Objective:To guide antithrombotic medication in the patients with PCI by GRACE and CRUSADE risk score. Meth-ods:The GRACE and CRUSADE score at the admission of 147 patients with ACS undergone PCI in one 3-level hospital were analyzed, and the two risk scores of the PCI patients and the correlation between the two scores were studied. Results:The risk factors in the two scores were part of the same, and the two scores had significant positive correlation. Conclusion: The GRACE score and CRUSADE score should be assessed at the same time in clinics to weigh the risk of bleeding and ischemia fully and then develop strategies for an-tithrombotic treatment.

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Adult ; Empyema, Pleural ; complications ; etiology ; Humans ; Male ; Neck Injuries ; complications ; Tracheoesophageal Fistula ; complications ; etiology

ObjectiveTo evaluate the impacts of pereutaneous nephrolithotomy (PCNL) on perioperative renal hemodynamics.MethodsThe hemodynamics of operated renal arteries of 30 patients who underwent unilateral PCNL with single pole access were observed 1 day before and 5-7 days after operation with CDFI.Parameters were analyzed statistically.ResultsAfter operation,resistance index (RI) of renal arteries decreased (P＜0.05).The diastolic flow statistically increased at main renal artery (MRA) of renal hilus,interlobar renal artery and interlobular renal artery (all P＜0.05).After PCNL,in serious hydronephrosis patients,RI decreased (P＜0.05) at segmental renal artery (SRA) and interlobar artery,end-diastolic flow velocity (Vmin) increased at interlobar renal artery (P＜0.05).In moderate hydronephrosis patients,RI decreased at all renal arteries (P＜0.05) after PCNL,Vmin increased at MRA and interlobular renal artery (P＜0.05).In minor hydronephrosis patients,RI decreased at MRA and SRA,Vmin increased at SRA.In patients without hydronephrosis,RI changeed like serious hydronephrosis patients.ConclusionAfter PCNL,ipsilateral renal perfusion improves,renal diastolic flow increases and RI decreases.CDFI can be used to observe the blood perfusion of kidney,and provide quantitative information of renal hemodynamics.

Objective:To investigate the criterion-related validity of Menopause-Specific Quality of Life Questionnaire (MENQOL)-Chinese version and to evaluate the effect of menopausal symptoms on health related quality of life. Methods:This study was a cross-sectional survey. Three communities were randomly chosenin Changsha,and then 340 menopausal women aged 45-55 years were randomly chosen from the documented data of the 3 community health service centers. They were required to fill out 4 questionnaires: demographic questionnaire, MENQOL-Chinese version, Kupperman Index (KI) and World Health Organization Quality of Life (WHQOL)-BREF. Correlation analysis was used to measure the criterion-related validity. Results: MENQOL-Chinese version subscales (vasomotor, psycho-social, sexual and physical) and KI total score were positively correlated (r=0.800,0.751, 0.607, 0.906 respectively); while negatively correlated with WHOQOL-BREF total score (r =-0.694,-0.851,-0.585,-0.873 respectively); MENQOL-Chinese version subscales (vasomotor, psycho-social, sexual and physical) were signiifcantly correlated with WHOQOL-BREF subscales (physical, psychological, social relationship, environment), and the physical domain was the highest among the correlation coeffcients (r=-0.915). Conclusion:MENQOL-Chinese version shows relatively high criterion-related validity compared with KI and WHOQOL-BREF, which can be widely used to measure the quality of life of menopause women in China.

ObjectiveTo investigate the effects of care bundles on the lactation of mothers of preterm infants.MethodsFrom January to June 2015, postpartum women who had preterm deliveries in First Maternity and Infant Hospital Affiliated to Tongji University with the neonates hospitalized in neonatal intensive care unit were enrolled in this study. They were randomly divided into intervention group (n=25) receiving bundle care (assist the mothers to determine lactation target; pump/express breastmilk within six hours after birth and keep a lactation diary to record the times and volume of pumped/expressed milk) and control group (n=22) given normal mammary guidance only. The time of the first pumped/expressed milk, the times for pumping/expressing milk a day, the total milk volume per day and rate of breastfeeding were compared between the two groups. Statistical analyses were conducted using two independent samplest-test,Chi-square test and nonparametric test.ResultsThe initial time of pumped/expressed milk of the intervention group was (6.1±3.4) h after delivery, significantly earlier than the control group [(10.7±9.3) h](t=-2.301,P=0.026). The times for pumping/expressing milk per day were significantly more in the intervention group than in the controlgroup on the 1st, 2nd and 3rd day after delivery [(4.2±2.2) vs (3.0±1.6); (6.2±1.1) vs (4.7±1.9); and (7.1±1.9) vs (5.9±1.9) times, respectively](t=2.083, 2.564 and 2.194, allP<0.05). From the second postpartum day, the milk volume of the intervention group was more than the control group [M(range) were 10.0(25.0) vs 2.0(5.0) ml] (Z=-2.879,P=0.005); and on the 21st day, the milk volume of the intervention mothers reached 800.0(295.0) ml, still higher than the control group [300.0(155.0) ml](Z=-3.179,P=0.001). The primarily breastfeeding (adding formula milk≤2 times a day) rate in the intervention group was significantly higher than in the control group on the 42nd postpartum day [68% (17/25) vs 41% (9/22),χ2=5.874,P=0.045].ConclusionThe care bundles on lactation can improve the lactation of the mothers of preterm infants.

Objective To investigate the clinical efficacy of laparoscopic hepatectomy.Methods The clinical data of 258 patients who received laparoscopic hepatectomy at the First Affiliated Hospital of Fujian Medical University from March 2010 to January 2013 were retrospectively analyzed.There were 196 patients with primary hepatic cancer,45 with hepatic hemangioma,13 with hepatic focal nodular hyperplasia,2 with hepatic metastatic cancer,1 with carcinoma of gallbladder and 1 with hepatic hamartoma.All patients were followed up via phone call or out-patient examination till March 2013.Results A total of 142 patients received single hepatic segmentectomy,98 received multiple hepatic segmentectomy,18 received multiple lesions resection.Fifty-one patients received hepatic tumorectomy + cholecystectomy.All the operations were successfully done under laparoscope without conversion to the open surgery.The mean tumor diameter and the operation time were (5 ± 3) cm (range,1.0-11.5 cm) and (113 ± 56) minutes (range,50-310 minutes),respectively.Intraoperative hepatic portal occlusion was performed on 122 patients,and the time for hepatic portal occlusion was (15 ± 7)minutes.The volume of intraoperative blood loss was (211 ± 195)mL (range,10-650 mL),and blood transfusion was not needed.The capsule of the tumor was complete.The distance between the resection margin and the malignant tumor was above 1.5 cm,and there was no residual tumor in the resection margin.The hepatic function was back to the normal level in 1 week after the operation,and no patient had hepatic failure.The duration of postoperative hospital stay was (7.2 ± 1.3)days (range,5-10 days).One patient was complicated with bile leakage,6 with slight peritoneal effusion,and other patients had no postoperative complications.The rate of follow-up was 91.47％ (236/258),and the time of follow-up was (16 ± 10) months.A total of 199 patients with malignant hepatic tumors were followed up.During the follow-up,180 patients had tumor-free survival; 18 patients had postoperative tumor recurrence; 1 patient had omental metastasis and received surgical resection.Thirty-seven patients with benign hepatic tumor survived without complication during the follow-up.Conclusion Laparoscopic hepatectomy is effective for the treatment of hepatic tumors.Multiple hepatic inflow occlusion under laparoscope in a short time may improve the safety of surgery,without prolonging the recovery time of patients.

Objective To calculate the residoal liver volume using a virtaal liver surgery planning system,and to investigate the value of standardized estimated liver remnant volume ratio (STELR) in prcdicting hepatic dysfunction after hepatectomy.MethodsThe clinical data of 76 patients with primary liver cancer who were admitted to the First Affiliated Hospital of Fujian Medical University from April 2007 to October 2011 were retrospectivcly analyzed.The virtual resection and residual liver volume measurements were carried out using Liv 1.0 software.The value of STELR in predicting hepatic dysfunction was assessed using receiver operator characteristic (ROC) curves.Effects of different risk factors on postoperative hepatic dysfunction were analyzed using univariate analysis of variance and multivariate Logistic regression models. Results The mean residual liver volumes predicted by the software and resected during operation were (489 ± 206)ml and (459 ± 199 )ml,respectively,with a positive correlation between predicted and actual resection volumes (r =0.916,P ＜ 0.05).Of the 76 patients,48 had mild hepatic dysfunction,19 had moderate hepatic dysfunction and 9 had severe hepatic dysfunction.A critical STELR of 53％ was associated with severe hepatic dysfunction.Severe hepatic dysfunction was detected in 2 out of 59 (3％) patients with STELR ≥ 53％ and 7 out of 17 (41％) patients with STELR ＜ 53％,which represented a significant difference ( x2 =5.085,P ＜ 0.05 ).The result of univariate analysis revealed that STEL,R,operating time,intraoperative blood loss were significant prognostic indicators for severe hepatic dysfunction ( F =7.227,8.630,13.809,P ＜0.05).Multivariate Logistic regession revealed that STELR was a significant independent predictor of severe hepatic dysfunction ( Wald =6.675,P ＜ 0.05 ).Conclusion The likelihood of severe hepatic dysfunction after hepatectomy can be predicted by STELR.

Objective To investigate the effect of astragalus polysaccharide (AP) on proliferation and apoptosis of human acute myelocytic leukemia cell line KG-1a and the underlying mechanisms.Methods Human acute myelocytic leukemia cell line KG-la was cultured under 37 ℃ and 5 ％ C02,when appropriate cell passage and cryopreservation were performed.After treatment for 48 h with different concentrations of AP,the proliferative activity and apoptosis rate of KG-1a cells were examined by CCK-8 assay and flow cytometry,respectively.The expressions of p-Akt and bcl-2 protein in AP-treated KG-1a cells were evaluated by Western blot.The expression of PTEN mRNA by quantified real-time PCR.Results The proliferative activity of KG-la cell was obviously suppressed by AP treatment,and the inhibition rate increased in a dosedependent manner.The flow cytometry showed that,compared with the control group,the apoptosis rates of KG-1a cells were significantly increased after treatment with AP for 48 h.The early apoptosis rates were (1.98±0.16) ％,(12.60±0.48) ％,(16.31±0.73) ％,the late apoptotic rates were (3.11±0.19) ％,(17.17±1.40) ％,(21.17 ± 0.81)％,the differences were statistically significant (P ＜ 0.05).Western blot showed that the expressions of p-Akt and bcl-2 protein in KG-1a cells decreased significantly after treatment with AP (P ＜ 0.05).In contrast,the mRNA level of PTEN increased (P ＜0.05),which was shown by real-time PCR.Conclusion AP could repress cellular proliferation activity of KG-1a cells,which could be attributed to inhibition of PTEN-PI3K-Akt signaling pathway.