Objective To explore the clinical significance of peripheral blood smear and bone marrow examination in the etiological diagnosis of panhematopenia.Methods 180 cases of panhematopenia were selected and were given peripheral blood smear and bone marrow examination,and the results were analyzed.Results There were 50 cases of panhematopenia because of non hematopoietic system diseases.Among 50 cases of non-hematopoietic system disease,there were 20 cases of chronic hepatitis,3 cases of cirrhosis,4 cases of lung cancer,10 cases of malignant tumors,3 cases of endocarditis,7 cases of connective tissue-like illness,1 case of gastric cancer,1 case of systemic lupus erythematosus and 1 case of hypersplenism.Due to diseases of the hematopoietic system,there were 130 cases of panbematopenia.Among 130 cases of panhematopenia due to diseases of the hematopoietic system,there were 74 cases of acute leukemia(AL),13 cases of myelodysplastic syndrome(MDS),13 cases of aplastic anemia(AA) and 30 cases of megaloblastic anemia(MA).Conclusion Peripheral blood smear and bone marrow examination is conducive to diagnose the cause of the panhematopenia.Bone marrow examination could improve the accuracy rate of panhematopenia.

Objective:To examine the effects of psychological and physiological stress on hippocampal extracellular monoamine content under simulated high-altitude hypobaric hypoxia.Methods:The male SD rats were randomly divided into ten groups:control(Con group), hypoxia(Hy group), psychological stress(twice/day)(Ps1group), psychological stress(twice/day?2day)(Ps2 group), psychological stress(twice/day) + hypoxia(Ps1+Hy group), psychological stress(twice/day? 2day) +hypoxia(Ps2+Hy group), physiological stress(twice/day)(Ph1group), physiological stress(twice/day?2day)(Ph2 group), physiological stress(twice/day) + hypoxia(Ph1+Hy group), physiological stress(twice/day?2day) + hypoxia(Ph2+Hy group).The contents of norepinephrine(NE), dopamine(DA) and 5-hydroxytryptamine(5-HT) in extracellular fluid of hippocampus collected by push-pull perfusion were determined by high performance liquid chromatography with electrichemical detection(HPLC-ECD).Results:①Compared with the Con group, the content of NE was significantly lower in Hy, Ps1+Hy and Ph2+Hy groups(P

Objective To evaluate the clinical significance of prostatic hypoechoic lesions on transrectal ultrasound(TRUS) for prostate cancer detection Methods 438 patients referred to our hospital between August 1999 and August 2006 for biopsy of the prostate.Every patient received 6～13 biopsy cores of the prostate.If a hypoechoic was identified,the biopsy was taken from this lesion.Correlation between hypoechoic lesions,isoechoic areas and cancer detection for each core was performed.Results Among 438 patients,cancer was detected in 112(25.6%) patients.Hypoechoic lesions were seen in 75(67%)patients with prostate cancer,the isoechoic areas in 37(33%).A total of 3504 biopsy cores were obtained from 438 patients.Among them,636 biopsy cores were taken from hypoechoic lesions.163(25.6%)biopsy cores taken from hypoechoic lesions harbored cancer and 473(74.4%) had no cancer.The cancer detection rate was similar in patients with hypoechoic lesions on TRUS or not,25.4%(75/298)and 26.4%(37/140)respectively.The difference was not statistically significant(P

Objective To investigate the influence of self-management and education on behaviors of medical compliance of patients undergoing vitrectomy combined with tamponade.Methods Sixty-four patients undergoing vitrectomy combined with tamponade were randomized equally into the control group and observation group in the order of admission.The control group received routine care and health education,while the observation group received self-management education follow-ups besides the routine nursing.The two groups were compared in terms of the cumulative time of the correct position,compliance behavior and the incidence of postoperative complications.Results The cumulative time of the correct position of observation group was longer than that of the control group after operation.The observation group did better in compliance behavior than the control group and the incidence of postoperative complications in the former group was lower than the latter(P<0.05).Conclusion Self-management and education can enhance patients’behaviors in medical compliance and decrease postoperative complications and promote the success of the surgery.

Objective To explore the clinical manifestations,diagnosis,misdiagnosis and treatment of primary hyperparathyroidism.Methods The clinical data of 36 patients with primary hyperparathyroidism admitted into the First Affiliated Hospital of Chongqing Medical University from January 2009 to October 2014 were reviewed and analyzed retrospectively.Results The manifestations of primary hyperparathyroidism were various and atypical.Primary hyperparathyroidism was often misdiagnosed as other diseases by 25.0％ (9/36).Among the patients,the ratio of male to female was 1:1,and median age was 58 years old.Of all patients,there were 9 persons with joint pain,digestive system symptoms in 7 cases,cervical mass discovered in 6 cases(3 cases were found when B ultrasonic examination),urinary calculus in 5 cases,fatigue symptoms in 4 cases,osteoporosis and urinary calculus in 2 cases,1 case with fracture,2 cases without any symptoms.Their calcium and parathyroid hormone level were increased by various degree.The accuracy rates of level diagnosis of Color Doppler ultrasound combine with CT or 99Tcm-MIBI were improved obviously,85.2％ and 93.1％ respectively.Twenty-eight patients received surgical treatment and pathology examination confirmed the accurate pathological types after surgery.There were 23 cases of parathyroid adenoma,1 case parathyroid hyperplasia,1 case parathyroid carcinoma,2 cases of parathyroid adenoma with nodular goiter,parathyroid adenoma merged thyroid carcinoma in 1 case.Serum calcium and parathyroid hormone level declined obviously after operation.The other 8 patients received non-surgical treatment,7 cases were alleviated and 1 case died due to irreformable high blood calcium crisis.Conclusion There should be pay attention to recognize primary hyperparathyroidism,check the blood calcium,and about suspected cases should be performed as early as parathyroid tested,neck color Doppler ultrasound.Early surgical treatment can significantly improve the prognosis and quality of life.

Objective To observe the effect of MG132 on the expression of extracellular regulated kinase 1/2 (ERK1/2) and connective tissue growth factor (CTGF) in rat peritoneal mesothelial cells (RPMCs) induced by high glucose.Methods RPMCs were isolated,cultured and passaged by trypsin,then identified.The second generation of cultured RPMCs were used in the experiment.RPMCs were divided into normal control group,high glucose (1.5％,2.5％,4.25％) for 24 hours,high glucose (2.5％) for 0,12,24,48 hours,incubated with MG132 (0.5,1,2 μmol/L) for half an hour and then with high glucose (2.5％) for 24 hours.ERK1/2 protein was detected by Western blotting,and CTGF protein in supernatant was detected by ELISA.Results Compared with the control group,the expression of p-ERK1/2 was significantly increased in the groups stimulated by high glucose (P ＜0.01),reached the peak at 24th hour (P ＜ 0.01),and then the expression decreased at 48th hour,but still was higher than that in the normal control group (P ＜ 0.01).CTGF protein expression of RPMCs induced by high glucose increased,in time-and dose-dependent manner (P ＜ 0.05).MG132 could significantly decrease the expression of ERK1/2 and CTGF induced by high glucose (P＜0.05).Conclusions MG132 can decrease the expression of p-ERK1/2 and CTGF in RPMCs induced by high glucose.The ubiquitin proteasome pathway participates in the development of peritoneal fibrosis,and blocking the way may contribute to the prevention of peritoneal fibrosis.

Objective:To evaluate the optimized efficacy of single-injection thoracic paravertebral block (TPVB) with multiple adjuvant drugs combined with general anesthesia for modified radical mastectomy (MRM) for breast cancer.Methods:Sixty American Society of Anesthesiologists physical statusⅠ or Ⅱ patients, aged 20-60 yr, with body mass index<30 kg/m 2, scheduled for elective primary modified radical mastectomy for breast cancer under general anesthesia, were divided into 2 groups ( n=30 each) using a random number table method: single-injection TPVB with multiple adjuvants group (group PV-SI) and continuous infusion via TPVB group (group PV-CI). In group PV-SI, single-injection TPVB was performed with 0.25% ropivacaine 25 ml, dexamethasone 3 mg, buprenorphine 120 μg, and adrenaline 2.5 μg/ml, and general anesthesia was performed after induction of anesthesia.In group PV-CI, the mixture of 0.25% ropivacaine 25 ml and epinephrine 2.5 μg/ml was injected after induction of anesthesia, and then 0.125% ropivacaine 8 ml/h was continuously infused via TPVB until 48 h after operation.At the end of operation, a patient-controlled intravenous analgesic pump was connected and programmed to deliver a bolus dose of morphine 2 mg with a lockout interval of 10 min and no loading dose and background infusion.The duration of postoperative analgesia, total consumption of morphine within 48 h after operation, occurrence of nausea and vomiting, and patient′s recommendation and satisfaction were recorded. Results:There was no significant difference in the duration of postoperative analgesia, total consumption of morphine within 48 h after operation, incidence of nausea and vomiting, and rates of patient′s recommendation and satisfaction between PV-SI group and PV-CI group ( P>0.05). Conclusion:Single-injection TPVB with multiple adjuvants combined with general anesthesia can be used as an optimized strategy to improve the postoperative analgesia in the patients undergoing MRM for breast cancer.

Objective To compare the clinical effect of two different kinds of wound dressing on postoperative skin reactions and phlebitis for PICC in critical patients. Methods A total of 313 PICC critical patients were divided into control group (157 cases) and treatment group (156 cases) by random digits table method. After PICC, the control group was attached to transparent dressing, the experimental group was attached to Mepilex, all of the patients were received routine nursing. The incidences of adverse effect, and the degree of local skin pruritus by Visual Analogue Scale(VAS) were compared in two weeks. Results The incidence of skin allergy, infection, and mechanical phlebitis were 24.20%(38/157), 10.83%(17/157), 18.47%(29/157) in control group and 7.69%(12/156),4.49%(7/156), 3.21%(5/156) in treatment group, and there were significant differences between two groups (χ2=13.99, 4.44, 18.83, P<0.01 or<0.05). The score of VAS in control group and treatment group were (4.84±1.29) points and (3.15± 1.82) points respectively, and the difference was statistically significant (t=8.66, P<0.01). Conclusions Application of Mepilex for PICC in critical patients can decrease the incidences of adverse effect, and increase the degree of comfort. It is worth utilizing widely in the clinic.

Patients with systemic lupus erythematosus (SLE)are susceptible to influenza virus infection due to autoimmune disorder,use of glucocorticoids and the immunosuppressive agents.Influenza virus infection affects the disease stability,and the mortality of influenza virus infection in SLE patients is 5 times higher than that in general people infected by influenza virus.Vaccination is the most effective measure to prevent influenza virus infection.There is lack of studies on the influenza immunization in SLE patients in China,so this paper reviews prevention effect and safety of inoculation,the immune response to vaccine as well as the factors influencing immune response in influenza vaccination for SLE patients.

The paper introduces the status of TCM symptoms information application,constructs the symptoms knowledge classification system by taking the TCM Diagnostics as the knowledge source,constructs the symptoms knowledge representation model based on the classification and coding technologies,and draws a conclusion that the data analysis result is consistent with the actual clinical situation based on collecting symptom data in the Electronic Medical Records (EMR) and correlation analysis using this model.