Objective To dynamic monitoring the changes of serum cortisol,adrenocorticotropic hormone (ACTH) in children with sepsis and servere sepsis,and to assess it's relationship with clinical features.Methods Thirty children with sepsis were enrolled in this study from Sep 2010 to Jan 2011 in our hospital,and were divided into severe sepsis group (n =10) and sepsis group (n =20).The serum cortisol and ACTH were analysed in acute and recovery period respectively in both two groups,and compared with 10 non-sepsis children as control group.Results In the acute period,the level of serum cortisol in severe sepsis group [ (33.97 ±6.83) μg/ml ] was significantly higher than those in sepsis group [ (26.30 ± 10.43) μg/ml]and control group [ ( 19.06 ± 6.91 ) μg/ml ] ( P ＜ 0.01 ) ; the level of serum ACTH in severe sepsis group [ (25.47 ± 9.41 ) pg/ml ] was significantly higher than those in sepsis group [ ( 15.52 ± 5.85 ) pg/ml ] and control group [ (9.16 ± 3.02 ) pg/ml ] ( P ＜ 0.01 ).Conclusion Stress response exists in the early period of sepsis,and the levels of serum cortisol and ACTH are increased significantly.The levels of serum cortisol and ACTH are positive correlation with the severity of diseases,and they could be used as serious index and a marker for evaluating prognosis in children with sepsis.

OBJECTIVE: To evaluate the therapeutic effect of multi-plane operations in treating obstructive sleep apnea-hypopnea syndrome (OSAHS). METHOD: One hundred and fifteen patients with OSAHS diagnosed by polysomnography were treated with uvuplopalatopharyngoplasty. Eighteen of them were treated combining with nasal septal construction. Twenty six patients also received nasal septal construction and partial inferior turbinectomy. One patients also received Genioglossus advancement and partial resection of corpus linguae. Five patients also received partial resection of corpus linguae. Some patients with the nasal disease and/or the lingual hypertrophy; AHI > 40 and/or BMI > 30 are received tracheotomy before general anaesthesia. RESULT: According to the postoperative follow-up 43 patients, were cured, 46 patients were improved, 26 patients were invalid, the effective power was 77.4%. CONCLUSION The operative effective power were increased by multi-plane operations in OSAHS patients. The serious complication were prevented through tracheotomy before general anaesthesia in multi-plane operations of severe OSAHS.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Sleep Apnea, Obstructive ; surgery ; Treatment Outcome

Objective To investigate the feasibility and safety of using vasodilators in the treatment of neonates with patent ductus arteriosus (PDA) accompanied by acute heart failure and pulmonary edema. Methods The clinical data of a case of neonatal PDA accompanied by severe cardiac insufficiency and pulmonary edema in Department of Intensive Care Unit (ICU) of Hebei General Hospital, and the neonate's hemodynamic characteristics and the efficacy and adverse reactions of phentolamine, a vasodilator, in the treatment of PDA were retrospectively analyzed. Results In this neonate, on the 8th day after birth and the improvement of pulmonary hyaline membrane disease, the respiratory distress occurred again, which was related to the severe cardiac dysfunction caused by the opening of PDA. Phentolamine was given on the basis of routine treatment to reduce systemic circulatory resistance. Two hours later, the respiratory distress was relieved significantly, that was presumably related to the decline of the left to right shunt volume through the PDA. There were no adverse reactions such as blood pressure reduction and coronary insufficiency. Conclusion Neonatal PDA is easily to be complicated with severe cardiac insufficiency, and vasodilators can reduce systemic circulatory resistance, reduce left to right shunt volume through the ductus arteriosus, and reverse the acute cardiac insufficiency and pulmonary edema, the therapeutic effect of vasodilators is remarkable, safe and reliable in neonatal PDA.

OBJECTIVETo study the incidence of injuries among residents living in the countryside of Huanghe delta area.

METHODSA household questionnaire survey was conducted to 15 276 residents in 20 villages of Dongying municipality of Shandong province with a stratified-cluster sampling on their injuries from March 1, 2002 to February 28, 2003. Data were analyzed with Excel 2000 and SPSS 11.0 software.

RESULTSThe crude incidence of injuries was 5.90% in total, and the standardized incidence was 5.93%. It was higher in men (7.79%) than in women (4.03%). There were 19 deaths with 20 cripples. The standardized death rate was 122.56 per 100 000 with leading causes of injuries was blunt or by sharp articles (24.61%), traffic accident (24.17%), falls (22.62%) and animal bites (13.08%). Peak incidence of age group was high in 25 - 54 age group and 0 - 4 age group (> 6.0%). 267 cases (29.60%) inpatients had had about 15.89 days hospitalization for each case. Rest of each case with injury had 19.20 days of rest. Direct economic loss for treatment would cost 904.85 RMB Yuan and 10.15 days with care takers and 221.88 RMB for other cost. The potential years of life lost was 24 years, the working years of life lost was 19.6 year, the valued years of life lost was 8.7 year, and the standardized period expected years of life lost was 31.73 year.

CONCLUSIONInjury was common and frequently occurred among residents in the countryside of rural Huanghe delta areas, that seriously endangered the health care systems and burden on families.

Accidental Falls ; economics ; prevention & control ; statistics & numerical data ; Accidents, Traffic ; economics ; prevention & control ; statistics & numerical data ; Adolescent ; Adult ; Aged ; Bites and Stings ; epidemiology ; Child ; Child, Preschool ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Incidence ; Infant ; Male ; Middle Aged ; Retrospective Studies ; Sampling Studies ; Suicide ; statistics & numerical data ; Surveys and Questionnaires ; Wounds and Injuries ; economics ; epidemiology ; prevention & control

The external wrapping of intracranial aneurysm is the definitive treatment of choice for surgical clipping or endovascular occlusion, yet there may exist considerable difficulties and risks because so far neither ideal wrapping techniques nor ideal wrapping materials have been obtained. An encapsulated aneurysm clip with biomembrane graft across the vessels is introduced in this article. By clipping the neck and wrapping the sack of aneurysm simultaneously, this clip successfully solves the problems of unreasonable encapsulated materials and techniques; it has been proved to be an effective method for treating intracranial refractory aneurysms.
Equipment Design ; Humans ; Intracranial Aneurysm ; surgery ; Ligation ; instrumentation ; Neurosurgical Procedures ; instrumentation ; Vascular Surgical Procedures ; instrumentation ; methods

Objective To evaluate the significance of hemoglobin H in the diagnosis of alpha thalassemia and Myelodysplastic syndrome. Methods A retrospective analysis of the complete clinical data of hemoglobin H in our hospital from January 2007 to October 2017 was performed. The hemoglobin H content in 34 cases of alpha thalassemia and the corresponding blood routine, reticulocyte, Bilirubin, and plasma free hemoglobin levels were analyzed by Pearson correlation. Results 39 cases of hemoglobin H positive cases, of which 34 cases diagnosed as alpha thalassemia,5 cases diagnosed as myelodysplastic syndrome; for alpha thalassemia, hemoglobin H content and reticulocyte, plasma free hemoglobin and Indirect bilirubin test results are related(r =0. 453 ,0. 398,0. 412,P<0. 05). Conclusion Hemoglobin H is not only found in alpha thalassemia but detected in other types of hematologic disorders.

Objective:To optimize the different salt preparation processes of salt-processed Psoraleae Fructus and compare the differences among different salt products.Methods:Ultra-high performance liquid chromatography (UPLC) characteristic chromatogram of Psoraleae Fructus was established. By using the comprehensive scoring method, the total content of psoralen and isopsoralen and the peak area of the characteristic chromatogram were used as the evaluation index to optimize the four different processing technologies, including "stir-frying with salt-water", "steaming with salt-water", "spraying with salt-water" and "microwaving with salt-water". Meanwhile, entropy weight TOPSIS method, clustering analysis (HCA), principal component analysis (PCA) and other chemical pattern recognition methods were used to compare the quality difference of different salt-processed Psoraleae Fructus.Results:The optimized "stir-frying with salt-water" process of salt-processed Psoralea Fructus was 170 ℃ for 13 min, "steaming with salt-water" process for 1 h, "spraying with salt-water" process for 110 ℃ for 13 min and "microwaving with salt-water" process for 105 s microwave heating. TOPSIS comprehensive evaluation results of entropy weight showed that the quality of different salt products of Psoraleae Fructus ranked as product of stir-frying with salt-water > product of stir-frying with green salt-water > product of spraying with salt-water > product of microwaving with salt-water > product of steaming with salt-water; HCA results showed that different salt products of Psoraleae Fructus could be polymerized into two categories, between which product of stir-frying with salt-water and product of stir-frying with green salt-water were polymerized into one category; product of spraying with salt-water, product of microwaving with salt-water and product of steaming with salt-water were another category; the results of PCA showed that different salt products of Psoraleae Fructus could be clustered into 4 categories, among which product of stir-frying with salt-water, product of stir-frying with green salt-water and product of spraying with salt-water were clustered into the same category respectively, and product of microwaving with salt-water and product of steaming with salt-water were clustered into the same category.Conclusion:The chemical composition of Psoraleae Fructus processed by different salting methods is different. The results of this study can provide reference for processing optimization of salt-processed Psoraleae Fructus and identification of different salt products.

Carotenoids are secondary metabolite responsible for colored pigments in plants and microbes (Li et al., 2022). They are a class of C₄₀ tetraterpenoids consisting of eight isoprenoid units, and can be classified into carotenes and xanthophylls on the basis of their functional groups (Saini et al., 2015). Carotenes can be linear (phytoene, phytofluene, and ζ‍-carotene) or branched (β‍-carotene and α‍-carotene). Xanthophylls comprise β,β‍-xanthophylls (β‍-cryptoxanthin, zeaxanthin, violaxanthins, and neoxanthin) and β,ε‍-xanthophylls (α-cryptoxanthin, α-carotene, and lutein). Citrus fruits are complex sources of carotenoids, which are the principal pigments responsible for the typical orange color of most types (Chen, 2020). The difference in total carotenoid content and the diversity of carotenoid isomer proportion also accounts for other colors of citrus fruits, such as yellow, red, and pink (Chen, 2020).
Citrus/metabolism* ; Carotenoids ; Xanthophylls ; Lutein/metabolism* ; Zeaxanthins/metabolism* ; Fruit

Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients, and it may lead to complications such as meningitis, ventriculitis, brain abscess, subdural hematoma or tension pneumocephalus. When misdiagnosed or inappropriately treated, traumatic cerebrospinal fluid leakage may result in severe complications and may be life-threatening. Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis. Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak, treatments for traumatic cerebrospinal fluid leakage varies greatly. Hence, the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the " Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults ( version 2023)" based on existing clinical evidence and experience. The consensus consisted of 16 recommendations, covering the leakage diagnosis, localization, treatments, and intracranial infection prevention, so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.