Adenine ; analogs & derivatives ; therapeutic use ; Adult ; Hepatitis B Surface Antigens ; blood ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; blood ; drug therapy ; Humans ; Male ; Organophosphonates ; therapeutic use ; Recurrence ; Treatment Outcome

Objective To investigate the diagnostic points of multiple sclerosis and multiple metastatic encephaloma.Methods Choose a case of multiple sclerosis,which had been misdiagnosed as multiple metastatic encephaloma and operated on,to analyse its reasons of misdiagnosis.Results Reasons for the misdiagnosis:The neglect of the importance of the disease history.The scant knowledge of the early represen- tations of the atypical MS(demyelinating pseudotumor).The lack of the knowledge of the non-demyelinating lesions of the MS.The lack of attention to the different representations of the MRI scan between the acute MS and the multiple metastatic encephaloma.The excessive importance is attached to the imageological report. The neglect of the routine examination of cerebrospinal fluid.Conclusion When multiple metastatic en- cephaloma develops,the differential diagnosis of MS should be made.The further examinations should be done to those cases which are hard to tell the difference with metastatic encephaloma by clinical and imageo- logical representations.Try to avoid undergoing surgery or radiotherapy hastily.

0.05 ).But the difference of positive ratio between 1-year-old group was significant in 6 cases of B19 DNA positive (P0.05).Conclusion There are no markedly association between kawasaki disease and human parvovirus B19 infection.

Based on the quality of students, we reasonably arranged thetraining course content and enhanced the training of clinical skills; and at the same time focused on teacher training of general practitioners to strengthen the training bases, so as to improve the overall construction of teaching effect, to adapt to the actual medical need of the community and improve community medical service level to achieve the purpose of general practitioners training.

Animals ; HSP72 Heat-Shock Proteins ; metabolism ; Hypoxia ; metabolism ; physiopathology ; Male ; Motor Activity ; physiology ; Muscle, Skeletal ; metabolism ; Oxygen ; metabolism ; Physical Exertion ; physiology ; Rats ; Rats, Sprague-Dawley ; Time Factors

sis were given.

Adult ; Combined Modality Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Infectious Disease Transmission, Patient-to-Professional ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Severe Acute Respiratory Syndrome ; therapy

OBJECTIVETo investigate the clinical efficacy of cannulated screw fixation with percutaneous Poking reduction for the treatment of Sanders II, III calcaneal fracture.

METHODSFrom January 2012 to January 2014, 19 patients with Sanders II, III calcaneal fracture were treated with cannulated screw fixation with percutaneous Poking reduction. There were 14 males and 5 females, ranging in age from 19 to 58 years old, with an average age of (38.3 +/- 4.1) years old. The changes of Bohler angle and Gissane angle were measured and compared preoperatively and postoperatively to observe the recovery of the articular surface. The Maryland Foot Score was used to evaluate operation outcomes.

RESULTSAll the patients were followed up, and the duration ranged from 12 to 28 months with a mean of (22.3 +/- 5.3) months. The Bohler angle and Gissane angle were improved significantly after operation compared with those before operation (P < 0.05). The Maryland score was 83.2 +/- 8.4.

CONCLUSIONTreatment of calcaneal fractures with screw fixation with percutaneous Poking reduction has several advantages such as satisfactory outcome,less damage, fewer complications, quicker recovery, and shorter hospital stay,and it is one of the effective treatments for Sanders II and III calcaneal fractures.

Adult ; Bone Screws ; Calcaneus ; injuries ; surgery ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

Objective:To investigate the prognostic value of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and prognostic nutritional index (PNI) before radiation in pancreatic cancer patients underwent radiation therapy. Methods:Clinical data of 61 patients with pathologically confirmed pancreatic cancer were retrospectirely analyzed. Query index values for each patient were clinically tested through electronic medical records. Overall survival (OS) data were collected through electronic medical records or telephone follow-up. Survival curves were compared using Kaplan-Meier methodology and log-rank test. Cox regression methodolo-gy was used for univariate analysis. Results:Using log-rank test and univariate regression analysis, we found that patients with lower NLR, PLR, CA19-9, increased PNI, and lower TNM-staging lived longer than those with increased NLR, PLR, CA19-9, lower PNI, and high-er TNM-staging, and that the difference was statistically significant. Through multivariate analysis, we found that NLR (P=0.029, OR 2.344, 95%CI:1.090-5.041) and PNI (P=0.026, OR 0.477, 95%CI:0.248-0.917) were independent predictors of OS in patients with pan-creatic cancer. Conclusion:NLR, PLR, and PNI are simple, effective, and reliable indicators for evaluating the prognosis of pancreatic cancer.

Objective To evaluate the effect of dexmedetomidine administered locally on the median effective concentration ( EC50 ) of ropivacaine for paravertebral nerve block ( PVNB) . Methods Forty?eight ASA physical status Ⅰ or Ⅱ female patients, aged 20-64 yr, with body mass index<24 kg∕m2 , scheduled for elective unilateral segmental mastectomy under PVNB, were randomly divided into 2 groups ( n=24 each) using a random number table: ropivacaine group ( group R) and ropivacaine mixed with dexmedetomidine group ( group RD) . PVNB was performed at T4 on the operated side guided by ultrasound and nerve stimulator. Ropivacaine 20 ml and a mixture of ropivacaine and 20 μg dexmedetomidine 20 ml were injected locally in group R and group RD, respectively. The concentration of ropivacaine was determined by up?and?down sequential allocation. The initial ropivacaine concentration was set at 0. 35%, and the ratio between the two successive concentrations was 1. 2. The EC50 and 95%confidence interval of ropivacaine were calculated using Dixon?Massey method. Results The EC50 ( 95%confidence interval) of ropivacaine was 0.27% (0.23%-0.30%) and 0.22% (0.18%-0.25%) in group R and group RD, respectively. Compared with group R, the EC50 of ropivacaine was significantly decreased by 19% in group RD. Conclusion Small dose of dexmedetomidine administered locally can significantly enhance the efficacy of PVNB with ropivacaine.