25 mmHg) had no response to conservative management, and,therefore,had to be decompressed by invasive procedure,including 6 patients performed by decompression laparotomy,2 patients by laparoscopic decompression and 5 patients by ultrasound/computed tomography location and needle paracentesis drainage.These 13 ACS patients had obvious amelioration in physiological variables (hemodynamic,respiratory and tissue perfusion) after 24 hour post-decompression (P

Objective To discuss the correlation between procrastination and the mentalities of anxiety and depression among medical postgraduates,so as to carry out mental health work effectively.Methods 423 medical postgraduates in Central South University were assessed randomly, using General Procrastination Scale (GPS),Self-rating Anxiety Scale(SAS),Self-rating Depression Scale (SDS).Results Procrastination score and incidence in medical postgraduates was 54.92±8.40 and 60.99%respectively,the differences of procrastination scores(53.3l±8.21,55.90±8.30,55.75±8.49,P=0.013)and incidences(52.60%,66.09%,65.58%.P =0.028)among three grades were statistically significant.Both total coarse score of anxiety and that of depressionwere higher than that of the whole country(31.24±7.40,29.78±10.07,P=0.000;34.8±8.11,33.46±8.55,P=0.000),the differences were statistically significant.Procrastination had a positive correlation with anxiety and depression significantly(r=0.304,P=0.000;r=0.369,P=0.000),the higher the grade was,the weaker the intensity of correlation was.Hish-delay group,low-delay group and normal-behavior group had different deglees of anxiety(46.63±10.55,44.01±10.12,38.32±7.57,P=0.000)and depression(51.45±10.12,47.81±10.78,40.69±8.23,P=0.000),which was statistically significant.Conclusion Anxiety and depression among medical postgraduates were outstanding and had a close relationship with procrastination behavior,which should be taken seriously and handled by strengthening mental health education.

OBJECTIVETo evaluate the safety and clinical outcomes of the novel simplified no-flip surgical approach to Shang Ring male circumcision in adults.

METHODSA total of 528 adult males, aged 18 - 58 (mean 35) years, 63 with phimosis and 465 with redundant prepuce, underwent no-flip Shang Ring circumcision with or without removal of the outer ring. The operation time and intraoperative blood loss were recorded and observations were made on such complications as postoperative bleeding, infection, edema, and wound dehiscence.

RESULTSThe operation time, intraoperative blood loss, and 2-hour postoperative pain score were (3.8 +/- 0.3) min, (0.6 +/- 0.1) ml, and 7.3 +/-0.3, respectively. Spontaneous ring detachment occurred at 21.6 +/- 2.1 days postoperatively in 12.7% of the patients (67/528) who had chosen not to remove the rings. Of those who preferred removal of the outer ring (87.3% [461/528]), none experienced any pain at the ring removal 7 days after the operation. Postoperative complications included infection in 3 cases (0.56%) and mild edema in 9 (1.70%), but no bleeding and wound dehiscence. Totally, 518 (98.1%) of the patients felt satisfied with the postoperative penile appearance.

CONCLUSIONNo-flip Shang Ring circumcision, with no need for removal of the inner ring, is a safe and simple approach for adult males, which is superior to conventional Shang Ring circumcision for requirement of fewer surgical instruments, shorter operation time, lower incidence of complications, and better satisfaction with the penile appearance. However, these advantages are to be further demonstrated by more randomized controlled trials.

Adolescent ; Adult ; Circumcision, Male ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Phimosis ; surgery ; Postoperative Complications ; Young Adult

Objective To analyze the chemical components of Fructus Aurantii (FA) and Fructus Aurantii Immaturus (FAI).Methods HPLC-ESI-MS with Surveg mass spectrometer was used in the study.Chromatographic column: Symmetry Shield TM RP_ 18 (150 mm?3.9 mm, 5 ?m) (Waters, Milford, MA, USA); mobile phase: (A) water (0.6% HAc, pH=2.5), (B) methanol. Gradient elutions: 20%- 40% B (0-48 min); 40% B (48-54 min); 40%-55% B (54-60 min); 55%-95% B (60-75 min); 95% B (75-85 min); 95%-20% B (85-90 min).Flow rate and wavelength were 0.7 mL/min and 283 nm at room temperature, respectively.Results Four kinds of flavonoids were identified as naringin, neohesperidin, naringenin, and hesperidin, synephrine was also identified in FA and FAI. Furthermore, the contents of them were determined individually.The results showed that the chemical constituents in FA and FAI were the same but the contents were different.Conclusion HPLC-ESI-MS method can be efficiently used to study FA and FAI.

The Qinghai⁃Tibet Plateau is known as one of the highest endemic areas of echinococcosis However，the dog infection rates of Echinococcus granulosus in the plateau regions were similar to other non⁃Tibetan areas with the high endemic，and most of the rates were below 40%. The infected dogs with E. multilocularis were ubiquitous in Ganzi Prefecture of Sichuan Province and Qinghai Province where many survey data were done and available，which was much different from those in non⁃Ti⁃betan areas where the geographical distribution of dogs infected with E. multilocularis was sporadic. The total infection rates of Echinococcus in dogs kept stable from 1983 to 2009 in Ganzi Prefecture of Sichuan Province and did not show much variation from 2000 to 2014 in Qinghai Province as well. Since 2006，the national comprehensive prevention and control strategy and mea⁃ sures against echinococcosis have been launched in China，and significant progress has been made. In the endemic Tibetan area of Sichuan，the general Echinococcus infection rates in dogs were 28.10%，15.87%，19.22%，3.28% and 1.11% from 2009 to 2013，respectively，and the Echinococcus coproantigen⁃positive rate in Gannan Prefecture of Gansu Province and parts of Qing⁃ hai Province also decreased. This paper reviews the literature on the characteristics of dog infections in the Qinghai⁃Tibetan Plateau，so as to provide useful information to support echinococcosis control and prevention there.

Humans ; Aortic Dissection/surgery* ; Aortic Rupture/surgery* ; Death ; Treatment Outcome

Object To investigate the effects of Angelica polysaccharide (AP 0) and its sulfates (APS) on blood coagulation and platelet aggregation. Methods Infrared turbidimetric method was used to estimate platelet aggregation, prothrombin time (PT) and thrombin time (TT), actiated partial thromboplastin time (APTT); bleeding time (BT) was measured by cutting the mouse's tail and coagulate time (CT) was measured by glass method sheet; hemorheology was measured with heparin as anticoagulant.Results The AP 0 and APS prominently enhanced the platelet aggregation at 5 min (PAG ), while showed less effects on the maximum platelet aggregation (PAG ); they, especially APS 1, also markedly prolonged CT but shortened BT, both AP 0 and APS 1 significantly prolonged TT and APTT in all experimental dosage, while only APS 1 in high dosage (8.46 mg/kg) significantly prolonged PT; AP 0 increased the aggregation index (AI) of RBC and the whole blood viscosity (? b) at shear rate of 5 s -1 at a dose of 2.00 mg/kg, however, unlike AP 0, APS 1 decreased AI and ? b at shear rate of 5 s -1 and 230 s -1 . Conclusion These results suggest that AP 0 and APSs have potent anticoagulant and haemostasis effects. The haemostasis effect is related to promoted platelet aggregation. Ameliorative effect of Angelica polysaccharide sulfate on hemorheology is better than that of Angelica polysaccharide itself.

Objective To identify the risk factors and early indicators for misplacement of subclavian vein catheter into ipsilateral internal jugular vein.Methods From August 2008 to July 2009,subclavian vein catheterization was successfully performed with Seldinger method in 167 patients in Department of General Surgery,Xuanwu Hospital of Capital Medical University.The paraeentesis side,pameentesis site,direction of puncture needle.and the perceptions of both patients and operators during catheter placement were recorded.The correlation of these factors,age,and gender with the misplacement of subclavian vein catheter into internal jugular vein was analyzed.Results Sixteen patients(9.58%)experienced misplacement of subclavian vein catheter into ipsilateral internal jugnlar vein,which was not significantly correlated with age(P=0.375),gender(P=0.259),paraeentesis side (P=0.175),or paracentesis site(P=0.061).Misplacement of subclavian vein catheter into internal jugular vein was significantly more frequent when the direction of puncture needle was toward the midpoint of suprasternal fossa and laryngeal prominence(P=0.002).When the paracentesis site was located at a point at the junction of medial one-third and lateral two-tllirds of the clavicle.it was more frequent that the puncture needle was toward the midpoint of suprasternal fossa andlaryngeal prominence(P=0.010).There were more misplacement events when the patients feel ears pain(P=0.000)and when the operator felt resistance when inserting gnidewire during catheter placement(P=0.000).Conclusions Misplacement of subclavian vein catheter into ipsilateral internal jugnlar vein occurs more frequently when the direction of puncture needle is towards the midpoint between suprasternal fossa and laryngeal prominence.Patients feel ears pain and operators feel resistance when inserting guidewire during catheter placement are early indicators of misplacement.

Objective To study the role of low-dose glucocorticoids in improving prognosis and adjusting septic shock. Methods A total of 46 patients with a confirmed diagnosis of septic shock were retrospaetivley analyzed. 24 patients without glucocorticoids treatment were taken as control group; 22 patients with glucocorticoids as therapy group (n = 22). The two group received standard treatment for septic shock. Results The percentage of shock reversal on day 7 was higher in therapy group than that in control group (P <0.05). However,there were notstatistical significances in the duration of mechanical ventilation, the length of ICU stay, the incidence of multiple or-gan dysfunction syndrome (MODS) and mortality between the two groups (P > 0.05). Conclusion Low-dose glucocorticoids can effectively accelerate refractory septic shock reversal and vasopreasor withdrawal. This seems to be related to the reduced production of CRP but the beneficial effects of low-dose steroids regimens on long-term outcome have not yet be determined.