Adult ; Humans ; Male ; Oils ; Pneumonia, Aspiration ; chemically induced

Objective To investigate the predictive value of trauma index on the prognosis in pa-tients with traumatic spinal cord injury.Methods Enrolled 168 cases of patients with traumatic spinal cord injury,the traumatic index score and the American Spinal Injury Association (ASIA)grade were as-sessed on admission,then followed up for 6 months,the Spearman correlation analysis was performed to a-nalysis the relationship between trauma index and ASIA grade,and Receiver operating curve (ROC)anal-ysis was used to evaluate the relationship between trauma index and prognosis.Results There was a sig-nificant negative correlation between trauma index score and ASIA grade(r =-0.68,P <0.01).A total of 157 cases (93.5%)completed follow-up,the trauma index score had a good predictive value on the traumatic death in these patients,it's sensitivity was 71.4%,specificity was 76.1%,the best cut-off point was 25 points(P <0.01 );Compared with the low score group (<25 points),the high group (≥25 points)showed a lower ASIA grade and higher mortality,the differences were statistically significant (P <0.01).Conclusion The trauma index score was related with the spinal cord injury,and it is a predictive factor of poor prognosis in patients with traumatic spinal cord injury.

OBJECTIVE:To investigate the cognition,evaluation and demands of medical staff to the clinical pharmacy work in the secondary and tertiary medical and health institutions in Xi’an city,and provide reference for further promoting the develop-ment of the local clinical pharmacy work. METHODS:20 secondary and tertiary medical and health institutions in Xi’an city were randomly selected to conduct a random sampling questionnaire for physicians,nurses (senior nurses),pharmacists (non-clinical pharmacist)and other medical technicians. And the results were statistically analyzed. RESULTS:Totally 1 020 questionnaires were sent out,851 were effectively received with effective recovery of 83.4%. 45.9% respondents knew clinical pharmacy,and“Col-league”was the main channel;34.3% thought clinical pharmacy“only maintained normal operation. 74.7% surveyed medical staff,92.6% surveyed pharmacists and 70.6% surveyed physicians thought clinical pharmacists“should”take round with the doc-tors and nurses;44.3% respondents showed“dissatisfaction”and“general satisfaction”with the clinical pharmacy work in their hospitals. 48.5% respondents would take the initiative to consult the clinical pharmacist for medication;45.5% respondents partial-ly accepted the drug information provided by clinical pharmacists. There were significant differences in the investigation results in aspects of respondents’understanding level and channel for clinical pharmacy,cognition for development situation of clinical phar-macy,evaluation for clinical pharmacists participating round,demand for consulting the medication,acceptance for drug informa-tion provided by clinical pharmacists,and other items(P<0.05). CONCLUSIONS:The cognition and effect of clinical pharmacy work on medical staff need to be further strengthened,clinical pharmacists should also have solid clinical knowledge and the knowl-edge of medicine to meet the demand of medical staff in different positions,the acceptance of medical staff to the pharmaceutical care needs to be further improved. Clinical pharmacists should earnestly fulfill their job functions through various efforts to promote rational drug use.

Acupuncture Therapy ; history ; instrumentation ; methods ; China ; History, Ancient ; Humans ; Medicine in Literature ; Needles ; history

Objective To evaluate the clinical efficacy of the application of auricular composite tissue flap in treatment of nasal alar de-fect. Methods 43 cases of nasal defects patients were admitted to our hospital from January 2008 to March 2013, 23 cases of them were treated with auricular composite tissue flap transplantation, and the other 20 cases were given nasolabial sulcus flap transfer operation. All patients were followed-up for 6 to 12 months, and the rate of secondary surgery, proliferation of scar, and flap survival of the two groups were compared. Results Treatment of auricular composite tissue flap transplantation has more advantages in terms of the rate of secondary surgery, proliferation of scar, and flap survival, and the difference is of statistical significance (P<0. 05). And there is no obvious differ-ence in satisfaction degree of cosmetic outcomes. Conclusion Auricular composite tissue flap surgery has the advantages of simple opera-tion, good appearance and good efficacy.

In order to solve the problem of poor communication, low efficiency of consultation, and even affecting self-confidence caused by unskilled skills and insufficient cooperation with patients in the real clinic, and to solve the problem during the clinical thinking training that beginners do not know how to organize effective information and complete the process of diagnosis and differential diagnosis more efficiently. By applying the artificial intelligence (AI) virtual patient (VP) system to the process of teaching diagnostic knowledge and clinical thinking training. It provides the students with the experience of simulating the diagnosis and treatment of the clinical real scene. Let the students talk with the VP system for inquiry training and then go to the clinic to give the real patients inquiry and by simulating the process of treating the real patients, let the students take the initiative to complete the collection of medical records and clinical decision-making under the simulated scene to train the clinical thinking. This can not only solve the shortcomings of the previous simulation teaching and clinical teaching, but also stimulate students' interest in learning. According to the results of the questionnaire, students have a high acceptance of VP system simulation teaching. Through the results of homework and assessment and evaluation, the teaching results are better than before, and this teaching method should be further popularized.

Objective To study the clinicopathologic features of brain tumors in patients with medically intractable epilepsy. Methods The clinical, radiologic and pathologic features of brain tumors in thirty-six patients with intractable epilepsy encountered during the period from 2008 to 2014 in the Epilepsy Center of Haidian Hospital were retrospectively reviewed. Results There were 18 males and 18 females in thirty-six patients. The mean age of seizure onset and disease duration were (14.05 ± 1.67) years and (10.04 ± 1.19) years respectively. The histological types of brain tumors included ganglioglioma (12/36, WHO gradeⅠ,1/36, WHO gradeⅡ), dysembryeplastic neuroepithelial tumor (2/36, WHO gradeⅠ), pleomorphic xanthoastrocytoma (1/36, WHO gradeⅡ), angiocentric glioma (1/36, WHO gradeⅠ), astrocytoma (4/36, WHO gradeⅡ), oligoastrocytoma (1/36, WHO gradeⅡ, 2/36, WHO gradeⅠ-Ⅱ), oligodendroglioma (1/36, WHO gradeⅠ-Ⅱ,1/36, WHO grade Ⅱ), cavernous hemangioma (4/36) and Sturge-Weber syndrome (1/36). Most of these tumors were located in temporal lobe (25/36, 69.4%). Patients were followed up for 0.5-7 years after operation. One patient was lost for follow up. Seizure outcome after the epilepsy operation revealed that 28 patients (77.8%) had Engel gradeⅠ, 4 patients (11.1%) had Engel gradeⅡ,2 patients (5.6%) had Engel gradeⅢ,1 patient (2.8%) had Engel gradeⅣ. Conclusion Brain tumors in patients with medically intractable epilepsy are almost low grade tumors of the nervous system. Focal cortical dysplasia is existed in most brain tissues from the epilepsy operation. Low grade tumors of the nervous system have close relation with focal cortical dysplasia in patients with medically intractable epilepsy. It is possible that the classifications of pathology diagnosis has connection with prognosis.

Objective To evaluate the clinical outcome of mono-segment transpedicular fixation of type B thoracolumbar fracture.Methods A retrospective analysis was conducted on 40 cases suffering from type B thoracolumbar fracture treated with mono-segment transpedicular fixation from May 2003 to October 2012.According to the AO classification,13 cases were identified with type B1.1,11 type B1.2,11 type B2.2,2 type B3.1,2 type B3.2,and 1 type B3.3.Radiological results were evaluated by measuring compression rate of the fractured vertebra and Cobb' s angle of the vertebra adjacent to the fractured segment.Clinical results were assessed using Frankel classification for spinal cord injury and visual analogue scale (VAS) for pain.Results Mean operation time was 71 minutes and mean intrao perative blood loss was 105 ml.Mean period of follow-up was 47.5 months (range,24-82 months).Mean Cobb' s angle of the vertebra adjacent to the fractured segment and compression rate of the fractured vertebra revealed great correction at one week post-operation compared with preoperative ones (6.2° vs 20.1° and 10.1％ vs 38.9％ respectively,P ＜0.05) and there was no significant correction loss at the last follow-up (6.9° and 10.8％ respectively,P ＞ 0.05).Mean VAS was 8.6 points before operation,but mean VAS was 2.4 points at final follow-up (P ＜ 0.05).Neurological performance improved in 37 cases (93％).No cases experienced neurological deterioration.Conclusions Mono-segment transpedicular fixation has small incision,short operation time,few bleeding and decreased motor function loss.The procedure is indicated for most type B thoracolumbar fracture and clinical results are satisfactory.

Objective To evaluate the effect of diabetic peripheral neuropathy on peripheral neurotoxicity induced by local anesthetics in rats.Methods Sixty healthy adult male SPF Sprague-Dawley rats,aged 6 weeks,weighing 150-180 g,were divided into either control group (n =18) or diabetic peripheral neuropathy group (n=42) using a random number table.The rats were fed a high-fat and high-sucrose diet for 8 weeks,and streptozotocin (STZ) 30 mg/kg was injected intraperitoneally to induce diabetes mellitus which was confirmed by blood glucose level≥ 16.7 mmol/L.The mechanical paw withdrawal threshold to yon Frey filament stimulation and thermal paw withdrawal threshold were measured.The decrease in reaction thresholds to thermal and mechanical stimuli (changing from sensitivity to insensitivity) was observed after STZ injection.At 4 weeks after STZ injection,the rats showing a marked hyperalgesia served as early diabetic group.At 8 weeks after STZ injection,the rats showing a marked insensitivity to pain served as late diabetic group.Experiments were carried out in early or late diabetic rats,and ordinary Sprague-Dawley rats of the same age were used as control group.Left sciatic nerve block was performed with 2％ lidocaine 0.2 ml.Before the sciatic nerve block and at 1 week after the sciatic nerve block,the nerve conduction velocity of the left sciatic nerve and F-wave minimal latency were measured,and the sciatic nerve block time was recorded.Results Compared with the baseline before block,the nerve conduction velocity was significantly decreased,and the F-wave minimal latency was prolonged in late diabetic rats (P＜0.05).Compared with control group,the sciatic nerve block time was significantly prolonged in late diabetic group (P＜0.05).Conclusion Diabetic peripheral neuropathy aggravates peripheral neurotoxicity induced by local anesthetics in rats.

Objective:To explore a crown form classification method for upper central incisor which is more objective and scientific than traditional classification method based on the standardized photography technique.To analyze the relationship between crown form of upper central incisors and papilla filling in periodontally healthy Chinese Han-nationality youth.Methods:In the study,180 periodontally healthy Chinese youth (75 males,and 105 females )aged 20 -30 (24.3 ±4.5)years were included.With the standardized upper central incisor photography technique,pictures of 360 upper central incisors were ob-tained.Each tooth was classified as triangular,ovoid or square by 13 experienced specialist majors in prothodontics independently and the final classification result was decided by most evaluators in order to ensure objectivity.The standardized digital photo was also used to evaluate the gingival papilla filling situation.The papilla filling result was recorded as present or absent according to naked eye observation. The papilla filling rates of different crown forms were analyzed.Statistical analyses were performed with SPSS 19.0.Results:The proportions of triangle,ovoid and square forms of upper central incisor in Chinese Han-nationality youth were 31.4% (113 /360),37.2% (134 /360)and 31.4% (113 /360 ), respectively ,and no statistical difference was found between the males and females.Average κvalue be-tween each two evaluators was 0.381.Average κvalue was raised up to 0.563 when compared with the final classification result.In the study,24 upper central incisors without contact were excluded,and the papilla filling rates of triangle,ovoid and square crown were 56.4% (62 /110),69.6% (87 /125 ), 76.2% (77 /101)separately.The papilla filling rate of square form was higher (P =0.007 ).Conclu-sion:The proportion of clinical crown form of upper central incisor in Chinese Han-nationality youth is obtained.Compared with triangle form,square form is found to favor a gingival papilla that fills the inter-proximal embrasure space.The consistency of the present classification method for upper central incisor is not satisfying,which indicates that a new classification method,more scientific and objective than the present one,is to be found.