Fulminant Clostridium difficile colitis (FCDC) means severe Clostridium difficile colitis (CDC), which often manifested with severe diarrhea, fever, abdominal distention, electrolyte disorder, hypoalbuminemia, and it can lead to pseudo membrane colonitis, toxic megacolon, bowel perforation, septic shock, and multiple organ dysfunction. Now Clostridium difficile (CD) becomes one of the most important medical institutions related infectious pathogens. In particular, the recently discovered mutant CD strain NAP1/BI/ribotype 027 has high pathogenicity in the global epidemic and its outbreak. The morbidity and mortality of FCDC has a significant upward trend in the global in recent years. All broad spectrum antimicrobials usage is considered to be the primary risk factor for the onset of FCDC. Therefore, FCDC has become a new challenge for clinical work. The epidemiology, related risk factors, pathogenesis, diagnosis, severity classification, recent progress in clinical treatment of FCDC were reviewed in order to provide help for clinical treatment of FCDC and related research.

OBJECTIVE: Based on the point of introducing novel analytical methods into the testing of implanted materials, this article will summarize the principle and development of those effective analysis technologies, and the applications in testing and evaluation of medical implantations.DATA SOURCE: We retrieved Medline database (http://www.isiknowledge.com/MEDLINE) from 1987 to 2009 and Wanfang database (http://www.wanfangdata.com.cn) from 1997 to 2009, with the key words of "implantation, analytical method, testing". A total of 75 literatures of original articles, review, commentary, exchange of experience, case report and meta-analysis were retrieved.DATA SELECTION: The literatures published in recent years with strong directions were included, and those in the same field published recently or in authoritative journals were used. The literatures of analytical syndrome method and application of implant material, or with repetitive and old contents, were excluded.MAIN OUTCOME MEASURES: Totally 75 literatures, including 29 Chinese articles and 46 English articles, were included.Following reading titles and abstracts, 30 articles of unrelated research objective, and 15 articles of repetitive content were excluded. Finally 30 articles were used, composing 6 reviews and commentaries and 24 original articles.RESULTS: The requirement of implantations are growing with the development of clinic technology, along with much more attentions have been paid on the testing and evaluation of implanted materials and products. Modern analytical technology should be introduced into testing of implanting materials, which could not only clarify the relations between structure and performance, but also standard the testing method and judge the failures in medical accident.CONCLUSION: Modern analytical technology plays an essential effect on detecting implantation materials and on failureanalysis of implantation products.

Through textual research of the literature on tiny collateral and perforator vessel, the two concep- tions were compared and the similarity was analyzed in terms of definition, anatomical level, quantity, the flow of qi and blood and clinical application, etc. It is considered that the tiny collateral in Neijing (Inner Canon of Yellow Emperor) and the perforator vessel of modern medicine are different names of one physical structure. It is proposed that the combination of the tiny collateral theory of CM and the research findings of perforator vessel of western medicine would deepen the understanding of the tiny structure of human skin and promote the development of both TCM and modern medicine.
Books ; history ; China ; History, Ancient ; Humans ; Medicine in Literature ; Meridians ; Microvessels ; pathology ; Qi

Objective To investigate the Chaihu Shugan decoction combined with Group cognitive behavioral therapy on curative effect and neurologic impairment in patients with depression after stroke. Methods 80 PSD patients were randomly divided into our hospital encephalopathy rehabilitation were selected as control group and observation group, 40 cases in each group. The routine drug treatment and rehabilitation training for all patients with Deanxit tablet. The observation group added ChaiHuShuGan Decoction and group cognitive behavioral therapy in the control group based on the treatment. Two groups of patients with 24h before treatment and after 8 weeks of treatment, the Hamilton Depression Scale, the degree of neural function defect scale and evaluation index of Basel. Results After 8 weeks treatment, the total effective rate of the observation group was 95% (38 / 40), and the control group was 75% (40/30), the difference was statistically significant (P<0.05). The improvement of HAMD, NIHSS and BI scores in the observation group were significantly better than those in the control group, the difference was statistically significant (P<0.05). Conclusion ChaiHuShuGan Decoction has synergistic effect with Group cognitive behavioral therapy in the treatment of PSD can significantly improve the symptoms of depression and neurologic impairment, and can improve the quality of life of patients.

Objective To investigate the effects of cyclophosphamide(CTX) on proliferation and morphology of human alveolar rhabdomyosarcoma cell-line PLA-802 xenografted tumor in nude mice.Methods Sixteen nude mice which had been implanted PLA-802 by subcutaneous injection into the right armpit were divided into control group(5 mice),normal saline group(5 mice) and 20 mg/kg CTX group(6 mice).They were given CTX or normal saline intraperitoneally once every two days,starting on the 7~(th) day after tumor cell transplantation.Tumor volumes were measured every two days for drawing the growth curve.Animals were anesthetized on the 26~(th) day after tumor cell transplantation to get weight and specimens of the tumors.Specimens were stained of HE or EM,and then examined with light microscope and electron microscope.Results The proliferation of xenografted tumors was inhibited significantly(P

Objective:To improve the understanding and diagnosis of embryonal rhabdomysarcoma of biliary tree in childhood.Methods:The management of 1 child with sarcoma botryoides of biliary tree and other 15 cases reported were reviewed.Results:11 cases of boys and 5 of girls,varying from 1 to 6 years old.Clinical symptoms at presentation included jaundice in 16/16,fever 8/16,abdominal pain 6/16,white feces 9/16 and hepatomegaly 13/16, etc.5 cases of which were misdiagnosed as having hepatitis.There were only 2 cases considered as rhabdomyosarcoma by ultrasound and 1 by abdominal CT scan.7 cases had not recurred in 8 months after combined treatment of complete surgical excision,chemotherapy and radiotherapy.Treated with combination of partial excision and chemotherapy,1 case's tumor turned smaller 3 months later.But 2 cases treated solely with partial excision died 2 months later and 1 case recurred 2 months later.Conclusion:All rhabdomyosarcoma of biliary tree in childhood are botryoid,embryonal rhabdomyosarcoma.The patients are aged from 1 to 6 years old,and boys are more common than girls.The main clinical symptoms are obstructive jaundice,fever and hepatomegaly,so it is easily misdiagnosed as hepatitis in clinic.Ultrasound and abdominal CT sacn are helpful in diagnosing embryonal rhabdomysarcoma (sarcoma botryoides) of biliary tree,but pathological examination is essential for confirming the disease.A combined approach of aggressive surgery,chemotherapy and radiotherapy may result in long-term survival.

The article reviewed the infected cases by implanting bone allografts in history and analyzed the reasons which resulted in the infections.The article also pay attention in the methods of serologic selection of donors,and emphatically introduced the processing of viral Inactivation and their effects,it has some significance to control the risk of hone allografts.

Objective: To observe the expression of Notch1 and Smad4in colorectal carcinoma and their clinical significance. Methods: Immunohistochemistry staining was used to detect the expression of Notch1 and Smad4 in 51cases of colorectal carcinoma. Results:(1) The expression of Notch1 in colorectal carcinoma was higher than that in the normal tissue(P0.05),except histological grading and pathological types of patients(P0.05),except Dukes stage,lymph node of metastasis and pathological types of patients (P

Objective To investigate the characteristic and optimal therapy of critical limb ischemia (CLI) caused by limb arteriosclerosis obliterans (ASO) in elderly patients ≥70 years. Methods The clinical and follow-up data of 122 elderly patients (≥ 70 years) with CLI caused by ASO were analyzed. The differences were compared between 70-79 years patients (67 cases) and 80- 91 years patients (55 cases). Results The time from onset to treatment in 80-91 years patients was significant longer than that in 70-79 years patients:(45 ± 15) d vs. (26 ± 10) d, the ratios Rutherford class 4-6 and Trans-Atlantic Inter-Society Consensus (TASC) Ⅱclass C-D lesions in 80-91 years patients were significantly higher than those in 70-79 years patients: 89%(49/55) vs. 67%(45/67) and 91%(61/67) vs. 100%(55/55), and there were statistical differences (P<0.01 or<0.05). The ankle arm index (ABI) after endovascular treatment in 70-79 years patients (37 cases) and 80- 91 years patients (22 cases) were significantly higher than those before treatment: 0.86 ± 0.05 vs. 0.40 ± 0.05 and 0.85 ± 0.05 vs. 0.39 ± 0.08, and there were statistical differences (P<0.05). There were no statistical differences in ABI of conservative treatment patients before and after treatment (P>0.05). The conservative treatment mortality in 80- 91 years patients was significantly higher than that in 70- 79 years patients: 29%(7/24) vs. 9%(2/23), and there was statistical difference (P<0.05). Ninety-five patients were followed up for 1-24 months, and the median was 15 months. Nine patients (7%) died within 30 d. In the first year of follow-up, 8 cases underwent amputation, 6 cases died, and 6 cases had stent thrombosis. In the second year of follow-up, 12 cases underwent amputation, and 18 cases died. The median survival time was 19 months. The mortality in conservative treatment patients was significantly higher than that in endovascular treatment patients:53%(19/36) vs. 24%(14/59), and there was statistical difference (P<0.05). The survival time in amputation patients had increasing trend, but there was no statistical difference (P>0.05). Conclusions The≥70 years elderly patients with CLI caused by ASO have more complications and longer time from onset to treatment, and the lesions are mainly Rutherford class 4-6 and TASC classⅡC-D. Endovascular treatment is difficult, but the effect is better than conservative treatment.

A lot of children with congenital heart disease have an abnormal development of nervous system. A variety of biochemical and physical examination indices can be used to predict adverse outcome of neurodevelopment caused by congenital heart disease and they contribute to early intervention and improvement of neurodevelopmental disorders. In recent years, new progresses in the laboratory tests, neurological physiccal examination and perioperative management of the neurodevelopmental abnormalities caused by congenital heart disease have been made. The predictive factors of abnormal neurodevelopment caused by congenital heart disease were reviewed in this article.