Objective To systematically evaluate the value of narrow band imaging(NBI)and iodine staining in early diagnosis of esophageal cancer and precancerous lesions.Methods The databases of PubMed,Embase,CNKI,VIP technological journals and Wanfang digital journals were retrieved by computer for searching the literatures on the value of NBI and iodine staining in diagnosing early esophageal cancer and precancerous lesions.The Meta-Disc 1.4 software was used to conduct the meta analysis and calculate the pooled sensitivity,specificity and 95％ confidence interval(95％ CI).Summary receiver operating characteristic(SROC)curve was drawn and the area under curve(AUC)was calculated,thus the diagnostic values of the two methods were evaluated.Results Totally 13 articles were included,including 975 patients.The pooled sensitivity and specificity for NBI were 0.88(95％CI=0.86 to 0.90)and 0.79(95％CI=0.76 to 0.82).The pooled sensitivity and specificity for iodine staining were 0.95(95％CI=0.93 to 0.97)and 0.45(95％CI=0.40 to 0.49).AUC of SROC for the two methods were 0.938 6 and 0.952 9 respectively.There was no statistically difference in the AUC values between the two methods(Z=0.519,P>0.05).Conclusion NBI and iodine staining are both effective ways in the diagnosis of early esophageal cancer and precancerous lesions.And both of them have a certain clinical value.

[Objective] To further study tanshinone role in intestinal barrier dysfunction in sepsis. [Methods] Mainly refer to nearly a decade at home and abroad on tanshinone pharmacological effects, and tanshinone in sepsis, especially the impact on the intestinal barrier dysfunction. [Results] Tanshinone in sepsis, and heart head blood-vessel, anti-tumor and so on in the field of study is more, but improving sepsis of intestinal barrier function in aspects of the study is less, but through tanshinone antibacterial anti-inflammatory, antioxidant, anti platelet aggregation, improve microcirculation, regulate immune function, this paper expounds tanshinone improving sepsis, possible mechanisms of intestinal barrier function. [Conclusion] Tanshinone can improve sepsis pathophysiological process, ischemia oxygen to the tissues and organs and whole body strong inflammatory reaction factors such as the cause of intestinal barrier function is impaired, but for its specific mechanism, further research is needed.

Nowadays, it is necessary to emphasize the three basic inseparable elements in the treatment of severe burn infection, which are systemic care, burn wound care, and rational use of antimicrobials topically or systematically. Systemic care has been shifted from simple nutritional support to maintaining the systemic homeostasis, including balancing immune-inflammatory response, and protecting organs from dysfunction. Some work focused on regulating systemic immune response in the initial phase and the balance of inflammatory response after occurrence of severe burn infection have been reported. These results at least broaden our thinking to recognize that treatment should not only destroy microbes, but also balance the response of the body. Escharectomy in earlier phase has been a consensus. Currently, we turn our vision into how to use "damage control surgery (DCS)" concept in management of severe burn. DCS in burn care includes the evaluation of perioperative situation more accurate to make a more appropriate surgical decision. Meanwhile, an overall strategy should be established to confront the rapidly increasing drug resistance of the pathogens. The release of endotoxin after use of antimicrobials, which has been studied widely, should be explored further.
Anti-Infective Agents ; therapeutic use ; Burns ; complications ; therapy ; Humans ; Infection Control ; Systemic Inflammatory Response Syndrome ; therapy

Child ; History, 20th Century ; History, 21st Century ; Humans ; Pediatrics ; history ; Pharmacology, Clinical ; history ; Societies, Medical ; history

Objective To explore the clinical and peripheral blood characteristics of childhood purulent meningitis complicated with subdural effusion. Methods A retrospective cohort chart review was performed. A total of 162 consecutive cases of purulent meningitis were identified in Shenzhen Children′s Hospital from January 2009 to De-cember 2013,all of them were divided into 2 groups according to whether complicating with subdural effusion, and the clinical characteristics of 2 groups were analyzed. The clinical characteristics were analyzed. The statistical data were determined by SPSS 17. 0 software. Results Forty-nine cases(30. 25%)of them were complicated with subdural effu-sion;and 37 cases (75. 5%)of them suffered from the disease in the first 10 days after the onset of the meningitis,and the incidence was 48. 84% (42 cases) in infancy. Fever,lethargy,seizures and bulging fontanelle were its common clinical signs,and there were no significant differences in the incidence between subdural effusion group and the control group(non-subdural effusion group),the white blood cell (WBC) count did not increase markedly and C-reactive pro-tein(CRP) was high in the subdural effusion group on the admission day(Z=1. 74,2. 10,all P<0. 05),but no differ-ence in platelet( PLT) . The PLT was high in the whole meningitis cohort,the ratio of cases whose PLT was higher than 300×109/L reached 93. 75%,but no difference between the 2 groups. There were many factors of WBC on admission, including age, cerebrospinal fluid culture results and the application of antibiotics before admission, but CRP was only affected by antibiotics. Conclusions Subdural effusion is common in infancy,and most occurred in the first 10 days af-ter onset of the meningitis. On admission day the CRP,was high, while WBC did not increase too much. If CRP rises for the second time it might predict the occurrence of subdural effusion in bacterial meningitis. The increased PLT may be considered as clinical feature of infectious diseases. The clinical implication of inflammatory pathophysiology in men-ingitis needs further investigation.

Objective:To discuss the performance management method for large medical equipments in hospitals.Methods:13 large medical equipments in a large hospital were selected as samples and the economic efficiency analysis method and comprehensive evaluation method were aaplied to carry out performance management of medical equipment.Results:11 sets of medical equipment had good economic returns,the remaining 2 sets of equipments had a greater degree of loss due to lack of business and lack of qualification.Conclusion:Performance management of large medical equipments would help change the efficiency management of equipment from extensive to elaborate management.

Objective To study the correlative risk factors of uterine cavity adhesion (UCA),and observe the clinical efficacy of hysteroscope operation treatment of UCA.Methods According to whether the occurrence of UCA,120 patients with spontaneous abortion were divided into two groups.The correlative risk factors of UCA were analyzed by multiple factors regression analysis.The patients with UCA were treated with hysteroscope operation treatment,and the clinical efficacy were observed.Results In 120 patients with spontaneous abortion,46 patients (38.3％) had UCA.Single factor analysis result showed:UCA was correlated with pelvic inflammation,gravidity,uterine cavity suction negative pressure,uterine cavity suction time (P ＜ 0.05),but UCA was not correlated with age,years of education,occupation,gestational weeks,menarche age (P＞ 0.05).Multiple factors analysis result showed:UCA was correlated with pelvic inflammation,uterine cavity suction negative pressure,uterine cavity suction time (P ＜ 0.05).The total effective rates of hysteroscope operation treatment of mild,moderate and severe UCA were 100.0％ (18/18),93.8％ (15/16)and 83.3％ (10/12) respectively,there was no significant difference among them (P ＞ 0.05).Conclusions Along with the increasing of uterine cavity suction negative pressure and extension of uterine cavity suction time,the risk of UCA is also increasing,pelvic inflammation is also an independent risk factor of UCA.Hysteroscope operation treatment of UCA has better curative effect,especially for mild UCA,it is worth clinical application.

Objective To explore the effects of cognitive behavioral intervention in psychological nursing of young female patients with facial burn.Methods 64 cases of young women patients with facial bum were selected as the research object,and randomly divided into the observation group and the control group,with 32 cases in each group.The observation group was given the cognitive behavioral intervention and the control group was done by conventional nursing methods.The anxiety and depression scores between the two groups before and after the intervention were compared.Results After injury,the anxiety and depression scores of both the observation group and the control group were higher than those of the domestic norm; the anxiety and depression scores between two groups showed no statistic significance before intervention,and after intervention,the anxiety and depression scores between two groups had significant difference,scores of the observation group were lower than those of the control group.Conclusions Cognitive behavioral intervention can reduce anxiety and depression of young female patients with facial burn.It is a kind of effective psychological nursing method,and worthy of clinical promotion.

Objective To investigate the expression of miR-200b in lung cancer and its relationship with clinicopathological features of lung cancer.Methods The specimens of lung tumor tissue and adjacent normal lung tissue of 36 cases of lung cancer who received surgical treatment in our department were collected,and then quantitative real time PCR (qRT-PCR) was applied to determine the expression of miR-200b in lung cancer tissue and adjacent normal lung tissue.Results The expression of miR-200b in lung cancer was significantly lower than adjacent normal lung tissue (P =0.000),and in small cell lung cancer was also significantly lower than adenocarcinoma and squamous cell carcinoma (0.13 ± 0.09 vs.0.64 ± 0.33,0.75 ± 0.30) (P =0.005 and P =0.001).The expression of miR-200b in patients with positive lymph nodes,advanced stage of lung cancer and in smokers were significantly lower than those with negative lymph nodes,early stage of lung cancer and in non-smokers,respectively (0.52 ± 0.29 vs.0.87 ± 0.35,0.46 ±0.25 vs.0.90 ±0.32,0.52 ±0.27 vs.0.90 ±0.39) (P =0.004,P =0.000 and P =0.015).Conclusions Low expression of miR-200b may participate in the occurrence and progression of lung cancer,especially in small cell lung cancer,and correlates with the metastasis of lung cancer.The down-regulated expression of miR-200b may be induced by smoking.Thus,miR-200b perhaps is a new target for the treatment of lung cancer.

Objective To evaluate the surgical methods and the results of treatment for open achilles tendon ruptures.Methods 56 patients with open achilles tendon ruptures were treated by Tsuge stuture or auxileary repair with free deep-fascia circuitously.Results 52 cases had the excellent results,3 case had the middle results,1 case had poor results that marginal skin of the wound were necrosis and subinfection.Conclusion It has a good effect that the open achilles tendon ruptures are treated by modified Tsuge stuture or auxileary repair with free deep-fascia circuitously.