Hepatectomy ; methods ; trends ; Humans ; Liver ; surgery

Objective To investigate the diagnostic value of laboratory evaluation of renal injury in early diagnosis index. Methods Eighty-six patients in in-patient and out-patient of the department of urology were tested in serum C (Cys C), serum creatinine (Cr) and serum UREA nitrogen (UREA). According to the diagnostics (sixth edition), we evaluated their values for diagnosis of renal injury by analyzing the characteristics of the work curve (ROC). Results According to the renal function indexes, 3 groups were divided such as group A (normal renal function control Ccr 80 mL/min) or the Cys C, Cr, and UREA in (0.47 ± 0.24) mg/L, (85 ± 14) μmol/L, and (4.55 ± 1.33) mmol/L, group B (a decrease in renal function reserves, and renal insufficiency 20 mL/min or less Ccr < 80 mL/min) of Cys C, Cr, and UREA in (1.59 ± 1.29) mg/L, (214 ± 173) μmol/L, and (11.04 ± 8.24) mmol/L and group C (renal failure and uremia Ccr < 20 mL/min) of Cys C, Cr, and UREA in (3.47 ± 0.75) mg/L, (669 ± 466) μmol/L, and (21.22 ± 13.10) mmol/L respectively. As reducing in Ccr, Cys C, Scr and UREA concentration increased and correlated with Ccr negatively. According to the mazimum Youden index, the critical values of Cys C, Cr, and UREA were 0.90 (mg/L), 115 (μmol/L) and 7.33 (mmol/L) separately, the sensitivity (%), specificity, positive predictive value (%), negative predictive value (%), diagnostic accuracy (%) and the area of the ROC curve (AUC) were Cys C (77.3%, 97.6%, 97.0%, 81.1%, 77.3%, 0.908), Cr (65.9%, 97.6%, 96.5%, 74.1%, 65.9%, 0.817), and UREA (63.6%, 97.6%, 96.4%, 72.8%, 63.6%, 0.785) respectively. The diagnostic accuracy showed that the Cys C > Cr > UREA. Their correspounding ROC curve (AUC) were in the area of 0.908, and 0.785 and 0817. Cys C had the highest AUC (0.908), and achieved a good diagnosis effect. Conclusion Renal damage laboratory indexes of in the early diagnosis, Cys C has a higher sensitivity and specificity to be worth of clinical promotion.

Objective To explore the value of combined use of laboratory indicators for diagnosis of early renal functional damage. Methods Eighty-six patients with various kidney diseases were enrolled in the Second Affiliated Hospital of Guangzhou Medical University. On admission,the serum Cystatin C(Cys C),creatinine(Cr), Urea,etc were determined. The value of using combined laboratory indicators in the diagnosis of renal functional damage was obtained through the analysis of the receiver operating characteristic curve(ROC curve);multiple variable indicators were grouped to establish multiple logistic regression models to be compared and evaluated. Results In the early and late renal injury groups(group B of 32 cases and group C of 12 cases),the serum levels of Cys C,Cr, and Urea were significantly higher than those in the normal renal function control group(group A of 42 cases),the elevation in level in group C being the most significant〔Cys C(mg/L):3.47±0.75 vs. 1.59±1.29,Cr(μmol/L):669±466 vs. 214±173,Urea(mmol/L):21.22±13.10 vs. 11.04±8.24,P<0.05 or P<0.01〕. The areas under the ROC curve(AUC)made by combinations of Cys C,Cr and Urea for the diagnosis of renal damage were 0.908,0.817 and 0.785. In the four different kinds of combination of the indicators,the AUC were sequentially arranged from large to small area as follows:Cys C+Cr+Urea=Cys C+Cr>Cys C+Urea>Cys C>Cr+Urea(0.920=0.920>0.911>0.908>0.809). In this sequence,the AUC made by Cys C+Cr+Urea and Cys C+Cr were equal,both 0.920, whose sensitivity was 75.0%,specificity 100.0%,positive predictive value 100.0%,negative predictive value 80.0%and diagnostic accuracy rate 87.5%. So,Cys C + Cr combination could be used to substitute Cys C + Cr + Urea, and the former clinical diagnostic effect was the best,much higher than that by using AUC whose curve was made by Cys C alone. Conclusion The value of using only one laboratory indicator for diagnosis of patients with early renal functional damage is not high,while applying Cys C+Cr combination can improve the diagnostic effect greatly,and its sensitivity and specificity are higher.

Objective To study the clinic effects and safety of budesonide suspension combined with tubertaline solution for nebulization therapy on infantile asthma.Methods Seventy-five cases with asthma were divided into 3 groups randomly,double-blinded and controlled,each group having 25 cases.Group A inhaling tubertaline solution(bricanyl),while group B inhaling pulmicort respules combined with bricanyl,group C inhaling budesonide suspension(pulmicort respules)only.Results In group A,16 cases was cure,3 cases was markedly improved,6 cases was failure,the total efficacy rate was 76 percent.In group B,22 cases was cure,2 cases was markedly improved,1 case failed,the total efficacy rate was 96 percent.While in group C,14 cases was cure,4 cases was markedly improved,7 cases failed,the total efficacy rate was 72 percent.The difference of efficacy rate between group A and group B was significant(P0.05).Conclusion Pulmicort respules combined with bricanyl for nebulising inhalation is effective and safety on infantile asthma and its effect is better than inhaling bude-sonide or tubertaline only.

Continuous exposure to conventional glucose-containing lactate-buffered solutions will ultimately lead to irreversible changes of the structure and function of peritoneum.Therefore,the development of novel peritoneal dialysis(PD) solutions has become the focus in the PD fields in recent years.Icodextrin,which has more adventages than conventional PD solutions,is one of the most important advancements in the past decade.Icodextrin has better biocompatibility,and can reduce the absorption of carbohydrates to decrease the metabolic complications in PD patients.Apart from increasing ultrafiltration,icodextrin can also improve the fluid status and protect the residual renal function of PD patients.However,adverse consequences may result from the pseudo-hyperglycaemia caused by limited measurement of serum glucose.This article reviews the features and applications of the new PD solutions—icodextrin solutions.

OBJECTIVETo evaluate the effects of prenatal stress on neurological functions after middle cerebral artery occlusion (MCAO) in adult offspring rats.

METHODSPregnant rats were randomly assigned to prenatal stress treatment, which was exposed to restraint three times daily in the last week of pregnancy, and no prenatal stress treatment. Adult male offspring rats were subjected to transient focal cerebral ischemia by MCAO. They were randomly divided into four groups: sham group, prenatal stress + sham group, MCAO group and prenatal stress + MCAO group (n = 10). After 24 hours of reperfusion, the neurological deficits were evaluated. The infarct size, cell apoptosis and expression of Caspase 3, cleaved Caspase 3 and Bcl-2 were detected.

RESULTSCompared with MCAO group, the neurological deficits, infarct size and apoptotic cells in prenatal stress + MCAO group were increased significantly (all P < 0.05). The expressions of Caspase 3 and cleaved Caspase 3 were much greater in prenatal stress + MCAO group than those of MCAO group, while the expression of Bcl-2 was significantly decreased in prenatal stress + MCAO group compared with MCAO group (all P < 0.05).

CONCLUSIONPrenatal stress might exacerbate neuroloeical deficits in the offspring rats after MCAO by increasing cell apoptosis.

Animals ; Apoptosis ; Caspase 3 ; metabolism ; Female ; Infarction, Middle Cerebral Artery ; physiopathology ; Ischemic Attack, Transient ; physiopathology ; Male ; Pregnancy ; Prenatal Exposure Delayed Effects ; physiopathology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rats ; Rats, Sprague-Dawley ; Stress, Physiological

OBJECTIVETo explore the clinical and function efficacy of the treatment of Herbert B2-type scaphoid fracture through volar approach with double screws prograde internal fixation.

METHODSFrom December 2005 to June 2010,18 patients with Herbert B2-type scaphoid fracture were treated with double screws prograde internal fixation through volar approach, including 14 males and 4 females with an average age of 33.11 years (ranged from 21 to 52 years). The fracture healing situation was evaluated by X-ray examination. Functional outcome was assessed by using Modified Mayo wrist score.

RESULTSAll patients were followed up with a mean time of (25.06 +/- 4.00) months. The bone healing time was (3.55 +/- 0.65) months. The pain,passive range of motion, grip of wrist were improved at 4 months after operation (P < 0.05). The Mayo wrist score were improved from preoperative 42.78 +/- 7.32 at 4 months after operation (93.89 +/- 5.83) (P < 0.05), the results were excellent in 9 cases and good in 9 cases.

CONCLUSIONVolar approach with double screws prograde internal fixation is an efficacy and safety surgical technique for Herbert B2-type scaphoid fracture.

Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Palmar Plate ; surgery ; Range of Motion, Articular ; Scaphoid Bone ; injuries ; surgery ; Wrist Injuries ; physiopathology ; surgery ; Young Adult

Biometry ; Clinical Protocols ; Cryoultramicrotomy ; methods ; Diagnostic Techniques and Procedures ; Frozen Sections ; utilization ; Humans ; Orthopedics ; methods

This article describes the progress of developing the training base and training methods for bronchoscopists at Changhai hospital in recent years,and then discusses the potential issues and solutions that might occure in the course of training,and finally explores the model and methodology to optimize the training program for Chinese bronchosocpists.

Objective To develop a blood gas,acid-base imbalance analysis computer software to diagnose systematically,rapidly,accurately and automatically determine acid-base imbalance type,and evaluate the clinical application. Methods Using VBA programming language,a computer aided diagnostic software for the judgment of acid-base balance was developed. The clinical data of 220 patients admitted to the Second Affiliated Hospital of Guangzhou Medical University were retrospectively analyzed. The arterial blood gas〔pH value,HCO3-,arterial partial pressure of carbon dioxide(PaCO2)〕and electrolytes included data(Na+and Cl-)were collected. Data were entered into the software for acid-base imbalances judgment. At the same time the data generation was calculated manually by H-H compensation formula for determining the type of acid-base imbalance. The consistency of judgment results from software and manual calculation was evaluated,and the judgment time of two methods was compared. Results The clinical diagnosis of the types of acid-base imbalance for the 220 patients:65 cases were normal,90 cases with simple type,mixed type in 41 cases,and triplex type in 24 cases. The accuracy of the judgment results of the normal and triplex types from computer software compared with which were calculated manually was 100%,the accuracy of the simple type judgment was 98.9% and 78.0% for the mixed type,and the total accuracy was 95.5%. The Kappa value of judgment result from software and manual judgment was 0.935,P=0.000. It was demonstrated that the consistency was very good. The time for software to determine acid-base imbalances was significantly shorter than the manual judgment(seconds:18.14±3.80 vs. 43.79±23.86,t=7.466,P=0.000),so the method of software was much faster than the manual method. Conclusion Software judgment can replace manual judgment with the characteristics of rapid,accurate and convenient,can improve work efficiency and quality of clinical doctors and has great clinical application promotion value.