Adolescent ; Humans ; Lung ; diagnostic imaging ; pathology ; Lung Neoplasms ; diagnostic imaging ; pathology ; surgery ; Male ; Papilloma ; diagnostic imaging ; pathology ; surgery ; Pneumonectomy ; methods ; Tomography, X-Ray Computed

Early recognition of severe sepsis and septic shock,early initiation of effective interventions,implementation of early goal-directed therapy may be key approaches for reducing the mortality and improving the prognosis.This article focused on the staging diagnosis systems for sepsis (PIRO sepsis classification system) and the systematic early warning or rapid response system.We also discussed the diagnostic value of biomarkers,proteomics and metabolomics in sepsis and severe sepsis.No single marker as golden standard has emerged that can provide clinicians with all the information they need for early recognition of sepsis.Therefore,we suggested that clinicians should have even more reason to combine the sepsis symptoms,signs and biomarkers for a comprehensive evaluation,and that they needed to dynamically monitor the changes in these parameters,in order to make reasonable clinical decisions and strategies.

Many problems have been found in the inspection of assets in universities conducted　by the Ministry of Finance,Accordingly,some measures were taken to solve the problems,and as a　result the management was enhanced and the efficiency of the assets were improved.The author,　working in the front line of the inspectiong,reported the experience and in-depth reflection over the　experience to propose for the management of laboratories in medical colleges.

Objective To investigate the relationship between serum hepatitis B virus markers (HBV-M ) and HBV-DNA . Methods Enhanced chemiluminescence enzyme immunoassay (ECLIA ) and real-time fluorescent quantitative polymerase chain re-action(FQ-PCR) were employed to detect HBV-M and HBV-DNA in 262 serum samples ,respectively .HBV surface antigen(HB-sAg) ,anti-HBV surface antibody(HBsAb) ,HBV e antigen(HBeAg) ,anti-HBV e antibody(HBeAb) ,anti-HBV core antibody(HB-cAb) were included in HBV-M .Results Compared the positive rates of HBV-DNA ,HBsAg ,HBeAb in HBeAg-negative patients with those in HBeAg-positive patients ,the differences were statistically significant (P< 0 .01) .29(36 .7% ) patients with HBV-DNA logarithm value not less than 5 were found in HBeAg-negative patients .Differences of HBeAg ,HBeAb positive rates among patients with different ages were statistically significant (P<0 .01) .25 patients with HBsAg less than 250 IU/mL were found in HBV-DNA-positive patients ,12(48 .0% ) of which showed HBV-DNA logarithm value not less than 5 .HBV-DNA logarithm value of HBV-DNA-positive patients was positively correlated to HBeAg and HBeAb (r= 0 .542 ,0 .607 ,P< 0 .01) .Conclusion Com-bined detection of HBV-M and HBV-DNA contributes to estimating the HBV infection .

Objective To analyze the clinical effect and safety of cortical bone decortication combined locking plate fixation for treatment of long bone nonunion of limbs. Methods Eighty patients with long bone nonunion of limbs who were treated in the Zhongshan Hospital Affiliated to Dalian University from Jun. 2010 to Jun. 2013 were selected as our subjects and their clinical data were recorded. According to different treatment methods,the patients were divided into control group and observation group,and each group with 40 cases. Patients in observation group were treated with cortical bone decortication combined locking plate fixation, while in control group were treated with locking plate combined slotted bone graft. Clinical effects and safety of two groups were compared. Results Excellent and good rate in observation group was 100%(40/40),obviously higher than that of control group(90. 0%(36/40);χ2 =4. 21,P﹤0. 05). Bleeding amount during operation in observation group was(370. 5 ± 56. 5)ml,obviously less than that of control group((486. 5 ± 64. 5)ml;t=8. 56,P﹤0. 01). And the fracture healing time was(5. 6 ± 1. 2)months in observation group,shorter than control group((7. 2 ± 1. 5)months;t =5. 27,P ﹤0. 01). The postoperative complication occurrence rate was 5. 0%(2/40),significantly lower than control group(20. 0%(8/40);χ2 =4. 11,P ﹤0. 05). Conclusion Cortical bone decortication combined locking plate fixation for treatment of long bone nonunion of limbs is safe and effective,and it can reduce operation injury and accelerate postoperative healing of fracture.

Objective To investigate the clinical characteristics of the patients with central brain herniation,and the operation effect of high coronary craniotomy for bilateral decompressive craniectomy.Methods A retrospective analysis was conducted on 26 cases of central brain herniation.The effectiveness of high coronary craniotomy for bilateral decompressive craniectomy and the influential factor of prognosis in patients with central brain herniation were analyzed.Results According to the Glasgow outcome score (GOS) 6 months after operation,5 cases were recovered well,6 cases moderately disabled,4 cases severely disabled,3 cases vegetative survived and 8 cases died.Conclusions High coronary craniotomy and timely and effective bilateral decompressive craniectomy are the most important treatment in patients with central brain herniation.The prognosis is unfavourable prognosis in patients with central brain herniation within 1 h after injury and older than 75 years old.

Objective To analyse the differences between idiopathic and symptomatic childhood epilepsy with occipital patoxysms. Methods The medical records of 38 patients with interictal spikes and/or sharp waves over occipital areas,posterior temporal-parietal areas,or both were retrospectively analysed.Epidemiological data,ictal symptoms,electroencephalogram,neuroimaging studies,treatment response and prognosis were compared using chi-square test or Mann-Whitney U test. Results Four patients of idiopathic group had positive family history related to nervous system.Seizures were more frequent in symptomatic group than in idiopathic group.Both groups showed autonomic symptoms,while ictal vomiting and deviation of eyes were more common in the presence of Panayiotopoulos type.The prognosis of idiopathic group was much better than that of symptomatic group. Conclusion Panayiotopoulos syndrome is more common.Neurologic deficits and electroencephalographic characteristics are major factors to predict seizure remission in children with occipital lobe epilepsy.Idiopathic childhood epilepsy with occipital paroxysms may result in better prognosis.

Acupuncture Therapy ; Adult ; Diarrhea ; therapy ; Humans ; Male

Acupuncture Therapy ; Adult ; Fatigue ; therapy ; Female ; Humans ; Seasons ; Sleep Wake Disorders ; therapy

Objective To discuss the clinical feature of cholestasis preterm infants who have used parenteral nutrition early after birth,and analyze the relative factors and preventive meatures of parenteral nutrition associated cholestasis (PNAC).Methods We retrospectively analyzed the preterm infants who were born and hospitalized at Shengjing Hospital of China Medical University from January,2011 to April,2016.There were 89 cases in total that used at least 2 weeks of parenteral nutrition in the early stage after birth and were developed to cholestasis afterwards.We divided 89 cases into PNAC group and multifactor group:the former was corresponded to PNAC diagnosis standards,accounting for41 cases (46.07％);the latter with other etiology in addition to parenteral nutrition accounts for 48 cases.The clinical characteristics were studied and analyzed using case-control method.Results The sex ratio of premature cholestasis was 2.18:1,the mean gestational age was (31.05 ±2.15) weeks,the mean birth weight was (1360.55 ±421.14) g,and the mean using-time of parenteral nutrition was (26.22 ± 9.78) d.Futhermore,PNAC group was divided into hepatitis group and non-hepatitis group according to the alanine aminotransferase level,and they both had statistical significance in gestational age,starting time of parenteral nutrition,appearance time of jaundice,enteral feeding time,starting dose of amino acid,maximum dose of fat emulsion (P ＜ 0.05).We divided them into long-term group (≥20 d) and short-term group (＜ 20 d) according to the using time of parenteral nutrition.The level of alanine aminotransferase,glutamic oxalacetic transaminase,total bilirubin,direct bilirubin and bile acid of longterm group was higher than those of short-term group,but with P≥0.05.The multifactor group was mostly accompanied with multiple infections in the order of bacterial infection (75.0％),fungal infection (20.83％),cytomegalovirus infection (8.33％) and syphilis infection (2.08％),etc.The other complication's incidence rate of PNAC group and multifactor group had no statistical significance.In terms of prognosis,the liver function of two group improved remarkably than before,with PNAC group having more significance (P ＜0.05).Conclusion PNAC is the major factor of preterm cholestasis,and the degree of liver damage of PNAC preterm was related to starting time of parenteral nutrition,using time of parenteral nutrition,enteral feeding time,starting dose of amino acid and maximum dose of fat emulsion.The liver function of PNAC group is recovered obviously through regulatory treatment,and it possesses a better prognosis than multifactorgroup.