Objective To explore the application value of thromboelastography(TEG) in perioperative evaluation of patients with antiplatelet therapy-associated cerebral hemorrhage. We aimed to investigate whether platelet transfu-sion, compared with standard care, reduced bleeding in patients with antiplatelet therapy-associated cerebral hemor-rhage. Methods A retrospective analysis of clinical data was conducted in 30 patients (12 patients receiving platelet transfusion) with antiplatelet therapy-associated basal ganglia hemorrhage who underwent emergency surgery. TEG was used to evaluate the intraoperative bleeding, postoperative bleeding and transfusion treatment. Results The routine co-agulation test was in the normal range in the two groups. However, TEG showed that the platelet function was exces-sively inhibited in patients with antiplatelet therapy before spontaneous cerebral hemorrhage (Platelet inhibition rate>90%). There were significant differences in the intraoperative blood loss (t=-3.998, P=0.008), total transfusion volume (Z=-3.245, P=0.001), postoperative hematoma volume (t=-2.909, P=0.043) and lead volume (t=-8.790, P=0.041) between two groups (P<0.05). One case from platelet transfusion group, and 4 cases from no-platelet transfusion group re-ceived a second surgical operation. However, the difference was not statistical significant ( P=0.317). Conclusion TEG can effectively assess the preoperative coagulation status in the patients with spontaneous cerebral haemorrhage after antiplatelet therapy. Platelet transfusion can reduce intraoperative and postoperative bleeding, decrease blood transfu-sion in the patients with antiplatelet therapy-associated cerebral hemorrhage.

Objective To investigate the infection status of Ureaplasma urealyticum (Uu) and its situation of drug resistance . Methods The separation ,identification and drug resistance test plate was used for Uu detection in 3 249 cases of cervical samples . Results The total infection rate of Uu was 47 .18% (1 533/3 249) .The patients with Uu infection mainly distributed in >20-40 years ,with the constituent ratio accounted to 90 .8% .The sensitive rates of Uu to josamycin and doxycycline were both higher than 95 .00% ,however ,the resistant rate of Uu to azithromycin and ofloxacin were both higher than 50 .00% .Conclusion The drug re‐sistant strains of Uu were common .The clinic should choose the sensitive antibiotics for the treatment according to the results of drug sensitivity test .

OBJECTIVETo recommend an improved method of prostate massage, which is safe, effective, simple and tolerable, and may increase the expressed prostatic secretin (EPS) success rate and promote the efficiency of the prostate massage.

METHODSTwo methods are described in this paper, one being the aside-bending and up-standing vs parallel and semi-squatting method to massage the prostate via the rectum, and the other being the traditional massage method. A total of 261 chronic prostatitis (CP) patients were randomly divided into two groups, and treated separately with the new method and the traditional method. Then, the two methods were compared by EPS quantity and the patients' tolerability.

RESULTSThe new method made it possible to collect larger quantity of EPS. The results of comparison showed that the new method was better received by the patients.

CONCLUSIONThe aside-bending and up-standing vs parallel and semi-squatting method to massage the prostate via the rectum may increase the EPS success rate of prostatic massage and hence help the clinical diagnosis and treatment of chronic prostatitis. This method is well worth recommending.

Adult ; Aged ; Chronic Disease ; Humans ; Male ; Massage ; methods ; Middle Aged ; Posture ; Prostate ; Prostatitis ; diagnosis ; therapy ; Rectum

Objective To evaluate the value of percutaneous hyperthermia-chemotherapy (PHC)under CT guided in treating original and secondary hepatic and pulmonary malignant tumor.Methods Percutaneous hyperthermia and chemotherapy under CT guided was performed for 21 patient with original and secondary hepatic and pulmonary malignant tumor.Chemical drugs against tumors were warmed to 55～60℃ and injected into the tumors.Injected volume was according to:V=4/3 ?(r+0.5 cm) 3.Observation depends upon attenuation changes of CT scanning and biochemical index(AFP)The therapeutic effect was classified into Ⅰ～Ⅴgrade.Results The period of observation was 36 monthes,In 20 cases,survival period was 8～22 monthes,average survival period was 16 monthes.A patient had treated with PHC and transcatheter arterial embolization and was alive for 28 monthes.Total effective rate was 95.2%.Conclusion PHC under CT guidence is an effective method in treating hepatic and pulmonary malignant tumors.especially for unresected tumors.Cooperating transcatheter arterial embolization(TAE)can raise curative effect.

OBJECTIVETo evaluate the clinical effects of laparoscopic occlusion of the internal spermatic vein with Hem-o-Lock clips and retroperitoneal ligation of the spermatic vessel (Palomo procedure) in the treatment of primary varicocele.

METHODSWe included in this study 42 varicocele patients treated by laparoscopic occlusion of the internal spermatic vein with Hem-o-Lock clips (Hem-o-Lock group) and another 38 treated by Palomo procedure (Palomo group). We recorded the operation time, intraoperative blood loss, hospital stay, bowel function recovery time, post-operative complications, as well as such seminal parameters as sperm concentration, sperm motility, sperm abnormality and the percentage of grade a + b sperm 6 months after surgery. We measured the interior diameter and reflux time of the spermatic vein and the ratio of flow velocity to the diameter using color Doppler flow imaging (CDFI), and observed the disappearance and recurrence of clinical symptoms.

RESULTSIntraoperative blood loss was markedly less and the operation time, postoperative hospital stay and intestinal function recovery time significantly shorter in the Hem-o-Lock than in the Palomo group (P<0.05), but there were no statistically significant differences in the incidence of postoperative complications (P>0.05). Six months after surgery, seminal parameters and the results of CDFI were significantly improved in both the Hem-o-Lock and Palomo groups (P<0.05), but with no significant difference between the two (P>0.05). No recurrence was found in either group at 18 months.

CONCLUSIONBoth laparoscopic spermatic vein occlusion with Hem-o-Lock clips and Palomo procedure can improve the semen quality and relieve the clinical symptoms of primary varicocele patients, but the former is even more preferable for its shorter operation time and hospital stay, less intraoperative bleeding, fewer complications, better clinical outcomes, and lower rate of recurrence.

Adult ; Humans ; Laparoscopy ; Male ; Treatment Outcome ; Varicocele ; surgery ; Vascular Surgical Procedures ; methods ; Veins ; surgery ; Young Adult

Objective To monitor the clinical epidemiology and etiology of acute diarrhea in children in the outpatient setting in Shanghai .Methods An active surveillance study in Children′s Hospital of Fudan University between August 2013 and July 2014 was conducted .Outpatient children with acute diarrhea were enrolled in this study and stool samples were collected .Pathogens including norovirus ,diarrheagenic Escherichia coli (DEC) , nontyphoidal Salmonella spp .(NTS),Campylobacter,Shigella,pathogenic vibrio and Yersinia enterocolitica were identified and typed .The χ2 test was used for statistical analysis .Results Of the 881 stool samples from enrolled children , the pathogens included into the target detection were identified in 246 (27 .92% ) cases . Norovirus ,DEC ,NTS ,Campylobacter and Shigella were detected in 98 (11 .12% ) cases ,74 (8 .40% ) cases , 61 (6 .92% ) cases ,34 (3 .86% ) cases and 2 (0 .23% ) cases ,respectively .Neither pathogenic vibrio nor Yersinia enterocolitica was identified .Children younger than 36 months old (3 .27% ,26/794) had a lower risk (χ2=7 .41 ,P=0 .006) of Campylobacter infection compared with older children (9 .20% ,8/87) .Vomiting (37 .76% ) and watery diarrhea (21 .34% ) were more commonly seen in children with norovirus infection;fever and mucous stool were commonly seen in diarrheal children with NTS infection (40 .98% and 21 .31% ,respectively) and Campylobacter infection (29 .41% and 26 .47% ,respectively) .Conclusion Enteric pathogens play a major role in childhood acute diarrhea in Shanghai .Continuous monitoring of enteric pathogens will be helpful for reasonable treatment and prevention of acute diarrhea in children .

OBJECTIVETo investigate the efficacy of the double-balloon and triple-channel catheter (DBTC) in the treatment of chronic bacterial prostatitis (CBP).

METHODSOne hundred and three CBP patients were randomly assigned to three different groups and received three different therapies, respectively: 1. 61 cases by transurethral perfusion and drainage with antibiotics with DBTC catheter; 2. 29 cases by intravenous antibiotics, and 3. 13 cases by transurethral irrigation with 0.9% saline. The lecithin, white blood cells (WBC) in expressed prostatic secretion (EPS) and Meares-Stamey's test fractionary urine culture pre- and post-therapies were compared.

RESULTSThe improvement rates of clinical symptoms and lecithin corpuscles were 81.9% and 68.9%, respectively. And the decline rate of WBC and bacteriological efficacy rate were 75.4% and 91.8%, respectively. There was a significant statistical difference between the DBTC group and the intravenous group in the lecithin, WBC and bacterial culture (P < 0.05, < 0.01 and < 0.01, respectively), and so was there between the saline group and the intravenous group in the decline of WBC(chi 2 = 5.6, P < 0.05), but with no difference in lecithin and bacterial culture. Among 61 patients treated with DBTC, 3 developed mild allergic reaction in urethra.

CONCLUSIONSTransurethral DBTC has a better clinical efficacy than traditional intravenous treatment for CBP. DBTC perfusion combined with other hypurgia holds obvious advantages of being safe, effective, easy and repeatable in the treatment of CBP.

Adolescent ; Adult ; Bacterial Infections ; complications ; therapy ; Catheterization ; methods ; Chronic Disease ; Humans ; Male ; Middle Aged ; Perfusion ; methods ; Prostate ; microbiology ; Prostatitis ; microbiology ; therapy

OBJECTIVETo investigate the clinical improvement of patient's sperm quality after the therapy on chronic prostatitis (CP) with double-balloon and triple-channel transurethral perfusion and drainage catheter.

METHODSDouble-balloon and triple-channel transurethral perfusion and drainage catheter along with millimeter wave physical therapy and intravenous infusion with antibiotics were adopted to treat 58 CP patients. The patient's sperm quality was analyzed pre- and post- therapy by Computer-assisted Sperm Analysis Instrument.

RESULTSThe comparison of patient's sperm quality parameters between pre- and post-therapy: percentage of motile sperm (42.66 +/- 17.12)% vs (55.23 +/- 14.79)%, grade a sperm (12.63 +/- 12.50)% vs (29.84 +/- 14.86)%, grade a + b sperm (29.14 +/-15.04)% vs (42.28 +/- 12.67)%, amplitude of the lateral head displacement (ALH) (3.04 +/- 1.55) microm vs (2.69 +/- 1.67) microm. The differences between pre- and post-therapy in above mentioned sperm parameters were all statistically significant (P < 0.01). While the differences among other sperm parameters were not statistically significant (P > 0.05).

CONCLUSIONTimely and effective therapy with transurethral perfusion and drainage catheter can improve the patient's sperm quality significantly, but sperm movement function cannot resume completely in a short time.

Adult ; Catheterization ; Chronic Disease ; Combined Modality Therapy ; Drainage ; Humans ; Male ; Perfusion ; Prostatitis ; physiopathology ; therapy ; Sperm Count ; Sperm Motility

Objective To investigate the relationship between serum progesterone level at the day with human chorionic gonadotrophin (hCG) administration and pregnant outcome from in in-vitro fertilization-embryo transfer(IVF-ET). Methods From Mar. 2002 to Apr. 2007, 786 cycles with serum progesterone measurement on the day of hCG administration for final oocyte maturation in IVF were analyzed retrospectively in Reproductive Medicine Center in First Affiliated Hospital of Nanjing Medical University.All stimulations were down-regulated with gronadotrophin release hormone agonist (GnRH-a) in both long protocols and short protocols before gonadotrophin stimulation. When the thresholds of serum progesterone were set at 5.5, 6.0,6.5,7.0,7.5,8.0,8.5 and 9.0 nmol/L, respectively. If the level of progesterone was less than the thresholds, those patients were in lower progesterone group, on the contrary, more than the threshold value, those patients were in higher progesterone group. The laboratory results and the clinical outcomes between all patients at lower and higher progesterone group at different thresholds value were analyzed. Results The rate of normal fertilization, quality embryos, successful implantation, chemical pregnancy, clinical pregnancy and live birth did not exhibit remarkable difference between patients with higher and lower serum progesterone level at multiple thresholds on the day of hCG administration in the 786 cycles (P >0.05). However, when the thresholds of serum progesterone were at 8.5 and 9.0 nmol/L, early abortion rates of 27.3% (3/11) and 3/7 in higher progesterone group were significantly higher than 8.8% (26/297) and 8.6% (26/301) in lower progesterone group (P<0.05). And the total abortion rates of 3/7 in higher progesterone group were significantly higher than 11.0% (34/301) in lower progesterone group when the thresholds of serum progesterone were 9.0 nmol/L (P<0.05). Conclusions This study did not prove the correlationship between progesterone level at the clay with hCG administration and the probability of clinical pregnancy or live birth. However, early abortion rates or the total abortion rates were associated with higher progesterone level when the thresholds of serum progesterone were at 8.5 nmol/L or 9.0 nmoL/L.

PURPOSETo explore the impact of subtropical maritime monsoon climate on the frequency of ambulance use for trauma patients in a coastal region in China.

METHODStatistical analysis of data on ambulance use from the 120 Emergency Command Center in Shantou City, Guangdong Province, from January to December 2012 as well as daily meteorological data from a Shantou observatory was performed to determine how climatic factors (seasons, time, and weather) affect the frequency of ambulance use for trauma patients.

RESULTSThe daily ambulance use for trauma patients differed between spring and summer or autumn (p<0.05), between sunny and rainy days (p<0.05), and between cloudy and lightly or moderately rainy days (p<0.05).We found a linear correlation between daily maximum temperature and daily ambulance use for trauma patients (R² =0.103, p<0.05). In addition, there was significant difference in ambulance use between good and bad weather (p<0.05).

CONCLUSIONFrequency of ambulance use for trauma patients is affected by the subtropical maritime monsoon climate in the coastal region. Better weather contributes to increased daily frequency of ambulance use, which is the highest in autumn and lowest in spring.

Ambulances ; China ; Climate ; Humans ; Retrospective Studies ; Wounds and Injuries ; therapy