A satisfaction survey carried out by Beijing Chao-Yang Hospital during the Beijing 2008 Olympic Games, found differences of patient satisfaction between locals and overseas patients in consulting environment, outpatient procedure, quality of service, quality of diagnosis and treatment. The patient satisfaction of overseas patients was lower than locals. Especially noteworthy is the low satisfaction of the former for the hospital coloring, privacy in the sector, registration, vocal communication, patient condition statement, nurse attitude and service quality. Real-time improvement in these aspects of medical services has harvested obvious progress. Results of the satisfaction survey provided valuable reference materials for large-scale activities, and ongoing improvement of medical services in the long run.

Objective To evaluate CT in the diagnosis of small bowel obstruction in children. Methods Thirty one cases with small bowel obstruction manifestations on CT and plain radiograph were analysed. The age ranged from 9 months to 14 years, male 17 cases, female 14 cases. There were 29 acute small bowel obstructions, and 2 chronic obstruction. Seven cases had history of previous abdominal operation. Results Corred diagnosis was made in 19 cases and 29 cases respectively by plain film and CT. The accurate etiologic diagnosis could be made by CT in 18 cases, including small bowell stone 4 cases, intussusception, 5 localized infection and adhesion 6 intraluminal bowel duplication, 1 congenital umbilical hernia, congenital malrotation of the intestine 1 case.Combined with history of abdominal operation the accurate CT etiologic diagnosis increased to 25 cases.There were 4 CT false negative cases and 2 plain film false negative cases. Conclusion The CT is obviously superior to plain radiograph in detecting strangulation and gas in bowel wall,better dilineating the transitional segment of bowel stenosis thereby demonstrating the case of obstruction which is very helpful for clinical management.

Objective To evaluate the usefulness of CT and US in the diagnosis of gastrointestinal involvement in children with rheumatoid purpura. Methods Abdominal CT and US findings in 14 cases of clinical and laboratory confirmed of rheumatoid purpura were analyzed. There were 9 males and 5 females with the age ranged from 6 months to 14 years. All patients was hospitalized because of acute abdominal emergency, and the clinical presentations included paroxysm of abdomen pain, vomiting, without skin rashes and subcutaneous hemorrhage. CT examination was done in 7 cases, and contrast enhancement was performed in 1 case. Abdominal ultrasound was done in 9 cases. Both CT and US were done in 2 cases. Results All patients demonstrated multiple or single areas of bowel-wall thickening, localized intraluminal narrowing, mesenteric edema, and liquid in abdominal cavity by CT and ultrasound. Conclusion Abdominal CT and US examination have important values in differential diagnosis of acute abdominal disorders in children patients with rheumatoid purpura. Before appearing skin rashes, classical picture can help for the diagnosis and clinical treatment. Abdominal CT and US examination can also find the intussusception, bowel obstruction, and perforation in rheumatoid purpura.

Objective To evaluate the value and limitation of Gd-DTPA enhanced MRI for neuroblastoma staging in children. Methods Twelve cases of neuroblastoma proved by operation or bone marrow aspiration were examined by gadolinium-enhanced MRI. The age ranged from seven months to five years, mean 3.7 years. Eight tumors originated from adrenal, and four from posterior mediastinum. Conventional sequences, double dose gadolinium-enhanced MRI, and 3D CEMRA were used in all patients. Six cases were examined by CT in same time. Imaging staging on surgic-histopathological-based International Neuroblastoma Staging System (INSS) was performed. Results Six patients were staged by CT, including stage Ⅰ-Ⅱ in 2 cases, stage Ⅲ in 4 cases, and stage Ⅳ in none. Twelve patients were staged by conventional MRI, including stage Ⅰ-Ⅱ in 2 cases, stage Ⅲ in 9 cases, and stage Ⅳ in 1 case. Twelve patients were staged by double dose gadolinium-enhanced MRI, including stage Ⅰ-Ⅱ in 1 case, stage Ⅲ in 1 case, and stage Ⅳ in 10 cases. Conclusion Gadolinium-enhanced MRI was a single best imaging modality for neuroblastoma, most useful for distal to diaphragm metastasis, dumbbell tumor intraspinal extension, and bone marrow metastasis that was not detected by aspirate examination. Enhancement MRI was important in evaluating the therapy and was also helpful in assessing the therapeutic efficacy and relapse. 3D CEMRA helps demonstrate large vascular encasement and tumor erosion into important organs, and it is useful in assessing the respectability. Long examination time and lack in showing the characteristic calcium were the limitations.

Objective To investigate the effects of mechanical stretch on the pelvic floor dysfunction and study the regulation of mechanical stretch on the morphology and extracellular matrix mRNA expression of fibroblasts derived from human uterosacral ligament.Methods 13 patients who underwent hysterectomy surgery due to uterine benign diseases in the Obstetric and Gynecological Department of the Second Hospital of Hebei Medical University from October 2009 to September 2010 and had no pelvic organ prolapse were recruited in this study.Fibroblasts of uterosacral ligament were cultured by collagenase digestion and identified by morphology and immunocytochemical methods.Fibroblasts of 3 ～ 4 generations were stretched by flexcell-4000 tension system for 0,4,15,24 hours.Total RNA was extracted from the fibroblasts and mRNA of Collagen Ⅰ,Collagen Ⅲ,matrix metalloproteinase-1 and tissue inhibitor of metalloprot einase-1were measured with real-time fluorescence quantitative PCR.Results In response to mechanical stretch,the morphology and orientation of the uterosacral ligament fibroblasts were changed as well as their synthetic function.Collagen Ⅰ mRNA for 4 or 15 hours' stretch (0.777 ± 0.251,0.730 ± 0.248)were statistically down regulated compared with 0 hour ( 1.000 ±0.284),( q =4.5786,4.6458,p ＜0.05).But for 24 hours'stretch,the mRNA expression ( 1.102 ±0.308) of collagen Ⅰ restored to the level of 0 hours.The expressions of collagen Ⅲ mRNA for 4,15,24 hours' stretch (4.771 ± 0.879,6.146 ± 1.109,5.022 ± 0.907 )were statistically up regulated compared with 0 hour (1.001 ± 0.284),(q =15.9481,21.7647,17.0099,P ＜ 0.01 ).MMP-1mRNA for 4,15,24 hours' stretch (6.420 ± 2.143,23.695 ± 2.221,20.169 ±2.794) were statistically up regulated compared with 0 hour ( 1.000 ±0.414),( q =9.3421,39.1178,33.0403,P ＜ 0.01 ).TIMP-1 mRNA for 4,15 hours' stretch (0.455 ± 0.370,0.481 ± 0.386)were statistically down regulated compared with 0 hour( 1.000 ± 0.425 ),( q =6.5265,6.3106,P ＜0.05).But for 24 hours'stretch,the mRNA expression( 0.883 ± 0.538 ) restored to the level of 0 hours.Conclusions The morphology,orientation and the synthesis function of the uterosacral ligament fibroblasts can be regulated by mechanical stress.Extracellular matrix remodeling may be adaptive changes due to the mechanical stress.

Objective To investigate the possibility that procalcitonin (PCT) can predict the outcome of ventilator weaning in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods The AECOPD patients caused by bacteria who received mechanical ventilation in intensive care unit (ICU)of the General Hospital of China National Petroleum Corporation in Jilin from January 2010 to March 2014 were retrospectively selected,and their venous blood PCT levels were monitored daily. When they had passed the spontaneous breathing trial(SBT),their breathing machine and trachea cannula were removed. Afterwards they were closely observed for 48 hours and divided into two groups:success and failure groups according to the outcome of the first weaning,and then the analysis of the PCT difference between the two groups was made. Results In the 52 patients enrolled,there were 38 patients in the success group and 14 patients in the failure group. The baseline information as age,sex,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score between the two groups showed no significant difference(all P>0.05). There was no statistical significant difference in PCT level(μg/L) between success and failure groups when they were admitted(5.33±1.35 and 5.37±1.34,respectively). When they were weaning,the PCT levels of both groups had reduced to some extent(1.37±0.39 and 1.74±0.42,respectively), and the success group was lower than that in the failure group(t=2.971,P=0.005). Conclusion PCT level can be used as a predictive index to guide the time for ventilator weaning in patients with AECOPD.

Carcinoma, Medullary ; complications ; pathology ; Humans ; Male ; Middle Aged ; Thyroid Neoplasms ; complications ; pathology

Infection rate and in-hospital treatment were two prognostic factors for SAP recurrence.

OBJECTIVETo explore the mechanisms of Qianjing Decoction in the treatment of oligoasthenospermia (OAS).

METHODSWe randomly divided 100 SPF male rats into five groups of equal number: normal, model, Huangjingzanyu, levocarnitine, and Qiangjing. OAS models were established in the animals followed by intragastrical administration of normal saline, ornidazole, Huangjingzanyu Capsules (200 mg per kg body weight per day), levocarnitine (100 mg per kg body weight per day), and Qianjing Decoction (10 g per kg body weight per day), respectively, qd, for 4 successive weeks. Then, we detected the concentration and motility of the epididymal sperm, obtained the contents of superoxide dismutase (SOD), malonaldehyde (MDA), glutathione peroxidase (GSH-Px), lactate dehydrogenase (LDH), α-glucosidase, and fructose in the epididymis, and determined the mRNA expressions of nuclear factor erythroid 2-related factor 2 (Nrf2) and succinate dehydrogenase (SDH) in the epididymal tissue of the rats by real-time PCR.

RESULTSThe concentration and motility of the epididymal sperm in the model, Huangjingzanyu, levocarnitine, and Qianging groups were (35.34 ± 4.22) x 10(6)/ml and (40.04 ± 7.05)%, (48.12 ± 5.56) x 10(6)/ml and (62.46 ± 7.12)%, (47.14 ± 4.87) x 10(6)/ml and (63.23 ± 6.34)%, and (50.25 ± 5.08) x 10(6)/ml and (66.34 ± 7.58)%, respectively, all significantly lower than in the normal group ([53.05 ± 4.55] x 10(6)/ml and [70.20 ± 8.54]%) (P < 0.05), but remarkably higher in the Huangjingzanyu, levocarnitine, and Qiangjing groups than in the model rats (P < 0.05). Compared with the thinned epididymal lumen walls, decreased sperm count, and disorderly and loose arrangement of the lumens in the OAS models, the rats in the Huangjingzanyu, levocarnitine, and Qiangjing groups showed evidently thicker epididymal lumen walls, with the lumens full of sperm cells and arranged regularly and compactly, similar to those of the normal rats. The levels of SOD and GSH-Px were significantly lower but that of MDA markedly higher in the model rats ([84.12 ± 23.25], [10.56 ± 3.02], and [14.04 ± 2.06] nmol/mg) than in the normal group ([110.04 ± 19.56], [17.25 ± 3.56], and [8.87 ± 1.35] nmol/mg) (P < 0.05), while the former two indexes remarkably higher and the latter one significantly lower in the animals treated with Qiangjing Decoction ([120.56 ± 23.68], [16.34 ± 3.12], and [8.45 ± 1.56] nmol/mg), Huangjingzanyu Capsules ([115.34 ± 21.35], [15.23 ± 3.67], and [8.33 ± 1.54] nmol/mg), and levocarnitine ([116.67 ± 22.67], [15.35 ± 3.45], and [8.05 ± 1.78] nmol/mg) than in the models (P < 0.05). The levels of fructose, LDH and α-glucosidase were decreased markedly in the OAS models ([100.22 ± 12.12] mg/[ ml x g], [322 ± 46.13] U/[ ml x g], and [10.48 ± 2.33] U/[ml x g]) as compared with the normal rats ([128.12 ± 13.45] mg/[ml x g], [428 ± 35.12] U/[ml x g], and [15.34 ± 3.12] U/[ ml x g]) (P < 0.05), remarkably higher in the rats treated with Qiangjing ([130.23 ± 13.67] mg/[ml x g] [455 ± 51.50] U/[ml x g], and [18.56 ± 4.67] U/[ml x g]), Huangjingzanyu ([124.16 ± 14.02] mg/[ml x g], [ 419 ± 43.14] U/[ml x g], and [17.64 ± 4.08] U/[ml x g]), and levocarnitine ([123.34 ± 14.02] mg/[ml x g], [430 ± 31.80] U/ [ml x g], and [16.85 ± 5.55] U/[ml x g]) than in the models (P < 0.05). The Nrf2 mRNA expression was significantly reduced in the models as compared with the normal rats (P < 0.05) but remarkably increased in the Huangingzanyu, Qiangjing and levocarnitine groups as compared with the model and normal animals (P < 0.05). The SDH mRNA expression was significantly lower in the model than in the normal rats (P < 0.05) but markedly elevated in the Huangjingzanyu, Qiangjing and levocarnitine groups as compared with the model and normal animals (P < 0.05), remarkably higher in the Qiangjing than in the Huangjingzanyu group (P < 0.05).

CONCLUSIONOrnidazole induces OAS in rats, which is closely associated with excessive oxidation and energy metabolism dysfunction. Qiangjing Decoction can improve and even reverse ornidazole-induced OAS in rats as well as improve the ultrastructure of their testicular and epididymal tissues. Antioxidation and improvement of energy metabolism are probably the action mechanisms of Qiangjing Decoction in the treatment of OAS.

Animals ; Antioxidants ; Asthenozoospermia ; chemically induced ; drug therapy ; metabolism ; Carnitine ; pharmacology ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; Energy Metabolism ; drug effects ; Epididymis ; metabolism ; Glutathione Peroxidase ; metabolism ; L-Lactate Dehydrogenase ; metabolism ; Male ; Malondialdehyde ; metabolism ; Oligospermia ; chemically induced ; drug therapy ; metabolism ; Ornidazole ; Random Allocation ; Rats ; Sperm Count ; Sperm Motility ; Spermatozoa ; drug effects ; physiology ; Succinate Dehydrogenase ; metabolism ; Superoxide Dismutase ; metabolism ; alpha-Glucosidases ; metabolism

Objective To explore the clinical results and complications of the traditional skeletal traction through olecranon on treating the irreducible humeral supracondylar fracture in children with of ulna.Methods Ninety-eight children patients of humeral supracondylar fracture with failure of reduction manipulation were selected as our subjects.The towel clamp-skeletal traction through olecranon of ulna was applied as the additional treatment methods.Meanwhile 5-24 months' follow-up were performed.Results According to Flynn elbow joint function evaluation standard.The curative effect was as followed.71 patients (74.7％) got the excellent outcome,17 patients (17.9％) for good outcome and 7 patients for improved utcome(7.3％).Therefore,the ratio of excellent operation reached to 92.6％.Conclusion The towel clampskeletal traction through olecranon of ulna might be an effective method to treat reliable fixation regarding of its high curing rate and simple process of performance.