Adult ; Humans ; Male ; Recurrent Laryngeal Nerve ; abnormalities

Child, Preschool ; Diagnosis, Differential ; Female ; Humans ; Hyperbilirubinemia, Hereditary ; diagnosis

0.05).During the DGF period,there was a lower incidence of acute rejection in the induction group compared with that in the control group(0% vs 25%,P

0.05).The expression percentage of IL-4 of CD3+CD8-T lymphocytes cells in peripheral blood of the patients in group A(4.0%?2.8%)was significantly lower than that in group B and C(7.9%?5.5% and 10.2%?7.5%,P0.05).The level of serum sCD30 in the patients of group A(20.2?12.4ng/ml)was significantly higher than that of group B and C(7.8?3.1ng/ml and 7.6?3.0ng/ml,P0.05).ROC curve analysis indicated that when the ratio of Th1/Th2 was at the cut-off value of 1.95,the sensitivity and specificity to identify CRAD caused mainly by immune injury was 80% and 90%,respectively;and when the level of serum sCD30 was at the cut-off value of 10ng/ml,the sensitivity and specificity to identify CRAD caused mainly by immune injury was 93.3% and 86.7%,respectively.Conclusions Disequilibrium of Th1/Th2(drift to Th1)and raised level of serum sCD30 exist in most of the patients with CRAD which was caused mainly by immune injury.It is with high sensitivity and specificity to identify the CRAD by determining the ratio of Th1/Th2 of CD3+CD8-T lymphocytes cells in peripheral blood and the level of serum sCD30.

Objective To evaluate ipsilateral hepatic blood flow exclusion in combination with liver hanging manoeuvre for hepatectomy. Methods From Jul 2007 to Feb 2008, 14 cases underwent hemihepatectomy under ipsilateral hepatic blood inflow and draining hepatic vein exclusion in combination with liver hanging manoeuvre for liver malignancier or ligating ligating vessels, portal vein branch and major hepatic vein to set up a tunnel at the interior vena cava. Results Small laceration on fight hepatic vein was encountered in 2 cases during the operation and managed by suturing. There was no intraoperative injury on inferior vena cava or short hepatic veins. Blood loss ranged from 100 ml to 600 ml with a mean of 280 ml. Postoperative pleural effusion was cured conservatively in 3 cases and paracentes was needed in one case. There was no severe postoperative hepatorenal dysfunction, biliary fistula, infection or other major complications. The operative mortality was nil. Conclusion For regular major hepatectomy, ipsilateral hepatic blood flow exclusion plus liver hanging manoeuvre has the advantage of less blood loss and protecting contralateral hemiliver from reporfusion injuries.

OBJECTIVE To learn the profile of Gram-negative bacilli in ICU ward during the eight years and analyze the drug resistant rates in order to provide the basis for empirical treatment of infection.METHODS The bacteria were identified by VITEK-2 and API system.Antibiotic sensitivity test adopted Kirby-Bauer method.Data were analyzed by WHONET5.4 software.RESULTS Totally 1492 strains of Gram-negative bacilli were isolated from ICU ward,which included 1146 strains of non-fermentaters,accounted for 76.8% and 346 strains of Enterobacteriaceae,accounted for 23.2%.The first five bacteria were Pseudomonas aeruginosa,Burkholderia cepacia,Acinetobacter baumannii,Stenotrophomonas maltophilia,and Escherichia coli by turns.The drug resistant rates were higher and had the tendency of increase by years.CONCLUSIONS Non-fermentaters are the main organisms in ICU ward.The species of bacteria are diversified and the drug resistant rates of them are serious,which should be monitored not only because helping clinical therapy but also discovering the prevalence of drug resistant strains.

OBJECTIVE To offer the clinical physician the basis of optimal application of antibiotic,we have investigated the variation of antibiotic resistance and the bacterial spectra in the blood culture.METHODS Blood was cultured in BACTEC9120 of BD.The clinical isolates were identified by API and VITEK-2 of Bio-Merieux of France.Antibiotic susceptive test was done by Kirby-Bauer method and the result which was analyzed by WHONET5.3 and SPSS11.5 software was determined by the NCCLS standard of 2005′s edition.RESULTS Organisms were isolated from the blood specimen of 1468 patients,and there were 743 strains of Gram-positive cocci accounted for 50.7%,565 strains of Gram-negative bacilli accounted for 38.5%.Ninety three strains of fungi accounted for 6.3%.We analyzed the drug-susceptive result of Staphylococcus,Escherichia coli,and Klebsiella pneumoniae during five years,and found that all the antibacterial drug lost efficacy in some degree,except that the sensitivity of the staphylococci to vancomycin was 100%.CONCLUSIONS Gram-positive cocci are the main bacteria in blood culture,the species from which are diversified,and the rate of the drug resistance of some bacteria is high.It indicated that doctors should take more blood culture and monitor the bacteria drug resistant for the data of etiology,so that they can utilize antibiotic more reasonably.

Objective To provide patients with appropriate and useful health education, improve the self-management of patients with neurogenic bladder and reduce the incidence of complications, through understanding health education requirement of clean intermittent catheterization in patients with neurogenic bladder. Methods The health education requirement of clean intermittent catheterization of 59 patients with neurogenic bladder were investigated by self-designed questionnaire. Results They extremely lacked the knowledge of clean intermittent catheterization. The mean score of health education requirement was 4.05 (5 as total score), and they had strongly request on the relevant knowledge, especially for dietary guidance, observation and prevention of complications, current bladder condition. The form of health education should be diversified, especially for expert lectures. Conclusion It is necessary for nurses to conduct health education on clean intermittent catheterization for paitents with neurogenic bladder, at the same time more pertinence is needed.

Objective:To investigate and summarize the procedures of direct-covedng pancreaticojejunostomy with remaining jejunal mucosa in pancreaticoduodenectomy and to analyze the incidence of pancreatic fistula and other postoperative complications.Methods:A total of 21 patients were treated with pancreaticoduodenectomy between May 2005 and June 2009.During the surgery,we dissected 3cm long remnant of the pancreas out of ambient tissues.Near the 2.0-3.0cm of the pancreatic remnant.we fixed partial posterior wall with the full-thickness jejunum without mucosa destroyed by interrupted suture,and then pushed the remnant into the jejunum and fixed the anterior wall.Finally,at the 1.0cm of the panceratic remnant,we binded the iejunum to surround the pancreas through 7-silk sutures.Results:One case was treated with secondary surgery due to bleeding of the pancreatic remnant.The other patients recovered smoothly without pancreatic fistula or other complications.Conclusion:Postoperative pancreatic fistula is related to the texture of pancreas,method of pancreaticojejunostomy,surgical skills and perioperative treatment.Compared with other types of pancreaticojejunostomy,direct-covering pancreaticojejunostomy with remaining jejunal mucosa is simpler.

Objective To investigate the changes of thyroid hormone in peritoneal dialysis patients and analyse its impact factors, as well as the therapeutic effects of small dose of thyroxine.Methods 150 uremic patients in Hunan Provincial People’s Hospital from December 2013 to December 2014 were selected, 70 cases of uremia non-dialysis patients were divided into group A, while 80 uremia peritoneal dialysis for more than half a year were divided into group B.70 cases healthy examinees during the same period in our hospital were selected as control group ( group C ) . The total triiodothyronine (T3), total thyroxine (T4), free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH), hemoglobin (Hb), serum albumin (ALB), total cholesterol (TC), triglyceride (TG), serum creatinine (SCr), C reactive protein (CRP) and left ventricular ejection fraction ( LVEF) , subjective global assessment of nutritional act ( SGA) and other indicators were detected in three groups.Patients in group B were divided into two sub-groups according to thyroid hormone levels: B1 group had normal thyroid level while B2 abnormal.And the administration of small dose of thyroid hormone was given to patients in group B2, and the effect of the administration was evaluated by the above indexes.Results The FT3 in group A and B were significantly lower than that in group C (P<0.01).There were significant differences of levels of ALB, CRP, SGA between group B1 and group B2, and the FT3 level in group B was significant correlated with SGA, ALB, LVEF(r=0.815,P<0.001;r=0.780,P<0.001;r=0.953,P<0.001).After treated with small dose of thyroid hormone, FT3 and LVEF were improved while FT4, TSH, ALB, SGA, CRP were not improved in group B2.Conclusion The thyroid hormone level in patients with continuous ambulatory peritoneal dialysis decreases which is dominated with FT3.The decreased thyroid level is significantly correlated with nutrition ( ALB, SGA) and left ventricular function.The administration of small dose of thyroid hormone can improve the left ventricular systolic function.