OBJECTIVE: To discuss the diagnosis and treatment of esophageal perforation induced by esophageal foreign body. METHOD: Ten patients, who were diagnosed as esophageal foreign body and esophageal perforation, were retrospectively analyzed. One patient was operated in other hospital and transferred to our department post-operation. The foreign bodies were removed through rigid esophagoscope in 7 cases and through the tracheotomy in 1 case. The last case was admitted into hospital for abscess around the esophagus. The foreign body wasn't find during the examination of rigid esophagoscope and the patient vomited out a glass foreign body after the surgery. RESULT: In all cases, there were three date stones, two button batteries, one metal gear, one pin, one metal cans pull ring, one glass plate, one arc hard plastic sheet. Seven patients were cured after conservative treatment, and restored normal diet. For the rest 3 cases, patients were cured after the repair operation of tracheoesophageal fistula. CONCLUSION The esophageal perforation must be highly suspected of the esophageal foreign body with a long history, sharp shape or corrosive foreign body. The esophageal radiography may be taken to obtain the final diagnosis. The patients diagnosed as esophageal perforation must be treated with antibiotics, nasal feeding or feeding by gastrostomy, and followed-up closely. Small perforation can heal after a period of time by nasal feeding, while tracheoesophageal fistula was needed to repaire after a period of time for restoring a good physical condition in most cases.
Abscess ; Child ; Esophageal Perforation ; diagnosis ; surgery ; Foreign Bodies ; diagnosis ; surgery ; Humans ; Retrospective Studies ; Tracheoesophageal Fistula ; Tracheotomy

Objective To investigate the effect and perioperative nursing experience of surgical operation on patients with incomplete cervical spinal cord injury caused by traumatic cervical spine fracture. Method Fifty-nine patients with traumatic cervical spine fracture in our hospital from January 2011 to 2014 were nursed perioperatively, including before operation , training accttenty with swallowing and blowing balloons besides basic nursing care , and after operation , mental care , close observation and functional exercises postoperatively. Results The operation time was (110.5+13.0) min, the amount of bleeding was (155.6+7.5)mL. Three patients developed hematoma compression, 13 patients developed high fever. All patients were cured after treatment and nursing. Conclusion Preoperative training of swallowing and blowing balloon is fundamental for ensured surgical effect and intraoperative surgical cooperation and close observation together with postoperative mental care, close obsersation and functional exercise are the guarantee for surgical effect.

OBJECTIVE:To provide reference for the rational use of vancomycin in neonatal sepsis. METHODS:A retrospec-tive survey was performed for newborns with neonatal sepsis in our hospital from Sept. 1st in 2011 to Sept. 1st in 2012,and the pathogenic examination results,bacterial resistance and use of vancomycin were analyzed and summarized. RESULTS:Totally 317 strains of pathogens were detected in 202 cases,including 147 strains of G+ bacteria(46.4%),88 strains of fungus(27.7%)and 82 strains of G- bacteria (25.9%). Coagulase-negative staphylococcus was the main pathogens. The use rate of vancomycin was 47.0%(95 cases),and the drug selections were all based on susceptibility,with most of two-drug combination(68 cases). No se-vere adverse reactions were found. CONCLUSIONS:Coagulase-negative staphylococcus is severe and has multi-drug resistance in the cases of neonatal sepsis in our hospital. While,the use of vancomycin is basically rational. However,the clinical use of vanco-mycin should be more cautious to prevent the generation of vancomycin-resistant strains.

Research-Based Teaching is to cultivate students’ competence of study and innovation,which requires teachers to change their concept and make careful design and full preparation before they put it into practice. The practice shows that adopting the teaching method of bringing students’ autonomous study into full play and intensifying the training of their scientific research is an important approach to implement it. Research-Based Teaching will play a more and more important role in cultivating students’ comprehensive competence.

Aged ; Aged, 80 and over ; Candidiasis ; complications ; microbiology ; Coal Mining ; Esophagitis ; complications ; microbiology ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; complications ; microbiology

Objective To build three-dimensional (3-D) finite element models for local advancement skin flap, by which the post-operative local strain and local stress of skin were figured out to assist in the design of skin flap in clinic. Methods The biomechanical parameters of human forehead skin were obtained in vitro from biomechanical experiments. The 3-D finite element model of local advancement skin flap was set up by MSC Marc/Mentat 2005 (3-D finite element software). Six models were built with the same flap but different skin defects, to simulate post-operative local strain of skin and local stress of skin in different models. Results Post-operative local stress of skin increased with the skin flaps stretching, but the relationship between increase and stretching did not meet the linear rule. Skin flap was able to stretch to 40 % of its initial length in theory if we did not consider blood supply of it. When the skin flap stretched over 40 % of its initial length, the maximal stress could exceed the yield limit. Conclusion It is an effective and workable way to simulate local advancement skin flap using 3-Dfinite element model and biomechanical parameters of human skin. The stretch ratio of local advancement skin flap should be not over 40% for safety.

BACKGROUND: It is discovered that trace elements in Chinese patent medicine play an important role in pharmaceutical efficacy and structural analysis. A new topic has been formed gradually in a further research on pharmaceutical efficacy and effective components of Chinese patent medicine in the view of inorganic trace elements. The fuzzy classified study on the interrelationship between trace and constant elements of Chinese herbs and therapeutic effects is to discuss the trace-element action of drugs in the holistic aspect of trace elenent and research rather scientifically the holistic coordination among trace elements in Chinese herbs.OBJECTIVE: To determine the contents of 21 kinds of trace and constant elements in Chinese patent medicines in the treatment of cardio-cerebral vascular disease. To study with fuzzy classified method the interdependence between trace, constant elements of drugs and therapeutic effects so as to provide a new approach for the quality evaluation of Chinese patent medicine.DESIGN: Testified observed study based on various Chinese patent medicines.SETTING: Chemistry teaching-research room in a university and department of cardiology in a general hospital of a chemical industrial group corporation.MATERIALS: Twenty-one kinds of common Chinese patent medicines for the treatment of cardio-cerebral vascular diseases in clinic, namely di' ao xinxuekang capsule(DXK), xueshuan xinmaining capsule(XMN), shan haidan capsule(SHD), buchang naoxintong capsule(NXT), linaoxin capsule(LNX), xinnaosu capsule(XNS), lixin wan(LXW), suxiao jiuxin wan (SJX), xinbao wan(XBW), yinxingye pian(YXY), fufang danshen pian (DSP), niuhuang jiangya wan(NHJY), naosaitong pian(NST), qiangli tianma duzhong wan ( TD W ) , tongsaimai pian ( TSM ) , tongmai ningxin infusion(TMNX), maitong capsule(MTC), fufang yinxing wan ( YXW ) , da huoluo dan(DHL), guanxin suhe capsule(GXSH) and xiaoshuan tongluo capsule (XSTL).METHODS: Wet digestion was used to manage samples, atomic absorption spectrophotometric method(AAS) method was used to determine the contents of 10 kinds of trace and constant elements in 21 Chinese patent medicines,namely Na, Ca, Mg, K, Fe, Cr, Ni, Cu, Zn and Mn. Data range method was applied for the standardized management of statistical indexes of various element contents in relevant drugs, dotprod(U, V) method was used to measure correlation coefficient(r) among the classified objects so as to determine fuzzy matrixes in universe. The interrelationship was analyzed between the contents of trace elements of various Chinese medicines and pharmaceutical efficacy. By the analysis of fuzzy matrixes in universe, it was to evaluate firmly on the efficacy similarity of various kinds of Chinese patent medicines with quantitative indexes.MAIN OUTCOME MEASURES: ① Results of element contents; ② Results of fuzzy cluster analysis on elements.RESULTS: The standardized management of statistical indexes was carried on the contents of Na, Ca, Mg, K, Fe, Cr, Ni, Cu, Zn and Mn in various drugs to determine correlation coefficient(r) among the classified objects so as to determine fuzzy matrixes in universe. When(r) = 0.55, there were 9 kinds of drugs similar in cluster, namely xueshuan xinmaining capsule, buchang naoxintong capsule, lixin wan, xin bao wan, qiangli tianmai duzhong wan,tongsaimai pian, maitong capsule, da h uoluo dan and xiaoshuan tongluo capsu le. When(r) =0. 65, there were 6 kinds of drugs similar in cluster,namely buchang naoxintong capsule, xin bao wan, qiangli tianmai duzhong wan, tongsaimai pian, maitong capsule and xiaoshuan tongluo capsule. When(r) =0. 87, there were 2 kinds of drugs similar in cluster, namely buchang naoxintong capsule and xin bao wan.CONCLUSION: It is indicated in the research that the drugs are in rich of trace and constant elements. The larger the correlation coefficient of drugs is,the more similar the pharmaceutical efficacy is. It is discovered the close interrelationship of the trace and constant elements in drugs with their pharmaceutical efficacy. In this research, fuzzy classified method is used to discuss, in the view of trace elements, the similarity of quantitative indexes in efficacy of Chinese patent medicine commonly administrated in the treatment of cardio-cerebral vascular disease, which has provided a new approach for the quality evaluation of Chinese patent medicine.

Objective To study the efficacy of CPT-11 TACE in the treatment of unresectable HCC.Methods A retrospective review was undertaken on unresectable HCC patients receiving doxorubicin transarterial chemoembolization (59 cases) and irinotecan(CPT-11) in 24 cases from May 2003 to November 2011.Survival analysis was performed with Kaplan-Meier statistics.Differences in survival between the two groups were assessed for statistical significance with the log-rank test.Results Overall survival time was significantly longer in patients treated with CPT-11 compared with doxorubicin treated group (21.7 vs 14.5 months,P =0.042).There was no significant difference in time to progression between the two groups,but time to progression was longer in CPT-11 group than doxorubicin treated group (11.42 vs 9.46 months,P =0.091).Subgroup analysis showed that for intermediate-stage HCC,CPT-11 resulted in a significantly longer time to progression and overall survival compared with doxorubicin treated group (P =0.029 and P =0.014,respectively).There were no significant differences in adverse events among the two groups (P ＞ 0.05).Conclusions Chemotherapeutic agent CPT-11 in the form of TACE significantly improved overall survival when compared with doxorubicin for the treatment of unresectable HCC.

Objective To evaluate the efficacy of chemoradiotherapy in patients with unresectable pancreatic cancer who were previously treated with PTCD.Methods From September 2005 to December 2012,47 unresectable pancreatic cancer patients with obstructive jaundice were enrolled in this study.They were divided into two groups.21 patients received after PTCD chemotherapy or radiation,or chemoradiotherapy.26 patients in support care group received only nutrition,analgesia and other related support treatment.Survival analysis was performed with Kaplan-Meier statistics.Differences in survival between the groups were assessed for statistical significance with the log-rank test.Results The median overall survival time of patients after PTCD was 7.19 months.The median overall survival time of chemoradiation group was 9.07 months,which was higher than that of support care group (5.52 months),P=0.017.12 patients received single therapy (either chemo or radiation),and 9 patients received chemoradiotherapy.The median overall survival times were 8.31 months and 11.15 months,respectively (P =0.325).Conclusions Post PTCD chemoradiotherapy helps prolong the survival time in unresectable pancreatic cancer patients.

Objective To assess the value of magnetic source imaging (MSI) in localizing the linguistic center of auditory function of epileptic patients before operation. Methods Epileptic focus and the linguistic center of auditory function in 24 patients were localized with MSI before operation. And the relationship between epileptic focus and auditory language area was observed. Results The linguistic center of auditory function was localized in left temporal lobe in 14 patients, in right temporal lobe in 5 patients and in bilaterial temporal lobe in 5 patients. Epileptic focus was localized in left temporal lobe in 14 patients, in left temporal lobe and left parietal lobe in 1 patient, in right temporal lobe in 4 patients, in right temporal lobe and parietal lobe in 1 patient, in left frontal lobe and left temporal lobe in 1 patient, in right frontal lobe, right temporal lobe and parietal lobe in 1 patient, and in bilaterial temporal lobe in 2 patients. Epileptic focus was superimposed with the linguistic center of auditory function in 10 patients, while was not superimposed with the linguistic center of auditory function in 10 patients. The epileptic focus was localized in front of the linguistic center of auditory function in 3 patients, in behind of the linguistic center of auditory function in 1 patient. The lesion of the patient suffered from dysembryoplastic neuroepithelial tumor was not excised completely because the epileptic focus was superimposed with the linguistic center of auditory function, and the patient appeared language functional disturbance after operation in short period, remaining auditory hallucination occasionally after operation. Conclusion Epileptic focus and the linguistic center of auditory function can be localized accurately and the relationship between them can be observed clearly with MSI. MSI is useful to reduce the occurrence of language disturbance after operation.