Objective To improve the awareness of rare mixed prostatic carcinoma. Methods We reviewed the clinical data of 5 patients with prostatic mixed tumor and relevant literature to ex-plore diagnosis and treatment for it. Results Patient 1 with mixed small cell carcinoma and adeno-carcinoma of the prostate who underwent transurethral electrovaporization of the prostate (TUVP) and flumamide therapy died of lung metastasis 7 months later. Patient 2 with mixed small cell carcinoma and adenocarcinoma of the prostate who underwent TUVP and bilateral testicular resection died of lung metastasis 10 months later. Patient 3 with adenosquamous carcinoma of the prostate who underwent TUVP, radiation therapy and flumamide therapy died of multiple organ failure 8 months later because of the lung, liver, and multiple bone metastasis. Patient 4 with prostatic adenosquamous carcinoma who underwent cystoprostatectomy combined with urinary diversion has already survived for 1 year. Patient 5 with prostatic carcinosarcoma who underwent cystoprostatectomy, urinary diversion, pelvic lymphadenectomy, and radiation therapy died of lung metastasis 13 months later. Conclusion Mixed prostatic carcinoma is quite aggressive with bad prognosis. Its diagnosis relies on detailed pathological examination and immunohistochemical techniques. Patients with prostate adenocarcinoma should be followed up timely after endocrine treatment or radiotherapy. Radical surgery is most effective for mixed prostatic carcinoma.

Objective To investigate the epidemiology and clinical features of epidemic cerebrospinal meningitis of children in Shanghai area in the last 2.5 years. Methods A retrospective study was conducted in 27 hospitalized patients with epidemic cerebrospinal meningitis by analyzing the clinical manifestation,epidemiology and laboratory test fingdings from Jan.2006 to Jun.2008.Statistical analysis of the clinical manifestations of cases in serogroup A,B and C was performed according to Neisseria meningitidis infection. Results There were sporadic cases of children with epidemic cerebrospinal meningitis in Shanghai area in the last 2.5 years.The seasonal distribution illustrated the peak occurrence from Feb.to Apr.Among all these cases,92.6% were floating children.Common types(74.1%) were the predominant clinical manifestations and the others were fulminate types(25.9%).Four cases in each of serogroup A and B,and 8 cases of serogroup C were identified by serotyping on 14 Neisseria meningitidis strains and genotyping on the other 2 cases′ cerebrospinal fluid specimens.All the patients in serogroup A with meningococcal diseases were not vaccinated before and 25.0% of them belonged to fulminate types.Half of the cases had petechia on the skin and the prevalence of skin necrosis was 25.0% and 50% had complications of nervous system.No fulminate type was present in cases of serogroup B meningococcal disease and only 1 case had slight petechia on the skin.However,intensive convulsions occurred in 75.0% of the patients,and all of them had complication of nervous system,with a few had sequela.Among the patients in serogroup C meningococcal disease,62.5% patients were vaccinated with serogroup A Neisseria meningitidis.In serogroup C,Neisseria meningitidis infection was found in each age group,with petechia on skin,skin necrosis,immunity correlation fever and complications of nervous system in 87.5%,50.0%,75.0% and 12.5% of the patients,respectively. Conclusions 1.Epidemic cerebrospinal meningitis occurred sporadically in children in Shanghai area,the majority of patients were floating populations.2.Clinical manifestation was typical in patients of serogroup A meningococcal disease.Subdural effusion or ventricalitis was more common in patients of serogroup B meningococcal disease.In serogroup C,Neisseria meningitidis was the most prevalent serotype leading to epidemic cerebrospinal meningitis.More cases were found in patients infected with serogroup C,Neisseria meningitidis with severe shock and immunity correlation fever compared with the other groups.Prophylactic vaccination of serogroup C polyvalent meningococcal organism should be recommended.

Adolescent ; Adult ; Drugs, Chinese Herbal ; chemistry ; therapeutic use ; Female ; Flavonoids ; therapeutic use ; Hepatitis B, Chronic ; drug therapy ; Humans ; Male ; Middle Aged ; Phytotherapy ; Salvia miltiorrhiza

The paper analyzes deficiencies in traditional manual screening of critical values , telephone notifications and manual record-ing of critical value reports , as well as problems existing in current critical value reporting systems in China .It designs a stable , timely and accurate reporting system for test critical values and mainly introduces the system design , system function and application features .

As the indexes of reflecting whole blood coagulation and fibrinolytic capacity, thrombelas-tography are being increasingly used in the fields of guiding intraoperative blood transfusion, hypercoagulable state monitoring and correction, treatment of trauma patients, and clotting mechanism research. This article reviews the clinical application value and limitation of thrombelastography in patients with ischemic cerebrovascular disease.

Objective To evaluate the cross-screws fixation for displaced radial neck fractures.Methods A total of 29 patients with displaced radial neck fracture (Mason type Ⅱb) were treated by open reduction and cross-screws fixation at our department from October 2009 to August 2012.They were 18 males and 11 females,aged from 18 to 56 years (average,37.2 years).The fractures affected 16 left and 13 right sides.The time from injury to operation was from 3 to 72 hours,with an average of 33.9 hours.All fractures were displaced by more than 2 mm or angulated by more than 30°,and caused by simple falling.The elbow function was evaluated by the Broberg & Morrey scoring system at one year postoperation.Results All the 29 patients were followed up for an average of 16 months (range,from 12 to 29 months).All fractures healed within 3 months,ranging from 4 to 12 weeks (mean,10.6 weeks).By the Broberg & Morrey scores at one year postoperation,15 patients were rated as excellent,10 as good,3 as fair and one as poor,giving an excellent to good rate of 86.2％.No wound infection,neural injury,fracture displacement or fixation failure occurred.No implants were removed due to local uneasiness.Conclusion Cross-screws fixation can achieve satisfactory outcomes for radial neck fractures.

The Hippocratic oath commands doctors to be the patients supreme advocate. Coupling this command with a well trained physician is the sine qua non of orthopaedic risk management. A favorable doctor and patient relationship is also essential. The occurrence of a malpractice lawsuit is more often the result of the failure to practice the art of medicine by the orthopaedist rather than a failure to apply the science of orthopaedics. The ER (emergency room) is a dangerous area. The risk of litigation in the emergency room is not directly proportional to the severity of injury. In fact, the risk of initiation of legal action is greater in cases of relatively modest disability.

Objective To study the role of the expression of P-selectin and intercellular adhesion molecule-1(ICAM-1) in hamster to rat concordant cardiac xenotransplantation.Methods Intra-(abdominal) cardiac transplantation was performed by using SD rats as recipients of Golden Syrian(hamster) hearts.The rats were divided into 4 groups randomly: group I(n=15),unmodified(recipients) were used as control; group II(n=15),splenectomy at day 0;group III(n=15),the rats were treated with cyclosporine A(CsA) 10 mg/kg every day from day 0;group IV(n=15),splenectomy in combined with CsA.The survival of hamster hearts was observed in each group.The xenograft was harvested at rejection and scheduled time in accordance with the experimental design,and analyzed for histology.The expression of P-selectin and ICAM-1 was detected by immunohistochemistry in xenograft after xenotransplantation.Results The mean survival time of the xenograft in group IV was 34.20?8.98 days,which was significantly longer in groups I,II and III (P

Adolescent ; Gene Rearrangement ; Humans ; Leukemia, Myeloid, Acute ; etiology ; genetics ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; complications ; genetics ; Receptor, Platelet-Derived Growth Factor beta ; genetics

Objective To obeserve the effects of acute hypervolemic hemodilution(AHH) with hypertonic .sodium chloride hydroxyethyl starch 40(HSH 40) on hemodynamics and fluid balance in patients under general anesthesia.Methods Fifty patients undergoing radical surgery for gastral cancer under general anesthesia were randomly divided into 2 groups with 25 patients each.Acute hypervolemic bemodilution (AHH) was performed with HSH 40 6 ml/kg in group A or with hydroxyethyl statch(HES) 6 ml/kg in group,which was infused within 30 minuts.HR,MAP,CVP were recorded before(T_0),at 30 min (T_1),60 min (T_2) after infusionand and the end of operation (T_3).The amounts of bleeding,HSH 40 and HES and urine output were recorded as well.Results There were no significant diferences in HR and MAP between two groups at all time points.CVP was sighificantly higher at T_1-T_3 than that at To in two groups.The urine output was more in groups A than that in group B(P<0.05).Conclusion AHH with HSH 40 can effectively expand blood vlume and increase urine output in surgical patients under general anesthesia.