Adult ; Coal Mining ; Cognition Disorders ; etiology ; Explosions ; Follow-Up Studies ; Humans ; Surveys and Questionnaires ; Survivors ; Young Adult

Child ; Child, Preschool ; Epilepsy, Generalized ; complications ; epidemiology ; genetics ; Female ; Humans ; Infant ; Male ; Pedigree ; Phenotype ; Seizures, Febrile ; complications ; epidemiology ; genetics

Liver resection is one of the important treatments of liver diseases,especially hepatocellular carcinoma.In China,the vast majority of liver cancer patients suffer from generalized damage of the liver parenchyma such as cirrhosis,lead to liver reserve function reducing in various degrees.Liver dysfunction or even liver failure after liver resection becomes an important reason of perioperative death and influences the patients' long-term survival.Therefore,accurate preoperative evaluation of liver reserve function is very important.Though there are seveal kinds of assessment of liver reserve function in recent years,it still lack of a clinically recognized,comprehensive assessment method.This paper reviewed the clinical commonly used preoperative liver reserve function evaluation methods,summarizes and analyzes the value and the insufficiency of several important methods,and prospects the development of evaluation methods about preoperative liver reserve function.

Objective To research the feasibility and superiority of video-assisted thoracoscopic surgery(VATS) in the diagnosis and treatment of thoracic traumas.Methods Video-assisted thoracoscopic surgery was used in 40 patients with thoracic traumas,including thoracic exploration,repair of pulmonary laceration,and evacuation of clotted hemothorax.[WTHZ]Results All the 40 patients were cured,including simple VATS in 31 patients,thoracoscopy-assisted mini-incision surgery in 8 patients,and conversion to open surgery in 1 patient.The time of operation was 79.9?33.1 min.The amount of blood clots and noncondensing blood cleared was 567.5?177.8 ml.The closed thoracic drainage tube was removed at 24~48 h postoperatively,with a drainage volume of 220?45.6 ml.The length of hospital stay was 4~13 d(mean,8.7 d).The sutured wound healed by first intention in all the patients.No postoperative complications were observed.Follow-up reviews in 35 patients for 6~12 months(mean,8.6?2.6 months) revealed uneventful recovery and no trauma-related complications.Conclusions As compared with conventional open surgery,VATS has shown advantages of exact diagnosis,timely management,little invasion,and quick recovery for patients with thoracic traumas.

Objective: To evaluate the effect of open-chest surgery for cancer patients in advanced stage, in aged and with respiratory insufficiency. Methods: From May 1992 to December 2002, 637 patients with lung cancer underwent thoracotomy in out hospital. 118 of the 637 patients fit in with the standards of advanced, aged or respiratory insufficiency. RVEF was consecutively assessed in 118 before pulmonary resection by echocardiography. According to right ventricular function, the 118 patients were dicided into group A(n=77, RVEF

Objective To evaluate the outcomes of thoracoscopy-assisted mini-incision procedure in patients with lung cancer.Methods From January 2003 to June 2003,66 patients with non-small cell lung cancer were treated in our hospital by lobectomy combined with mediastinal lymph node resection using thoracoscopy-assisted mini-incision(36 patients,VATS Group)or traditional surgery(30 patients,traditional group).The clinical and follow-up data of the two groups were compared after the operation.Results No significant difference was found in the operation time between the VATS and traditional groups(114.6?47.4)min vs(123.3?43.9)min,t=-0.768,P=0.449],while the postoperative hospital stay of the VATS group was significantly shorter than that in the traditional group (9.2?1.4)d vs(10.5?1.7)d,t=-3.408,P=0.001].Log-rank test showed that the survival curve in the two groups was comparable(?2=0.270,P=0.605).Cox regression model indicated that the pathological characteristics(risk ratio:3.912,P=0.000),TNM stage(risk ratio:3.737,P=0.000),and lymph node metastasis(risk ratio:15.495,P=0.000)were independent,unfavorable prognostic factors for the disease;whereas,no relation was detected between the thoracotomy incision and prognosis(P=0.414).Conclusions Thoracoscopy-assisted mini-incision procedure is a safe and reliable approach for patients with lung cancer with satisfying outcomes.

Objective To investigate the characteristics and patterns of lymph node metastasis in lung cancer and to provide evidence for determining the range of lymph node dissection.Methods One hundred and eighteen patients with lung cancer received complete resection combined with systematic lymph node dissection according to the mapping system developed by Naruke.Results A total of 835 lymph nodes were dissected from 118 lung cancer patients.The positive ratios of N1 and N2 were 15.6% and 17.4% respectively.Fifteen patients were found with skipping N2 which were located in 2,4,5,6 and 7 lymph node groups respectively.There was no significant relationship between the size of primary tumor and lymph node metastasis.Small cell lung cancer showed the highest risk of lymph node metastasis.The metastatic rate of lymph node in adenocarcinoma was markedly higher than that of squamous cell carcinoma.Skipping mediastinal lymphatic metastasis was found more frequently in lower lobar tumors than that in upper lobar ones.Conclusion Lymph node metastasis of lung cancer may occur in multiple groups and regions,even in a skipping pattern.Systematic lymph node dissection may be routinely performed in pulmonary resection for lung cancer.

This paper introduces a free and publicly open ICU database: multi-parameter intelligent monitoring in intensive care II: MIMIC-II, which has been built up and maintained by the laboratory of computational physiology at the Massachusetts Institute Technology, Beth Israel Deaconess Medical Center and Philips Healthcare over the past decade. This paper briefly introduces its infrastructure, implementation and applications in clinical studies. Clinical study pertaining to circadian variation in heart rate and blood pressure during sepsis is shown as a typical example of research performed with MIMIC-II. In this study, it was found there was significant difference in circadian variation in both heart rate and blood pressure between survival and non-survival groups in septic patients. This study tackled several important techniques necessary for the investigation of the circadian rhythm.
Blood Pressure ; Circadian Rhythm ; Critical Care ; Data Mining ; Databases, Factual ; Heart Rate ; Humans ; Medical Informatics

Objective To investigate the clinical value of the transluminal radiofrequency catheter ablation (RFCA) for malignant esophageal obstruction.Methods The retrospective cross-sectional descriptive study was conducted.The clinicopathological data of 52 patients with malignant esophageal obstruction who underwent transluminal RFCA at the Affiliated Hospital of Shandong Academy of Medical Science between March 2013 and March 2016 were collected.Patients received the bipolar radiofrequency ablation (RFA) under dualchannel endoscopy and X-ray.Observation indicators:(1) intra-and post-operative situations:operation situations,operation time,time of RFA,postoperative complications and duration of postoperative hospital stay,(2) follow-up.Follow-up using outpatient examination and telephone interview was performed to detect the subsequent treatment,survival of patients and recurrence of esophageal obstruction up to June 2016.Measurement data with normal distribution were represented as average (range).Results (1) Intra-and post-operative situations:52 patients underwent successful RFCA,without the occurrence of aspiration,asphyxia,hemorrhage and perforation.Esophageal obstruction was disappeared after treatment,X-ray findings showed a smooth esophagus.Average operation time and time of RFCA were respectively 58 minutes (range,20-71 minutes) and 23 minutes (range,8-42 minutes).Patients took liquid food at postoperative day 2 and normal food at postoperative day 3,without the sensations of esophageal obstruction.Of 52 patients,1 with postoperative hypotension returned to normal level through rehydration and increasing blood volume.Five patients with postoperative substernal pain were improved after 2-day symptomatic treatment.And other 46 patients didn't have postoperative complications.Average duration of postoperative hospital stay was 3 days (range,1-5 days).(2)Follow-up:52 patients were followed up for 3-24 months,with a median time of 13 months.Of 52 patients,17 underwent single intravascular interventional therapy,15 underwent intravascular interventional therapy combined with single systemic chemotherapy,14 underwent single systemic chemotherapy and other 6 didn't undergo antineoplastic therapy.During the follow-up,9 patients didn't have esophageal obstruction and 26 were complicated with esophageal obstruction again.Esophageal obstruction of 26 patients was respectively occurred at 3-8 months postoperatively,20 patients were improved after bipolar transluminal RFCA under dual-channel endoscopy and X-ray and 6 received parenteral nutrition support therapy due to extreme exhaustion.Seventeen patients died of cachexia caused by terminal malignant tumors.Conclusion Transluminal RFCA is safe and effective for malignant esophageal obstruction,with a good short-term outcome.

Objective To observe the effect of resveratrol on arterial remodeling in spontaneous hypertensive rats.Methods Spontaneous hypertensive rats (SHRs, n=20) and Wistar-Kyoto rats (WKYs, n =10) were randomly assigned to three groups: control group, model group and resveratrol group.Systolic blood pressure (SBP) and pulse wave velocity (PWV) of the three groups was observed.Morphological observations were obtained by hematoxylin and eosin or victoria blue and picrosirius red.The content of nitric oxide (NO) and endothelin-1 (ET-1) were determined to assess the endothelial function.Oxidative stress was assessed by malondialdehyde (MDA), hydrogen peroxide (H2O2) , and activities of antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT).Results Compared with control group, SBP, PWV, wall thickness, wall-lumen ratio,vascular cross-sectional area (VCSA), luminal cross-sectional area (LCSA) and collagen-elastic ratio were increased, and the levels of NO, SOD, CAT in rat aortic tissues were decreased, while ET-1,MDA, H2O2 levels in rat aortic tissues were enhanced in model group at the end of 22 weeks.After the treatment of resveratrol, SBP had no significantly difference between model and resveratrol groups, while PWV, aortic wall thickness, wall-lumen ratio, VCSA, LCSA and collagen-elastic ratio were decreased in resveratrol group as compared with model group [(6681.1 ± 2154.9) cm/s vs.(4283.1±946.1) cm/s, (234.7±51.8) μm vs.(123.4±21.5)μm, (10.3±2.3) ％ vs.(5.8±1.4) ％, (6.4±0.4) mm2 vs.(4.8±0.6) mm2, (4.1±0.1) mm2 vs.(3.2±0.4) mm2, (1.1±0.3) vs.(0.4±0.2), P＜0.05 or 0.01].Compared with model group, the expressions of NO, SOD, CAT in rat aortic tissues were increased and levels of ET-1, MDA, H2 O2 in rat aortic tissues were decreased in resveratrol group after treatment of resveratrol (P＜0.01 or P＜0.05).Conclusions Resveratrol has an antioxidant effect, and it could attenuate arterial remodeling by improving oxidative stress.