Objective To investigate the diagnosis and treatment of cystic renal cell carcinoma.Methods The clinical data of 67 cases of cystic renal cell carcinoma treated from January 2005 to April 2013 were analyzed retrospectively.Preoperative imaging procedures indicated masses of renal cysts in 67 cases,including malignant tumors in 59 cases.Intraoperative pathological examination was performed in 59 cases and the pathological results showed malignant tumors in 56 cases,renal cyst in 2 cases and multilocular cyst of kidney in 1 case.The surgical procedures included radical nephrectomy (n=19),partial nephrectomy (n =12),retroperitoneal laparoscopic radical nephrectomy (n =9),retroperitoneal laparoscopic partial nephrectomy (n =20),retroperitoneal laparoscopic cyst unroofed then transferred to radical nephrectomy (n =6),and retroperitoneal laparoscopic partial nephrectomy transferred to radical nephrectomy (n =1).Results The 67 cases were diagnosed as renal carcinoma,including clear renal cell carcinoma with cystic changes in 31 cases and multilocular renal cell carcinoma in 36 cases.Sixty-two cases were followed up for 10-110 months (median 56 months),and there was no recurrence or metastasis,among which 7 cases diagnosed as benign pre-operation or intra-operation but malignant by pathological examination after surgery were followed up for 61-103 months (median 82 months).Conclusions Imaging plays an important role in the early diagnosis of cystic renal cell carcinoma.Intraoperative pathological examination should be performed in suspected cases.Nephron-sparing surgery is preferred with good outcome.

Objective To explore influence and variation of smoking and occupational exposure to air pollution on lung function.Methods Ninety eight sanitation staffs from Panyu District were divided into smoking and non-smoking sanitation groups; and all subject accepted the Chronic Obstructive Pulmonary Disease Assessment Test (CAT) scales,questionnaires,lung function test,and data statistical analysis.Healthy people accepted health examination from Guangzhou Panyu medical health center were used as the control group.Results (1) Forced expiratory volume in the first second (FEV1％),forced expiratory volume in the first second/ forced vital capacity(FEV1/FVC),maximal expiratory flow in 50％ vital capacity (FEF50％),maximal expiratory flow in 75％ vital capacity (FEF75％),maximal mid-expiratory flow (MMEF) of non-smoking sanitation group was significantly lower than non-smoking healthy group (P ＜ 0.01).(2) Abnormal rates of FEF50％,FEF75％,and MMEF of non-smoking sanitation group were significantly higher than non-smoking healthy group (P ＜ 0.01).(3) Abnormal rates of FEF50％,and FEF75％ of sanitation group were significantly higher than healthy group with or without smoking.(4) Abnormal rates of FEV1％ and FEV1/FVC did not have significant difference between non-smoking sanitation group and non-smoking healthy group,but had significant difference between non-smoking and smoking healthy groups.It means smoking and occupational exposure had different impacts on pulmonary function.(5)Moderate score of nonsmoking sanitation group and smoking healthy group were significantly higher than non-smoking healthy group by P =0.049 and P =0.001,respectively.Conclusions Occupational exposure to air pollution and smoking can lead to small airway damage,which was not as obvious as pulmonary function changes.It is necessary to regularly monitor lung function for sanitation staffs who risk occupational exposure to air pollution.Increasing physical exercise would benefit to improve sport lung endurance of the people in our country.

Objective To explore the change trend and antimicrobial resistance of pathogens causing infection in extensive burn patients,and provide reference for clinical prevention and treatment.Methods Specimens from 9 extensive burn patients who were admitted to a hospital at the same time were performed pathogenic culture and an-timicrobial susceptibility testing, change trend and antimicrobial susceptibility of pathogens were observed. Results The main specimen was wound secretion,accounting for 93.81 %.The major pathogens causing infection were Acinetobacter baumannii (44.85%),Staphylococcus aureus (32.47%),Pseudomonas aeruginosa (12.37%), and Klebsiella pneumoniae (5.15%).With the prolongation of hospital stay,pathogens changed from one kind to multiple strains, and from susceptibility to resistance,multidrug resistance,and extensive drug resistance. Conclusion Itis difficult to avoid infection in burn patients,timely realizing the changes of pathogens causing infec-tion and antimicrobial resistance play an important role in the control of infection.

Early diagnosis and intervention is an important way to delay the progress of Alzheimer′s disease (AD).Compared with cerebrospinal fluid, blood sampling is not invasive and easy to be obtained in clinic practice.In this study, the serum samples of 9 controls, 10 AD and 12 mild cognitive dysfunction (MCI) patients were analyzed and compared through one by one analysis to screen potential markers for AD diagnosis.The experimental results showed that VGFYESDVMGR of α-2-macroglobulin peptide was closely related to the late stage of AD disease, and the large amount degradation of apolipoprotein C-Ⅲ, histone H1.2 and histone H1.4 was significantly related to early stages of AD progression.The characteristics of serum peptidome were different for the early and late AD, and these four proteins may be used as potential biomarkers of AD disease.In addition, the obvious ladder sequence characteristic was observed for apolipoprotein C-Ⅲ and histone H1, which could partly explain why the peptides distribution in different samples was somewhat contingent.On the contrary, the distribution at protein level was more stable.Finally, it was confirmed that the peptides of proteins such as fibrinogen α-chain, thymosin β-4 and patchy proteins were the dominant peptides in all serum samples.Overall, this study showed that the method of using serum peptidomics to diagnose AD was possible.The results may provide evidence and references for the large-scale clinical validation of AD.

Objective To investigate the occurrence of central venous catheter-related bloodstream infection(CRB-SI)in mass severe burn patients,evaluate related risk factors for infection,and effectiveness of prevention and con-trol measures.Methods In August 2014,9 cases of severe burn patients were rescued in a hospital,all patients re-ceived CVC,infection prevention and control intervention measures were performed during the whole process of catheterization.Results All patients received 30 episodes of CVC,total CVC-days were 227 days,bacterial culture for three-cavity catheters of femoral veins in 2 patients were positive,incidence of CRBSI was 8.81 ‰;1 patient was isolated Enterococcus faecium ,1 isolated both Acinetobacter baumannii and Stenotrophomonas maltophilia .2 CRB-SI patients received femoral vein catheterization,catheterization site was trauma surface,duration of catheterization were both ≥7 days,both used three-cavity catheters,and third degree burns were ≥60%,both patients were cured after timely removal of catheters and receiving of antimicrobial agents.Conclusion CVC is helpful for long term, safe and effective fluid infusion,but it can cause CRBSI;infection prevention and control intervention for patients receiving CVC during the whole process of catheterization can reduce the occurrence of CRBSI.

According to the infection characteristics of batches of patients with extensive burns in dust explosion, the article focused on the concept and mode of whole-range fine management.Based on the characteristics and rules of infection prevention in bat-ches of patients with extensive burns, the measurement and examination of infection management were refined, the infection monitoring indexes were designed scientifically, the infection prevention scheme and monitoring table were formulated.By early and whole-range intervention of infection prevention, quantitative evaluation, fine management and precise control at different times, all levels of infec-tion management teams could fully serve their purposes in order to realize effective infection prevention.

Background and Objectives: Stroke mimics are medical conditions producing stroke-like symptoms but eventually get diagnosed as non-stroke diseases. Epileptic seizure is a common type of stroke mimic. The purpose of this study is to investigate the application of emergency multimodal computed tomography (CT) in the diagnosis of epileptic seizure. Methods: We retrospectively reviewed the case group of patients with suspected stroke in the emergency stroke care service of the First Affiliated Hospital of Suzhou University from September 2017 to October 2019. We included those who underwent multimodal CT, including non-contrasted cranial CT, CT perfusion with CT angiography, and were ultimately diagnosed as epileptic seizures. Ten patients with acute anterior circulation ischemic stroke were assigned as controls. Results: A total of five cases met the inclusion criteria. Multimodal CT was completed within 2.25 to 3.50h from symptom onset. On CT perfusion, hyperperfusion was shown in four cases and slightly increased perfusion in one case with epileptic seizures. Cerebral blood flow and cerebral blood volume were significantly increased, while time to peak and mean transit time decreased in the regions of interest of the epileptic hemisphere when compared to either the non-affected hemisphere or the ischemic area in the control group (P<0.05). The abnormal perfusion areas did not follow vascular territory supply and CT angiography did not show vessel occlusion in the case group. Conclusion: Emergency multimodal CT could be used effectively to differentiate epileptic seizure from stroke.

Objcetive To investigate the relationship between blood β-hydroxybutyric acid and urine ketone in the di-agnosis of diabetic ketosis (DK). Methods Peripheral blood β-hydroxybutyric acid and urine ketone were detected when the peripheral blood glucose was more than 13.9 mmol/L in patients with diabetes. Results (1) In 81 diabetes pa-tients with blood glucose more than 13.9 mmol/L, the incidence of DK was 13.58% and the incidence of diabetic ke-toacidosis (DKA) was 9.88%. (2) The peripheral blood glucose was positively correlated with β-hydroxybutyric acid (r=0.330, P=0.003), but it was not correlated with urine ketone. (3) The peripheral blood β-hydroxybutyric acid was posi-tively correlated with urine ketone (r=0.516, P=0.000). (4) In patients with DK or DKA, 5.26%(1/19) of those were with urine ketone(-) or (+-), whereas 36.84% (7/19) of those were with blood β-hydroxybutyric acid less than 1 mmol/L. (5) When urine ketone was used as the reference test for diagnosis of DK, the optimal value of blood β-hydroxybutyric acid was 0.35 mmol/L. Conclusion For missed diagnosis of DK may be happend if blood β-hydroxybutyric acid or urine ketone is used alone, the co-monitoring of blood β-hydroxybutyric acid and urine ketone can reduce the inci-dence of missed diagnosis of DK. The urine ketosis may have existed when the blood β-hydroxybutyric acid is slightly elevated (≥0.35 mmol/L). In the situation, the urine ketone should be tested in order to avoid missed diagnosis of DK.

Objective To translate English version of sensory-motor profile awake ( SMP-a) into Chinese version (the Chinese Version of SMP-a),and analyze the reliability and validity of the scale before and after craniotomy under awakening anesthesia. Methods Eighty-one patients whose tumors were located near or already in sensory-motor functional area were included in this study. Before and after awake cranioto-my,the Chinese version of SMP-a was used to accurately assess the sensory-motor function of each patient. Finally, the reliability and validity of the scale were analyzed by SPSS statistical software. Results Cronbach's α coefficient in the Chinese version of SMP-a was 0. 971,and Cronbach's α coefficient in the four subscales of face,hand,leg and sensation was 0. 965,0. 989,0. 981 and 0. 970,respectively. The test-retest reliability of the Chinese version of sensorimotor assessment scale was 0. 910,0. 904,0. 884,0. 898 and 0. 695 (total,face,hands,legs and sensory score respectively). The raters' consistency reliability was above 0. 949,0. 960,0. 934,0. 887 and 0. 660,respectively. The Pearson correlation coefficients of sensorimotor function score with SF-36 physiological function factors and KPS score were 0. 868 and 0. 790,respectively. Conclusion Before or after operation,the Chinese version of SMP-a has preferable reliability,internal con-sistency reliability and structural validity. It is feasible in awakening anesthesia craniotomy,and the degree of damage can be determined by repeated measurement of the sensorimotor sites that may be impaired by the patient.

Objective To evaluate the clinical and pathological features of patients with prostate cancer who were diagnosed by single positive core biopsy and treated by radical prostatectomy (RP).Methods Between July 2012 and June 2016,164 patients with prostate cancer diagnosed by single positive core biopsy underwent RP.The mean age was 66.3 years old (ranged 41-82 years old),and the mean PSA level was 12.3 ng/ml (ranged 0.6-59.5 ng/ml).The biopsy Gleason score showed 6 scores in 113 cases,3 + 4 =7 scores in 21 cases,4 + 3 =7 scores in 18 cases,≥8 scores in 12 cases.Clinical stage was cT1 in 71 cases,cT2 in 92 cases,and cT3 in 1 case.The patients were divided into subgroups according to age,preoperative PSA level,biopsy Gleason score and clinical stage,and the pathological results were compared among these subgroups.Results Of the 164 patients,67 cases had Gleason score ≤ 6,52 cases Gleason score 3 + 4 =7,24 case Gleason score 4 + 3 =7,and 11 cases Gleason score ≥ 8.Ten patients had pT0 disease according to the RP specimen,3 had extraprostatic extensions,5 had seminal vesicle invasions,and 24 had positive surgical margins.Compared to the biopsy,the Gleason score of RP specimens was higher in 53 cases,concordant in 77 cases,and lower in 24 cases.There was no significant difference in the postoperative pathological features between the age group ＜ 70 years and the group ≥ 70 years.Compared with PSA ＜ 10 ng/ml,the likelihood of postoperative Gleason score ＞ 7 was significantly increased in PSA ≥10 ng/ml group [41.4％ (36/87) vs.66.2％ (51/77),P＜0.05].When the biopsy Gleason score was divided into four groups (6,3 + 4 =7,4 + 3 =7,≥ 8),there were significant differences in postoperative pathological stages among the four groups (P ＜ 0.05),and the patients with biopsy Gleason score 6 were more likely to have no residual cancer (stage T0) when compared with other Gleason scores [8.8％ (10/113) vs.0,P =0.09].The probability of no residual cancer in clinical T1 stage patients was significantly higher than that in T2 stage [11.3％ (8/71) vs.2.8％ (2/92),P =0.02],while the probability of Gleason score upgrading was significantly lower [23.9％ (17/71) vs.39.1％ (36/92),P ＜ 0.05].Conclusions Most single core prostate cancer have clinically significant disease.The treatment plan must be evaluated individually for patients with single core prostate cancer.