Child ; Humans ; Pulmonary Embolism ; diagnosis ; etiology ; therapy ; Risk Factors

Objective To observe the efficacy and safety of pegylated interferon apha-2a combined with ribavirin in the treatment of chronic hepatitis C.Methods One hundred and six patients with chronic hepatitis C were divided into 2 groups randomly.Patients in the observation group were treated with pegylated interferon alpha-2a,and patients in the control group were treated with interferon alpha-1b.All patients were given ribavirin according to the weight,and the treatment course was 48 weeks.HCV-RNA was tested before treatment,4 weeks, 12weeks and 24 weeks after the start of treatment,end of treatment,24 weeks after the end of treatment.The adverse reactions were also observed.Results In the observation group,the rapid virological response (RVR) was 77.4%,the complete early virological response (cEVR) was 83.0%,the end treatment virological response (ETVR) was 90.6%, the sustained virological response (SVR) of 24 weeks after the end of treatment was 84.9%.and these rates were significantly higher than the control group.All patients received the whole course of treatment.Condusion Treatment of chronic hepatitis C with pegylated interferon apha-2a combined with ribavirin is effective and safe.

Objective To observe the results of crown lengthening surgery on the teeth with subgingival defect.Methods Crown lengthening surgery was performed on 54 terior teeth,which were divided into two groups based on probing depth of pre-operation:group A (<3 mm) and group B (3-4 mm).All teeth were restored 8 weeks after operation and followed-up to 1 year.The parameters of plaque index (PLI),suleus bleeding index (SBI),maximal defect probing depth (PD) and mobility degree (MD) at different times were measured,respectively.Results PLI,BI and PD were significantly improved during the follow-up period (P<0.01).The success rates of both groups were 96.8% and 69.6%, respectively (P<0.01).No significant difference about MD in the group A one year after restoration (P>0.05),but a significant improvement in the group B (P<0.01).Conclusion Crown lengthening surgery is a good method on the teeth with subgingival defect,but one must select the right indication.

Objective To investigate risk factors related to postoperative death of patients with rectosigmoid junction tumor perforation.Methods The clinical data of 76 cases with rectosigmoid junction tumor perforation confirmed by laparotomy from January 2000 to October 2015 were collected.Results Of the 76 cases,17 patients died postoperatively,the mortality rate was 22％,the single factor analysis showed that age(x2 =4.649,P =0.031),duration of abdominal pain(x2 =8.218,P =0.016),severe heart and lung diseases(x2 =11.996,P =0.007),circulatory and renal function(x2 =10.360,P =0.016),serum albumin(x2 =7.252,P =0.027),white blood cell count(x2 =7.633,P =0.022),Perforation diameter (x2 =9.770,P =0.008),Geroge grade of intraperitoneal contamination (x2 =10.086,P =0.006) were related to postoperative death (P ＜ 0.05).Multivariate analysis showed that complicating severe heart and lung diseases,preexisted circulatory and renal dysfunction,white blood cell count ＜ 4 × 109/L,size ＞ 3 cm,intraperitoneal contamination larger than one quadrant were independent risk factors for postoperative death.Conclusion Risk factors related to postoperative death of rectosigmoid junction tumor perforation were preoperative important organ dysfunction and intraperitoneal infection.

Objective To select the ultrasonic appearances which effect the benign and malignant of thyroid lesions,and to explore the establishment and applications of supersonic evaluation system for thyroid imaging reporting and data system (TI-RADS) classification.Methods The ultrasound images of 1 080 thyroid nodule cases were retrospectively analyzed by Logistic equation,and the ultrasonic appearances were screened to identify benign and malignant of thyroid lesions.All appearances were obtained weights.The TI-RADS classification analysis software was assigned,which was used to analyze 332 patients with thyroid diseases and to verify the diagnostic performance of the TI-RADS classification system.Results Five ultrasonic features were selected into the regression model,including aspect ratio (odds ratio [OR]=3.61),margins (OR=3.83),composition (OR=11.46),echogenicity (OR=14.12),microcalcification foci (OR =48.82).Using objective evaluation system for TI-RADS classification in ultrasound in diagnosing 332 cases,the area under the ROC curve was 0.91 (P＜0.05).Conclusion Relatively the weight and formation of malignant indicators should be more concern than the number of ultrasonic malignant thyroid lesions indicators.The objective evaluation system for TI-RADS classification in ultrasound has relatively high diagnosis capability which established by the methods of Logistic equation.

Objective To observe the efficacy of antiviral therapy of pegylated interferon (Peg-IFN) α-2a combined with ribavirin for patients with hepatitis C cirrhosis and hypersplenism underwent splenectomy or partial splenic embolization. Methods Thirty-eight patients with hepatitis C cirrhosis (genotype Ⅰ HCV infection) hypersplenism failed to the anti-viral therapy were performed splenectomy or partial splenic embolization to improving hypersplenism. After 3 months,Peg-IFNα-2a 90μg or 135 μg was given subcutaneously once weekly, plus ribavirin 600-1 000 mg/d orally for 1 year of the treatment. During the treatment, patients were followed at four-week intervals, and then followed-up every month until the 24th week after stopping. Liver function, blood routine, renal function, HCV RNA, and adverse reaction of medication were observed during treatment and the follow-up period. Results Splenic function of patients with hepatitis C cirrhosis and hypersplenism was improved after hypersplenism splenectomy or partial splenic embolization. The sustained virologic response (SVR) rate was 63.88%after giving Peg-IFNα-2a combined with ribavirin anti-viral treatment. Conclusion After splenectomy or partial splenic embolization, patients with hepatitis C cirrhosis and hypersplenism showed the better SVR at the treatment of Peg-IFNα-2a combined with ribavirin. The treatment could delay the progress of the hepatitis C cirrhosis and reduce the incidence of liver failure and liver cancer.

BACKGROUND: Stimulating cerebellar fastigial nucleus can regulate, dilate blood vessels and greatly increase local blood flow. However, if its mechanism is to improve the function of vascular endothelium is still uncertain.OBJECTIVE: To study the effects of stimulating cerebellar fastigial nucleus by electricity to vascular relaxation of transient ischemic attack(TIA) patients which is induced by blood flow and explore its protective mechanism to blood vessels of TIA patients.DESIGN: Randomized case control study to patients based on diagnosis SETTING: Department of general diseases, rehabilitation room and ultrasound department of a university hospital.PARTICIPANTS: Forty-four TIA patients(＞ 60 years old) admitted into Department of General Diseases of Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology during February 2001 to October 2002 were selected after excluding cerebral hemorrhage or cerebral infarction, atrium fibrillation and other arrhythmia or heart failure and blood system diseases. They were randomly divided into treatmentgroup(22 cases)and control group(22 cases) which were conducted stimulating fastigial nucleus + routine treatment and only routine treatment respectively.METHODS: High resolution ultrasound technique and brachial artery congestion method were used to test the internal diameter change rate of brachial artery in TIA patients before and after treatment.MAIN OUTCOME MEASURES: The internal diameter change rate of brachial artery of TIA pat ients.RESULTS: The internal diameter change rate of brachial artery was (4.59 ± 3.32) % and ( 10. 34 ± 3.13 ) % respectively before and after conducting electric stimulus to fastigial nucleus with significant difference ( t = 5.91, P ＜ 0.01 ). There was significant difference on internal diameter change rate between treatment group and control group( t =5.41, P ＜ 0.01 )while there was no difference in control group before and after treatment [(4.68±3.20) %,(5.10±3.29) %](t=1.72, P＞ 0.05).CONCLUSION: Conducting electric stimulating to fatigial nucleus can greatly improve the reactively vascular congestive function of brachial artery internal diameter and it can improve the vascular endothelial functions of TIA patients.

Objective: In acute pancreatitis, traditional treatment insists fasting on purpose to avoid activation of proteolytic enzymes and pancreatic enzyme secretion. The aim of our study was to evaluate the efficacy and feasibility of early oral feeding as compared to traditional fasting in patients with mild acute pancreatitis.Methods: Seventy-two patients were randomized to the two treatment groups, fasting or early oral feeding. The inclusion criteria were pancreas amylase≥3times above normal, onset of abdominal pain within 48h, acute physiological and chronic health evaluation-II score<8 and C-reactive protein(CRP)<150 mg/L. Measures were amylase, systemic inflammatory response, length of hospital stay. Results: The groups were comparable with respect to age, sex, etiology, APACHE II, time from onset of pain and amylase at admission. No significant differences were seen between the groups concerning levels of amylase, CRP, leukocytes, abdominal pain or number of gastrointestinal symptoms. The length of hospital stay time was significantly shorter in the oral feeding group (13 vs. 17 days; P<0.05).Conclusion: Early oral feeding would not exacerbate disease process. The differences between treatment groups for amylase or systemic inflammatory response were not obvious. In mild acute pancreatitis, early oral feeding was feasible and safe and may accelerate recovery.

Child ; Congresses as Topic ; Humans ; Pediatrics

Humans ; Pediatrics ; manpower ; Personnel Administration, Hospital ; Respiratory Therapy Department, Hospital ; manpower