignant ascites than thos in non-malignant ascites(P

Aim To observe the timed analgesic effects by butabital (B), acetaminophen(A) and caffeine (C) in combination (BAC), in which the proportion was fixed as1. 25∶ 8. 1∶1. Method Three types of experimental methods, including the tailflicking method, the hot plate method and the pressurizing tail method, weretaken to determine indices at different times after the animals were adminstered(ig) high, median and low BAC dose. Results and conclusion BAC had a stronganalgesic effect in three types of experiments. The effect began 30 min after ad-ministration, arrived maximum at 1 h, decreased at 2 h and disappeared at 4 h.There was a dose-effect relationship between large and little BAC dose.

Objective To understand the incidence of abnormal glucose metabolism during pregnancy and the maternal and neonatal outcomes after standard management.Methods A retrospective study of maternal and neonatal outcomes was conducted in 1490 pregnant women who were diagnosed and treated for abnormal glucose metabolism and delivered in the Department of Obstetrics and Gynecology of First Hospital of Peking University from Jan 1995 to Dec 2004 by reviewing the medical records.The selected cases consisted of 79 women with diabetes mellitus(DM group),777 with gestational diabetes mellitus(GDM group),including 355 cases of A1,316 with A2 and 106 cases unclassified,and 634 with gestational impaired glucose test(GIGT group).Maternal and fetal outcomes were analysed in comparison with the controls of 19 013 pregnant women with normal glucose metabolism who delivered during the same period.Results(1)The total incidence of gestational abnormal glucose metabolism was 7.3% and increased gradually from 1995 to 2004.The first stage,from Jan 1995 to Dec 1999,saw a slow increase in the incidence [4.3%(376/8739)];the second stage,from Jan 2000 to Dec 2001,showed a fast increasing trend.The average incidence was 10.8%(445/4133).The incidence in the third stage kept stable at 8.9% (678/7640)from Jan 2002 to Dec 2004.(2)The incidence of macrosomia,preeclampsia and preterm birth were 12.1%(180/1490),9.5%(141/1490)and 9.4%(140/1490),which were significantly higher than those women with normal glucose metabolism(P0.05).(3)The perinatal mortality rate(PMR)of abnormal glucose metabolism group was 1.19%(18/1513)which was significantly higher in the DM group (4.93%)than GDM(1.14%)and GIGT groups(0.78%,P

Objective To assess whether dynamic arterial elastance (Eadyn)can be used to predict the reduction of arterial pressure after decreasing norepinephrine (NE) dosage in patients with septic shock.Methods A prospective observational cohort study was conducted.Thirty-two patients with septic shock and mechanical ventilationwere enrolledfrom January 2014 to December 2015 in ICU of Wuxi People's Hospital of Nanjing Medical University.Hemodynamic parameters were recorded by pulse contour cardiac output(PiCCO) monitoring technology before and after decreasing norepinephrine dosage.Eadyn was defined as the ratio of pulse pressure variation (PPV) to stroke volume variation (SVV).Mean arterial pressure (MAP) variation was calculated after decreasing the dose of NE.Response was defined as a ≥ 15％decrease of MAP.AUC was plotted to assess the value of Eadyn in predicting MAP response.Results A total of 32 patients were enrolled in our study,with 13 responding to NE dose decrease where as the other 19 did not.Eadyn was lower in responders than in nonresponders (0.77 ± 0.13 vs 1.09 ± 0.31,P ＜ 0.05).Baseline Eadyn was positively correlated with systolic blood pressure variation,diastolic blood pressure variation,systemic vascular resistance variation and MAP variation (r =0.621,P =0.000;r =0.735,P =0.000;r =0.756,P =0.000;r =0.568,P =0.000 respectively).However,stoke volume variation,baseline level of systemic vascular resistance and NE baseline dose were not correlated with Eadyn baseline value (r =0.264,P =0.076;r =0.078,P =0.545;r =0.002,P =0.987 respectively).Eadyn ≤ 0.97 predicted a decrease of MAP when decreasing NE dose,with an area under the receiver-operating characteristic curve of 0.85.The sensitivity was 100.0％ and specificity was 73.7％.Conclusions In septic shock patients treated with NE,Eadyn is an index to predict the decrease of arterial pressure in response to NE dose reduction.

OBJECTIVE: Comparative analysis of the clinical curative effect of manipulative reduction and TRV- CRP treatment of BPPV, comfort degree during reset and quality of life improvement. METHOD: One hundred and thirty-two patients with BPPV were randomly divided into two groups ,one group underwent the traditional manip- ulative reduction, the other group with TRV-CRP. DRI and VAS was evaluated in the pre and after treatment and evaluation of the efficacy was conducted. The results of two groups were compared. RESULT: The effective rate of manipulative reduction after a week treatment was 89. 23% and TRV-CRP.was 98. 51%, which was higher in TRV-CRP group than that of the manipulation reduction group(P<0. 05). The comfort degree of the manipulation reduction group was 4. 54±2. 48,higher than the TRV-CRP group which was 5. 48±1. 44 (P<0. 05). The score of DHI showed no significant difference before treatment between manipulation reduction group and TRV-CRP group(P>0. 05), the score of the two groups were decreased after a week of reduction, but the improvement of TRV-CRP group was higher than that of manipulation reduction group(P<0. 05). CONCLUSION The success rate of TRV-CRP was higher than that of manipulative reduction,but manipulative reduction comfort degree was higher than TRV-CRP, the two methods can both improve the quality of life of patients with BPPV. TRV-CRP has many advantages over manipulative reduction, but manipulative reduction is simple with low cost, and the effect is still a great advantage. In clinical work, we should reasonable combine the two methods,so as to improve the cure rate of RPPV.
Benign Paroxysmal Positional Vertigo ; therapy ; Humans ; Patient Positioning ; Quality of Life ; Treatment Outcome

With the increase of the incidence and the refinement of clinical treatment,the clear preoperative staging and the assessment of tumor recurrence and metastasis of cervical cancer is particular important.Different results may be explained in the same tumor applied different methods of imaging examination,which influences the clinical diagnosis and treatment.So imaging examination plays a more and more important role in the assessment of preoperative staging and tumor recurrence.

Objective To observe the clinical efficacy of comprehensive acupuncture therapy in treating tinnitus in elderly neurosensory deafness. Method Eighty elderly neurosensory deafness patients were randomized into a treatment group and a control group, 40 cases in each group. The control group was intervened by oral administration of Mecobalamin tablets, and the treatment group was intervened by acupuncture plus acupoint injection plus auricular point sticking. The changes of tinnitus intensity after the treatment in the two groups were observed, the clinical efficacies were compared between the two groups, and the correlation between disease duration and therapeutic efficacy was also observed. Result The tinnitus degree was significantly changed after the treatment in both groups (P<0.01). The total effective rate was 83.3% in the treatment group, versus 57.1% in the control group. There was a significant difference in comparing the clinical efficacy between the two groups (P<0.05). In both groups, the clinical efficacy of the patients with a disease duration ≤3 years was significantly different from that of the patients with a disease duration > 3 years in the same groups (P <0.05). Conclusion Comprehensive acupuncture therapy is an effective method in improving tinnitus in elderly neurosensory deafness.

0.05) . Conclusion An acceptable image quality can be achieved for pediatric patients by reducing the mA value to 40 to 80mA used for conventional temporal bone, and the low dose CT scanning ought to be extended in the temporal bone decease for children.

Objective To detect the changes of visceral sensitivity in rats presenting intestinal dysbacteriosis and the expressions of tight junction protein (ZO-1)and Toll-like receptor 4 (TLR4)so as to explore the effect of intestinal dysbacteriosis on visceral sensitivity and the possible mechanisms.Methods We randomly divided 30 male SD rats of SPF grade into normal control group (n = 12 )and dysbacteriosis group (n = 18 ).Rats in dysbacteriosis group were administered with lincomycin hydrochloride (300 mg/mL),1 mL each time per rat once a day for 7 consecutive days;those in normal control group were fed with the same amount of saline.On the eighth day,six rats were randomly selected from normal control group and dysbacteriosis group respectively to detect whether the model was successful.After the model was successfully constructed,the remaining 12 dysbacteriosis rats were randomly divided into the negative control group and the probiotics intervention group with 6 in each.Rats in the intervention group were given probiotic bifidobacterium triple viable capsules (Bifico)orally,one capsule with 1/3 mL of saline,1 mL each time per rat once a day for 7 consecutive days;those in the negative control group received the same amount of saline.On the eighth day,fresh feces was cultured for flora to detect visceral sensitivity by abdominal withdrawal reflex (AWR),the mRNA and protein expressions of ZO-1 and TLR4 in the colon,and the expression of serum inflammatory cytokines IL-10 and TNFα.Results The expression of ZO-1 in the colon was significantly lower in the rats of dysbacteriosis group than those in the control group,and the expression of TLR4 was also significantly increased.Correspondingly,the expression of pro-inflammatory factor TNFα in the serum of the rats in dysbacteriosis group was significantly increased,while that of anti-inflammatory factor IL-10 was significantly lower than in the control group (P <0.05).Furthermore,compared with dysbacteriosis group,the expression of ZO-1 was increased significantly and TLR4 was decreased in probiotics group in varying degrees. Similarly,the expression of TNFα was obviously lower while that of IL-10 in the serum was higher (P < 0.05 ). Conclusion Inhibiting the expression of ZO-1 and increasing the expression of TLR4,thus leading to chronic low-grade inflammation, may be one mechanism of visceral hypersensitivity caused by intestinal dysbacteriosis. Probiotics may restore the dysbacteriosis and thus improve visceral hypersensitivity.

Objective To evaluate the application of the binary Logistic regression model to analyze ultrasonographie indexes of the solid breast tumors. Methods The indexes of two dimensional gray scale ultrasonography,two dimensional color Doppler flow imaging,three dimensional gray scale ultrasonography, three dimensional color Doppler flow imaging and ultrasonic elastography were evaluated in 151 breast lesions confirmed by surgical pathology. A Logistic regression model for predicting breast rnalignaney on the basis of ultrasonographic indexes was obtained. A receiver operating characteristic (ROC) curve was used to assess the performance of the Logistic regression model. Results Six ultrasonic indexes were finally entering the Logistic regression model. They were elasticity score, shape,internal echo, RI, enhancement of posterior acoustic alteration and the converging pattern in the coronal plane. The area under the ROC curve was 0. 996. The percentage correct of prediction was 97.35 %. Conclusions The multivariate analysis model of binary Logistic regression can describe and analyze the process of differential diagnosis of malignant and benign solid breast tumors by ultrasonography and can select out the valuable indexes of differential diagnosis.