Objective To investigate the risk factors and predictors of poor outcome in full-term neonates with severe hyperbilirubinemia. Methods Data were retrospectively collected from 326 neonates with severe hyperbilirubinemia hospitalized between January 1, 2012 and December 31, 2012. Results A total of 326 full-term neonates with severe hyperbilirubinemia were included in this study (181 males and 145 females). The average gestational age was 39.12±1.17 weeks. Two hundred and sixty (260) cases were followed up successfully by phone while 66 cases were lost to follow-up. Infection (74.40%) and hemolytic disease (51.19%) were the main causes of severe hyperbilirubinemia. Multiple factors regression analysis found that threshold TSB was an independent risk factor of poor outcome (OR=2.02, 95%CI:1.13~3.62, P=0.018). The outcome of neonates with BIND scored between 0-6 had poor prognosis and some of them were reversible, and the outcome in those scored between 7-9 were of worse prognosis. Threshold TSB, USB and B/A ratio in group of poor outcome were signiifcantly higher than those in other groups and their area under the ROC curve evaluating the prognosis was 0.682, 0.671 and 0.698, respectively. With TSB at 474.5 μmol/L, UCB at 449.15 μmol/L and B/A at 0.923 mg/g, Youden index was the higest. The results of BAEP, OSE, MRI and NBNA were not signiifcantly different between groups with or without poor outcome. Conclusions Threshold TSB is an independent risk factor of poor outcome in full-term newborns with severe hyperbilirubinemia. BIND score is a very good predictor of outcome. TSB threshold, USB and B/A ratio are the predictors of outcome, but their diagnostic values are limited. NBNA, hearing screening and hyperintense globus pallidus on T1W1 in the acute phase of jaundice might not related with neurologic prognosis.

Objective To discuss which drainage method is more efficient in treatment of choledocholithiasis with obstructive jaundice. Methods Compared the difference of serum total bilirubin,direct bilirubin, the variation of serum total bilirubin and direct bilirubin before and after drainage and daily biliary drainage by endoscopic nasobil-iary drainage (ENBD) and endoscopic nasobiliary drainage with continuous negative-pressure suction after three days. Results The daily biliary drainage about the patients by ENBD with continuous negative-pressure suction is much more effective than the patients by ENBD. The serum total bilirubin and direct bilirubin about the patients by ENBD with continuous negative-pressure suction is less than the patients by ENBD after three days. The variation of serum total bilirubin and direct bilirubin before and after drainage about the patients by ENBD with continuous neg-ative-pressure suction is more than the patients by ENBD. Conclusion The ENBD with continuous negative-pres-sure suction is more effective for choledocholithiasis with obstructive jaundice.

Hazardous Substances ; Risk Assessment ; methods ; Workplace

Objective To investigate the incidence of spasticity 6 months after first stroke. Methods 355 patients hospitalized from March 2012 to December 2013 were assessed with the modified Ashworth Scale 1 month, 3 months, and 6 months after stroke. Results The incidence of spasticity was 42.7% in the 1st month, and increased to 63.7% and 65.7% 3 and 6 months after stroke, respectively. The incidence of spasticity was the most 3 months after stroke both in arms and legs. The incidence of moderate to severe spasticity was more in the arms than in the legs. There was no significant difference at incidence of spasticity among foci and ages. Conclusion Spasticity usually occurs within 3 months after stroke, and more frequent in the upper limb than lower limb.

Objective To observe the effect of Botulinum toxin-A (BTX-A) injection on upper limb pain after stroke. Methods A case with upper limb pain after stroke was reported. The symptom, the location and dosage of injection, and the prognosis were recorded. Results The pain relieved after injection, and disappeared 4 weeks after injection. Conclusion BTX-A injection is effective on upper limb pain after stroke.

Infectious endophthalmitis refers to the acute suppurative inflammation of the uveal and retinal, with acute onset, severe symptoms, and poor prognosis.Early diagnosis and effective treatment is particularly important.Based on the way of intraocular infection, endophthalmitis can be divided into endogenous endophthalmitis and exogenous endophthalmitis.In the East Asian, liver abscess is the main source of endogenous endophthalmitis, and Klebsiella pneumoniae is the main pathogen.Liver abscess endophthalmitis is a serious cause of blindness caused by intraocular infection.A liver infection disseminated through hematogenous and the primary focus was hidden, which makes the disease was easy to be confused with immune related uveitis, causing high misdiagnosis rate, delaying the best time for diagnosis and treatment.In this article we reviewed the etiology, clinical features, diagnosis and treatment and prognosis of endogenous endophthalmitis caused by liver abscess.Clinicians should maintain a high index of suspicion to the endogenous endophthalmitis caused by liver abscess.

The identification of the specific cause in every patient has important clinical implications, because ischemic stroke is an etiologically heterogeneous disease. The Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification can be used to define the etiology of stroke. However, TOAST classification can not be completed timely on admission of patients with acute stroke, which has impacted early guidance of clinical treatment. This article reviews the biological markers of early differential-diagnostic significance of the TOAST classification.

Education to medical postgraduates is relatively special. Their study and research work have something to do with their clinical practice. Based on their technical training for thoracic surgery,postgraduates were demanded to follow up and instruct their patients on postoperative recovery from surgery. In this way,these postgraduates were trained not only in clinical practice but also in other aspects,such as communication techniques,how to take care of patients,professional moral education. Instruction to outpatients is helpful to cultivate post-graduates and promote their abilities in self-thinking,self-acknowledging,initiative,creation,and so on. Instruction to outpatients is an important way to bring up excellent medical postgraduates.

There is a high incidence of esophageal cancer(EC) in China.The survival and prognosis of EC is unoptimistic due to the lack of efficient early diagnostic markers.There is an urgent demand of novel biomarkers with more stability,sensitivity and specificity.miRNAs are a class of small non-coding single stranded RNAs consisting of 21-23 nucleotides,which are involved in the pathological and physiological process of life activities.miRNAs are stable not only in tumor tissues,but also in serum/plasma.There are significant differences in the expression patterns of circulating miRNAs between two main types of EC.They are closely related to the occurrence and progression of EC,which make circulating miRNAs a novel kind of biomarkers for differential diagnosis,early supervision of esophageal cancer,and prognosis.

[Summary] Extracellular calcium is essential for the regulation of a variety of biological processes. Calcium-sensing receptor (CaSR) plays a central role in maintaining Ca2+ homeostasis, while G-protein α-11 (Gα11 ) subunit and adaptor-related protein complex 2 sigma (AP2σ) are also involved in CaSR signaling transduction. Loss- or gain-of-function mutations of these encoding genes cause different types of familial hypocalciuric hypercalcaemia (FHH) and autosomal dominant hypocalcaemia (ADH). Calcimimetic and calcilytic drugs are useful in treating these FHH and ADH disorders. The current paper is a Chinese translation of a review entitled as “Disorder of the calcium-sensing receptor and partner proteins: insights into the molecular basis of calcium homeostasis” published in 《 Journal of Molecular Endocrinology》(2016,57:R127-R142) with the permission from the author and the journal.