Objective To evaluate the risk factors for the postoperative acute renal failure requiring dialysis (ARF-D)after heart valve surgery. Methods Adult patients (age≤18 years) underwent valve surgery with preoperative serum creatinine ＜300 μmol/L were included between January 2005 and December 2008. Fifty patients developed ARF-D within 30 days postoperatively (ARF-D group). While random 220 patients had the same operation without ARF-D served as the control group. Univariate analysis and multivariable logistic regression were used to identify risk factors of ARF-D after valve surgery.Results The incidence of ARF-D was 1.78%, and the early mortality rate was 65.5%. Multivariate analysis identified the following independent risk factors of ARF-D: age, previous cardiac surgery, preoperative serum creatinine, NYHA class Ⅳ,and low cardiac output syndrome. ARF-D group had a longer hospital stay and ICU stay than that of the control group ( P ＜0.001 ). Conclusion Conclusion ARF-D had a higher mortality rate and longer hospital stay following heart valve surgery.Age, previous cardiac surgery, preoperative serum creatinine, NYHA class Ⅳ, and low cardiac output syndrome were the independent risk factors of ARF-D after heart valve surgery.

Objective To sonographically measure nuchal skin thickness(NT) and biparietal diameter/femur length (BPD/FL) for normal fetuses between 10 and 24 gestational weeks,screen abnormal cases then to culture fetal cells and chromosome analysis, diagnosis aneuploid chromosome deformed fetuses Methods Ultrosonic estimation of fetal gestation according to gestational sac or CRL or BPD/Fl and AC, measuring NT, BPD/Fl of 100 cases per gestational weeks, drawing normal curve of NT, making curve of 90 th and 10 th NT and BPD/Fl. Restropectively analysis 5 cases trisomy 21.Results The average of NT was 1 76mm between 10 and 13 gestational weeks. The average of NT was 3 52mm between14 and 24 gestational weeks. The value of 50th was 2 40～1 40 between14 and 24 gestational weeks.Conclusions If the value of NT is more than 90 percent of normal fetuses, and if BPD/FL ratio is morn than 90 percent of normal fetuses,the sensitivity of trisome 21 should increase.Combining factors as elderly and high risk parturition, the sensitivity of trisomy 21 is much more increasing.

Objective To explore the value of ambulatory electroencephalography (AEEG) monitoring in diagnosis and differential diagnosis of epilepsy.Methods 24-hour AEEG in 761 patients with epilepsy and 1327 patients with paroxysmal disorder was analyzed retrospectively.Results The positive finding of epileptiform discharge by AEEG was obviously higher than routine EEG (all P

High-resolution magnetic resonance imaging (HRMRI) is a safe, non-invasive, inexpensive, accurate and reproducible clini-cal imaging modality, and the results can acutely reflect the extent of atherosclerotic disease and have high predictive values for future clini-cal events. It uses black blood imaging techniques and can obtain sufficient sensitivity for submillimetre imaging. HRMRI has been used widely to visualize the vessel wall and differentiate the components of atherosclerotic plaques. It is of important clinical meaning to evaluate plaque vulnerability with HRMRI, which is related to the remodeling pattern, plaque burden, intraplaque hemorrhage and contrast enhance-ment, and plaque distribution, etc.

Objective To improve the diagnostic value of MRI on orbital diseases,especially on benign and malignant tumors,through analyzing the characteristics of orbital diseases with dynamic contrast-enhanced MRI.Methods Forty-one patients with solitary orbital masses, including 31 benign tumors and 10 malignant tumors,underwent MR examinations. All the cases were verified by pathology.1.5 T MR system and head coil were employed.Conventional scan was performed with axial,sagittal,and coronal T_1WI,as well as axial T_2WI and the slice thickness of 4 mm.After the injection of contrast agents,dynamic contrast-enhanced MRI was immediately performed so as to observe dynamic changes of lesions.Enhancement rates(E%) was calculated and time-intensity curve was portraited according to the signal intensity of conventional scan and dynamic-contrast enhanced scan.SPASS Ver10.0 was used to do the statistical analysis,while cartographies were completed with Powerpoint.Results(1)Comparision between benign and malignant tumors in average enhanced rates of the 1~(st) minute: it was higher than 60% in malignant tumors,while lower than 60% in benign ones(P

Objective To evaluate the application status of China Disease Prevention and Control Information System of Hy?datid Disease,in which questions existed are summarized in order to promote the system update. Methods A questionnaire was designed and distributed to Inner Mongolia,Sichuan,Tibet,Gansu,Qinghai,Ningxia,Xinjiang and Xinjiang Production and Construction Corps to evaluate the application status of China Disease Prevention and Control Information System of Hydatid Disease assistant with telephone. Results The recovery rate of questionnaires was 87.5%. The statistics of closed questions showed that national application rate of the China Disease Prevention and Control Information System of Hydatid Disease was 100%,of which 15.3%were low frequency users,57.1%believed the system was necessary,28.6%considered it was dispens?able,and 14.3%believed that it was totally unnecessary. The statistics of open?ended questions indicated that 6 endemic regions suggested to increase the guidance and training,while 4 endemic regions had opinions on sharing the information of the national infectious disease reporting systems and hydatid disease prevention and control information system,and the opinions on turning monthly report to quarterly report,and increasing statistics and analysis module,and 3 endemic regions deemed that the system had logic errors and defects. Conclusion The problems of the system are mainly focused on the existence of systemic deficien?cies and logic errors,lacking of statistical parameters and corresponding analysis function module,and lacking of the guidance and training,which limits the use of the system. Therefore,these problems should be resolved.

Objective To investigate the prevalence of healthcare-associated infection(HAI)in medical institutions in Pudong New Area.Methods Ten medical institutions in Pudong New Area were selected as monitored hospitals, cross-sectional survey on HAI in each hospital at a given day of November 2013 and November 2014 were conduc-ted.Prevalence of HAI in different levels of hospitals were compared.Results The prevalence rates of HAI in 2013 and 2014 were 4.04% and 3.75% respectively,there was no significant difference between two years(χ2 =0.709,P=0.400).The prevalence rates of HAI in primary,secondary,and tertiary hospitals in 2013 were 0.66%,3.32%, and 4.60% respectively,in 2014 were 0,3.52%,and 4.01 % respectively,prevalence rates of HAI in different lev-els of hospitals of each year were significantly different (all P <0.05).Prevalence rates of HAI were high in depart-ments of neurosurgery,hematology,intensive care units(ICUs),and gerontology.The prevalence rate of infection in ICUs increased obviously,from 10.09% to 18.78% (χ2 =3.921 ,P =0.048),departments of gerontology de-creased obviously,from 10.07% to 5.02%(χ2 =5.698,P =0.017).The main HAI sites were lower respiratory tract (36.72%),upper respiratory tract (9.96%),and urinary tract (12.89%).172 pathogenic isolates were de-tected in 2013,and 177 were detected in 2014,gram-negative bacteria,gram-positive bacteria,and fungi accounted for 60.74%,26.37%,and 12.89% respectively.Constituent ratios of pathogens causing HAI between two surveys were not significantly different (χ2 =5.819,P =0.830).Conclusion Among different levels of hospitals in Pudong New Area,tertiary hospitals have the highest prevalence rate,HAI in ICU increases obviously,the main HAI site is lower respiratory tract,the main pathogens are gram-negative bacteria.

Objective: To investigate the clinical effect of combination therapy on ankylosing spondylitis. Methods: 160 Cases were divided into treatment group and control group randomly. The patients of treatment group were given Bushenqingdu Decoction and Hanbiwaiyongfang by external use. The patients of control group were given Wangbi Granule. The symptoms and signs were observed before and after treatment in both groups. Results: There was significant difference between treatment group and control group in total effective rate as well as morning stiffness and signs (P

Objective To investigate early and differential diagnosis of Alzheimer disease and vascular dementia (VD)using FDG-PET scan. Methods Clinical data was collected from AD,VD and normal control(NC). 18F-2-fluo-ro-deoxy-D-glucose(18F-FDG)PET scan was conducted to detect the cerebral FDG metabolism. The average standard uptake value (SUV) of cerebral regions was expressed as semiquantitative index relative to ipsilateral cerebellum. Re-sults There were no differences in age and the mean total scores of the mini mental status examination (MMSE) between patients with VD and those with AD.The AD group showed that the SUV was significantly decreased in the right frontal, parietal,temporal lobe,hippocampus,temporo-parietal junction,and bilateral posterior cingulate cortex compared to the VD and in the bilateral posterior cingulate cortex,temporo-parietal junction,frontal and temporal lobe comparing to the NC(P≤0.01). SUV was significantly increased in the right parietal,posterior cingulate cortex and hippocampus whereas was significantly decreased in the left frontal lobe,temporo-parietal junction and thalamus in the VD compared with NC group(P≤0.01). Conclusion AD patients have typical features of 18F-FDG PET which may be helpful for the diagnosis of AD in the early stage.

Objective To explore the diagnostic value of Talaromyces marneffei (T.marneffei)-specific mannose glycoprotein Mp1p antigen for T.marneffei infection in acquired immune deficiency syndrome (AIDS) patients.Methods All cases were recruited in this study from January 2012 to June 2015 in Guangzhou No.8 People′s Hospital, including 184 AIDS patients with T.marneffei infection confirmatively diagnosed by culture, and 205 controls including 176 AIDS patients without T.marneffei infection and 29 health controls.Double antibody sandwich enzyme linked immunosorbent assay and fluoroimmunoassay combined with double-antibody sandwich were both utilized to detect serum Mp1p antigen levels, and their sensitivity and specificity for diagnosing T.marneffei infection in patients with AIDS were analyzed.x2 test and t test were used for statistical analysis.Results The ratio of males to females and age of the study group were both comparable to those of the control group (x2=0.019, P=0.889;t=1.810,P=0.07, respecitvley).The sensitivities of double antibody sandwich enzyme linked immunosorbent assay and fluoroimmunoassay combined with double-antibody sandwich were 82.07%(151/184) and 83.15%(153/184), respectively (x2=0.076, P=0.783).The specificities were 93.17%(191/205) and 92.68%(190/205), respectively (x2=0.037, P=0.847).The accuracy values were 87.92%(342/389) and 88.17%(343/389), respectively (x2=0.012, P=0.912).The false positive rates were 6.83%(14/205) and 7.32%(15/205), respectively.The false negative rates were 17.93%(33/184) and 16.85%(31/184), respectively (x2=0.049, P=0.829).The positive predictive values were 91.52%(151/165) and 91.07%(153/168), respectively (x2=0.021, P=0.886).The negative predictive values were 85.27%(191/224) and 85.97%(190/221), respectively (x2=0.045, P=0.832).The Kappa values were 0.83 and 0.80, respectively.Conclusion Detection of serum Mp1p antigen of T.marneffei possesses high specificity and sensitivity, which may be utilized for rapid and early diagnosis of T.marneffei infection in patients with AIDS.