Child, Preschool ; Female ; Gastrointestinal Diseases ; epidemiology ; etiology ; therapy ; Humans ; Incidence ; Infant ; Male ; Prognosis ; Retrospective Studies ; Sepsis ; complications

Objective:To investigate the effect of amlodipine atorvastatin on blood pressure and blood lipid in the patients with hy-pertension complicated with coronary heart disease (CHD). Methods: Totally 80 cases of outpatients with hypertension complicated with CHD were randomly divided into the observation group (40 cases) and the control group (40 cases). The control group was given amlodipine 10 mg,po,qn, and the observation group was given amlodipine and atorvastatin tablets 20 mg,po,gn, and the treatment course was 6 weeks. The changes of blood pressure and blood lipid in the two groups before and after the treatment were observed, and the clinical curative effect and adverse reactions were also studied. Results:Compared with those before the treatment, systolic blood pressure, diastolic blood pressure and blood fat in the two groups were all improved after the treatment, and the difference was statisti-cally significant (P<0.05), and the improvement in the observation group was more notable than that in the control group (P <0. 05). The total effective rate of the observation group was 92. 5%, which was higher than that in the control group(80. 0%, P<0. 05). The incidence of adverse reactions between the two groups showed no significant difference (P>0. 05). Conclusion: Amlo-dipine atorvastatin tablets can significantly improve blood pressure and blood lipid in the patients with hypertension complicated with CHD with promising clinical curative effect and few side effects, which is worthy of wide use in clinics.

China ; Conservation of Natural Resources ; Electricity

Objective To predict the occurrence of hypoparathyroidism following total thyroidectomy. Methods In this study, 124 patients underwent total thyroidectomy, 46 for thyroid cancer and 78 for multinodular goiter, additional neck dissection was performed on cancer patients. Serum calcium and parathyroid hormone (PTH) levels were examined preoperatively and at 1 h, 1 d and 2 d postoperatively. The occurrence of postoperative hypoparathyroidism was observed. Receiver operating characteristic curve analysis was employed to identify the best indicator to early predict the occurrence of clinical hypocalcemic symptoms. Results Fifty-eight (46.8%) patients suffered from postoperative transient hypoparathyroidism, with 22 ( 47. 8% ) cases in thyroid cancer group and 36 ( 46. 2% ) in multinodular goiter group ( λ2 = 0. 033, P = 0. 857). One (0.8%) patient in cancer group had permanent hypoparathyroidism. 90 patients (72.6%) had postoperative hypocalcaemia, 58 (46. 8% ) had subnormal serum PTH levels, 40 (32. 3% ) had hypocalcaemia symptoms. Postoperative serum calcium (F=21. 358,P =0. 000) and PTH ( F = 18.253, P =0.000) levels decreased more in cancer group than in goiter group.Receiver operating characteristic curve analysis demonstrated that the percentage of serum PTH level decline at 1 h postoperatively was most predictive and 76. 6% decline was the best cut-off value for the occurrence of clinical hypocalcaemia symptoms ( area under the curve being 0.933 ) with a sensitivity of 89. 7% and a specificity of 87.9%. Conclusions Neck dissection added to total thyroidectomy can decrease the postoperative serum calcium and PTH levels more seriously, but may not increase the incidence of postoperative transient hyperparathyroidism. The percentage of serum PTH level decline at 1 h postoperatively predicts the occurrence of clinical hypocalcaemia symptoms.

Adolescent ; Child ; Humans ; Reference Values ; Vitamin D ; analogs & derivatives ; blood ; Vitamin D Deficiency

Objective To establish a reasonable method to evaluate nursing quality with both the quantity and quality of nursing taken into account.Methods Quantity indexes of nursing were analyzed with decision tree method (CHAID)in SPSS18.0,which included the number of patients admitted to wards,first grade' s nursing days,critically ill patients,emergencies,operations,intravenous infusions,intramuscular injections,oxygen inhalations,urinary tract catheterizations,gastric tube catheterizations,enemas and the average turnover rate of beds.After the quantity analysis,the nursing units were divided into different groups according to their workload.Then,we made a comprehensive evaluation of nursing quality with 12 indicators on the same group.Results Decision tree analysis can identify hierarchy relationship of various nursing quantity indicators and high-priority work quantity variables.Furthermore,it can establish the hierarchical rule based on the distribution of high-priority variables,and serve the purpose of classifying nursing units based on nursing workload.Conclusion The decision tree method can provide a same-level nursing workload platform for quality examination.This has minimized the influence of nursing workload discrepancies on nursing quality examination,and made nursing quality more comparable with nursing workload units of the same level,thus a scientific method for comprehensive nursing quality evaluation.

Objective: To investigate the possible pathogenesis and report the postoperative results of the late tricuspid regurgitation (TR) after left cardiac valve replacement. Methods: 56 patients developed severe TR after left cardiac valve replacement, including 10 patients with normal prosthesis valve function (group A) and 46 patients with prosthesis valve dysfunction (group B). Four patients underwent mitral valve replacement (MVR) and 6 patients underwent mitral and aortic valve replacement (DVR) in group A. In group B, 36 patients received MVR, 4 aortic valve replacement (AVR) and 6 DVR. Ten patients underwent tricuspid De Vega annuloplasty and 46 patients' tricuspid valves were normal during the initial operation. The surgical treatment of tricuspid valve included tricuspid valve replacement (TVR) in 9 and tricuspid valve plasty (TVP) in 47 at the second operation. Results: Two patients died postoperatively with hospital mortality of 3.6%. The 54 survivors were followed up from 6 to 132 months, mean 79.4 months. The heart function improved significantly in 8 after TVR and 40 after TVP. However, echocardiography showed moderate TR in 5 and severe TR in 1 patient after TVP and medical treatment was needed. Conclusion: The sustained pulmonary hypertension, irreversible right heart impairment, resumption of left ventricular function and sustained atrial fibrillation may be responsible for the development of late TR after left cardiac valve replacement. TVR may achieve a reliable result for severe functional TR and rheumatic tricuspid valve lesion. In some patients with TVP during the follow up, the TR might become more serious.

Objective To set up a novel clinical method for storage of oocytes by slowly freezing and successful pregnancy by intracytoplasmic sperm injection (ICSI). Methods The frozen oocytes (n=33) in metaphase Ⅱ (28),which were normal in morphology,were denuded of their cumulus-corona complex.The protective freezing solution contained 1,2-propanediol (1.5 mol/L) and sucrose (0.35 mol/L) and the process was slow for freezing and rapid for thawing.The recipients of these oocytes received hormone replacement therapy (HRT). Results A high survival rate of oocytes (32/33) was obtained when the sucrose concentration was 0.35 mol/L.ICSI induced a higher fertility rate (23/28),a good embryo cleavage rate (21/23) and a satisfactory embryo morphology for thawed oocytes.Embryo transfers were performed in 6 cycles/6 cases. Four cases got clinical pregnancy by demonstration of four gestation sacs on B ultrasonic examination 7 weeks after ICSI,1 fetal was first trimester spontaneous abortion,another 3 survival fetal were ongoing pregnancy and the first case gestation week is 17 weeks. Conclusions This study is the first successful application of human oocyte cryopreservation in China and this method can increase the survival rate of freezing oocytes.It’s easy to carry out,low in cost and high in the recovery rate of oocytes after thawing.

OBJECTIVE: To standardize the management on test of hospital preparations to ensure the quality of preparations. METHODS: The Access database and Word application of in Microsoft Office automatic groupware were integrated organically using VBA programming, and the data management system suitable for hospital preparation test was designed. RESULTS: The print files of various primary records and reports related to testing work exhibited beautiful page and uniformed format. Testing data of preparations were included into data base by computer recording, which facilitated data inquiry and data processing related to quality of hospital preparations. CONCLUSION: Due to this system, both the efficiency and quality of hospital preparation test work have been enhanced, which contributes to institutionalization and standardization of hospital preparation work.

Objective To understand the features of lymphatic vessel,and to summarize the foundation and mechanism of the promotion and inhibition of tumor lymphangiogenesis recorded on the current studies of animal ex- periments and clinical researches.Methods The related literatures of the structural features of lymphatic vessel, lymphatic endothelial molecular markers,the origin of lymphatic tumors,the molecular mechanisms and regulatory factors were reviewed,and the relationship between tumor lymphangiogenesis and lymphatic metastasis,the treat- ment targeting at the formation of the anti-tumor lymphatic vessel and its existing problems were also analyzed.Re- suits Hyperplasia of lymphatic vessels occurred during the process of tumor formation and progression.The struc- tural features of the lymphatic vessels in the tumor were conducive to tumor lymphatic metastasis.In recent years, methods of anti-lymphangiogenesis and inhibition of tumor lymphatic metastasis had achieved considerable success in animal experiments.However,there were still a lot of problems need to be solved.Conclusion Tumor lymphangio- genesis has a significantly positive correlation between tumor lymphatic metastasis and patients'prognosis,which may indicate that treatment against the formation of tumor lymphatic vessel maybe effective.