Objective To analysis and conclude the problem of preventing post-operational acute pulmonary embolism. Methods Data from 29 cases of post-operational acute pulmonary embolism,including primary disease ,high risk factors ,process of operation, the coming on of post-operational acute pulmonary embolism,and the problem of prevention . Results There is inadequate attention on the prevention of post-operational acute pulmonary embolism.Conclusions Failing of bring the prevention measures into effect is the reason of the high incidence rate and mortality rate of post-operational acute pulmonary embolism.

Objective To investigate the long-term prognostic factors and the significance of serum cardiac troponin T (cTnT) and C-reactive protein (CRP) in maintenance hemodialysis (MHD) patients.Methods Clinical data of 76 MHD patients in our hospital from January 2002 to January 2003 were retrospectively analyzed.Time and cause of death in the next 10 years were recorded.Survival rate was calculated by Kaplan-Meier and impact factors of long-term prognosis were explored.Significance of cTnT and CRP was elucidated by COX regression analysis.Results CRP was positive in 28 cases (36.8％) and cTnT was positive in 22 cases (28.9％) among 76 patients.The median survival time was 37.9 months,2-year survival rate was 65.9％ and 10-year survival rate was 24.2％.Univariate analysis found positive CRP,positive cTnT,old age,diabetes,cardiocerebrovascular disease,anemia,low serum albumin,Kt/V decline were associated with long-term prognosis.Multivariate analysis showed that increased age (P =0.010),cardiocerebrovascular disease (P =0.048),positive cTnT (P =0.036),positive CRP (P =0.009) were independent risk factors of the 10-year survival of MHD patients.Ten-year mortality of cardiocerebrovascular diseases in positive cTnT group was not significantly different as compared with negative cTnT group (50.0％ vs 35.4％,P =0.248).But the positive cTnT group had higher 2-year mortality than negative cTnT group (40.9％ vs 14.6％,P =0.015).Mortality of cardiocerebrovascular disease was higher in positive CRP group as compared to negative CRP group at both 2-year and 10-year time (48.1％ vs 7.0％,P =0.000; 66.7％ vs 23.3％,P =0.000).Compared with both negative cTnT and CRP group,both positive cTnT and CRP group had much higher all-cause mortality (92.9％ vs 55.6％,P =0.030),higher mortality of cardiocerebrovascular disease at 10-year (64.3％ vs 25.0％,P =0.009),and higher mortality of cardiocerebrovascular disease at 2-year (57.1％ vs 5.6％,P =0.000).Conclusions Aging,cardiocerebrovascular disease,positive cTnT and positive CRP are independent risk factors of long-term prognosis for MHD patients.Positive cTnT can predict cardiocerebrovascular mortality of MHD patients in 2 years,while positive CRP can predict short-and long-term cardiocerebrovascular mortality.Positive cTnT combined with positive CRP may be more valuable in predicting the poor prognosis of MHD patients.

Objective To investigate the change of renal tubular function in elderly patients after use of β lactam antibiotic. Methods The elderly patients with pulmonary infection were treated with β lactam antibiotic,the dosage was 50%-70% of normal use. The renal tubular function indicated by urine α1-MG, β2-MG, pro/Cre, NAG/Cre and glomerulus function marked by eGFR, serum creatinine (Cre)), cystatin C were detected during drugs treatment and 7 days after stopping medications. Results The infection was controlled well in 3-7 days after treatment. Urine α1-MG, β2-MG, pro/Cre and NAG/Cre were abnormal before treatment, were elevated in 3, 14 days after using antibiotic, and came down to the level before treatment on 7 days after stopping treatment. The level of Cre and eGFR was (89.0±25.97) μmol/L and (26.39±8.17) ml/min before treatment, then elevated and decreased in 14 days after treatment, respectively, and down to the level before treatment on 7 days after stopping of antibiotic. Cystatin c was abnormal before treatment and did not change significantly after treatment and after stopping antibiotic. Conclusions It is important to protect renal tubular function and to adjust antibiotic dosage according to eGFR during using antibiotic in elderly patients to control infection.

Objective To evaluate the value of CT scan in diagnosing non-intestinal lesions on the right lower abdomen.Methods CT scan was performed in 70 patients with clinically supected non-intestinal lesions in the right lower abdomen.The diagnosis was confirmed by surgery or biospy in all cases,except 1 case of nephroptosis.Results 41 cases were benign lesions,which appeared as cystic or solid masses with definite bound on plain CT scans and were slight or middle enhanced on contrast enhanced CT scans,but abscess and tuberculosis were showed peripheral or multilocular enhancement with indistinct bound.The remaining 29 cases were malignant masses which presented as large irregular soft tissue mass and inhomogenous enhancement.Conclusion CT scan of certain is value in diagnosis and differential diagnosis of non-intestinal lesions of right lower abdomen.

Thermometry of body by a contact temperature or thermal imaging analysis by infrared radiation (IR)is a routine method in clinical application. Twelve cerebrovascular disease patients and some patients who suffered from joint inflammation,nerve inflammation were examined.The result made clear that the method and the instrument is adaptable to simple and reliable thermal diagnosis for the discovery and premonition of different kinds of diseases and their course and tendency.

Objective To investigate the clinical characteristics and laboratory examinations in incident dialysis effect on the prognosis of elderly patients undergoing hemodialysis.Methods Ninety-three patients aged 65 years or older initiating hemodialysis were enrolled from Hemadialysis Center of Beijing Hospital from January lst,2007 to June 30th,2016.The duration time of HD of all patients was more than three months.Patients were divided into death group and non-death group.The clinical characteristics and laboratory examinations were compared between the two groups.Cox proportional hazards regression was used for the multivariate analysis to determine independent prognosis factors.Results The average year of patients was 74.2±6.5 years old with 43 months of median time of follow-up.The first two causes of death were infection (n =25,49.0％) and cardiovascular and cerebrovascular diseases (n =16,31.4％).Cox single factor regression analysis showed that the older ages,diabetic nephropathy being the cause of end-stage renal disease (ESRD),complicating with diabetes mellitus or congestive heart failure,the higher Charlson cardiovascular diseases score,ALB being under 35 g/L were correlated with poor outcome respectively(P＜0.05).Cox multivariate regression analysis indicated that older ages (HR =1.056,P =0.021),diabetic nephropathy being the cause of ESRD (HR =2.661,P =0.001),the higher Charlson cardiovascular diseases score (HR =1.675,P =0.010),central venous catheters being vascular access(HR=1.167,P=0.048) on incident dialysis were the main risk factors for mortality in elderly patients.Conclusion The older ages,diabetic nephropathy being the cause of ESRD,the higher Charlson cardiovascular diseases score,central venous catheters being vascular access on incident dialysis are independent risk factors influencing survival of elderly patients.

Objective To investigate serum cardiac troponin T(cTnT) and C-reactive protein (CRP) levels and assess the prognostic values of cTnT and CRP of mortality and cardiovascular events in maintenance hemodialysis (MHD) patients. Methods One hundred and six MHD patients were enrolled in this study. Serum cTnT, CRP, creatinine, albumin were measured in pre-hemodialysis at the beginning of the study. The mortality and cardiovascular events were recorded during the period of follow up. Results At the initiation of the study,28 patients (26.42%) were recorded with positive cTnT level, 32(30.19%) with positive CRP and 16 (15.09%) with positive cTnT and CRP. Logistic regression analysis showed a significant correlation between serum cTnT and serum CRP and Scr. Patients with positive cTnT and CRP levels had higher mortality and more cardiovascular events than those with negative levels. Kaplan-Meier survival analysis showed a significant difference between patients with normal and abnormal cTnT and CRP levels. Conclusions Some MHD patients have elevated serum cTnT level. Serum cTnT level is correlated with serum CRP and creatinine level. Patients with positive cTnT and CRP levels have higher mortality and more cardiovascular events than those with negative levels.

Objective To evaluate the effect and complication of inductio n chemot herapy combined with three-dimensional conformal radiation therapy (3DCRT) for l ocally advanced non small cell lung cancer (NSCLC). Methods Ninety-two such pa t ients were randomized into radiation therapy alone group(RT-, 50 patients) and i nduction chemotherapy combined radiotherapy group (CMT-, 42 patients). The indu c tion chemotherapy consisted of 2-4 cycles of platinum-based regimen. Results Th e overall median survival time was 15 months with 12 months in the RT group and 18 months in the CMT group(P=0.014)respectively. The 1-year o verall survival rates were 48.6% and 71.2% in RT and CMT group,respectively (P=0.004). The 2-year survival rates w ere 20.8% and 37.6% in RT and CMT group, respectively (P=0.0 41). Treatment was w ell tolerated and the toxicities were similar in either group. C onclusion The ad dition of induction chemotherapy to 3DCRT takes a survival advantage over 3DCRT alone for Stage Ⅲ NSCLC without increasing toxicities.

OBJECTIVE: To observe the short-term results of Tos modified combined approach tympanoplasty (MCAT) in chronic suppurative otitis media. METHOD: This study is an observational study. The data of 26 patients (28 ears) underwent MCAT were collected. The surgical techniques, complications and preoperative and postoperative air-bone gap (ABG) were analyzed. RESULT: Of 28 ears, 26 ears (92.86%) get dry after surgery. 3 ears (10.71%)repaired tympanic membranes and reperforate postoperatively in which 2 minimal perforations were cured to close up patient treatment. One ear develops posterosuperior retraction pocket and one ear re-occurs cholesteatoma. One ear occurs blunting in the anterior sulcus and one ear has lateralization of the tympanic membrane. There are no hearing worsen and facial nerve palsy. For hearing, the postoperative pure tone threshold is better than preoperation (42.8 +/- 17.97 vs 47.49 +/- 18.01, P < 0.05) and postoperative ABG shrinks significantly (19.76 +/- 7. 49 vs 30.65 +/- 10.02, P < 0.01). CONCLUSION Based on the short-term results, Tos' MCAT can successfully dissect the diseases of tympanic cavity and mastoid and develop a stable aerating middle ear with a complete hearing conduction. It is safe and feasible in the treatment of chronic suppurative otitis media, as well as in the poor-pneumatic mastoid.
Adolescent ; Adult ; Chronic Disease ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Otitis Media, Suppurative ; surgery ; Retrospective Studies ; Treatment Outcome ; Tympanoplasty ; methods ; Young Adult

ObjectiveTo investigate the effects of exogenous transforming growth factor β1 on the apoptosis of nerve cells and its functions following spinal cord injury in rats.MethodsNinety-six male Wistar rats were randomly divided into 4 groups:group A(control group),group B(spinal cord injured group),group C (spinal cord injuried +TGF-β1 treated group),group D (spinal cord injuried +anti-TGF-β1 treated group).The rat model of spinal cord injury was found by the Allen's method.In group C and D,drugs were injected into subarachnoid cavity continuously by minipump.The changes of spinal cord were observed by HE staining.Nerve cells apoptosis was detected by transferase-medi-ated dUTP nick end labeling (TNUEL) method and the expression of cell apoptosis factor Fas by immunohistochemistry staining.Functional recovery of hind limbs was measured by Basso-Beattie-Bresnahan locomotor open field behavioral rating test.ResultsThe expression of TGF-β1and Fas increased following spinal cord injury.The amount of TGF-β1and Fas reached the peak 7days and 1day after injury.The apoptosis of neuron had increased and peaked 8 hours after injury.The apoptosis of neuroglia cells had increased and peaked 7 dayss after injury.The slight changes was found in spinal cord in group C.Both of the number of apoptosis of nerve cells and expression of the apoptosis factor (Fas) decreased significantly; compare with group B and D.The BBB score was higher in group C than that in group B and D.ConclusionTGF-β1 can improve the functional recovery of spinal cord by inhibiting the nerve cell apoptosis after the spinal cord injury.