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

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 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 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.

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 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 observe the complications and mortality of hyponatremia in patients with acute exacerbation of chronic obstructive pulmonary disease.Methods The patients with acute exacerbation of chronic obstructive pulmonary disease were selected and divided into non -hyponatremia group(252 cases)and hyponatremia group(65 cases).The differences in the general status,serum ions,blood gas,APACHE Ⅱ score,complications dur-ing the hospitalization,using of ventilator and mortality between the two groups were compared,and drew the receiver operating characteristic(ROC)curve,to acquire higher serum sodium cut -off values.Results In the hyponatremia group,the body weight was (68.3 ±14.4)kg,BMI was (25.5 ±4.9)kg/m2 ,those in the non -hyponatremia group were (74.9 ±15.9)kg and (28.2 ±5.3)kg/m2 respectively,there were statistically significant differences(t =2.009,8.494,all P <0.05).The incidence rate of pneumonia in the hyponatremia group was 23.1%,which was higher than 13.1% in the non -hyponatremia group(χ2 =4.007,P =0.045).The hospital days of the hyponatremia group was (13.1 ±8.9)d,which was longer than (7.8 ±4.9)d of the non -hyponatremia group(t =15.638,P =0.000).The invasive ventilation days of the hyponatremia group was (1.1 ±0.4)d,which was longer than (0.9 ± 0.1)d of the non -hyponatremia group(t =2.885,P =0.004).The non invasive ventilation days of the hyponatremia group was (3.1 ±0.8)d,which was longer than (0.8 ±0.3)d of the non -hyponatremia group (t =2.984,P =0.003).The hospital mortality rate of the hyponatremia group was 12.3%,which was higher than 3.1% of the non -hyponatremia group(χ2 =7.189,P =0.007).The 90 -day mortality rate of the hyponatremia group was 29.2%, which was higher than 15.1% of the non -hyponatremia group(χ2 =7.017,P =0.008).When the serum sodium cut-off value was 128.8mmol/L by drawing ROC curve,the mortality rate in patients with lower than this value was 26.3%,while the mortality rate in patients with higher than the value was 3.7%.Conclusion Hyponatremia is related with the severity and prognosis of acute exacerbation of chronic obstructive pulmonary disease.It is most important to prevent and correct hyponatremia at early disease stage.

Objective To investigate the influence of severity of obstructive sleep apnea hypopnea syndrome (OSAHS)on acute ST -segment elevation myocardial infarction (STEMI).Methods 86 STEMI patients were divided into two groups,STEMI with OSAHS(OSAHS group,n=38)and STEMI without OSAHS(control group,n=48).Clinical data about biochemical index,cardiac function index and the duration of STEMI onset were compared between OSAHS group and control group.Logistic statistic analysis was used to investigate the risk factors that influ-ence the circadian rhythm of onset in STEMI.Results A total of 86 patients met the inclusion criteria,they were divided into two groups,STEMI with OSAHS(OSAHS group,n=38)and STEMI without OSAHS(control group,n=48).The incidence rate of STEMI onset during 0600 am~1 159 am was significantly higher in OSAHS group compared to control group(20.8% vs.44.7%,χ2 =5.626,P=0.018).This variation was weaken in mild OSAHS group compared to moderate-severe OSAHS group(20.8% vs.31.3%,χ2 =0.726,P=0.394;20.8% vs.54.5%,χ2 =7.956,P=0.005).Multivariate logistic analysis showed that the severity of OSAHS was a risk factor to the STEMI onset during 0600 am~1159 am(OR=2.458,95%CI 1.110~5.439,P=0.027).Conclusion The severity of OSAHS significantly increases the STEMI onset during 0600 am~1 159 am.