Objective To investigation effect of glucocorticoid combined with Qingkailing injection on lobar pneumonia IL-10 and serum TNF-levels.Methods 120 cases of lobar pneumonia in children were selected respiratory department fromasin our hospital in December 2012 to December 2014 as the object of study, were divided into control group and observation group, control group were treated with dexamethasone sodium phosphate injection,the observation group in the control group based on the combined with Qingkailing injection, serum IL-10, TNF-a level and curative effect were compared between the two groups pre-and post-treatment in patients.Results The total effective rate of the observation group was 86.67%, higher than that of the control group, the total effective rate was 70%(P <0.05).Before treatment, the two groups of patients with TNF-αand IL-10 were not statistically significant difference.After treatment, the two groups of patients with TNF-αand IL-10 were decreased, and lower than the control group (P<0.05) .Conclusion Glucocorticoid combined with Qingkailing injection can reduce serum IL-10, TNF-alpha level in lobar pneumonia,has a definite effect.

Objective To explore the complications of augmentation mammoplasty by polyacrylamide hydrogel (PAHG) injection and their management.Methods Preoperatively,174 patients underwent breast ultrasound image,and some patients received magnetic resonance imaging (MRI) to ascertain the distribution of injected PAHG.We used the periareolar incision and dissection extended to the subcutaneous tissue,mammary gland,and subgland space.We were able to suck most of the gel by the negative pressure machine and remove the abnormal breast tissue.The secondary breast deformity was repaired with subpectoral placement of silicone mammary implants (48 cases immediately,39 cases secondarily after 3-6 months) according to the individual situation.Results Following-up for 3 to 6 months,most of their symptoms were relieved after removal of the polyacrylamide hydrogel.In the patients who were performed with the implants augmentation mammoplasty,77 cases gained satisfactory results on the shape and texture of the breast (44.3％),and 10 cases were not satisfied with texture of the breast (5.7％).79 cases appeared breast atrophy or flat chest (45.4％).The severe breast deformities occurred in 8 cases (4.6％).Conclusions PAHG should be removed with surgical operation as soon as possible.The open operative technique via periareolar incisions may be a better method for the patients.The breast reconstruction is performed with implants prosthesis for those who are suitable and willing after removal of PAHG.

Objective To assess the relationship betw ee n the ultrasonographic manifestation and the pathological histology type in pros tatic cancer. Methods 50 cases of CaP and 50 cases of BP H were included in this study.All the patients were ultrasonographic,and the dat a were compared with its the pathological histology type postoperatively. Results The typical ultrasonographic manifestation is hypoecho ic nodules (62%) in CaP group and mixed echo nodules (54%) in BPH group.There is a significant differences between CaP group and BPH group( P

Objective To improve a HPLOUV method for the determination of Tramadol hydrochlo-ride in human plasma. Method Alkalinized samples of plasma were extracted with dichloromethane. Tramadol and internai standard were analyzed on Elite C18 column (200mm?5.0mm, 5?m) with a acetoni-trile-phsphate buffer (pH6.5) (74:26, v/v) mobile phase and detedted at 220nm. Results The Calibra-tion plots in human plasma were linear (r=0.9984, n =5) from 10 to 800 ng/ml. The limit of detection was 10 ng/ml. For 20, 100, 400 ng/ml check samples, intra-run precisions (RSD) were 3.81% -5.44% and inter-run preceisions (RSD) were 3.95% -4.41% , respectively. The average recoveries were 89% , 96% and 92% for the low, middle and high check samples, respectively. Conclusion The improved ana-lytical method for Tramadol hydrochloride was found to be sensitive, simple and rapid, suitable for applica-tion in forensic toxicological analysis and routine determination of numerous samples.

Objective To explore the methods and significance of section of multiple fibroadeno mas of breast with better incision.Methods From may 2005 to December 2014,21 cases were per formed by removing multiple fibroadenomas of breast with a new incision.Preoperatively,the diag nostic work-up included clinical examination,breast ultrasonography and/or mammography.A new approach,for removing of multiple fibroadenomas of the breast with the incision in periareolar site,was used in our hospital.All palpable breast lumps were excised with this approach through which the fibroadenomas were removed as a whole unit.Then,the breast cavity were irrigated with normal saline solution,and strict haemostasis of the bed was done by electrocautery.If the resulted cavity was larger,interrupted sutures should be performed with the absorbable stitches;otherwise,it was unnecessary.The skin wound was sutured to the deepithelialized area with Vicryl 5-0 (Ethicon).Results There were 21 cases,who underwent surgery using the described technique through which 95 lumps (0.5 cm× 0.5 cm-6.0 cm× 5.0 cm) were removed and included in the study.All patients' resected tumor specimens were pathologically confirmed as fibroadenoma.No major complications were encountered in any of the patients.The incision was well concealed by the dome of the nipple and the areolar pigmented and corrugated skin.Both doctors and patients were satisfied with postoperative aesthetic effect of the incision scar.Conclusions The incision in periareolar site for excision of multiple fibroadenomatas results in minimal scarring and a better appearance than that can be achieved with traditional methods.This technique,which can improve the aesthetic outcome of breast surgery,should be performed when feasible.

Adult ; Diagnostic Errors ; Humans ; Male ; Thyroid Diseases ; diagnosis ; Tuberculosis, Endocrine ; diagnosis

Objective To explore the current status of humanistic care among medical students in clinical practice in obstetrics and gynecology department and its related influencing factors and to propose the corresponding countermeasures.Methods Scale of humanistic care quality was used in the survey for clinical practice students in obstetrics and gynecology department.ResultsThe total score rate of human care quality of medical students before clinical teaching were (84.12 ± 9.24)with a scoring rate of 72％.Significant differences were observed in the medical students with different medical professional(P ＜0.05).The total score of humanistic care quality of medical students after clinical teaching were (96.41 ± 1 1.53 ),significant higher than that of before training ( P ＜ 0.05 ).ConclusionHumanistic care quality in medical students needs to be strengthen.Clinical training in obstetrics and gynecology department combined with humanities education has important practical significance to improve the quality of medical students.

Objective To investigate the effects of ghrelin on proliferation of vascular smooth muscle cells(VSMC)and the expression of mitochondrial fusion 2(Mfn-2)in cultured human aortic smooth muscle cells(HASMCs).Methods HASMCs were cultured in vitro,treated with different concentrations(10-9,10-8,10-7,10-6,10-5 mol/L)ghrelin or 10-6 mol/L ghrelin for different time(0,6,12,18,24 h).Subconfluent HASMCs at passage 4-6 were used in experiments.MTT essay was used to investigate the effect on proliferation of HASMCs.RT-PCR and Western blot were used to analyse the expression of Mfn-2.Results 10-7-10-5 mol/L ghrelin inhibited the proliferation of HASMCs,and the inhibitory effect of concentration of 10-6 mol/L was the most obvious(P<0.01).Ghrelin inhibited the proliferation of HASMCs in 6-24 h,and it reached the peak at 24 h(P<0.01).10-6 mol/L ghrelin significantly increased the expression of Mfn-2 mRNA and protein(P<0.01).The up-regulation of 10-6 mol/L ghrelin on Mfn-2 mRNA and protein expression reached the peak at 18 h(P<0.01).Conclusion Ghrelin might inhibit the proliferation of HASMC by up-regulating the expression of Mfn-2.

Objective To analyze the learning curve of an experienced interventional radiologist engaged in thoracic endovascular aortic repair (TEVAR) for Stanford type B aortic dissection.Methods The clinical data of 70 patients with Stanford type B aortic dissection,who received TEVAR that was carried out by the same group of interventional physicians over the past 10 years,were retrospectively analyzed.According to the sequence of operation date,the patients were equally divided into group A,B,C,D and E with 14 patients in each group.The operation time,procedure-related complications,postoperative hospitalization days were compared among the 5 groups,and the curative effects at different stages were evaluated.Results No statistically significant differences in the age,sex,classification,concurrent hypertension,concurrent diabetes,active smoking,maximum diameter of false lumen,viscera artery supplied by the false lumen,etc.existed between each other among the 5 groups (P＞0.05).The operation time of group A and group B was (3.29±0.61) hours and (2.87±0.37) respectively (P＜0.05),while the operation time of group C,group D and group E was (1.80±0.62) hours (1.74±0.34) hours and (1.52±0.39) hours respectively (P＞0.05).The operation time of group A and group B was significantly longer than that of group C,D,and E (P＜0.001).The difference in the occurrence of complications was not statistically significant between each other among the 5 groups (P＞0.05).The hospitalization time was gradually shortened from group A to group E,although the difference was not statistically significant (P＞0.05).The surgeries of 28 patients in group A and group B were completed within 2 years and 6.2 years respectively,with an operation frequency being 3.3 patients per year and 7 patients per year respectively;while the surgeries of 42 patients in group C,group D and group E were completed within 2.2 years,1.2 years and 0.5 years respectively,with an operation frequency being 6.4 patients per year,11.7 patients per year and 17.5 patients per year respectively.Conclusion The learning curve of performing TEVAR for type B aortic dissection is approximately 28 cases;after completing 28 TEVAR procedures for type B aortic dissection at the yearly frequency of 4.6 cases by one interventional radiologist,the operation time becomes significantly shortened,and the surgical skills of theinterventional physician team can been significantly improved.

Objective To investigate the expression of Notch1,Delta-like ligand 4 (DLL4),hairy and enhancer of split-1 (HES-1),microvessel density (MVD),lymphatic vessel density (MLD) in gastric carcinoma,so as to discuss their roles in the development of gastric carcinoma.Methods Gastric carcinoma,paracancer tissues which was apart from the edge of cancer tissue ＞ 60 mm obtained during operation and normal gastric mucosa obtained during gastroscopy were used as controls.All specimens were made tissue microarray.The expressions of Notchl,DLL4,HES-1 were detected by immunohistochemistry.Immunohistochenical double taining was used to detect MVD and MLD.The relationships between Notch1,DLL4,HES-1 expression and angiogenesis,lymphangiogenesis and their significances were analyzed.Results The positive rate of Notch1 in gastric carcinoma was 48.30％,significantly higher than that of paracancerous (25.00％,x2 =6.38,P ＜ 0.05) and control group (16.67％,x2 =10.18,P ＜0.05).The differences of the positive rate of DLL4 in gastric carcinoma (55.94％),paracancerous (45.70％) and control group (56.67％) were not significant (x2 =1.18,P ＞0.05 ; x2 =0.005,P ＞ 0.05).The differences of the positive rate of HES-1 in gastric carcinoma (36.64％),paracancerous (34.40％) and control group (33.33％) were not significant (x2 =0.05,P ＞ 0.05 ;,x2 =0.11,P ＞ 0.05).The mean of MVD in gastric carcinoma group was 28.84 ± 14.17,which was significantly higher than that in paracancerous group (17.02 ±8.54,t =4.03,P＜0.05) and control group (16.69 ±7.21,t =5.01,P＜0.05).The mean of MLD in gastric carcinoma group was 8.55 ±4.98,which was significantly higher than that in paracancerous group (4.05 ± 2.48,t =9.30,P ＜ 0.05) and control group (3.99 ± 1.56,t =10.32,P ＜ 0.05).The expression of DLL4 was correlated with MVD (t =2.77,P ＜ 0.05),but wasn't correlated with MLD (t =1.89,P ＞0.05).There were no correlations between the expression of Notch1,HES-1 and tissues MVD,MLD (P ＞0.05).Conclusion Notch1 plays important roles in the development of gastric carcinoma.There are many angiogenesis and lymphangiogenesis in gastric carcinoma.The expression of DLL4 in gastric carcinoma has certain effect in the formation of microvessel.