Objective To perform APACHEⅡand SOFA in assessmentof EICU patients with sepsis ,and analyze the risk factors. Methods A retrospective analysis from January 2014 to October 2015 in EICU of our hos-pital ,a total of 83 patients suffered from sepsis ,including sepsis group(30 cases)and septic shock(53 cases). PCT,PT,APTT,lactic acid,mechanical ventilation time and APACHE Ⅱ and SOFA score were collected, through the receiver-operating characteristic curve(ROC)index to predict the prognosis of patients with sepsis.Re-sults The mortality of the patients in the septic shock group,PT,APTT,APACHEⅡ,SOFA score,mechanical ventilation time and PCT were significantly higher than thosein the sepsis group(P<0.001). APTT,APACHEⅡ, SOFA score and mechanical ventilation time had significant difference (P ≤ 0.001) between survival and dead. The lactic acid level of the dead group was significantly higher than that in the survival group(P=0.038). The ar-ea under curve(AUC=0.806)of APACHEⅡscore was better than the SOFA score(AUC=0.765).The outcome of sepsis had correlation with APACHEⅡ,SOFA score,lactic acid,and mechanical ventilation time(P<0.05). Conclusion APACHE II and SOFA scores can accurately predict mortalityoutcome in emergency intensive care units patients with sepsis,especially the APACHEⅡscore.We can measure blood coagulation function,APACHEⅡ,SOFA score,PCT,lactic acid and mechanical ventilation time to assess the severity of patients with sepsis.

Objective To explore and establish the effective model of assessment for residen-cy training. Methods Totally 181 residents completed general specialist stage of resident training of Liaoning province in 2010. Assessment process was designed and implemented for general specialist training stage, including theory exam (basic knowledge, professional knowledge and public knowledge) and objective structured clinical examination (OSCE) (standardized patient(SP), computer-based case simulations(CCS) and clinical skills operation). T test and variance analysis were used and P≤0.05 stands for statistically significant difference. Results The total results consisted of two parts, theory examination results (40.00%) and OSCE results (60.00%) and two students failed the examination. The mean score of OSCE was up to standard (66.58±5.50). The mean score of SP and CCS was close to standard. The mean score of clinical skills operation reached a good level. In terms of the OSCE, SP examination and CCS examination, the performance of residents from the two universities had sig-nificant difference (t=3.818, P=0.000; t=5.581, P=0.000; t=5.419, P=0.013) and the performance of residents from the five hospitals also had significant differences. Conclusions The assessment of standardized resident training is improving gradually. Through the widespread application of OSCE in the assessment;it could be helpful to the clinical training of residents.

Stage assessment is an important part of standardized resident training.After two years of practice and exploration,Liaoning had established the complete examination and evaluation system including the theory test and skill test and this system was future improved through analyzing two years' results and summing up the experiences making it more suitable for residency training in the future.

The aim of this study was to evaluate the effects of compound probiotics on milk performance,blood biochemical indexes,rumen fermentation parameters and nutrient digestibility of Holstein dairy cows in middle-and-later lactation.Forty-eight dairy cows with similar milk yield,days in milk and age were randomly divided into 4 groups treated with four different levels of compound probiotics as follows:the control group (0 g/d),group 1 (10 g/d),group 2 (20 g/d) and group 3 (30 g/d).The adaptation period was 7 days,and the total experimental period was 60 days.Results showed that:compared with the control group,supplementation of compound probiotics could improve milk yield and significantly increase the concentration of milk protein,lactose and total solids (P＜0.05);there was no significant effect on blood biochemical indexes (P＞ 0.05);compound probiotics could significantly increase the content of ammonia and microbial protein content (MCP) in the rumen (P＜ 0.05);the apparent nutrient digestibility of crude protein and crude fat of group 2 was significantly higher than other groups (P＜0.05);compared with the control group,the economic benefits of group 1,2,3 increased 2.28,4.80 and 4.09 yuan/d,respectively.In summary,dietary supplementation with 20 g/d of compound probiotics was the most effective method for milk performance,rumen fermentation parameters,nutrients apparent digestibility and economic benefit of Holstein dairy cows.

Aged ; Anthracosis ; physiopathology ; Humans ; Lung ; physiopathology ; Male ; Middle Aged ; Pulmonary Ventilation ; Respiratory Function Tests

e tissue and myocardium, as well as myocardial uhrastructure were well-improved; the gene expressions of PPAR-α and GLUT4 were raised in APSgroup. APS may be partially effective in treating diabetic cardiomyopathy.

Objective To explore the value of dexamethasone(DEX) for neuronal cell injury and death by observing the effect of DEX on excitatory amino acid(EAA) and monoamine neurotransmitter in cerebral tissue of neonatal rat with hypoxia-ischemia.Methods Hypoxic-ischemic neonatal rat models were established,the levels of EAA and monoamine neurotransmitter in cerebral tissue were analyzed by using capillary electrophoresis and fluorospectrophotometry method.The rats were divided into 4 groups: small dose DEX group pre-treated with DEX(0.5 mg/kg) prior to hypoxia-ischemia,large dose DEX group pre-treated with DEX(10 mg/kg) prior to hypoxia-ischemia,HIE group and shamful operation group.Results The levels of EAA and monoamine neurotransmitter contents in HIE group were significantly higher than those in shamful operation group(P0.05).EAA contents of large dose DEX group greatly decreased compared with HIE group (P

OBJECTIVETo search for an optimum method for testicular prothesis implantation in the treatment of testis loss.

METHODSWe retrospectively analyzed the surgical methods and outcomes of 53 cases of terminal prostate cancer and 4 cases of unilateral testicular torsion treated by implantation of testicular prothesis with the polypropylene mesh.

RESULTSThe 57 male patients all received testicular prothesis with the polypropylene mesh. All the patients were satisfied with the appearance and size of the scrotum after surgery. No scrotal hematoma, prosthesis infection, or autoimmune disease occurred postoperatively.

CONCLUSIONTestis loss is not a rare condition clinically, for the treatment of which surgical implantation of testicular prothesis with the polypropylene mesh can achieve both a fine tissue compatibility and a desirable scrotal appearance.

Humans ; Male ; Polypropylenes ; Prostatic Neoplasms ; surgery ; Prostheses and Implants ; Retrospective Studies ; Scrotum ; Spermatic Cord Torsion ; surgery ; Surgical Mesh ; Testis

AIMTo establish HPLC chiral separation method for ketoprofen enantiomers by using Chirobiotic V chiral seperation phase (CSP) (A) and vancomycin as chiral mobile phase additives (B).

METHODSThe separation was first performed on Chirobiotic V CSP with the mobile phase of terahydrofran (THF)-0.5% triethylanine acetate(TEAA) buffer (15:85) at the flow rate of 0.7 mL.min-1. When using vancomycin as chiral mobile phase additive, the separation was carried out on C8 column (150 mm x 4.6 mm), the mobile phase was methanol-0.25% TEAA buffer (50:50), the flow rate was 0.7 mL.min-1. The effects of the concentration of vancomycin, organic modifier and the pH of the buffer on the resolution of ketoprofen enantiomers were investigated. Also, the feasibility of these two methods to be used as quantitative method was studied.

RESULTSKetoprofen enantiomers were separated at a baseline level under the chromatographic condition of both methods A and B, the resolution was 2.28 and 2.22, respectively. In method A the linearity of enantiomer was obtained from 0.5 mg.L-1 to 100 mg.L-1, the detectionlimit was 1 microgram.L-1. When using vancomycin as mobile phase additive the system was shown to have a high efficiency. In this system, the assay of enantiomer is linear from 2.5 mg.L-1 to 250 mg.L-1. The detection limit was 14.5 micrograms.L-1.

CONCLUSIONBoth methods can be used to detect optical purity of S-(+)-ketoprofen.

Anti-Inflammatory Agents, Non-Steroidal ; isolation & purification ; Chromatography, High Pressure Liquid ; Hydrogen-Ion Concentration ; Ketoprofen ; isolation & purification ; Stereoisomerism ; Vancomycin ; chemistry

Objective To assess the safety and efficacy of a novel technology referred to as percutaneous ureteroscopic laser deroofing in the management of renal cysts.Methods From November 2014 to August 2016,59 patients having surgical indications with renal cysts were enrolled and evaluated by ultrasound and CT scan.Of all the 59 patients,36 were males and 23 were females.Their mean age was 46 years (ranging 35-64 years).41 patients complained about the reported flank and abdominal pain.18 patients were found by imaging examination.Their mean diameter of cyst was 6.3cm(ranging 4.9-9.1cm).In regards to the 59 patients,include 6 patients suffered with parapelvic cysts and 4 patients suffered with renal cyst complicated with ipsilateral renal calculi.Their mean stone surface area was 5.7 cm2 (ranging 3.4-9.8 cm2).All of the patients received combined spinal and epidural analgesia or paravertebral nerve block anesthesia.Patients were placed in the prone position for percutaneous puncture and tract dilation.Under ultrasound guidance,an eighteen gauge needle was placed inside the cyst cavity percutaneously,a metal guidewire was introduced followed by sequential dilation up to F26-28.9.8F rigid ureteroscope was inserted through the Amplazt access sheath and advanced into the cyst cavity.Then sheath and ureteroscope both returned to the exterior cyst together.Cyst wall was dissociated from perirenal adipose tissue by used ureteroscope.A majority of the collapsed cyst wall was grasped and gently pulled towards the Amplazt sheath interior using grasping forceps and incised using either Thulium (Power 40 ～50W) or Holmium laser(Power 60 ～70W) and was taken for pathological examination.Nephrostomy tube was left in place for 2-3 days and removed before discharge.For parapelvic cysts patients,ureter stent was inserted into the renal pelvis i n the dorsal lithotomy position firstly.Patients were then placed in the prone position for percutaneous puncture and tract dilation.Laser was used to incise cyst wall towards identified pelvis to create a permanent communication between the cyst and adjacent renal collecting system.F6 double-J stent was inserted into the cyst cavity at the end to prevent auto-closure for at most two months.F22 nephrostomy tube was left in renal pelvis for two weeks.For renal cyst complicated with ipsilateral renal calculi patients,a puncture was created targeting the stone through the cyst,after fragmenting and extracting the stone,the same laser was used to deroof the cyst.More than 50％ reduction in cyst volume was considered a success.The perioperative complications,hospitalization days and the effective rate of surgery were evaluated.Results All operations were conducted without intraoperative complications such as bleeding,urinary leakage or injury of the renal parenchyma and the adjacent organs.The hospital stay after the surgery was 2-4 days (mean 2.5 days).After 3-12 months follow-up (mean 8.1 months),patients underwent imaging examinations.42 out of 59 cases were completely resolved,15 were reduced to less than 50％,the total effective rate for the operation is 96.6％ (57/59).4 patients with ipsilateral renal calculi were completely clear.However,two cases failed probably due to incomplete resection and follow treated with laparoscopic renal cyst deroofing.Conclusions Percutaneous ureteroscopy renal cyst laser deroofing is a safe,effective,less invasive,which can be performed in any endourological center without the need of special instruments and training.