Objective To evaluate the effects of stellate ganglion block(SGB) in treating seroma after modi-fled radical mastectomy of breast cancer.Methods 76 patients were treated with SGB besides local compressed bind-ing and were evaluated after ten days.Results There were ten seroma with the incidence rate of 13.2% and no skin flap necrosis.Conclusions SGB combined with local compressed binding could treat secroma after modified radical mastectomy of breast cancer.

Objective To determine the clinical indicators of early death (within 72 hours) in patients with acute paraquat poisoning.Methods The data of 93 acute paraquat poisoning patients admitted to emergency intensive care unit (EICU) of the First Hospital of China Medical University were retrospectively analyzed.The patients were divided into two groups according to whether they died within 72 hours or not.The gender,age,poison dose,paraquat concentration in urine,reduction of paraquat amount in urine after each hemoperfusion,and the worst value of white blood cell (WBC) count,lymphocytes count,arterial blood gas analysis,blood K +,Na+,Cl-,and serum amylase,serum lipase,serum total bilirubin,troponin Ⅰ,creatine kinase (CK),blood urea nitrogen,serum creatinine within 24 hours after poisoning were compared.Spearman correlation analysis was used to analyze the correlation between paraquat concentration in urine and the dose of paraquat.The predictive value of each indicator at death in early stage of poisoning was analyzed with receiver operating characteristic curve (ROC curve).Results Nineteen patients in the group of those died in early stage of poisoning (within 72 hours) resulted in a mortality rate of 20.4％.Compared with non-early death group,in early death group,the value of poison dose (mL:133.4 ± 108.8 vs.58.6 ± 40.0,t=3.145,P=0.002),paraquat concentration in urine [mg/L:16.34 (11.87,96.76) vs.4.46 (1.21,12.78),Z=-3.422,P=0.001],WBC (× 109/L:22.63 ±9.72 vs.14.95 ±8.39,t=3.446,P=0.001),blood lactate [Lac (mmol/L):6.7 (2.2,12.1) vs.1.9 (1.1,3.4),Z=-3.294,P=0.001] were significantly higher,and the reduction rate of paraquat concentration in urine after first perfusion [(38.4 ± 15.63)％ vs.(67.59 ± 27.87)％,t=2.945,P=0.004] and arterial partial pressure of carbon dioxide [PaCO2 (mmHg,1 mmHg=0.133 kPa):28.7 ± 9.3 vs.34.8 ± 6.7,t=-3.245,P=0.002] were significantly lowered.There was no significant difference between two groups in other indexes.Poison dose and paraquat concentration in urine showed significantly positive correlation (r=0.450,P＜0.001).ROC curve showed that the predictive value of paraquat concentration in urine,WBC,and Lac in early death were significant [area under the ROC curve (AUC) of paraquat concentrations in urine was 0.806,95％ confidence interval (95％CI) 0.699-0.913,the cut-off value was 11.64 mg/L,with sensitivity 84.6％,specificity 71.4％; AUC of WBC was 0.734,95％CI 0.569-0.899,the cut-off value was 15.94 × 109/L with sensitivity 69.2％,specificity 76.8％ ; AUC of Lac was 0.729,95％CI 0.568-0.891,the cut-off value was 1.95 mmol/L with sensitivity 84.6％,specificity 42.9％].Conclusions Paraquat concentrations in urine,WBC,Lac,poison dose and PaCO2 were the risk factors of the early death of the acute paraquat poisoning.The research suggests that paraquat concentration in urine,WBC and Lac are valuable in predicting early death of the patients.

Objective To observe and analyze the characteristics and trends of the liver and gallbladder damage caused by long-term use of anti schizophrenia drugs through the observation of the abdominal ultrasound. Methods From August 2013 to April 2016, the patients diagnosed as schizophrenia and met criterions were enrolled in our hospital. The observation group I included patients taking anti schizophrenia drug for 3 to 5 years. The observation group II included patients taking anti schizophrenia drug more than 5 years. In addition, the control group recruited healthy person who were over 30 years old and had never taken anti-schizophrenia drug. The change in ultrasound of liver and gallbladder were recorded and analyzed. Results The rate of cholecystolithiasis, chronic cholecystitis in observation group II were higher than those in the other two groups (P<0.05), while there had no significant difference between observation group I and control group. The rate of pure fatty liver in observation group II were higher than those incontrol group (P<0.05), while there had no significant difference between observation group I and observation group II, and there had no significant difference between observation group I and control group. There had no significant difference among three groups regarding as the rate of hepatic cyst and hepatic cavernous hemangioma. Conclusion Long-term use of anti-schizophrenia drugs could increase the risk ofcholecystolithiasis, chronic cholecystitis and pure fatty liver .

Objective　To establish the normal growth velocity of fetal liver length and compare them with those of intrauterine growth retardation, pregnant diabetes and maternal-fetal blood types imcopatible. Method　Three hundred and five normal pregnant women and 24, 10, 16 pathological pregnant women of intrauterine growth retardation (IUGR), gestational diabetes and maternal-fetal blood types incompatible respectively had ultrasonographic measurement of fetal liver length at 18 to 42 weeks′ gestation. Results　Normal fetal liver length has a linear relation to gestational age, and showed a significantly rapid increase after 28th week with a growth rate of 1.76 mm per week, and 1.00 mm per week before 28th week (P<0.05). The growth rate of IUGR group before and after therapy were 1.19 mm and 1.23 mm per week, significantly lower than those of normal group (P<0.05). The growth rate of pregnant diabetes group before and after therapy were 1.63 mm and 1.63 mm per week, no statistical significance with normal group (P>0.05). The growth rate of maternal-fetal blood types incompatible group before therapy was 1.98 mm, showed no difference with normal group (P>0.05), but after therapy, the growth rate of fetal liver was 1.38 mm per week, significantly lower than normal group (P<0.05). Conclusion　Dynamic measurement of fetal liver length can help us to understand whether the fetus grow well in uterus and whether the treatments are effective.

Objective To discuss the pharmaceutical care protocol and methods for clinical pharmacists taking part in cancer pain management. Methods A patient developed delirium and drowsiness after using oxycodone hydrochloride prolonged-release tablet ( OXYCONTIN) and morphine hydrochloride tablet for pain titration treatment. The clinical pharmacist analyzed the reasons of delirium and drowsiness,and suggested a dose reduction of OXYCONTIN or converting OXYCONTIN to another opioid analgesic. Results The suggestion of the clinical pharmacist was partly accepted. After adjusting the treatment, the delirium and drowsiness disappeared gradually, and the pain was well controlled. Conclusion In clinical practice, especially when faced with a rare adverse drug reaction, clinical pharmacists are helpful for ensuring the safety and effectiveness in pain management, as well as improving the level of the treatment, by the implementation of individualized drug therapy.

Objective To observe effect of acupuncture with combination of front and back points in the treatment of lumbar disc herniation(LDH).Methods The 64 LDH cases were randomized into the treatment group(34 cases) which was treated with the combination of front and back points and control group(30 cases) which was treated with the routine selection of points.The effect of two groups was compared to observe the Visual Analogue Scale(VAS) scores and the improvement in Japan Orthopedics Association(JOA) scores.Results After treatment the curative and remarkably effective rates in the treatment group were higher than those in the control group(P

Objective The incidence of pancreatic cancer is increasing worldwide, and also in china. The characteristics of the cancer are: short course, rapid progress and high mortality, with median survival time of about 6 months. Unfortunately, the early symptoms of patients are not peculiarity. There are not simple, direct and effective methods of early diagnosis. When the patients have jaundice and abdominal pain, probably they are the advanced disease (stage Ⅲ-Ⅳ) ,with unresectable tumours,and have to perform biliary bypass operation for alleviative treatment. Furthermore, the most of all patients exhibit advanced disease, which is often associated with a reduced performance status, malnourished condition, immune function deficiency, all of which severely limit patients tolerance for toxic chemotherapy regimens. These may result in physiological problems that can alter the metabolism and distribution of cytotoxic drugs and therefor lead to an increase in treatment-related toxicity. Purpose To explore the effect of TPN in the post-palliative operations, Roux-en-Ycholedceho-jejunostomy, of advaneed pancreatic carcinoma patients receiving chemotherapy. Methods From Jan. 1996 to Jan. 1999, 40 cases had receiving combination chemotherapy after palliative operations for relief of jaundice by biliary hypass, and surgical biopsy for histologically cemented. The patients were randomly divided inter 2 groups: (1) treatment group (chemotherapy + TPN), 12 men and 8 women had a median age of 57.8 years old. (2) Control group (chemotherapy + routine treatment), 13 men and 7 women had a median age of 58.2 years old. All the patients received combined chemotherapy, the regimen was 5-Fu+ CF + MMC + DDP/EPI (5-fluorouracil + Calcium folniate + Mitomycin C + Cisplatin or Epirubicin ) or IFN-γ (interferon-γ). Dosages of drugs were modified for bone marrow toxicity, stomatits and declining performance status. After 28 days, the regimen performed once again. The regimen of TPN was: total caloric value (NPC) 20 Kcal/kg·d, nitrogen 0.2kg/kg·d, N/Q = 1g: 125Kcal, Glucose/Fat=6:4. The nutritional & immunological parameters, quality of life, effects of treatment wrer monitored. Results Treatemnt group is superior to control group. After TPN, serum pre. albumin, transferrin concentration, retinol-binding protein, total lymphocyte count, natural killer cells activity, IL-2R+ cells (CD25) percentage of peripheral blood, grades of quality of life and survival time increased significantly (P<0.05, P<0.01 respectively). However, no significant difference was observed in IFN-γ application group (P>0.05). Conelusions The nutritional support can improve nutritional and immune situation and quality of life, and prolong the survival time of the patients, but no relapse-free survival.

Objective To provide application stellate ganglion block treatment of hot flashes′latest data by clinical.Methods 24 patients who were put in the research were taken record of each patient after stellate ganglion block when two months later,especially of the clinical symptoms and hot -flashes -onset,and they were asked to fill a symptom questionnaire for each one.The main concern of hot flashes in patients with seizure frequency of hot flashes and score changes were observed.The data were analyzed.Results After the implementation of stellate ganglion block,the number of episodes of hot flashes in breast cancer patients,and ratings declined,and after 6 weeks decreased by 46% and 49%.21 patients observed in Horner's syndrome.Conclusion Stellate ganglion block for the control of hot flashes in breast cancer is effective.

Objective To open the reset common bone and open ordinary osteosynthesis(MIPPO)(in effect in the treatment of high energy tibial fracture.Methods High energy tibial fracture in 42 cases of patients,according to the condition of the patient and the treatment were divided into two groups,using open reduction and bone treatment (open group,22 cases),treated with MIPPO technique(MIPPO group,20 cases).The indicators of operation,postop-erative complications and clinical efficacy of the two groups were observed.Results The operation time,intraopera-tive bleeding volume,fracture healing time of the MIPPO group were (75.2 ±9.7)min,(107.3 ±11.3)mL,(13.1 ± 3)weeks,which of the open group were (73.4 ±10)min,(208.5 ±16.3)mL,(18.2 ±4.7)weeks,the two groups had no statistically significant differences in operative time(P >0.05),two groups of blood loss,fracture healing time, the differences were statistically significant(t =23.153,4.143,all P <0.05);the complication rate in the MIPPO group was 10.0%,tibial shaft fracture healing function excellent rate was 95.0%.The complication rate of the open groupwas healing function excellent rate was 72.7%,36.4% tibial shaft fracture,there were significant differences between the two groups(χ2 =12.316,22.964,all P <0.01).Conclusion MIPPO technology in the treatment of high energy tibial shaft fractures,with less bleeding,fracture healing fast,and the characteristics of a significant effect, which is worth promoting.

Objective To explore the antihypertensive, diuretic and natriuretic effects of furosemide and hydrochlorothiazide alone or combination in chronic kidney disease ( CKD) at advanced stage and hypertension.Methods 126 cases of chronic kidney disease at advanced stage and hypertension in our hospital were randomized divided into 3 groups (A, B and C).Each group had 42 cases.Patients of group A and B received furosemide single drug and hydrochlorothiazide single drug, respectively.Patients of group C received furosemide combined with hydrochlorothiazide.The filtration sodium excretion fraction ( FENa) , the filtration chlorine excretion fraction( FECI) , blood pressure and renal functional indexes were measured.Results There was no significant difference in FENa and FECI between pre-treatment and post-treatment in group A and B.The FENa and FECI in group C post-treatment were significant higher than pre-treatment ( P<0.05 ) .There was no significant difference in blood pressure between group A and B post-treatment.The blood pressure in group C post-treatment was significant higher than group A, group B,respectively(P<0.05).There was no significant difference in GFR between pre-treatment and post-treatment in group A and B.The GFR in group C post-treatment was significant higher than pre-treatment(P<0.05).There was no significant difference in RPF and RVR between pre-treatment and post-treatment in three groups.The GFF in three groups post-treatment were significant higher than pre-treatment( P<0.05 ) .Conclusion The antihypertensive, diuretic and natriuretic effects of single furosemide and single hydrochlorothiazide are good and have no significant difference, while the combination treatment is better.