Child ; Evidence-Based Medicine ; Guidelines as Topic ; Humans ; Nephrotic Syndrome ; diagnosis ; therapy ; Steroids ; therapeutic use

Objective To explore therapeutic effects and indications of stereotatic puncture and drainage under multi-parameter orientation in the treatment of hypertensive intracerebral hemorrhage(HICH).Methods A total of 56 patients with HICH underwent stereotatic puncture and drainage from October 2003 to May 2005.The entrance position,the puncture plane,the puncture angle and depth,and the length of side hole of drainage tube were accurately designed before operation,and,if necessary,multiple drainage tubes were introduced via one hole.Results According to the Glasgow Outcome Scale(GOS) scores,12 patients recovered well(21.4%),29 patients were moderate disability(51.8%),and 12 patients were severe disability(21.4%).No longstanding coma was noted.Three patients died(5.4%). Conclusions Stereotatic puncture and drainage under multi-parameter orientation has better therapeutic effects and less damages than open operation.The procedure is suitable for 10~60 ml hematoma,especially in elderly patients and deep-located hematoma.The best operation timing is 3~6 hours after the onset of hemorrhage.

Objective To explore the clinical value of CT-guided selective radiofrequency thermocoagulation of the semilunar ganglion for the treatment of primary trigeminal neuralgia(PTN).Methods A total of 24 patients with PTN were included.Under local anesthesia and CT guidance,the semilunar ganglion was punctured by way of the oval foramen via the anterior approach using the Hartel's technique.Selective radiofrequency thermocoagulation was performed after the targets were confirmed by electrical stimulation. Results The pain was completely relieved in 18 patients,partially relieved in 5 patients,and unchanged in 1 patient,the total effective rate being 95.8%(23/24).Follow-up observations for 3~18 months(mean,12 months) in the 24 patients showed recurrence in 2 patients(8.3%).Conclusions CT-guided selective radiofrequency thermocoagulation is a safe,simple,and effective option for the treatment of PTN,especially suitable for the elderly and high-risk patients.

Objective To analyze implementation outcomes of the new health reform policy at a provincial hospital for the past six months.Methods Trend analysis,factor analysis and ratio analysis approaches were used in monthly surveillance,along with comparative study of the data before and after the reform,to probe into impacts of the new policy on hospital operations.Results Medical income increased by 22.09％,mainly contributed by volume growth (22.28％) of medical services; Medical income dropped by 0.16％ due to pricing policy factors; medicine proportion deceased by 4.84％; following the reform,the income per outpatient and inpatient increased by 12.32％ and 5.35％ respectively.Conclusion Following the drug zero profit policy and rise of the charging standards for medical treatment service at the hospital,the growth of total income mainly comes from growing volume of medical services instead of pricing policy factors.The new health reform is conducive to optimizing the hospital's income structure and raising value to doctors' technical service.

Objective To develop a feasible method for evaluating uncertainty in colony forming units(CFU)on the disinfected skin of nurses of operation room.Methods A nurse of operation room in a hospital involved the study.Ten spots on her disinfected hand skin were selected for evaluation of uncertainty in the acquired data and analysis of reliability of the evaluation methods,according to Technical Norms for Monitoring the Disinfection and Sterilization Quality in Hospitals in Jiangsu Province and JJF1059-1999 Evaluation and Expression of Uncertainty in Measurement.Results The CFU on the disinfected skin of nurse was(4±2)cfu/cm2, which indicated that the disinfection of the nurse's hands was not qualified.Conclusion The evaluation method by our study is reliable for evaluating the uncertainty in CFU on nurse’s disinfected hand skin.It is simple and fitful for the uncertainty evaluation of hospital disinfection effect.

OBJECTIVE:To select the optimum conditions for germination test of Sophora alopecuroides seed,and to provide reference for formulating seed test rule and standardization of S. alopecuroides. METHODS:S. alopecuroides seeds were soaked in 98% H2SO4 for 30 min and 35 ℃ warm water for 29 h,and then treated under different temperature conditions (15 ℃,20 ℃, 25℃and 30℃),different germination beds(on paper,between paper,on sand,in sand)and different light conditions(2 000 lx lighting 16 h,dark). Optimal germination condition was screened by using germination rate,germinative potential and germinative index as indicators. S. alopecuroides seeds were cultured under this condition for 7 days,and then germination rate was determined. RESULTS:Different temperatures had no significant effect on germination rate,but influenced germinative potential and germina-tive index;those indicators reached maximal value at 20 ℃. Different germination beds affected each indicator,and under condi-tion of on sand,those indicators were the highest. Light treatment had no significant effect on germination indicators. Under suit-able condition,the seed sprouted since first day of germination bed treatment;germination rate was more than 90% on second day,and reached maximal value on fifth day and didn’t increase any longer. CONCLUSIONS:The suitable condition of seed ger-mination was soaking in 98% H2SO4 30 min+35 ℃ warm water for 29 h,on sand under light at 20 ℃. Initial count on second day of germination bed treatment and final count on forth day were analyzed statistically as well as germination rate. This method can be used as standard quality test of the seed of S. alopecuroides.

Combined with the development of modem hospital pharmacy,in light of the present condition of the continuing education for the hospital pharmacists,based on the continuing education mode and method of the affiliated provincial hospital of Anhui medical university pharmacists,from the establishment of continuing education's goal and mode,the construction of hierarchical continuing education system,and education content integration aspects,this paper expounds the role and influence of the pharmacist professional skill contest.Through pharmacist professional skill contest,pharmacist can test and evaluate the hospital pharmacist professional ability,gradually improve pharmaceutical service level and quality of pharmacists.By introducing the pharmacist professional skill contest,pharmacist can not only timely adjust the continuing education's plan and ways,better coordinate with the development of hospital pharmacists,but also provide important technical support and talent reserves for the pharmacist professional skill contest.

5 days.Blood gas analysis and blood pressure were determined at admitted day.Meanwhile,peripheral white blood cells at d1,3,5,and blood glucose were measured every day,respectively.GCS at d1,3,5 and hyperglycemia scorce(HS) were evaluated.Results Of the 82 studied patients,36 cases died.Univariate analysis showed that hypotension,lower GCS,higher peripheral white blood cells and HS were the independent death risk factors(Pa0.05).In multivariate logistic regression,the factors significantly associated with an increase in mortality were hypotension,lower GCS and higher HS.Conclusion Lower GCS,higher HS and hypotension are associated with poor outcome of children with severe trauma brain injury.

Objective To summarize the clinical characteristics,diagnosis and treatment of pulmonary sequestration(PS) in children.Methods The clinical data of 19 children with PS confirmed by operation and(or) imaging examination from Mar.2003 to May.2008 were analyzed retrospectively.Thirteen cases were male,and 6 cases were female.One case was newborn infant.Seventeen cases received operation.Intralober type had a pulmonary lobectomy and extralobar type had a sequestrectomy.Chest X-ray and CT scan examinations were performed on the patients before operation.Results Seventeen cases got complete cure by operation,and the mean age at operation was 5.2 years.Chest enhanced CT indicated abnormal feeding arteries.Lobectomy was performed in 13 cases of intralobar PS,4 cases of extralobar PS were resected in the separated lung tissue,and all patients had unilateral lesions.No late deaths occurred in this group except 1 case who was complicated with malformation,and the postoperative follow-up showed an excellent recovery.Conclusions The main diagnostic methods of PS are CT and angiography.The diagnosis of PS can be confirmed when systemic feeding arteries are indicated on enhanced CT scans.Surgical resection is the main choice of treatment in all cases of PS in order to prevent recurrent infection and hemoptysis.The excellent results can be obtained by surgery.

BACKGROUND:Understanding the difference of miRNA-34s expression in normal tissue and tumor tissue wil contribute to screen out a miRNA with high sensitivity as the specific tumor molecular marker.
OBJECTIVE:To investigate the differential expression of miRNA-34s (miR-34a/b/c) between normal skin and keloid tissue using real-time fluorescent quantitative PCR, and to evaluate the role and mechanisms of miRNA-34s in keloid formation and development.
METHODS:Ten cases of keloid tissue and two cases of normal skin tissue were col ected as specimens. Total RNAs were extracted from keloid and nomal skin tissue by Trizol method, and miRNA-34s were further isolated by Ambion’s miRNA Isolation Kit. Real-time fluorescent quantitative PCR was applied to verify expression levels of microRNA-34s (miR-34a/b/c) in keloid tissue and normal skin tissue.
RESULTS AND CONCLUSION:miRNA-34s (miRNA-34a/b/c) expression was down-regulated in keloid tissue compared with normal skin tissue (P<0.01). The findings showed that miRNA-34s (miRNA-34a/b/c) are involved in keloid formation and development, and down-regulation of the family member may result in neoplastic growth of keloid.