3 cm ?3 cm) in 19 cases (0.8%). No nursing-related complications occurred in-hospital. Conclusion Standardized nursing management is related to the prognosis of aged ACS patients and is an important part of the perioperative preparation for primary PCI.

Objective To discuss whether it is necessary to integrate metabolic indices into diagnosis of polycystic ovary syndrome(PCOS).Methods Taking ESHRE /ASRM diagnosis standard as gold standard,the case group composed of 51 women with PCOS and the control group composed of 47 women without PCOS were selected.By using classification tree C5.0,significant variables chosen by single factor analysis were used to establish a new diagnostic model which combined reproductive indices and metabolic indices.The validity and reliability of the new diagnostic model by using ROC curve analysis were evaluated.Finally,the consistence and difference between the new diagnostic model and the gold standard were analyzed.Results Single factor analysis chose 13 significant variables. ROC analysis showed an area under the curve of 0.930(P =0.000)and the optimal cut -off point was 0.190 with a sensitivity of 94.10%,a specificity of 91.50% and a consistency of 92.86%,which told us the new diagnostic model had superior validity and reliability.The two diagnostic methods had excellent consistence (Kappa =0.857,P =0.000)and there was no statistically significant difference (P =1.000).Conclusion Considering that whether metabolic indices are integrated into diagnosis of PCOS doesn′t change the diagnosis result,and it is unnecessary to integrate metabolic indices into diagnosis of PCOS.

Objective To study the feasibility and curative effect of transumbilical single-incision (TSIL) vs multiple-incision (MIL) laparoscopic splenectomy.Methods Ten cases (2 cases of idiopathic thrombocytopenia purpura,1 case of hereditary spherocytosis,3 cases of splenic hemangioma and 4 cases of cirrhotic splenomegaly) underwent TSIL from Jan 2010 to Ju12011,and 12 cases (3 cases of ITP,2 cases of hereditary spherocytosis,3 cases of splenic hemangioma and 4 cases of splenomegaly) underwent MIL.Clinical data were compared with each other.Results No severe complications occurred in either group.The mean operation time of single-incision group and multiple-incision group was ( 182 ± 23 ) min and ( 169 ± 19) min,and blood loss was( 160 ± 13 ) ml and ( 155 ± 16) ml ( P ＞ 0.05 ).The post-operative pain score in TSIL and in MIL group was respectively [ ( 1.60 ± 0.20) vs (3.60 ± 0.90) on day 1,P ＜ 0.05 ; (0.50 ±0.10) vs (2.00 ±0.45) on day 2,P ＜0.05].There was no significant difference between the two groups in the recovery of the gastrointestinal function,the length of hospital stay and the cost of hospitalization, all P ＞ 0.05.The umbilical incision in TSIL cases is more cosmetic.Conclusions Transumbilical single-incision laparoscopic splenectomy is feasible and safe in experienced hands.

The effects of Spirulina on intestinal microflora of diarrhea model mice were observed.Diarrhea model mice were geted by gastric perfusion ampicillin,then these mice were given different doses spirulina by gavage.Selective culture media were used to culture bifidobacteria,bacterium lacticum,enteric bacilli,enterococci,bacteroid,clostridium perfringens in feces at different times.In order to find the difference of collecting samples from feces and intestine,the quantity of detection flora in different segment of intestine were compared too.The result showed that in middle dose group and high dose group spirulina can regulate and improve intestinal flora of diarrhea model mice,and effectively shorten time from disturbance to balance.Fecal sample and intestinal contents sample both manifest a same trend,that is the quantity of bifidobacteria,bacterium lacticum in treatment recovery group is significantly higher than saline group,and enteric bacilli,enterococci,bacteroid,clostridium perfringens is significantly lower than saline group,but each index flora in intestinal contents sample has a significant difference in quantity.

The patient,a 11-year-old boy,presented with a 4-year history of erythema and vesicles on the face and arms as well as a 4-month history of tumor and ulcer on the extremities,accompanied by progressive fatigue and intermittent fever.The patient had a body temperature of 37.7℃.No lymph node involvement was observed.Cutaneous examination revealed minimally indurated pink-red patches on the face and nose and dusky red firm nodules and tumors of varying sizes on the extremities.The nodules ranged from 2.0 cm to 18 cm in diameter,some had necrosis and black crusts on the surface.Ulcers were observed in some of the larger nodules;many of the ulcers extended into the muscle layer.White purulent discharge was seen on the surface of many of the nodules.The lesions were sharply demarcated,firm,tender, and surrounded by small satelite nodules.Histologically,there were large quantities of irregularly shaped, middle-sized tumor cells with clear cytoplasm,large twisted nuclei and prominent chromatin,infiltrating from the epidermis to subcutaneous tissue.The tumor cells infiltrating the follicles and eccrine sweat glands were either distributed perivascularly in a nest shape,or dispersed.There were broken nuclei and reactive histio- cytic infiltration in the dermis and subcutaneous tissue.Immunohistologically,the tumor cells were positive for cytoplasmic CD3 around the nuclei,for CD56,CD45RO and T cell intracellular antigen-l,and partly for CD30,CD8 and Ki67.Epstein-Barr virus-encoded nuclear RNA was positive with in situ hybridization. TCR?-2 gene rearrangement was positive in these tumor cells.A diagnosis of hydroa vacciniforme-like primary cutaneous NK/T-cell lymphoma was made.Therefore,this is a case report of hydroa vaccini- forme-like primary cutaneous NK/T-cell lymphoma with primary involvement in the skin;the condition was slowly progressive over 51 months.

OBJECTIVETo explore the effective method of the prevention and treatment of procedural pain in dressing changes of burn wounds.

METHODSNinety patients of burn injury were randomized into 3 groups, 30 cases in each one. In the group A, fentanyl citrate injection was used at corresponding injury area, jiaogan (AH6a, sympathetic nerve), fei (CO14, lung), neifenmi (CO18, endocrine) on ear, 0.25 mL at each point. In the group B, fentanyl citrate injection was applied subcutaneously in the deltoid muscle, 1 mL. In the group C, 0.9% sodium chloride injection was applied subcutaneously in the deltoid muscle, 1 mL. The visual analogue scale (VAS) was used to evaluate the analgesic effect before, during and 10 min after dressing change in the patients of the three groups separately.

RESULTSIt was not different in VAS score before dressing change among the three groups (P> 0.05). Compared with that before dressing change, the pain was not significant and VAS score was not different during and after dressing change in the patients of the group A (both P>0.05), but the score in the patients of the group B and C was different significantly (all P<0.05). The VAS score during and after dressing change in the group A was lower than that in the group B and C (all P<0.05), and the score in the group B was lower than that in the group C (P<0.05).

CONCLUSIONFentanyl injection of small dose at auricular points achieves definite analgesic effect on procedural pain in dressing changes of burn wounds, superior to subcutaneous injection of fentanyl.

Acupuncture Points ; Adolescent ; Adult ; Aged ; Burns ; complications ; therapy ; Female ; Fentanyl ; administration & dosage ; Humans ; Male ; Middle Aged ; Pain ; drug therapy ; etiology ; Pain Measurement ; Young Adult

Objective To investigate the efficacy of combined high-dose intravenous immunoglobulin (IVIG) pulse therapy in patients with severe systemic lupus erythematosus (SLE). Methods Thirty-six patients were enrolled into this study, and randomly classified into WIG group (n=17) and methylprednisolone (MP) group (n=19). The treatment of patients in MG group began with a 3-day intravenous MP followed by intravenous WIG 400 mg per kilogram of body weight per day for 3-5 days, then was switched to oral prcdnisone and cyclophosphamide at routine dose. Intravenous MG was given repeatedly with an interval of 1 month for 2-5 sessions. Patients in MP group were treated with the same corticosteroids and immunosuppressants as used in WIG group but without IVIG. Patients were followed up for 3-12 months.The clinical efficacy, related serum parameters, and systemic lupus activity measurement (SLAM) were evaluated and compared between the two groups. Results Most patients in both groups showed a remission of symptoms and reduction in disease activity after treatment. The decrease in SLAM, positivity rates of antinuclear antibodies and anti-double-stranded DNA (anti-dsDNA) antibodies as well as the increase in platelets were faster in IVIG group than those in MP group (all P<0.05), but the long-term efficacy of the two groups was similar (P>0.05). Infections occurred in 11.8% of patients in WIG group and 36.8% of patients in MP group. Conclusions High-dose intravenous immunoglobulin may serve as an effective aid in the treatment of severe SLE, and is particularly beneficial to patients resistant to corticosteroids and immunosuppressants of routine dose and those accompanied by severe infections and intolerable to high dose of corticosteroids and immunosuppressants.

Objective To investigate the relationship between vaspin,Apelin,leptin and polycystic ovary syndrome.Methods We determined the serum vaspin,Apelin and leptin levels of 40 cases of PCOS patients and 30 cases of control group,and divided the PCOS group into three subgroups (normal weight,overweight and obesity) according to WHO criteria for obesity.Then we compared the serum vaspin,Apelin and leptin levels in PCOS and control group,and the differences in body weight index (body mass index,BMI) in women with polycystic ovary syndrome,and analyzed roles of adipokine vaspin,Apelin and leptin in the pathogenesis of PCOS.Results In PCOS patients adipokine vaspin,Apelin,leptin,insulin resistance index (Homeostasis model assessment for insulin index in resistence,HOMA-IR),fasting insulin (INS) and blood glucose,blood lipid were higher than those of the control group and increased with the increase of body mass index (BMI),and three kinds of adipokines and PCOS patients with HOMA-IR were positively correlated,there were statistically significant differences (P ＜ 0.05).Conclusion The results of vaspin,Apelin and leptin may be involved in the occurrence of PCOS.

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Background The construction of tissue-engineered corneal endothelium needs the functional seeding cells,so how to culture a large amount of functional corneal endothelial cells (CECs) is an urgent problem to be solved.Objective The aim of this study was to evaluate the role of aqueous humor on bovine CECs in vitro.Methods Aqueous humor of 1.2 ml was collected from the anterior chamber of bovine and sterilized,and the liquid supernatant was obtained.The bovine CECs were isolated from bovine cornea and then cultured in low glucose Dulbecco Modified Eagle Medium with 10％ fetal bovine serum (FBS) in vitro.Aqueous humor was added into the medium with the final concentration of 2.5％,5.0％,l0.0％,15.0％ and 20.0％,respectively,and no aqueous humor was added in the control group.Cell counting kit-8 (CCK-8) assay was used to detect the absorbency value of CECs for the evaluation of cell proliferation.Progression of the cell cycle was analyzed by flow cytometry (FCM).After confluence of the cells was reached,1 ml plastic spear tip was used to scratch the cell single layer,and the cells were incubated consequently in medium with 10％ FBS and with or without aqueous humor for 24 hours.Healing area of the cell single layer was measured.The cells were incubated at a density of 6 × 105 cells/ml and cultured using medium with or without 10.0％ aqueous human for 5 days,and the number of the cells was analyzed by DAPI fluorescence technique.Results Under the phase-contrast microscopy,the confluent CECs showed a slabstone-like and hexagonal appearance.CCK-8 assay revealed that the absorbance values of CECs was significantly different among the various culture groups (F=4.051,P =0.007),and the absorbance value in different concentrations of aqueous human culture groups was significantly higher than that in the control group (P ＜ 0.01).FCM showed that the percentage of the cells in S-G2 phases was (34.80-±3.13)％ in the 10.0％ aqueous humors group and (23.06±1.13)％ in the control group,showing a significant difference (t =-5.729,P=0.005).The scratch test showed that the healing area of the cell signal layer was (0.116±0.019) mm2 in the 10.0％ aqueous humors group and (0.358 ±0.049) mm2 in the control group,showing a significant difference (t =13.842,P =0.000).The density of cells in the 10.0％ aqueous humor group was (1439± 1 10)/field,which was more than (1162±45)/field in the control group (t =-11.020,P=0.000).Conclusions Aqueous humor at the concentration of 10.0％ promote the growth and proliferation of bovine CECs.The result suggests that 10.0％ aqueous humor can be used as a promoting agent during the culture of CECs.