OBJECTIVE: Aneurysmal subarachnoid hemorrhage is mainly due to intracranial aneurysm rupture. Modern techniques enable most survivors to make a good functional recovery Nevertheless,it has been suggested that such patients suffer from a persistent disturbance of cognitive function,which affects their life quality. Therefore,cognitive assessment following aneurysmal subarachnoid hemorrhage has been gradually drawing increasing attention in recent years.DATA SOURCES: Related literature was searched through the computer in PUBMED with key terms of "aneurysmal subarachnoid hemorrhage" and"cognitive deficit" and the language was limited to English. Meanwhile literature between 2001 an.d 2004 was also searched with key terms of"subarachnoid hemorrhage" and "cognitive function" in the Chinese or English language,respectively.STUDY SELECTION: Literature with cognitive assessment as its main index determined by standardized measurement was enrolled in this study.DATA EXTRACTION: A total of 101 related articles were collected,including 15 ones closely related to the present study,while those with cognitive assessment as part of their content and cognitive function determined with new methods were excluded.DATA SYNTHESIS: Cognitive assessment was analyzed in respect of its content,measurement,results and risk factors. Effect of aneurysmal subarachnoid hemorrhage itself and its complications,as well as therapeutic methods on the onset and development of cognitive disturbance were also explored.CONCLUSION: Patients with aneurysmal subarachnoid hemorrhage suffer from cognitive impairment,which also results from operation,anesthesia and drugs.

Urinary tract infection (UTI)is a commonly encountered disease during routine clinical care. In the mean time, it is also a commonly encountered hospital acquired infection. UTI possesses various clinical symptoms, and usually the symptoms are atypical. The detection of leukocyturia and bacteriuria is an essential index for screening and confirmatory diagnosis of UTI. This article summarized the pathogenesis of UTI, diagnostic criteria, clinical significance and application evaluation of detection of the WBC and bacteria in urine.

Bronchoalveolar Lavage ; methods ; Humans ; Pneumoconiosis ; therapy

Objective: To determine the frepuency and severity of cognitive impairments associated with aneurysmal subarachnoid hemorrhage. Methods: A series of 37 patients with aneurysmal subarachnoid hemorrhage were examined by means of a battery of cognitive tests before surgical treatment. Results: In 70.3% of the patients, one or more cognitive functions were impaired. Compared with normative data, 2.7% of patients showed impairment on arithmetic, digit symbal and picture complement respectively, 5.4% on digit span, 48.6% on Visual Reproduction , 27%(food) and 18.9% (ordinary tools) on verbal fluency test, 18.9%(part A) and 21.6% (part B) on trail-making test,?18.9% on MMSE (mini mental state examination). Conclusion: The patients have impressive cognitive deficits after aneurysmal subarachnoid hemorrhage. SAH patients were especially impaired in functions that are related to short-term memory, concentration capacity, and frontocortical functions.

Intrahepatic cholangiocarcinoma (ICC) is a highly malignant liver tumor with strong invasion and poor prognosis. ICC originates from the bile duct and locates in the liver, so it is classified as either primary liver cancer or cholangiocarcinoma, which the classification is indeterminate and the pathological typing is still debatable. The mechanism of ICC induced by many high-risk factors is still unclear. There are no characteristic manifestations in early symptom and no specific tumor markers, and the diagnosis of ICC mainly depends on imaging examination, which enhanced CT and MRI are the most important evaluation method. TNM staging of ICC is of great significance to guide the treatment, nevertheless, the division of T stage updated by AJCC 8th Edition is still controversial. Radical surgery is the only way to cure ICC currently, but there are still many controversies on definition of R0 resection and the scope of lymph node dissection. The application of local therapy and the rapid development of immunity and targeted therapy bring new hope for the transformation therapy of locally advanced patients, however, the efficacy needs to be verified by multi center large sample clinical studies. To grasp the current focus issues in diagnosis and treatment of ICC timely will be an important direction of basic and clinical research of ICC in the future.

To measure esophageal manometric parameters in liver cirrhosis, patients with different liver function grades were chosen. In the normal control group ( n =72) gastrointestinal disease history and symptoms, abdominal surgery and injury history were all negative. In liver cirrhosis group ( n =94) liver cirrhosis was diagnosed by clinical picture or pathology, and their liver function in Child grade was: grade A, 38 cases and 8 had ascites; grade B, 37 cases and 20 had ascites; grade C, 19 cases and 18 had ascites. Taking no motility medicines within seven days before measurement, esophageal motility parameters of these subjects were taken by a Biolab System made by Sandhill Company. The data were analyzed with SAS statistical software. The results showed that from Child grade A to C, LESP in cirrhosis group reduced, relaxation pressure increased, and relaxation percentage become lower successively; from Child grade A to C, onset peristaltic wave velocity in upper esophageal body became slower, peristaltic contraction reduced, and abnormal contraction increased; from Child grade A to C, peristaltic wave amplitude reduced in lower esophageal body, and velocity of onset peristaltic wave velocity became slower, peristaltic contraction reduced, and abnormal contraction increased. It suggests that more severe injury in liver function, more serious impact in esophageal motility. At the same time complications of portal vein hypertention such as esophageal varices and ascites behave synergetically.

Objective To assess the feasibility and safety between ALPPS and two-stage hepatectomy (TSH).Methods An electronic search was performed of the MEDLINE,EMBASE using subject heading to identify nearly three-years articles published that related to this topic.Pooled odds ratio was calculated for binary data and mean differences for continuous outcomes,using fixed-effects and random-effects models for meta-analysis.Results Four studies involving a total of 312 patients were used in the analysis.We found that ALPPS produced a higher increase rate of FLR than TSH (MD =24.78;95％CI:0.63 to 48.94;P =0.04).Comparing with TSH,ALPPS produced a shorter FLR growth time (MD =-26.55;95％ CI:-37.13 to -15.97,P ＜ 0.05).There was no statistical significance in overall mortality (OR =2.43;95 ％ CI:0.94 to 6.31;P =0.07),while ALPPS produced a more severe complication rate (≥ Ⅲ b) than TSH (OR =2.47;95 ％ CI:1.14 to 5.36;P =0.02).Conclusions It was better to make the FLR increasing to safe resection for ALPPS than TSH in a short period of time.There was no statistical significance in overall complication and mortality between ALPPS and TSH,but ALPPS produced more severe complication rate (≥ Ⅲb) than TSH.

0.05); awake time were (10.08?5.67) min and (15.50?3.47) min (P

Driven by information technology,medical English classes are becoming more plural and autonomous. However,how can the application of modern information technology assist class teaching more effectively? This paper explores into the internal cause and external cause while collecting real-time videos for English classes,the influence of system platform on English learning as well as the realization of the platforms.

Objective To explore the signification and method of Cut-off verification and gray zone setting in chemiluminescent assay.Methods NCCLS EP-12 A2 document defines that C50 is the analyte concentration of cut off value for immunology qualitative test and C5-C95 interval is the range of analyte concentration that yields 5％ positive results to 95％ positive results for immunology qualitativc test.The C50 and C5-C95 interval of HBeAg in ARCHITECT i2000 were worked out according to the cut off value provided by HBeAg reagent calibrated in ARCHITECT i2000,which were verified to approve the character declaimed by manufactory or not.Gray zone was set and the procedure of cut off verification and gray zone set in chemiluminescent were built; A set of quality control was detected 20 times with two different lot HBeAg reagent kits,S/CO was caculated and compared with t test.Results C50 and C5-C95 interval of reagent (lot 06087L100,96378HN00) were 0.171 PEI U/ml,0.125 PEI U/ml; ＞0.154 PEI U/ml to 0.188 PEI U/ml,0.119 PEI U/ml to ＜0.150 PEI U/ml,respectively.S/CO of negative quality control and positive quality control were (0.550 ±0.038),(2.422 ±0.084) and(0.334 ±0.063),(3.587 ±0.321),respectively.They all approved the character (the sensitivity at cut off was less than 0.5 PEI U/ml)declaimed by manufactory,and the results of S/CO between two lot kits were obvious difference (t =9.944,15.499,P ＜0.01).Conclusion C50 and C5-95 interval can be used to verify cut off value and set gray zone in chemiluminescent assay;They may vary in different lot reagents and they must be verified to approve the character declaimed by manufactory.