Objective To investigate the clinical efficacy and safety of ziprasidone and risperidone in the treatment of schizophrenia.Methods According to the digital table,64 patients with schizophrenia were randomly divided into the two groups,32 cases in each group.The control group was given risperidone for treatment,while the observation group was given ziprasidone for treatment.The clinical efficacy was assessed by using the positive and negative symptom scale(PANSS),and adverse events were observed.Results The total effective rates of the control group and the observation group were 84.38％ and 87.50％,there was no significant difference between the two groups(x2 =2.66,P ＞ 0.05);The PANSS score and each factor score of the two groups after treatment decreased significantly than before treatment (t =8.11,7.86,7.72,7.90,6.77,6.58,7.52,7.40,all P ＜ 0.05),but there was no significant difference between the two groups (t =2.18,P ＞ 0.05) ;The incidence rate of adverse reaction of the observation group was 18.75％,which was significantly lower than 40.63％ of the control group (x2 =8.66,P ＜0.05).Conclusion Ziprasidone has therapeutic equivalence with risperidone in the treatment of schizophrenia,with less adverse reaction,high security,it has good clinical application value.

Idiopathic pulmonary fibrosis is divided into chronic progression stage and acute exacerbation stage according to progression of disease;early,middle and late stage according to onset time and clinic symptoms.It is considered that the etiological factors of idiopathic pulmonary fibrosis are repeated suffering of exogenous pathogen,environmental pathogen, deficiency of lung and kidney.The basic pathological products are blood stasis and phlegm turbid,the key point of pathopoiesis is that phlegm and stasis hides deeply and stagnated,the pulmonary collaterals are blocked.In addition,the evolutions of pathogenesis during its different stage are discussed.

Objective To investigate the association between polymorphism of protein C inhibitor(PCI)gene G10877T and male infertility,and provide theoretical basis for treatment of male infertility.Methods PCR and sequencing technique were applied to detect PCI gene G10877 T polymorphism in 53 normal control and 102 male infertility.Results There were three genotypes of wild type(G/C),hybridization mutation(G/T)and pure mutation(T/T).The analysis of sequencing indicated that in sperums of a proportion of the male infertile patients,TGG in PCI gene G10877T mutated into TGT.The contrast of BLASTB indicated that this mutation made Trp in 271 position change into Cys.Compared with control group,TT genotypic frequency and T allelic frequency in male infertility group had significant differences(P

About 5％- 15％ patients suffered from gallbladder stones may have secondary bile duct stones.How to diagnose secondary bile duct stones in time preoperatively or intraoperatively has been a focus of research.In this paper,the advantages and disadvantages of a variety of diagnostic methods of secondary bile duct stones including B ultrasonography,computed tomography,percutaneous transhepatic cholangiography,endoscopic retrograde cholangiopancreatography,endoscopic ultrasonography,magnetic resonanced cholangiopancreatography,intraoperative cholangiography,intraoperative ultrasonography,choledochoscope,are reviewed.

ObjectiveTo analyze the characteristic of the T peak-end interval (Tpe) in dilated cardiomyopathy(DCM) patients with heart failure and its significance in evaluation of global dispersion of ventricular repolarization.MethodsFifty-three inpatients were enrolled in this study,which included 28patients with DCM and heart failure (DCM group),and 25 patients with supraventricular tachycardia and without structural heart disease (control group).The Tpe and the dispersion of QT interval (QTd) from the 12-lead surface electrocardiogram(ECG) were acquired and measured,and consequently the corrected numerals of the average of Tpe (Tpe-AVEC),the maximal Tpe (Tpe-MAXC) were acquired.ResultsThe levels of Tpe-AVEC,Tpe-MAXC and QTd in DCM group were significantly higher than those in control group [ ( 106.31 ±26.34) ms vs.(82.72 ± 10.01 ) ms,(234.05 ± 69.75) ms vs.( 119.15 ± 11.55 ) ms,( 119.17 ± 67.62) ms vs.( 39.74 ± 17.04 ) ms ] ( P ＜ 0.05 or ＜ 0.01 ).ConclusionsThe global dispersion of ventricular repolarization is significantly increased in patients with DCM and heart failure.The Tpe-AVEC and Tpe-MAxc are recommended to be used for evaluating the dispersion of ventricular repolarization as the prognostic index in patients with DCM and heart failure.

Objective To study the giant invasive pituitary tumor neuroendoscopic operation indications,operation excision,risk aversion,and the operation skills.Methods The clinical data of 7 patients with giant invasive pituitary tumor among of endoscopic transsphenoidal surgery 61 cases of neurological patients with pituitary tumors were analyzed retrospectively.Results There were 1 case of total resection,6 cases of subtotal resection invading cavernous sinus cases,diaphragma sellar was seen in 5 cases of resection of the tumor,and 2 cases showed no diaphragma sellar.The average operation time was 100 minutes.No intraoperative transfusion.Postoperative hemorrhage in 2 cases,and 1 death case in this group after 36 hours,and 1 case undergoing endoscopic hematoma resection and cured.Conclusions With the development of endoscopic techniques,indications for operation with the new changes,for the giant invasive pituitary tumor operation therapy,endoscopic technique provides a disposable operation resection,the method is safe and avoid catastrophic consequences.

Objective To investigate the diagnosis and treatment of pancreatic cystic tumors. Methods The clinical data of 35 patients with pancreatic cystic tumors were retrospectively analyzed. Results The preoperative diagnosis rate was as follows: ultrasound was 28.6% ( 10/35 ), CT 44.4% ( 12/27 ), MRI 70% (7/10). Twenty-eight cases underwent operation and were diagnosed finally by postoperative pathology. Serous cystic neoplasm (SCN) was found in 2 cases, mucinous cystic neoplasm (MCN) in 9 cases,cystic adenocarcinoma in 7 cases, intraductal papillary mucinous neoplasm ( IPMN ) in 3 cases, solid pseudopapillary tumor (SPT) in 7 cases. Twenty-three cases were followed up successfully. The post-operative 5 years survival rate was 62.5% (5/8) in pancreatic cystic adenoma without recurrence. The longest survival time in cystic adenocarcinoma after complete resection was 5 years and 8 months, while in which after incomplete resection was 6 months. The 4 cases of SPT are all alive, and one of them has survived for 4 years as the longest one. Conclusions It is difficult to diagnose the pancreatic cystic neoplasm accurately before operation. CT and MRI may be helpful to make the diagnosis. Surgical resection is the most effective treatment. The enhancement of the communication and cooperation between the related departments, the early diagnosis, and the appropriate operation are needed to improve the diagnostic and therapeutic efficacy.

Objective To summarize the clinical and laboratory characteristics of patients with severe fever with thrombocytopenia syndrome (SFTS ) and to identify the related risk factors for mortality .Methods Clinical features and laboratory parameters were collected from 40 SFTS patients (7 deaths and 33 survivors) .Dynamic changes of laboratory data were compared between the two groups , including white blood cell count (WBC ) , platelet count (PLT ) , alanine aminotransferase (ALT ) , aspartate aminotransferase (AST) ,creatine kinase (CK) ,lactate dehydrogenase (LDH) ,prothrombin time (PT) ,activated partial thromboplastin time (APTT) and thrombin time (TT) .Continuous variables with normal distribution were compared with t test ,and those with non‐normal distribution were compared with nonparametric test ;categorical variables were compared with χ2 test .Univariate Logistic regression was used to evaluate the risk factors associated with death .Results For the deceased patients and the survivors ,the APTT were 56 .40 s and 44 .45 s ,respectively (Z=5 .419 ,P=0 .04) at day 1—7 .Those were 66 .25 s and 36 .85 s ,respectively (Z=10 .112 ,P=0 .009) at day 8—10 ,and (125 .06 ± 11 .88) s and (33 .44 ± 6 .50) s ,respectively (t=45 .760 ,P<0 .01) at day 11—13 .At day 11—13 ,the ALT levels in deceased patients and survivors were (783 .00 ± 210 .12) U/L and (137 .33 ± 89 .59) U/L ,respectively (t=7 .989 ,P=0 .016) ,AST levels were 890 U/L and 99 U/L ,respectively (Z=60 .248 ,P <0 .01) , CK levels were 2 315 U/L and 314 U/L ,respectively (Z= 122 .065 , P< 0 .01) ,LDH levels were 1 075 U/L and 509 U/L ,respevtively (Z=44 .642 ,P<0 .01) ,PT were 16 s and 11 s ,respectively (Z=7 .917 ,P=0 .031) ,and TT were 120 s and 20 s ,respectively (Z=1 361 .674 ,P<0 .01) .Day 11—13 after the onset of illness was the critical stage for SFTS .Consciousness alteration (OR=6 .60 ,95% CI:2 .94—14 .80) ,bleeding (OR=9 .29 ,95% CI:1 .48—58 .47) ,PT> 15 s (OR= 24 .00 ,95% CI:1 .99—289 .60) ,APTT>70 s (OR= 42 .67 ,95% CI:3 .54—514 .85) and TT > 120 s (OR= 0 .14 ,95% CI:0 .02—0 .88) were risk factors for the death of SFTS patients (all P< 0 .05) .Conclusion Prolonged APT T ,T T and PT at early stage and progressively increasing during the disease course suggest poor prognosis of SFTS .

Objective:To study the relationship between hepatitis B surface antigen(HBsAg)and the primary liver cancer (PLC).Methods:A 20-year prospective follow-up study was performed continuously in Qidong on a cohort of 515 HBsAg positive male patients aged 20-60 years old.The markers of hepatitis B virus,HBsAg,HBsAb,HBeAg,HBeAb and HBcAb (HBVM 1,2,3,4,5)were detected at the first time of the follow-up.Results:The PLC incidence of the whole cohort was 1340.90/100 000 person years(PY).The middle age of the PLC diagnosis was 43 with an average survival of 15 months.The PLC incidence was significantly higher in 41-50 age group than that of other age groups(P＜0.05).The three major HBVM patterns were 15,135 and 145 in the cohort with percentages of 38.83%(200/515),15.92%(82/515)and 44.08%(227/515)respective1y.The PLC incidences of these three patterns were 1 433.69/100 000 PY,2 284.71/100 000 PY,984.10/100 000 PY respectively,showing a significant difference between 135 and 145(P＜0.01).The percentages of 15,135 and 145 were 39.64%(44/111),23.42%(26/111)and 35.14%(39/111)in PLC patients respectively,showing a significant difference between 15 and 135(P＜0.01).The liver cirrhosis mortality of those three patterns were 195.50/100 000 PY,966.61/100 000 PY and 277.57/100 000 PY respectively,showing the significant differences between 135 and other two patterns(P＜0.01).Conclusion:HBsAg carriers were high risk population of PLC.The regular following-up is helpful on early diagnosis and treatment of PLC in those people,and can prolong the survival time.It was found that 135 had higher PLC risk than other HBVM patterns,suggesting a relationship between HBV duplication and PLC.The anti-virus treatment may delay or remove the occurring of PLC.

ObjectiveTo evaluate the therapeutic value of neoadjuvant chemotherapy for patients with stages Ⅱ and ⅢA(Only T3N1M0) breast cancer,and assess the relationship of the tumor size and pathologically complete response.MethodA total of 408 breast cancers patients at stages Ⅱ and ⅢA,were studied,which were divided into neoadjuvant chemotherapy group (group A) and control group (group B).All patients of group A received 2-4 cycles NAC with TE scheme in breast cancer.The impact of neoadjuvant chemotherapy on surgical methods choice,local control rate,5-year overall survival rate and 5-year disease free survival rate were analyzed.ResultsFor patients of stage Ⅱ,the rate of breast conservation significantly increased from 23.6％ to 49.1％ (P =0.000) and there was no significant difference between groups A and B ( P =0.939,0.858 ) in 5-year overall survival rate and disease free survival rate.For patients of stage ⅢA,the 5-year overall survival rate (59.8％ ) and disease free survival rate (51.8％) in group A were greatly higher than that in group B (35.7％ and 27.6％ ) (P =0.000,0.000).The 3-year local relapse and metastasis rate(7.9％ ) was lower than group B (18.4％)(P ＜ 0.05 ).The tumor less than 3.0 cm is easy to achieve pathological complete remission (P =0.001 ).ConclusionsThe neoadjuvant chemotherapy can improve potential rate of breast conservation,reduce the rate of local-regional recurrence rate for the patients with stage Ⅱ and ⅢA breast cancer,and also improve the 5-year survival rate for the patients of stage ⅢA.Patients with clinically complete response or PCR may have higher 5- year overall survival rate and disease free survival rate.Primary tumor size was found to be the significant predictive factor for pathologically complete response to neoadjuvant chemotherapy in patients with breast cancer,particularly,the small tumor is easy to reach pathologically complete response.