Surgery is the main treatment for Cushing's syndrome.The disturbed metabolic consequences such as prolonged exposure to excessive glucocorticoid,high glucose and hypertension will add the risks and difficulties to surgery.This paper reviews the perioperative glucocorticoid replacement,correction of the hypercotisolaemia before operation,and prevention of complications after operation.

Objective To evaluate the effect of crisis prediction score nursing in reducing complication and nursing deficiencies in patients with myasthenia gravis complicated with thymoma.Methods 46 patients were randomly divided into the study group and the control group,the study group was given with crisis prediction score nursing,the control group was given with individual nursing.The postoperative complications incidence,hospitalization time,nursing defect rate,patient satisfaction were compared between two groups,and Osserman efficacy evaluation was implemented.Results Compared with the control group,postoperative complications (hemorrhage,pneumothorax,respiratory tract infections and myasthenia gravis crisis)rates and nursing defect rate in the study group were lower,hospitalization time shortened,and patients' satisfaction degree increased.Conclusions The crisis prediction score care can significantly reduce postoperative complications and nursing defect rate,which is important for patients' health.

0.05).But only 23 lesions(38.3%)showed high signal on T1WI.Conclusion:This research confirmed the MRI-guided HIFU equipment is useful to monitor the HIFU treatment and evaluate the curative effect accurately,which provids a basis for the latter treatment of liver tumors.

Child ; Humans ; Urolithiasis ; diagnosis ; therapy

Objective To compare the application value of routine electrocardiogram and dynamic electrocardiogram in the diagnosis of arrhythmia and heart rate variability in children.Methods In our hospital,pediatric arrhythmia patients were given routine electrocardiogram and dynamic electrocardiogram.The relationship between arrhythmia and heart rate variability in children was analyzed.Results Supraventricular tachycardia (13.33%),ventricular tachycardia(5.56%),premature ventricular contraction (21.11%),premature atrial contraction (14.44%),block (12.22%) in the dynamic electrocardiogram were significantly better than the conventional electrocardiogram,and the differences were statistically significant x2=11.93,4.56,9.22,10.74,11.55,all P<0.05).There were significant differences in the heart rate variability between ventricular arrhythmias and non-ventricular arrhythmias in children[(78.85±0.88),(4.68±2.43),(24.78±2.56),(21.66±0.94), t=10.88,11.79,9.84,9.92,all P<0.05].Conclusion Compared with routine electrocardiogram, dynamic electrocardiogram has better diagnostic value for pediatric arrhythmia of ventricular tachycardia.The detection rate of ventricular tachycardia,ventricular tachycardia,premature ventricular contraction,atrial premature contraction,conduction block and other arrhythmias are obviously superior.And dynamic ECG measurement of heart rate variability is helpful to assess the severity of the disease.

Objective To evaluate the clinical efficacy of atorvastatin combined with salvianolate in treatment of chronic obstructive pulmonary disease (COPD) complicated with pulmonary arterial hypertension (PH) , and its influence on hypoxia inducible factor-1 alpha (HIF-1α), endothelin-1 (ET-1), adrenomedullin (ADM) in serum.Methods 30 cases of COPD patients with PH were randomly divided into 2 groups, each of 15 cases.The two groups were given conventional treatment, including rest, continuous low flow oxygen, anti infection, relieving cough and phlegm, relaxing tracheal, correcting water and electrolyte balance.Control group was received Atorvastatin Calcium Tablets 20 mg orally, once daily.Observation group was received Atorvastatin Calcium Tablets 20 mg once daily, once daily;salvianolic 200 mg+0.9% sodium chloride solution 250 mL, intravenous drip, once daily.The course of treatment was 10 d.Before and after treatment, 6 min walking distance(6 MWD) and hemodynamic parameters were detected, including pulmonary artery systolic blood pressure (PASP), cardiac output (CO), right ventricular end diastolic pressure (RVEDP) , and HIF-1, ET-1 and ADM level in serum.Results After treatment, 6MWD, PASP, CO, RVEDP of the two groups were significantly improved compared with the same group before treatment.But compared with control group, observation group was improved significantly, the difference was statistically significant (P<0.05).After treatment, HIF-1 alpha, ET-1 of the two groups were significantly lower than the same group before treatment, but ADM were significantly increaser( P <0.05 ) .Compared with control group, HIF-1 alpha, ET-1 of observation group were significantly decreased, while the ADM was significantly increased, the difference was statistically significant (P<0.05).Conclusion Atorvastatin combined with salvia miltiorrhiza polyphenols can significantly reduce the pulmonary artery pressure in patients with COPD and PH, increase exercise tolerance, and its mechanism maybe related to the regulation of the expressions of HIF-1, ET-1 and ADM.

Kawasaki disease has been the major etiology of aquired heart problems in children. Mecha-nisms of Kawasaki disease are still unclear in the past years. Some Kawasaki disease patients were not responsive to intravenous immunoglobulin therapy. And corticosteroid therapy remains controversial in the treatment of Ka-wasaki disease. A few patients with Kawasaki disease presented severe systemic symptoms,and even died for it. It is difficult to evaluate the severity of coronary artery lesions and prognosis of Kawasaki disease. In this article, we reviewed some new concepts on diagnosis and treatments on Kawasaki disease.

Eisenmenger syndrome (ES) was considered as a surgical contraindication in the past time. Only a few patients got lung transplantations or heart-lung transplantations due to lack of donors. Most of the patients had to choose conservative treatment to prolong their survival time. Recently, some clinical trials indicated targeted therapies in pulmonary arterial hypertension (PAH) were effective for the treatment of ES. This article reviewed the recent advances in this area.

With the rapid development of China's higher education and the intensified reforms in medical and health services,the problems and contradictions are increasingly prominent in ortho-pedic clinical teaching,especially how to improve medical interns' ability to read images. Picture archiving and communication system (PACS)plays an important role in academic education of medi-cal imaging. Case-based learning (CBL)is a team seminar teaching mode that is guided by cases, based on problems,targeted at students,and dominated by teachers. PACS and CBL were perfectly combined in orthopedic clinical teaching to improve teaching efficiency and the outcome was evaluat-ed through a questionnaire. Results showed that this teaching method inspired students' interests in learning,cultivated the orthopedic clinical way of thinking thus achieved better teaching effects.

Objective To explore the effect, safety and value of propofol combined with fentanyl in painless gastrointestinal endoscopy.Methods 1 200 patients were collected and divided into normal group and painless group,600 cases in each group.Normal gastrointestinal endoscopy was performed on unanesthetic patients,while painless gastrointestinal endoscopy was operated on anesthetic patients with Propofol and Fentanyl.The safety and clinical effect were compared between the two groups.Results 1 200 cases of patients were able to complete the gastrointestinal endoscopy examination successfully with no serious side effects.Compared with normal gastrointestinal endoscopy,the patients undergoing painless gastrointestinal endoscopy examination guaranteed more comfortable experiences,suffering less pain and side effects.The differences were significant between the two groups (all P < 0.05 ).Conclusion Propofol combined with fentanyl in painless gastrointestinal endoscopy was a safe,effective and painless process and was worthy of promoting widely.