Objective To observe the clinical effect of treating refractory ascites by intermittent cycle ascites reinfusion.Methods Having 30 refractory ascites patients of both chronic renal failure and maintenance hemodialysis(MHD),treating them 102 times by intermittent close ascites reinfusion and synchronous hemodialysis,having reinfusion ascites 3000～5000ml each time,checking the change of serum creatinine(Scr),blood urea nitrogen(Bun),and serum albumin before and after hemodialysis(HD) by blood-test,and observing their temperature,weight,belly size,blood pressure,and pulse before and after treatment.Results After treatment,all the patients feel well,have good appetite,and have less swollen belly.The average treatment is 3.2 times.The table shows the patients' weight,belly size,serum albumin,serum creatinie and blood urea nitrogen(Bun) before and after treatment.The difference is obviously distinctive(P

Objective To evaluate efficiencies of 4 kinds of γ‐interferon release assay(IGRA) detection kits in diagnosis of pul‐monary tuberculosis .Methods 4 kinds of IGRA reagents produced by Oxford Immunotec Ltd (Oxford) in British ,Shanghai Fuxing Changzheng Medical Science Co .,Ltd(Fuxing) ,Cellectis in Australia(Cellectis) and Haikou VTI Biological Institute(VTI) ,respec‐tively ,were used to determine release levels of peripheral bloodγ‐interferon which had antigenicity of Mycobacterium tuberculosis in 86 cases of patients with tuberculosis and 80 cases of healthy individuals ,and diagnostic efficiencies were evaluated .Results Among the 4 kinds of IGRA reagents ,including Oxford ,Fuxing ,Cellectis and VTI ,the sensitivity was 93 .02% ,88 .37% ,90 .70% and 91 .86% ,respectively ;the specificity was 92 .50% ,75 .00% ,82 .50% and 87 .50% ,respectively ;the positive predictive value was 93 .02% ,79 .17% ,84 .78% and 88 .76% ,respectively ;the negative predictive value was 92 .50% ,85 .71% ,89 .19% and 90 .91% ;the diagnostic accordance rate was 92 .77% ,81 .93% ,86 .75% and 89 .76% ,respectively ;the area under receiver operating charac‐teristic(ROC) curve was 0 .975 ,0 .892 ,0 .958 and 0 .963 .Conclusion There are no significant differences among Oxford ,Fuxing , Cellectis and VTI reagents ,and reagents could be selected according to clinical requirements .

Objective To assess the feasibility of intracavitary drainage using three equally-sized double pigtail stents in the treatment of ureteral stricture. Methods Placement of three identical double pigtail stents in ureters for indwelling for 10～12 weeks was carried out in 27 cases of ureteral stricture from March 2000 to June 2003. Results The patients were followed for 2～24 months, with a mean of 18 months. No lumbar distending pain or fever occurred after the removal of the drainage in 26 cases, with the IVP examination indicating patency drainage and no ureteral stricture. Re-examination of IVP 6 months after the surgery found no improvement of hydronephrosis in 1 case. The overall success rate was 96% (26/27). Conclusions Intracavitary drainage using three equally-sized double pigtail stents in the treatment of ureteral stricture is feasible.

Animals ; Brain Ischemia ; complications ; physiopathology ; Excitatory Amino Acid Antagonists ; pharmacology ; Humans ; Infant, Newborn ; Leukomalacia, Periventricular ; etiology ; Receptors, N-Methyl-D-Aspartate ; antagonists & inhibitors ; physiology ; Signal Transduction ; physiology

0.05).Conclusions Neither the new nor old SIRS diagnostic criteria had a high conforning rate with neonatal critical illnesses;There was no significant difference between them in each clinical item.It shows that the new SIRS diagnostic criteria is not superior to the old one,therefore we should improve the neonatal SIRS diagnostic criteria in the future.

Antimony ; blood ; Humans ; Spectrophotometry, Atomic ; methods

Objective To investigate the application value of anatomic segmental hepatectomy in treatment of left hepatolithus.Methods The 80 patients with left hepatolithuswere divided into the control group (n =40)and the observation group (n =40)in accordance with dif-ferent surgical methods,and they were given traditional surgery and precise pedicle anatomic segmental hepatectomy respectively.Operation index levels,postoperative complications and stress reaction levels before and after surgery of the two groups were compared.Results The blood loss,operative time,the time of drainage tube remove,time of analgesic drug use,and postoperative hospital stay of the observation group were significantly less than the control group,and the difference was statistically significant (P <0.05).The rate of postoperative com-plications was 17.50% in the control group,while it was 15.00% in the observation group,which showed no significant difference between the two groups (P >0.05).During the surgery,epinephrine,cortisol,IL-6 and CRP levels of patients decreased after a slight increase, while NK cell levels of patients decreased firstly and then increased.There were statistically significant differences in trems of the above inde-xes immediately after surgery to 24 hours after surgery (P <0.05),and the rangeability of the observation group was less than the control group (P <0.05).Until 48 hours after surgery the above indexes recovered to the preoperative level.Followed up for 3 to 24 months,the calculi recurrence rate and abdominal ache recurrence rate of the observation group were lower than the control group,and the difference was statistically significant(P <0.05).Conclusion Precise pedicle anatomic segmental hepatectomy applied in the treatment of left hepatolithus showed makedly curative effect,and it has little effect on the stress response of patients.

OBJECTIVE:TO summarize the treatment of complicated proximal humeral fracture with artificial shoulder replacement.METHODS:A computer-based online search of VIP was performed for related articles published between January 1998 and October 2009 with the key words"shoulder joint,prosthesis replacement,proximal humeral fracture".Articles with high correlation were included.and repetitive studies were excluded.The data were firstly collected,the references of each article were reviewed.RESULTS:A total of 18 articles were included The treatment of complicated proximal humeral fracture remains controversial.Early semi-shoulder ioint replacement is an appropriate method.Shoulder replacement includes humeral head replacement and total shoulder replacement.Neer and Biligani type are typical artificial humeral head.The fixation patterns of humeral head prosthesis shaft include cemented and cementless.Bone cement includes total bone cement and proximal cement fixation,and cementless includes pressure fixation and compaction bone grafting.Complications following shoulder replacement involve prosthesis instability,nodule heterotopia,heterotopic ossification,prosthesis loosening,periprosthetic fracture,infection and nerve injury.CONCLUSION:Majority of complications can be prevented by appropriate location of prosthesis,reconstruction of greater and lesser tubercle.and in combination with postoperative rehabilitation treatment.

Objective To analyze and evaluate neoadjuvant chemotherapy's value and significance in combining with surgical treatment for limited small cell lung cancer(LD-SCLC).Methods A total of 94 LD-SCLC patients underwent complete resections combined with chemotherapy between January 2000 and January 2011 in Shanghai Pulmonary Hospital.Among these cases,initial two cycles of neoadjuvant chemotherapies were performed for all pathologically confirmed patients (Group A),and initial operations followed by adjuvant chemotherapy were administered to patients without pathology (Group B).The survival rate was analyzed by log-rank test and Kaplan-Meier method.Multivariate analysis of the prognostic factors was performed using Cox's regression model.Results Group A included 43 cases and Group B included 51 cases.The mean age was (56.37 ± 10.18) years.According to the 6th edition of Tumor,Node,Metastasis(TNM) classification of lung cancer,54 cases were at stage Ⅰ or Ⅱ,40 cases were at stage Ⅲ.Overall 5-year survival(5-YS) was 27％.The 5-YS for patients with stage Ⅰ-Ⅱ was notably better than that of stage Ⅲ (34％ vs 20％,P =0.033).For patients with stage Ⅲ,the 5-YS of Group A was significantly better than that of Group B(34％ vs 12％,P =0.020),besides median overall survival for Group A and Group B were 46 and 15 months(P =0.009).Furthermore,the results of multivariate analysis showed that neoadjuvant chemotherapy,surgery and histopathology of SCLC were independent factors that strongly affected survival and prognosis.Conclusion In combined surgical treatment for LD-SCLC,neoadjuvant chemotherapy obviously improved the prognosis of patients with stage Ⅲ.Therefore,it was very important and necessary that pre-surgical neoadjuvant chemotherapy was administered to resectable stage Ⅲ LD-SCLC patients.

Background and purpose:Neuroendocrine neoplasm is one kind of infrequent neoplasms from neuroendocrine cell and peptidergic neurons. This study aimed to investigate the epidemiology and clinicopathological characteristics of neuroendocrine neoplasms (NEN) in Dalian. Methods: We retrospectively analyzed all neuroendocrine neoplasms patients in First Afifliated Hospital of Dalian Medical University from 2000 to 2013. The epidemiology characteristics, pathogenic sites and pathological types were reviewed, and the differences between gender and age were also analyzed. The statistics analysis such as independent-samples t test and one-way ANOVA and chi-square test were performed. Results:There were 279 NEN cases, including 166 male and 113 female patients (male:female=1.14:1), detection rate was 0.258%. The mean age of all cases was 59.4±17.1 (20-83), for male 58.9±19.4 (20-81) and female 61.7±15.0 (29-83). There was no statistical signiifcance of detection rate and mean age between male and female patients. Digestive system was the most common occurred site of NEN (71.68%), then was the respiratory system (20.79%). There was no statistical significance of pathogenic sites between male and female.In all case, 132 with neuroendocrine tumor (47.31%), 140 with neuroendocrine cancer (50.18%), 7 with mixed adenoneuroendocrine carcinoma (2.51%). There was no statistical signiifcance of pathological types between male and female (P>0.05).Conclusion:Recently, the detection rate of neuroendocrine neoplasms was raised in Dalian, but there was no signiifcance differences in detection rate,pathogenic sites and pathological types between male and female.