Objective To investigate the value of prognosis of NT-proBNP in severe sepsis and septic shock patients .Methods 70 patients with sepsis admitted to our hospital were divided into general sepsis group (n=23) ,severe sepsis group(n=28) and sep-tic shock group(n=19) according to the severity of the disease ,the plasma NT-proBNP ,lactic acid ,C-reactive protein were meas-ured within 1 h after admission ,and calculated the 24 h acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) .Results (1) Plasma NT-proBNP concentration ,lactic acid ,CRP and APACHE Ⅱ score in severe sepsis group ,septic shock group was sig-nificantly higher than that of general sepsis group(P< 0 .05);Plasma NT-proBNP concentration ,CRP and APACHE Ⅱ score in septic shock group was significantly higher than severe sepsis group (P<0 .05) .(2)70 cases of patients with sepsis with 15 cases died and 55 cases survived .Plasma NT-proBNP concentration ,lactate ,CRP and APACHEⅡscore of death patients was significantly higher than the survival patients(P<0 .01) .(3) Plasma NT-proBNP concentration at the time of sepsis patients admitted to hospi-tal with positively correlated to APACHE Ⅱscores(r=0 .528 ,P<0 .01) .Conclusion The plasma NT-proBNP is closely related to the prognosis of patients with sepsis ,early detection of plasma concentration of NT-proBNP helps to evaluate the prognosis of pa-tients w ith sepsis .

Objective:To analyze the distribution characteristics of traditional Chinese medicine (TCM) syndromes in patients with coronavirus disease 2019 (COVID-19) in plateau areas, and to provide theoretical basis for further clinical treatment of patients with COVID-19.Methods:From August 9 to August 24, 2022, patients with COVID-19 admitted to the Third People's Hospital of Tibet Autonomous Region (designated hospital for COVID-19) were included, and their baseline characteristics (age, gender, source), clinical classification and distribution of TCM syndrome types were collected and analyzed. Data analysis was performed using SPSS 26.0 statistical software.Results:A total of 161 COVID-19 patients were enrolled with ethnic distribution: 124 (77.02%) Tibetans, 35 (21.74%) Han, and 2 (1.24%) Hui, 68 males and 93 females. The male-to-female ratio was 0.73∶1. Aged 1 to 94 years, the average age was (39.06±23.64) years old, of which 4 patients were under 1 year old (excluded because the information was missing). A total of 157 patients were enrolled, and 124 patients (78.9%) were under 60 years old, including 120 cases of common type, 4 cases of severe type, 0 cases of critical type, 7 cases over 80 years old, 1 case over 90 years old, and 32 cases under 18 years old. The clinical manifestations of the patient are mainly cough, expectoration, fever, aversion to cold, dry throat, headache, fatigue, running nose, dry mouth, bitter mouth, etc. Most of the tongue is pale, red, and white greasy moss or thin white coating. In TCM, the most common syndrome was cold-dampness blocking lung syndrome (99 cases, 63.06%), followed by cold-dampness stagnant lung syndrome (22 cases, 14.01%), damp-heat accumulating lung syndrome (22 cases, 14.01%), and humidity stagnant lung syndrome (11 cases, 7.01%). Syndromes of epidemic (2 cases, 1.27%), epidemic toxins blocking the lung pattern (1 cases, 0.64%), toxins with dryness intense heat in both qi and ying phases pattern (0 cases) accounted for less than 2%, and the distribution of various syndrome types in COVID-19 patients was uneven ( χ2 = 0.48, P < 0.05). Conclusion:The most common TCM syndromes of COVID-19 patients in Lhasa are cold-dampness blocking lung syndrome, followed by cold-dampness stagnant lung syndrome, damp-heat accumulating lung syndrome, and humidity stagnant lung syndrome.

Objective To explore the value of plasma procalcitonin (PCT)detection in dif-ferentiation and judgment of severe pyemia.Methods 70 patients with pyemia were divided into general pyemia group (n =23),severe pyemia group (n =28)and pyemia shock group (n =19), and plasma PCT,lactic acid,c-reactive protein,the acute physiology and chronic health evaluationⅡ 24 hours (APACHE Ⅱ)and 1,2,3 days in hospital as well as serum PCT,lactic acid,c-reac-tive protein were detected and compared.Results Plasma PCT,lactic acid,CRP and APACHE Ⅱscore of pyemia shock patients were significantly higher than the general pyemia group (P <0.05). Serum PCT,CRP and APACHE Ⅱ score of pyemia shock patients were significantly higher than that of severe pyemia group (P <0.05).15 patients with pyemia died,55 patients survived.72 hours plasma PCT,lactic acid,CRP and APACHE Ⅱ score in death group were significantly higher than the survival group (P < 0.01).When pyemia patients were admitted to hospital,PCT were positively correlated with APACHE Ⅱ scores (r =0.528,P <0.01).Conclusion PCT is superior to the current clinical application of CRP inflammatory response parameters,and it can be used as an early identification of systemic infection,judgment of pyemia severity and prognosis judgment in-dex.

Objective To explore the value of plasma procalcitonin (PCT)detection in dif-ferentiation and judgment of severe pyemia.Methods 70 patients with pyemia were divided into general pyemia group (n =23),severe pyemia group (n =28)and pyemia shock group (n =19), and plasma PCT,lactic acid,c-reactive protein,the acute physiology and chronic health evaluationⅡ 24 hours (APACHE Ⅱ)and 1,2,3 days in hospital as well as serum PCT,lactic acid,c-reac-tive protein were detected and compared.Results Plasma PCT,lactic acid,CRP and APACHE Ⅱscore of pyemia shock patients were significantly higher than the general pyemia group (P <0.05). Serum PCT,CRP and APACHE Ⅱ score of pyemia shock patients were significantly higher than that of severe pyemia group (P <0.05).15 patients with pyemia died,55 patients survived.72 hours plasma PCT,lactic acid,CRP and APACHE Ⅱ score in death group were significantly higher than the survival group (P < 0.01).When pyemia patients were admitted to hospital,PCT were positively correlated with APACHE Ⅱ scores (r =0.528,P <0.01).Conclusion PCT is superior to the current clinical application of CRP inflammatory response parameters,and it can be used as an early identification of systemic infection,judgment of pyemia severity and prognosis judgment in-dex.

: To evaluate the application of medical magnifying loupes in diagnosis of oral mucosal diseases. Twenty-four patients with plaque-type oral lichen planus or homogeneous oral leukoplakia were inspected by naked eyes or assistance with magnifying loupes. Histopathological results were used as the gold standard to evaluate the sensitivity, specificity and accuracy of the two methods in clinical diagnosis. Questionnaires were used to evaluate the subjective effect of magnifying loupes on the diagnosis efficiency of oral mucosal diseases and to explore the most suitable parameters for application. The sensitivity, specificity and accuracy of medical magnifying loupes for the identification of plaque-type oral lichen planus and homogeneous oral leukoplakia were 94.74%, 100.00% and 95.83%, respectively, which were significantly higher than those of naked eye inspection (89.47%, 80.00% and 87.50%). The effective rate of magnifying loupes assisted diagnosis was 91.76% according to physicians' subjective evaluation. The most suitable parameters were 3.5 times magnification and working distance. The medical magnifying loupes can effectively improve the efficiency of the inspection and diagnosis of oral mucosal diseases, and have the characteristics of convenience and real-time. The recommended clinical parameters are 3.5 times magnification and working distance.
Efficiency ; Humans ; Lenses ; Surveys and Questionnaires

An intravascular ultrasound-enhanced thrombolysis excitation system with adjustable frequency, amplitude and duty cycle was designed based on FPGA (ZYNQ-7Z020). Firstly, the FPGA generated waveform amplitude binary data based on direct digital frequency synthesis (DDS) technology, and then the data was converted into burst signal through an external daughter card, which included D/A conversion circuit, active low-pass filter, power amplifier circuit and impedance matching circuit. The test results demonstrated that the output waveform reached the target with advantages of simple implementation and flexible control, the peak negative pressure generated from ultrasound transducer was doubled by means of an electrical impedance matching network. In vitro thrombus models were applied to verify the excitation system, it turned out that ultrasound cavitation effect generated could accelerate the penetration of urokinase and increase the thrombolysis rate by about 20%.
Amplifiers, Electronic ; Electric Impedance ; Thrombolytic Therapy ; Ultrasonography ; Ultrasonography, Interventional

Traumatic rib fractures are the most common injury in thoracic trauma. Previously，the patients with traumatic rib fractures were mostly treated non-surgically，of which 50%，especially those combined with flail chest presented chronic pain or chest wall deformities and over 30% had long-term disabilities，being unable to retain a full-time job. In the past two decades，thanks to the development of internal fixation material technology，the surgical treatment of rib fractures has achieved good outcomes. However，there are still some problems in clinical treatment，including inconsistency in surgical treatment and quality control in medical services. The current consensuses on the management of regional traumatic rib fractures published at home and abroad mainly focus on the guidance of the overall treatment decisions and plans，and relevant clinical guidelines abroad lacks progress in surgical treatment of rib fractures in recent years. Therefore，the Chinese Society of Traumatology affiliated to Chinese Medical Association and Chinese College of Trauma Surgeons affiliated to Chinese Medical Doctor Association，in conjunction with national multidisciplinary experts，formulate the Chinese Consensus for Surgical Treatment of Traumatic Rib Fractures（2021）following the principle of evidence-based medicine，scientific nature and practicality. This expert consensus puts forward some clear，applicable，and graded recommendations from aspects of preoperative imaging evaluation，surgical indications，timing of surgery，surgical methods，rib fracture sites for surgical fixation，internal fixation methods and material selections，treatment of combined injuries in rib fractures，in order to provide references for surgical treatment of traumatic rib fractures.