Procalcitonin (PCT), a precursor of hormone calcitonin, is used as an indicator of bacterial infections in recent years. PCT plays an important role in early identiifcation of pathogens, evaluation of the severity of infection, medication guidance and prognosis judgment in children with community acquired pneumonia.

Objective To survey cognitive and processing mode of urethral distraction defect associated with pelvic fracture (PFUDD) in China and hope to find a reasonable treatment scheme for (PFUDD).Methods From Jan 2011 to Dem 2015,a questionnaire on surgical treatment for PFUDD was sent to 286 Chinese consultant urologists in more than 56 comprehensive hospitals throughout the China.The investigation includes the age of urologsit,the type of hospital,the number of patients treated during the last 5years,operation mode and optional time to do the surgery,the selection of operation approach,evaluation of the treatment effect were analyzed.At same time,we also investigated the methods of 260 cases about PFUDD.Results The age of the urologist were 30-55 years old.Over the past five years,229 urologists had fewer than 10 patients diagnosed each year,and only 57 had 10 patients diagnosed each year.There were many different kinds of operation method,including urethral realignment 36 (14％),direct vision internal urethrotomy 121 (46％),internal urethrotomy plus laser 57 (22％),trans-perineal urethral anastomosis 46(18％).The success rates were 58％ (21/36),50％ (60/121),46％ (26/57),76％ (35/46)respectively.70％ (200/286) of specialists did an open exploration urethral realignment or cystostomy when patients were injured in 2-6 hours.28％ (80/286) of specialists did urethral realignment with endoscopic surgery.About 75％ (216/286) of specialists believed that the treatment of patients with posterior urethral atresia should follow the ladder principle.Minimally invasive methods at the start,including urethral dilation,direct vision internal urethrotomy was the first choice.They would prefer open surgery only after intial treatment failure.65％ (186/286) of doctors believed that the overall outcome of the surgery was moderated.Conclusions Urethral distraction defect associated with pelvic fracture (PFUDD) was rare to be done.The direct vision internal urethrotomy was the first choice for most of the urologists(75％).They considered the urethroplast only after the failure of initial mini-invasive surgery.Trans-perineal urethral anastomosis had the best results.

CD4 Antigens ; metabolism ; CD56 Antigen ; metabolism ; Dendritic Cells ; pathology ; Diagnosis, Differential ; Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor ; Hematologic Neoplasms ; drug therapy ; genetics ; metabolism ; pathology ; surgery ; Humans ; Immunohistochemistry ; Leukemia, Myeloid ; pathology ; Lymphoma, Extranodal NK-T-Cell ; pathology ; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma ; pathology ; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma ; pathology ; Skin Neoplasms ; drug therapy ; genetics ; metabolism ; pathology ; surgery

Objective:To investigate the curative effects and mechanism of Shuxuetong injection (疏血通注射液) on treating coronary heart disease(CHD).Methods:The treated group (n=20) based on conventional therapy was treated with Shuxuetong injection infused intravenously,meanwhile the control group treated with conventional therapy only.Before and after therapy the changes in concentrations of plasma endothelin(ET),thromboxin B2(TXB2),6ketoprostaglandin F1α(6ketoPGF1α) and blood rheology between two groups were compared.Results:After therapy the clinical symptoms were convalescent,the ET and TXB2 reduced,the 6ketoPGF1α increased,and the parameters of blood rheology improved.Conclusions:Shuxuetong injection is able to dilate vessels,increase blood flow volume,anticoagulate,and improve blood rheology so that it is effective drug to treat CHD.

Objective To analyze the level of satisfaction and its influencing factors in emergency patients, and to improve the satisfaction level of emergency patients. Methods The patients who visited the emergency department with the triage number ended with 1 from August 1 to August 15, 2015 in Second Affiliated Hospital of Zhejiang University School of Medicine were selected by the method of convenience and equidistant sampling, to take the Press Ganey′s Patient Satisfaction Questionnaires which were collected and analyzed at the end of the patient's emergency treatment. Results A total of 200 cases were investigated. Patient experience overall satisfaction was (91.64 ± 8.74) points. There were no significant differences in satisfaction between the gender, age, place of residence, the investigator, the clinic department, the time to wait, whether the first visit and the previous stay in hospital (P>0.05). The correlation between the satisfaction score and the patient's education, prognosis was less (r=-0.251,0.262, P =0.009,0.018) , but more higher correlated with the service attitude of ancillary hospital staff, nursing staff in the provision of nursing instructions, nursing staff can protect the privacy, the waiting time of the triage and the doctor′s explanation of the treatment of the disease (r=0.79-0.84, P<0.05). Conclusions The service attitude of the ancillary hospital staff, nursing staff in the provision of care instructions and privacy protection, and the waiting time of the triage and the doctor′s explanation of the treatment are the most important factors influencing the patients′ satisfaction in emergency department which also will be the key content for us to improve the patients′experience and satisfaction inemergency patients.

Objective To investigate the safety and feasibility of laparoscopic removal of exogenous caesarean scar pregnancy (CSP).Methods From January 2009 to May 2011,71 patients with CSP treated in Shengjing Hospital of China Medical University were studied retrospectively.Thirty-nine patients were treated with hysteroscopic excision of CSP,while 32 patients were treated with laparoscopic surgery.The following clinical parameters were compared,including intraoperative blood loss,quantity of postoperative uterine drainage,postoperative hospital days,the time for the mass absorption and the return of β-hCG to normal were studied.Results Two cases in the hysteroscopic group were transformed to abdominal surgery because of introperative bloody loss,the 37 cases underwent hysteroscopic surgery successfully with the ultrasound supervision and guidance.Laparoscopic surgery were successfully completed in all 32 cases.In hysteroscopic group,the operation time,the time for the return of serum β-hCG to normal,postoperative uterine drainage volume and the postoperative hospital stay were (44 ± 18) minutes,(27 ±5) days,(38 ± 12) ml,(3.8 ±0.7) days.While,in laparoscopic group,they were (100 ±21) minutes,(17 ±4) days,(19 ± 6) ml,(3.5 ± 0.6) days,respectively,the differences reached statistically significant (all P ＜ 0.05).But the amount of intraoperative bleeding were was (113 ± 63) ml in hysteroscopic group and (109 ±59) ml in laparoscopic group,the difference was not statistically significant (P ＞0.05).The duration of absorption of mass were (88 ± 17) days in hysteroscopic group.In laparoscopic group,the mass were completely removed.Conclusions Laparoscopic exicion of CSP could be suitable in treatment of exogenous CSP which offers advantages including prompt recovery,blood loss and hospital stays.This management could repair the uterine scars,reduce the reoccurring risk and conservate the fertility potential.

Acute Disease ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Myocarditis ; diagnosis ; diagnostic imaging ; Ultrasonography ; methods ; Virus Diseases ; diagnosis ; diagnostic imaging

Objective To investigate the risk factors of pelvic fracture related urethral injury (PFUI).Methods We retrospectively reviewed 120 patients with pelvic fracture from March 2014 to October 2016 in our hospital.Of all the patients,87 were males and 33 were females.The average age was (42.6 ± 15.4) years old (ranging 1 1-78 years old).The etiology of pelvic fracture included traffic accident in 70 cases,fall injury in 27 case.Heavy crash in 23 cases.43 male patients had an PFUI.Their average age was (40.4 ± 14.5) years old (ranging 14-61 years old).Of PFUI patients,the location of urethral injury included membranous part in 16 cases,bulbomenbranous part in 17 and prostatic part in 10 cases.The average length of stricture was (3.0 ± 1.9) centimeter.One patient suffered the stricture,combined with bladder rupture.One patient had urethro-rectal fistula.Two patients had urethrocutaneous fistula.The pelvic fractures were categorized using Tile classification,including type A1 fractures in 10 cases,A2 in 10 cases,B1 in 14 cases,B2 in 31 cases,B3 in 42 cases,C1 in 2 cases and C2 in 11 cases.The patients' number of urethral injury in each type was 1,2,2,7,29,0,2,respectively.Hazard degree analysis and chisquare test were used to evaluate the risk factors.Variables with an association of P ＜ 0.05 were then tested using binary logistic regression and the area under the curve(AUC).Results On hazard degree analysis,female(x2 =25.419,P ＜ 0.05,OR =0.571) and type B3 fracture (x2 =31.002,P ＜ 0.05,OR =10.198)have a significant impact on the occurrence of PFUI.On binary logistic regression,female(Walds =16.528,P ＜ 0.05,adjusted OR =0.003)is the protective factor of PFUI while type B3 fracture (Walds =10.853,P ＜0.05,adjusted OR =28.537) is the risk factor.The area under the curve (AUC =0.891,95％ CI0.826-0.956) illustrates the regression model has a high credibility.Conclusions Pelvic fracture urethral injury is much less likely to occur in females than men.Type B3 fracture is more likely to cause an PFUI than the others type.

Objective To study the application of androgens,AMH for female infertility diagnosis value.Methods Used chemiluminescence to detect androgen testosterone (To),androstenedione (AND),17 (HS)To hydrogen sulfate therapy (17HS),sex hormone binding globulin (SHG)and resistance To seedling le’s hormone (anti-Mullerian hormone,AMH)of 258 cases of patients with female infertility.According to the reason of infertility,female infertility patients were divided into observation group (158 cases of endocrine infertility)and control group (100 cases of tubal factor infertility)and two groups of data had statistical analysis with t test.Used Pearman’s correlation method to analyse the relationship between serum AMH level and AND,SHG in patients wirh female infertility.and used ROC curve to evaluate efficiency of AND and AMH to the diagnosis of female infertility.Results ①The indicators To observation group AND control group,AND,AMH and SHG were (1.25±0.41 vs 0.25±0.15)nmol/L,(4.9±0.62 vs 1.80±0.51)nmol/L,(13.6±3.5 vs 6.4±1.81)ng/ml and (64.2±32.1 vs 89.3±30.2)nmol/L,respectively.Compared with the control group,observation group To,AND and AMH were significantly higher than the control group (t=13.02,11.36,9.35,P values<0.01),but SHG was significantly low-wer than thecontrol group(t=7.35,P<0.01).②Between the biology to produce ets (AMH:7.63~10.1 ng/ml,AND:0.3~3.3 ng/ml,17 HS:18~144μg/dl,SHG:80~560 nmol/L)as the standard,in the observation group:17 HS increased 17.7%,AND increased 72.2%,AMH increased 87.9% and SHG 51.2% reduction.③AMH level and the AND existed positive correlation (r=0.579,P<0.05),negatively correlated with SHG (r=0.763,P<0.05).④AMH,AND and SHG diagnosis of infertility area under the ROC curve (AUC),were 0.921,0.863 and 0.736 respectively,best cutoff value were11.26 ng/ml,4.62 nmol/L and 32.62 ng/ml respectively,and sensitivity of 89.7%,72.9% and 59.6%.Specific degrees were 86.2%,86.2% and 75.6% respectively,and accuracy of 87.1%,87.1% and 81.6%.Jointed inspection of AND,AMH and SHG in the diagnosis of infertility,the sensitivity of the specific degree were 96.3% and 90.2% respectively.Conclusion It showed that AMH,AND and SHG have diagnostic value of internal secretory infertility with ROC curve analysis.De-tection of combined AMH,AND and SHG is more meaningful to the early diagnosis and treatment of infertility.

Objective To investigate the clinical efficacy of modified YV-plasty for refractory bladder neck contracture (BNC) caused by transurethral resection of prostate (TURP).Methods From June 2013 to March 2016,11 patients with BNCs secondary to TURP were included in this study.Their mean age was 63.7 years (range,56-73 years).All patients presented voiding difficulty and failed after 2 or more prior endoscopic treatments.Modified YV-reconstruction of bladder neck was performed,by incising the anterior wall of bladder neck in a T-shaped manner,and creating two well-vascularized and tension-free flaps,which offer the possibility to reconstruct a wide bladder neck.Results After a mean follow-up of 14.6 months (ranging 3-24 months),successful outcome was achieved in 9 patients without incontinence secondary by surgery.Recurrent voiding difficulty developed in 2 patients,which was cured after a following endoscopic treatment.Conclusion A wider bladder neck can be obtained through modified YV-reconstruction of bladder neck,while avoiding external urethral sphincter injury.It is an available option for refractory bladder neck contracture.