Objective To analyze the relationship between the levels of plasma total homocysteine (Hcy) and umbilical arterial with color doppler ultrasound with the severity of preeclampsia(PE).Methods A total of 70 cases of the third trimester of normal pregnancy, 72 cases of mild PE, and 66 cases of severe PE were selected.Then plasma Hcy levels and umbilical arterial with color doppler ultrasound were detected.Results Hcy levels were statistically significant difference among the normal control group,mild PE group,and severe PE group((8.950±0.585), (11.116±0.615), (14.648±0.620) μmol/L,P＜0.05).Umbilical artery blood flow parameter S/D values in severe PE group was significantly higher in mild PE group and in contrg.1 group (3.43 ±0.72 vs.2.86 ± 0.82 vs 2.75 ± 0.56, P＜ 0.05), while the control group, mild PE group had no significant difference(P＞0.05).Resistance index(RI) ,Pulsatility index(PI) in mild PE group and severe PE group were significantly higher than control group(0.60±0.05,0.78±0.07 vs.0.57±0.06;1.24±0.21,1.47±0.64 vs.0.67±0.35), and the differences among three groups were significant(P＜0.05), while the mild PE, severe PE group had no significant difference(P＞0.05).Hcy of mild PE group was positively correlated with S/D, RI and PI(r=0.548,P=0.009;r=0.587,P=0.008;r=0.324,P=0.02).Hcy of severe PE group was positively correlated with S/D,RI and PI(r=0.752,P=0.001;r=0.627,P=0.003;r =0.438,P=0.024).Hcy and the severity of PE was positively correlated (r =0.450, P ＜ 0.05), S/D and the severity of PE was positively correlated(r=0.316, P =0.002).RI, PI and the severity of PE was no correlation (r =0.024, P =0.726;r =0.054,P =0.649).Conclusion The levels of Hcy and S/D were related to the severity of PE.To reduce Hcy,and monitor S/D were new ways for the diagnosis and treatment of pre-eclampsia.

Objective To analyze main influencing factors of hospitalization expenses by support vector machine modeling,and explore effective influence factors analysis methods of medical expenses. Methods Random selection of six hospitals in Zhejiang province.Using hospital electronic medical record system of the hospitals and selecting three kinds of typical diseases of internal medicine and surgery,to build the support vector machine model,BP neural network model,and multiple linear regression model for comparison of analysis results.The SVM model is used to analyze three various diseases.Results The support vector machine model based on radial basis kernel function scored the highest prediction accuracy on the hospitalization expenses,up to 96.07%.In a mixed analysis of different diseases,analysis results of all three models pointed the main influence factors of hospitalization expense as days of stay,disease types,and hospital coding for the surgery.In the analysis by diseases individually,the influencing factors, though varying with diseases, key factors remain the same. Conclusion The support vector machine in the influence factor analysis is feasible in hospitalization expenses.According to the analysis results,the single disease payment system can be made rationally, which can effectively control excessive growth of medical expenses.

Objective To explore the features of leukoencephalopathy with cerebral calcifications and cysts (LCC) in clinic, radiology and pathology in order to improve skills in diagnosis. Methods Two female patients had CT and/or MRI scan, and case 2 had contrast enhancement MRI scan additionally. Both cases had blood biochemistry examinations including calcium, phosphorus and alkaline phosphatase et al. Case 2 had lumbar puncture and cerebrospinal fluid test. The major cystic lesion was surgically removed in both patients and offered a histopathological examination. Results CT scan reveaed diffuse calcifications in the bilateral basal ganglia, white matter of frontal lobe and/or dentate nuclei of cerebellum in both cases, and major cystic lesion in right frontal lobe (case 1) and the left parietal lobe (case 2). The rim of enhancement was observed in cystic lesion on MRI. Histopatbological examination revealed angiomatous rearrangements of the microvessels with fibroid, hyaline degeneration and haemosiderin deposits, brain tissue associated with areas of demyelinization, some Rosenthal fibers, gliosis, calcium deposits and hemorrhage, fibrinoid necrosis occurs in partial vessels associated with thrombogenesis and stenosis as changes in arteriolitis. Blood biochemistry examination showed normal. Cerebrospinal fluid test in case 2 showed increased intracranial pressure(350 mm H_2O,I mm H_2O =0. 0098 kPa). Conclusions The onset of LCC varies and occurs from early infancy to adult. The asymmetrical calcification is characteristic in LCC. Hemorrhage could be involved in the pathogenesis of cystic formation. LCC is characterized by a cerebral obliterative microangiopathy, both demyelinization and the edematous changes could probably result in white matter abnormalities on neuroimaging.

Objective To compare the clinical effects of catheter-directed thrombolytic therapy for acute superior mesenteric vein thrombus (SMVT) between via superior mesenteric vein (SMV) route and via superior mesenteric artery (SMA) route. Methods The clinical data of 32 patients with acute SMVT, who were treated with catheter-directed thrombolytic therapy at the Central Hospital of Shengli Oil Field, were retrospectively analyzed. Among the 32 patients, percutaneous transhepatic catheter-directed thrombolytic therapy via SMV route was performed in 23 (SMV group), and percutaneous transhepatic catheter-directed thrombolytic therapy via SMA route was carried out in 9 (SMA group). Results After the treatment, the clinical symptoms were significantly improved in 28 patients, including 22 of SMV group (95.7%) and 6 of SMA group (66.7%). CT angiography showed that the blood flow became almost complete patency in 17 patients of SMV group (73.9%) and in only 3 patients of SMA group (33.3%). Both the thrombolysis procedure time and X-ray exposure time of SMV group were obviously longer than those of SMA group. Conclusion Both via SMV and via SMA catheter-directed thrombolytic therapies are effective treatment for acute SMV thrombosis. The former is more effective, while the manipulation of the latter is technically simpler.

Objective To compare the analgesic effects of fire needling, conventional acupuncture and acupoint catgut embedding in rats with rheumatoid arthritis.Methods Fifty healthy male SD rats were randomized into control, model, acupuncture, fire needling and catgut embedding groups, 10 rats each. A SD rat model of rheumatoid arthritis was made by intracutaneous injection of complete Freund’s adjuvant into the right hind foot pad. Right Kunlun and Zusanli were selected as therapeutic points in the three groups and given fire needling, acupuncture or catgut embedding. The right paw mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL) were used as observation indices and measured in every group of rats at one day before and four days after model making and at one, seven and fourteen days after the beginning of treatment. Rat paw inflammatory tissues were separated after the completion of treatment. The IL-1 and TNF-α contents of them were measured. Results There were statistically significant differences in MWT and TWL between the model, acupuncture, fire needling or catgut embedding group and the control group after model making, and one, seven and fourteen days of treatment (P<0.01). There were statistically significant differences in MWT and TWL between the fire needling group and the model, acupuncture or catgut embedding group after one, seven and fourteen days of treatment (P<0.01,P<0.05). There was a statistically significant difference in MWT between the acupuncture or catgut embedding group and the model group after one, seven and fourteen days of treatment (P<0.01). There was a statistically significant difference in TWL between the acupuncture or catgut embedding group and the model group after seven and fourteen days of treatment (P<0.01,P<0.05). There were statistically significant differences in IL-1 and TNF-α contents between the model, acupuncture, catgut embedding or fire needling group and the control group after model making (P<0.01). after treatment, there were statistically significant differences in IL-1 and TNF-α contents between the acupuncture, catgut embedding or fire needling group and the model group and between the acupuncture or catgut embedding group and the fire needling group (P<0.05).Conclusions Fire needling can raise pain threshold in rats with rheumatoid arthritis. It alleviates rheumatoid arthritis-induced chronic pain by reducing the inflammatory factor content of affected muscular tissues.

OBJECTIVE To dectect the possible association between interleukin-4 receptor gene polymorphism and allergic rhinitis. METHODS The study was conducted in two different groups: patients with allergic rhinitis (the case group,n=50) and healthy people (the control group,n=40). The IL-4R Q576R polymorphism was genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The study compared frequencies distribution of genotype and allele between the two groups,and calculated odds ratio (OR) of genotype. RESULTS IL-4R allelic frequencies showed significant difference between the two groups (x2=9.12,P

Objective To discuss the optimal retrieval time of the indwelling Gunther Tulip and Cook Celcet inferior vena cava filters (VCF). Methods During the period from March 2013 to April 2015 at Shengli Oilfield Central Hospital, the implantation of retrievable inferior vena cava filter was performed in 58 patients. Among the 58 patients, Gunther Tulip VCF was used in 13 and Cook Celcet VCF was employed in 31. Twenty-one patients followed the doctor's advice to receive retrieval procedure of VCF within three months after the implantation. Results Among the 21 patients, successful retrieval of VCF was obtained in 19. The mean indwelling time of Gunther Tulip VCF was 54.4 days, the longest time being 79.0 days. Gunther Tulip VCF was successfully removed in 3 patients and retrieval of VCF failed in 2 patients, with a retrieval success rate of 60%. The mean indwelling time of Cook Celcet VCF was 37.6 days, the longest time being 67.0 days. Cook Celcet VCF was successfully removed in 16 patients, with the success rate of retrieval being 100%. Conclusion Despite many VCFs that have been indwelled for a long time can be safely retrieved, retrieval procedure should be performed as early as possible in order to improve the retrieval success rate of VCF. It seems that the use of Cook Celcet VCF is a better choice although it is more expensive.

OBJECTIVETo evaluate the clinical effects of single posterior debridement, bone grafting, internal fixation and local chemotherapy in treating thoracolumbar spinal tuberculosis.

METHODSFrom February 2009 to September 2012,11 patients with thoracolumbar spinal tuberculosis were treated by single posterior debridement, bone grafting, internal fixation and local chemotherapy. There were 7 males and 4 females, aged from 27 to 65 years old with an average of 53.7 years. The courses of disease was from 3 months to 2 years with the mean of 9 months. According to ASIA standard of spinal cord injury, 3 cases were grade C and 8 cases D. After treatment, clinical effects were evaluated by ASIA grade, visual analogue score (VAS) and Oswestry Disability Index (ODI); kyphosis Cobb angle change was observed by X-rays.

RESULTSEleven patients were followed up from 12 to 29 months with an average of 18 months. ASIA grade of spinal cord injury, 3 patients with grade C improved to grade D in 2 cases and grade E in 1 case 8 patients with grade D improved to grade E in 7 cases and unchanged in 1 case. VAS decreased from preoperative 6.10 ± 1.30 to 1.70 ± 0.80 at 3 d after operation (P < 0.05). ODI improved from preoperative (68.36 ± 10.41)% to (14.55 ± 8.99)% (P < 0.05) at 3 d after operation. Kyphotic Cobb angle was corrected from preoperative (22.64 ± 4.84)° to (4.27 ± 1.49)° (P < 0.05) on the 3rd day after operation, and angle loss was mild at final follow-up, there was no significant difference between postoperative at 3 d and final follow-up.

CONCLUSIONSingle posterior debridement, bone grafting, internal fixation and local chemotherapy for the treatment of thoracolumbar spinal tuberculosis can effectively remove the lesion, improve nerve function and correct deformity, has advantage of single incision, little trauma, and low recurrence rate. But it still need long-term and systemic treatment with anti-TB drugs.

Adult ; Aged ; Bone Transplantation ; Debridement ; Female ; Humans ; Internal Fixators ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Thoracic Vertebrae ; surgery ; Tuberculosis, Spinal ; therapy

Objective To explore the influence of automatic and semi-automatic hemodialyzer reuse method on hemodialyzer reuse effect. Methods 1728 dialyzers were randomly divided into automatichemodialyzer reuse group and semi- automatic hemodialyzer reuse group with 864 dialyzers in each group. Thetime of douching and testing, the cost of sterilization,the frequency of the pyrphgen reaction,the broken dialyzer membrane and re-examined dialyzer between the two groups were measured. Results The time of douching dialyzer, testing of total cell volume and pressure in the semi- automatic hemodialyzer reuse group was (26.443±3.237), (2.172±0.128) and (2.157±0.090) minutes respectively,while the automatic hemodialyzer reuse group was (5.793±0.193), (1.257±0.118) and (1.110±0.076) minutes respectively. The frequency of re-examined dialyzer in testing total cell volume and pressure was 499(57.755%), 243(28.125%) respectively. At the same time, all dialyzer in semi-automatic hemodialyzer reuse group could be examined successfully at a time. The cost of sterilization in automatic henmdialyzer reuse group was (9.330±0.138)yuan. No pyrogen reaction and broken dialyzer membrane happened. Conclusions The semi-automatic bemodialyzer reuse group can retrench cost during perfusion,but consumes long douching time, lacks matching detection equipment, difficult to detect, and is not easy to read data and has high re- examination rate. while in the automatic hemodialyzer group, it is convenient of douching and detection, but the cost of sterilization and equipment is high, and clinical demand can be fulfilled only when the dialysis center can allocate reasonable number of the machines.