Humans ; Infant ; Lung Diseases ; etiology ; Male ; Milk Hypersensitivity

This study aimed to study the criteria of two-way referral between tertiary-care hospital and communityhealth-care service center for patients with cerebralhemorrhage and a protocol of implementation to promote its treatment and rehabilitation.The criteria of two-way referral between tertiarycare hospital and community health-care service center for patients with cerebral hemorrhage after surgical operation were formulated on a trial basis with mutual consultation by the department of neurosurgery,Shenzhou hospital affiliated to Shenyang Medical College and Hunhewan Community Health-Care Service Center,Heping district,Shenyang. Totally,91 patients of cerebral hemorrhage admitted to the hospital during October 2007 to September 2010 were recruited for the study,46 in the intervention group with two-way referral and 45 in the control group by self-referral determined by their family members.All the patients of the two groups were followed-up for three years.During the follow-up in the intervention group,40 of 46 (95％) patients could comply with taking medication ordered by physicians,ability of daily living remarkably improved by Barthel index in 21 (50％),physical function recovered well in 33 (79％),34 (81％) could insist in self-monitoring and 32 (76％) could visit physicians for regular consultation,all these being significantly better than those in the control group (64％,31％,28％,25％ and 25％,respectively) (P ＜0.01 ).Medical and rehabilitative cost for patients with cerebral hemorrhage accounted for 575 RMB yuan per month in intervention group,as compared to 2246 RMB yuan for those in control group.Two-way referral for patients with cerebral hemorrhage can reduce their medical cost and promote their better rehabilitation.

Arginine ; therapeutic use ; Burns ; drug therapy ; immunology ; Critical Care ; methods ; Critical Illness ; therapy ; Glutamine ; therapeutic use ; Humans ; Linolenic Acids ; therapeutic use ; Nutritional Support ; methods ; Wounds and Injuries ; drug therapy ; immunology

Child ; Chromobacterium ; Female ; Humans ; Sepsis ; drug therapy ; etiology ; microbiology ; mortality

Adult ; Aged ; Aged, 80 and over ; Anti-Infective Agents ; pharmacology ; therapeutic use ; Cross Infection ; drug therapy ; microbiology ; Female ; Hospitalization ; Humans ; Inpatients ; Male ; Middle Aged ; Pneumoconiosis ; microbiology ; Pneumonia ; drug therapy ; microbiology ; Retrospective Studies

Objective To compare the effect of scapula lateral margin approach and standard Judet approach in the operative treatment of scapular fracture. Methods Medical data of 48 patients with scapular fractures from January 2006 to February 2013 were retrospectively analyzed. They were divided into the observation group and the control group according to the surgical approach. 27 patients in the observation group were treated with operative treatment through scapula lateral margin approach and 21 patients in the control group were treated with sur-gical treatment through standard Judet approach. Compared the clinical effects and complications of the patients in two groups. Results To operation time and intraoperative hemorrhage in the observation group were less than that of the control group (P<0. 05),fracture healing time was shorter than that of the control group after operation (P<0. 05). Six months after operation,the excellent rate of the observation group was higher than that of the control group. Scores of daily activities and myodynamia in the observation group were higher than that of the control group,the differences were statistically significant(P<0. 05),and there was no significant difference in the scores of pain and joint motion between the groups(P>0. 05). Conclusion Scapula lateral margin approach in treatment of scapular fracture has the advanta-ges of easy operation,small trauma,definite effect,little complication and it can be used as the preferred scheme of scapular fracture operative treatment.

Objective To evaluate the factors associated with recurrence of chronic hepatitis B (CHB) after nucleoside analogs (NAs) withdrawal.Methods A literature search from PubMed,Wanfang data,CQVIP,CNKI,Duxiu and SinoMed was conducted to identify studies on the recurrence of CHB after NAs withdrawal.Meta-analysis was performed using RevMan 5.3.Random-effects or fixed-effects model was performed based on the heterogeneity.Weighted mean difference (WMD) was used to assess the continuous data,and odds ratio (OR) was used to assess the dichotomous data.Publication bias was evaluated with Egger' s regression test using Stata SE 11.0.Results A total of 20 case-control studies were included in this analysis.The recurrence rates were 21.0％,30.4％,33.2％ in HBeAg-positive CHB patients,and 26.5％,34.1％,50.1％ in HBeAg-negative patients after NAs withdrawal for 3 months,6 months and 1 year,respectively.For patients treated with lamivudine,the recurrence rates of CHB were 21.0％,28.0％,34.3％ at 3-,6-and 12-month after NAs withdrawal.Meta analysis demonstrated that among HBeAg-positive CHB patients,the average age (WMD =7.36,95％ CI:5.72-9.00,Z =8.81,P ＜0.01) and baseline HBV DNA level (WMD =0.26,95％ CI:0.05-0.46,Z =2.44,P =0.01) were higher in recurrence group,while antiviral treatment duration was shorter in recurrence group (WMD =-3.12,95％ CI:-4.56--1.68,Z =4.26,P ＜ 0.01),and the rate of recurrence was higher in patients with liver cirrhosis (OR =2.59,95％ CI:1.33-5.04,Z =2.79,P ＜ 0.01).Among HBeAg negative patients,the average age of patients in recurrence group was higher than that in non-recurrence group (WMD =5.90,95％ CI:1.57-10.23,Z =2.67,P ＜ 0.01),and no difference was observed in other factors between recurrence and non-recurrence patients.Among patients treated with lamivudine,the average age (WMD =7.68,95％ CI:5.02-10.34,Z =5.66,P ＜0.01) and baseline HBV DNA level (WMD =0.26,95％ CI:0.05-0.46,Z =2.44,P =0.01) were higher,while antiviral treatment duration was shorter in recurrence group (WMD=-2.11,95％CI:-3.85--0.38,Z=2.39,P＜0.01),and the rate of recurrence was higher in patients with liver cirrhosis (OR =2.59,95％ CI:1.33-5.04,Z =2.79,P ＜ 0.05).Conclusion Among HBeAg-positive and lamivudine-treated patients,age,baseline HBV DNA level,antiviral treatment duration and liver cirrhosis are associated with the recurrence of CHB after NAs withdrawal; while for HBeAg-negative patients,age is the only risk factor.

The status of anesthesia and psychotropic substances use for cancer pain control was analyzed in 355 cancer patients in Huanggu District of Shenyang City.The results revealed that patients aged 60 and above accounted for 62.8％ of the total; the 5 leading diseases were lung cancer ( 132 cases,37.2％ ),colorectal cancer (34 cases,9.6％ ),liver cancer (33 cases,9.3％ ),stomach cancer ( 31cases,8.7％ ) and pancreatic cancer (20 cases,5.6％ ).There was no significant difference in constituent ratio of disease categories in the last 4 years ( x2 =18.75,P ＞ 0.05 ).The daily oral dose of morphine sulphate was 60 - 200 mg with an effective rate of 91.5％ (325/355). The side effects including constipation,nausea,vomiting and itching can be effectively reduced by prophylactic medication.