Medullary syndrome is a group of syndromes caused by medullary lesions,which is characterized by ipsilateral cranial nerve damage symptoms combining contralateral conductive fasciculus type sensory disturbance or hemiplegia.Medullary infarction is a major cause of medullary syndrome.Knowing medullary syndrome will have some help for the diagnosis and treatment of medullary vascular disease.

Objective To investigate the diagnosis and treatment of HELLP syndrome through analyzing the clinical data of seven patients of HELLP syndrome.Methods We reviewed the study.There were three patients in the absolute HELLP group,four patients in the partial HELLP group.The laboratory data,clinical symptom,delivery method and the outcome of the pregnant women and infants of the two groups were analyzed.Results All the seven patients had clinical presentations of PIH.Total bilirubin(TB) value in absolute HELLP group was significantly higher than that in partial HELLP group(P

Objective To study an effective treatment of severe thoracic and abdominal injury accompanied with acute respiratory distress syndromes (ARDS).Methods Emergency treatments of 32 patients with severe thoracic and abdominal trauma accompanied with ARDS were retrospectively analyzed.Results All of the 32 patients had severe thoracic and abdominal injury,ribs fracture or pulmonary contuson.Anti-shock treatment,reasonable supplemental blood volume,rational mechanical ventilation and emergency operation were performed.Twenty-six patients were cured,and 6 died,with mortality 18.75%.Conclusions Early diagnosis,timely anti-shock treatment,early treatment for thoracic and abdominal injury and correct mechanical ventilation are essential for treating thoracic and abdominal trauma accompanied by ARDS,and is also an effective method for reducing mortality.

Objective:To analyze the value of serum ceruloplasmin (CP) levels in predicting the outcome of patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF).Methods:The clinical data of 1 751 patients with HBV-ACLF treated in the Third Affiliated Hospital of Sun Yat-sen University from January 2010 to March 2018 were retrospectively analyzed. According to 30-day outcomes, 1 220 survival patients were classified into group A; 465 fatal patients and 46 patients receiving liver transplantation were classified into group B (total 531 cases). Risk factors associated with 30-day survival were estimated using Cox proportional hazards regression. ROC curve analysis was performed to evaluate the predictive value of CP on the 30-day outcome of patients with HBV-ACLF.Results:Multivariate analysis indicated that CP, albumin and alpha fetoprotein were independent protective factors for 30-day survival of HBV-ACLF patients ( P<0.05 or <0.01), while age, white blood cell count, AST, total bilirubin, INR, serum creatinine, HBV DNA, hepatorenal syndrome and hepatic encephalopathy were independent risk factors ( P<0.01). The area under the ROC curve (AUC) of CP was 0.570 (95% CI 0.540-0.599, P<0.01); while AUC of MELD score was 0.783 (95% CI 0.759-0.807, P<0.01) and MELD-Na score was 0.774 (95% CI 0.750-0.798, P<0.01). Compared with MELD score and MELD-Na score, the value of CP in predicting the 30-day prognosis of HBV-ACLF patients was lower ( P<0.01). The cut-off value of CP for predicting 30-day outcome of HBV-ACLF patients was 0.173 g/L, with the sensitivity of 69.4%, and the specificity of 41.6%. According to the cut-off value, the patients were divided into low CP level group (level of CP<0.173 g/L) and high CP level group (level of CP≥0.173 g/L); the 30-day cumulative survival rate of low CP level group was lower than that of high CP level group ( χ2=17.75, P<0.01). Conclusions:Serum CP level can predict the 30-day outcome of HBV-ACLF patients to a certain extent.