Adult ; Choanal Atresia ; etiology ; therapy ; Constriction, Pathologic ; etiology ; Humans ; Male ; Nasopharyngeal Diseases ; etiology ; therapy ; Otorhinolaryngologic Surgical Procedures ; adverse effects ; Palate ; surgery ; Postoperative Complications ; therapy ; Uvula ; surgery

Objective To investigate the risk factors for early postoperative cognitive function in the patients with peritoneal surface malignancies after cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy(CRS-HIPEC).Methods Fifty-one patients(21 men and 30 women), ranged from 25 to 65 years,42-80 kg,ASA Ⅰ-Ⅲ,undergoing CRS-HIPEC under combined intrave-nous-inhalational anesthesia,were studied.Patients were assigned into postoperative cognitive dys-function (POCD)group or non-POCD group according to their performances of visual verbal learning test,concept shifting task,letter-digit coding test and stroop color-word test 1 day before operation and 7 days after operation.Years of education,medical history,duration of operation,intraoperative blood loss,frequency of cardiovascular events,amount of fluid infused per hour and VAS scores were recorded.Venous blood samples were taken at five time points:before surgery(T0 ),30 minutes after the beginning of the procedure(T1 ),30 minutes after the beginning of HIPEC(T2 ),at the end of the surgery(T3 )and 24 hours after the surgery(T4 ),to determine the concentration of serum amyloid A (SAA).pH,PaCO 2, Hb,blood glucose were recorded at T0-T2.Then the data was statistically analyzed.Results According to the diagnostic criteria,twenty patients developed POCD 20 (39.2%). There were significant differences between POCD and non-POCD groups on age,gender, pre-operative complications and the origin of tumor(P <0.05).The concentration of SAA increased from T2 and reached the peak at T4 ,and SAA concentration for patients in POCD group was higher than that for patients in non-POCD group(P <0.05).Compared with non-POCD group,the levels of blood glucose were significantly increased in POCD group at T2 (P <0.05).Conclusion CRS-HIPEC resul-ted in exaggerated and prolonged inflammatory response.Advanced age,female,diabetes,hyperten-sion,peritoneal carcinomatosis from ovarian cancer and endometrial cancer are associated with early POCD in the patients undergoing CRS-HIPEC.

Objective To explore the regularity and characteristics of violence-related injury. Method Data from the injury surveillance in the Emergency Medicine department of Nan-shan hospital was used in this study. Data of all injured patients, who admitied to the emergency department between 1 January 2004 to 31 November 2005, was analysed. Results During the study period, 25376 injured patients were collected and 12280 (48.4%) were violence-related injury patients. The male to female ratio was 2.4: 1. Most of patients were aged 15～44 years old, accouting for 79.9%. The majority of the violence-related patients were wonters, accounting for 59%, most injuries were open wounds and occurred in working places, injuries occurred most during 13 pm to 18 pm. Conclusions Analysis of data from the violence injury surveillance in emergency department can be an aid for the depiction of the overall severe injury profile in area and, in this way, it will be essential for the implementation of properly preventive and controlling measures, despite some limitation. It is urgent to explore and develop an violence injury surveillance system to cope China's milieu.

Objective To explore the effects of peripheral stem cell transplantation on extremely severe bone marrow form of acute radiation sickness.Methods One patient was radiated aecidently with the radiation dosage of 9～15 Gy and diagnosed as extremely severe bone marrow form of acute radiation sickness.Pretreatment was performed at 4th day after the accident and 3 days later,HLA- matched allogeneic stem cell transplantation on the patient was performed.Graft versus host disease (GVHD) was prevented with cyclosporin A (CsA) and mycophenolate mofetil (MMF).Results The haematopoiesis was recovered at 9th day after transplantation.At 11th day after transplantation, WBCs were increased to 14.74?10~9/L and returned to the normal levels subsequently,number of platelets risen to 51?10~9/L and hemaglobin was over 80 g/L.TRS-PCR and blood type dynamic detection testified that the donor's cells were stably implanted,the chromosome aberration and micro- nuclei disappeared after transplantation,and the patient's blood type changed into the donor's at 27th day after transplantation.But the radiation injury were still getting worse complicated with multiple infections,At 68th day after transplantation (75 days after the accident),the patient was died of mul- tiple organs failure.Conclusion Extremely severe bone marrow form of ARS can achieve hematopoie- sis recovery by allogeneic stem cell transplantation,but only hematopoiesis recovery can not cure the immunodefficiency and the radiation injury of the whole body.

Objective To explore continuous renal replacement therapy(CRRT) machine for plasma exchange in critical disease in children.Methods Retrospective study of 8 patients(8 month to 14 years,mean 5.7 years) and 32 plasma exchange treatments,after(adowble) lumen catheter inserted into the subclayian venous,using the Baxter BM25 machine with commercially available plasma filters.Results Five patients(3 ABO-incompatibility in bone marrow transplantation,1 thrombotic thrombocytopaenic purpura TTP,1 sepsis) gained full recovery.One systemic lupus erythematosus(SLE) and 1 sepsis experienced moderate improvement while 1 case of acute disseminated encephalomyelitis failed PE treatment.The average total exchange volume was 80-100 mL/kg,achieved at a blood flow rate of 5-10 mL/(kg?min) and a turnover rate of 60-120 mL/(kg?h) over a 3-hours duration.Thirty-one PE treatments were finished smoothly,one of which experienced the serious complication involving plasma filter.Conclusion Plasma exchange therapy is a safe and effective procedure for severe autoimmune abnormalities and pathogen removal in children.

Objective To investigate the characteristic immunophenotype of B cell chronic lymphoid leukemia in china. Method Single and multiparameter flow cytometry were used to analysis 163 cases of B cell chronic lymphoid leukemia. Results 71.8%(117/163) of cases co-expressed CD5 and B cell markers. The patients were classified into category of B cell chronic lymphocytic leukemia(B-CLL), hairy cell leukemia(HCL) and other B-cell lymphoproliferative disorders(LPDs) by using the scoring system that was recommended by world health organization (WHO). The B-CLL typically display the composite phenotypes: CD5+,CD23+,CD20+,CD19+,HLA-DR+,but the CD22,CD11c,CD25 and FMC7 were variable present in some B-CLL cases.CD103 seems the most specific marker for HCL.To differentiate diagnosis of atypical B-CLL with B-prolymphocytic leukemia(B-PLL) or mantle cell lymphoma(MCL), one must not rely exclusively on immunophenotypic dates, cytogenetic or molecular biology detection would be helpful. The index of froward scatter( FSC) and antigens expression of tumor B cells could be calculated by dividing the relevant value of residual normal T cell within same sample as internal control, so the cell size and the intensity of antigen expression could be comparable each other and quantitative between different investigations. Conclusion immunophenotypic analysis is an extremely useful adjunct in the diagnosis of chronic lymphoid leukemia.

Objective:A questionnaire for the compliance with moxibustion was designed based on the 4-item Morisky scale, and the reliability and validity of the questionnaire was investigated.Methods:A modified Morisky scale was designed based on the 4-item Morisky scale for the compliance with moxibustion, and 146 patients having received moxibustion for over 2 weeks were investigated using this scale to evaluate their compliance with moxibustion; the internal equity and the construct validity of the scale were statistically analyzed.Results:The analysis of reliability showed that in item of internal consistency, the Cronbach's α was 0.72 and the split-half coefficient was 0.71, the correlation coefficients between the 4 component scores and the total score ranged 0.67-0.80, and the between-component correlation coefficients ranged 0.24-0.56; the exploratory factor analysis (EFA) totally extracted 1 common factor, and the explicable variation was 55.02%, and the loads of the 4 items were respectively 0.82, 0.81, 0.74 and 0.58.Conclusion:The reliability and validity of the modified Morisky scale for the compliance with moxibustion are acceptable, while several items need further modification and improvement in the expression and content.

Aged ; Coal Mining ; Electrocardiography ; Heart Rate ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; complications ; physiopathology ; Tachycardia ; etiology

Objective:To investigate the correlation between polymorphisms of serine hydroxymethyltransferase1 gene and the adverse reactions of high-dose methotrexate (HD-MTX) in children with acute lymphoblastic leukemia (ALL). Methods:A total of 51 patients with ALL were treated with HD-MTX, and clinical manifestations after HD-MTX treatment were evaluated retrospectively. cD-NA was obtained from mRNA. The polymorphisms of SHMT1 gene containing rs1979277, rs3783, rs1979276, and rs12952556 sites were tested by denaturing gradient gel electrophoresis and direct sequencing. Effects of SHMT1 gene polymorphisms on HD-MTX ad-verse reactions were evaluated. Results:Severe adverse reactions in ALL patients treated with HD-MTX appeared to be mainly neutro-penia and hepatoadverse reactions. The frequency distributions of rs3783 (C>G), rs1979276 (C>T), rs12952556 (A>G), and rs1979277 (C>T) were the same. The polymorphisms of rs1979277 showed no correlation with neutropenia (P>0.05) but rs1979277 CT and TT genotypes were correlated with hepatoadverse reactions (CT: OR=0.129, 95% CI: 0.020 to 0.817, P=0.03; TT: OR=0.103, 95% CI:0.017 to 0.620, P=0.013). Conclusion: No correlation was found between the combination of rs1979277, rs3783, rs1979276, rs12952556, and neutropenia, but one or more of these loci may reduce the risk of hepatoadverse reactions.

Objective To explore the CT findings of mucoepidermoid carcinoma (MEC) of the tracheobronchial tree and improve the diagnostic accuracy. Methods The CT images, histopathological and clinical data in 24 patients with pathologically proved MEC of the tracheobroncbial tree were retrospectively analyzed. Results The clinical symptoms included cough, sputum, fever, wheezing, chest pain and hemoptysis. The patient was proved to be low-grade (n=19) and high-grade (n=5) MEC histopathologically. One lesion was located in trachea, 6 in main bronchus, 12 in lobar bronchus and 5 in segmental, subsegmental and distal bronchus. The tumor presented as no-invasive endotracheobronchial well-defined round-like nodule (n=13, locating in lobar and higher bronchus) and columnar sharp (n=3, locating in main bronchus), or intra-and-extraluminal well-defined round-like nodule or mass (n=6, locating in lobar and lower bronchus) and irregular mass with invasive pattern (n=2, high-grade type). The density of lesion was similar to the muscule and the calcification within lesion was showed in 4 patients on non-enhanced CT. The lesion had marked enhancement in 17 patients on enhanced CT. Obstructive changes were found in 20 patients. Conclusion MEC of the tracheobronchial tree is usually low-grade malignancy and locates in main and lobar bronchus with no-invasive well-defined airway mass, marked enhancement and calcification on CT.