Objective To explore the causes of the misdiagnosis of spontaneous rupture of spleen.Methods 8 cases of spontaneous rupture of spleen during 1986～1998 were reviewed retrospectively.Results 5 cases were misdiagnosed, with the misdiagnosing rate of 62.5%.Conclusion For unknown upper bellyache accompanied with unexplainable loss of blood and with no history of trauma,the patients should be examined by B ultrasound or abdominal puncture should be peformed.If there is pathological process of liver and spleen such as schistosoma and hepatitis or the excessive functioning of spleen,the more attention should be paid to the occurrence of spontaneous rupture of spleen.Furthermore,the increase of the belly pressure caused by satiation or hard labour helps to diagnose such case.

OBJECTIVE:To study the consistency policies of generic drugs in China,America and Japan comparatively,and provide reference for perfecting quality and efficacy consistency evaluation of generic drugs in China. METHODS:Generic drugConsistency evaluationQuality evaluationDESIwere used as keywords to search the related literatures or information of ge-neric drugs published or reported in CNKI,Web of Science,Elsevier,Springer database and USA FDA website during Jan. 1st, 1950-Jun. 30th,2016. And comparative analysis was conducted for the historical background,evaluation methods and policy influ-ences of consistency policies of generic drugs in China,America and Japan. RESULTS:There were differences in the historical background,evaluation methods,major participants and policy influences of consistency policies of generic drugs in China,Ameri-ca and Japan. The evaluation for generic drugs in USA was reevaluation of the drugs effectiveness under the history of drug registra-tion regulation was imperfect. With experts'review,it was evaluated based on FDA,enterprises,scientific literature evidence and experts review. Main evaluation method was in vitro dissolution test in Japan. The consistency evaluation of generic drug in China focused on the generic drug marketing authorization,mainly using in vivo bioequivalence. And the standards of reference prepara-tions were from the basically similar drugs to the original drugs. CONCLUSIONS:Compared with innovation-based countries like America and Japan,the availability of reference preparations in China is low,and policy environment is more complex. China should further improve the laws and regulations,giving reasonable buffer period,considering the diversity of evaluation methods, exemptions in special circumstances and current situation of pharmaceutical industry,paying attention to the balance between techni-cal supervision and system supervision.

In order to quickly and accurately identify the onset and offset of the QRS complex in electrocardiogram (ECG) signal with different forms, a triple local transform method was employed in the present study to detect the suspected onset and offset points of QRS. The accurate onset and offset points of QRS complexes were selected according to the rules drawn by the trial process based on the characteristics of angle and amplitude constituted within these suspected points. The method makes full advantage of the angle and amplitude characteristics of the QRS complex, by which the results can be acquired with some simple arithmetic quickly, accurately and adaptively. The method was investigated with data from the MIT-BIH arrhythmia database and satisfactory results were obtained.
Algorithms ; Arrhythmias, Cardiac ; diagnosis ; Databases, Factual ; Electrocardiography ; Humans ; Signal Processing, Computer-Assisted

Embryonic Stem Cells ; Humans ; Myocardial Infarction ; therapy ; Stem Cell Transplantation

Objective To explore the Caprini risk assessment model for the application of the prevention of VTE in clinical nursing. Methods With a cross:sectional survey research, 6 624 patients were interviewed of a hospital from March to June in 2015.The Caprini risk assessment model was used to screen patients with VTE risk assessment. Results Patients have VTE risk in 6 229 cases, accounting for 94.04%. The patients of low risk, moderate risk, high risk, and super high-risk was 1 889 cases, 1 507 cases, 1 930 cases, 903 cases, accounted for 28.52%, 22.75%, 29.14%and 13.64%respectively. Surgical patients with VTE risk, low risk, moderate, high risk and super high-risk rate was 5.15% (79/1 533), 15.72%(241/1 533), 28.77%(441/1 533), 30.59%(469/1 533), 19.77%(303/1 533), the no-surgery group were 6.21% (316/5 091), 32.37% (1 648/5 091), 20.94% (1 066/5 091), 28.68% (1 461/5 091), 11.79%(600/5 091), two groups compare was statistically significant (χ2= 53.46, P = 0.000); High-risk ratio of trauma surgery,thoracic surgery, neurosurgery, orthopedics, mammary gland and thyroid surgery were63.2%、62.9%、61.5%、58.3%、55.8%; High-risk ratio of oncology medical, respiratory medical, neurology medical, cardiology medical were 92.0% , 68.2% , 55.9% and 64.4% . Conclusions Hospitalized patients have high risk of VTE, it is suggested that include VTE in nursing quality evaluation standard, establish an effective system of VTE risk management. Caprini risk assessment model has been clear about the VTE patients should be special attention, and has been great significance to early screening and prevention of VTE.

OBJECTIVE To investigate the associated risk factors for the infected patients in respiratory intensive care unit(RICU) and to study the resistance of isolates.METHODS To study the bacterial spectrum and drug resistance test of all the patients with hospital acquired infection from Jan to Dec 2005.Identification and antimicrobial susceptibility were determined with the methods of API and K-B,respectively.RESULTS A total of 265 strains were isolated from 117 patients,the rate of isolation of Gram-negatives was the highest(74.3%),the species were predominated by Pseudomonas aeruginosa,Acinetobacter baumannii and Klebsiella pneumoniae,the rates of isolates were 28.68%,23.02% and 5.66%,respectively.The predominated species of Gram-positives was Staphylococcus aureus.Gram-negative bacilli were susceptible to imipenem and meropenem,there were not vancomycin-resistant strains.CONCLUSIONS It is important to realize the associated risk factors of infected patients in RICU and to promote the rational use of antimicrobial agents.

OBJECTIVE To investigate the resistance of Staphylococcus aureus,includ MRSA and MSSA,to antimicrobial agents in intensive care unit(ICU),and to provide basis for clinical therapy.METHODS K-B disk diffusion method was used to determine the drug susceptibility of 171 strains of S.aureus,and meticillin-resistant S.aureus(MRSA) was detected by using the disk diffusion method according to NCCLS/CLSI.RESULTS In ICU,S.aureus was isolated mostly from the respiratory tract,urine tract and blood.MRSA made up 57.89%.For MRSA and MSSA,no resistance against vancomycin and norvancomycin was observed.The resistance rates of MRSA to other agents were as follows: chloramphenicol 20.45%,and minocycline 20.45%.While the resistance rates of MSSA to other agents were as follows:cefazolin 6.25%,and amikacin 6.25%,minocycline 9.38%.CONCLUSIONS MRSA shows the multidrug resistance.Pathogenic monitoring,keeping the patients apart,rational utilization of antibiotics,medical facility sterilization strictly and intensive hand hygiene are very important to prevent MRSA infection.

BACKGROUND:Anterior cruciate ligament is the important anatomic structure to maintain the knee joint stability. The tendon bone healing and clinical functional recovery after anterior cruciate ligament have attracted more attention. OBJECTIVE:To observe the healing of graft tendon and surrounding bone with histological method through the same diameter grafts matching with the bone tunnel of different sizes in the anterior cruciate ligament reconstruction surgery, and to detect the functional recovery with biomechanics. METHODS:Middle 1/3 of canine autologous tendon was selected as the anterior cruciate ligament graft, and then trimmed into the same diameter of 4 mm. Sixteen adult mongrel canine were randomly divided into four groups. The anterior cruciate ligament was resected completely, and the tibial and femoral tunnels were prepared on the end sites of tibia and femur with the diameters of 5, 4.5, 4 and 3.5 mm, then implanted into the tendon in prepared and linked into the bone tunnel. At 6 weeks after reconstruction, the experimental canine were sacrificed under general anesthesia to col ect the tissue and organs in the surgical area. Then the hematoxylin-eosin staining, biomechanical testing and statistical analysis were performed. RESULTS AND CONCLUSION:At 6 weeks after anterior cruciate ligament reconstruction, anatomical observation showed that there were no significant differences in growth of grafts and bone tunnels between groups;hematoxylin-eosin staining showed sharpey-like fibronectin could be seen in the tendon bone healing surface, and the col agen fibers in the 3.5 mm bone tunnel group were more compact and regular than those in the other groups;the biomechanical testing results in the 3.5 mm bone tunnel group were better than those in the other groups. The results indicate that during anterior cruciate ligament reconstruction, decreasing the diameter of bone tunnel that matched with grafts in order to make the tendon and the bone tunnel closely matched can provide a more stable cel biological and mechanical environment, accelerate the formation and transformation of tendon-bone healing interface, and can improve the quality of tendon-bone healing.

Objective: To evaluate the clinical effectiveness of multi-directional mechanical traction (MT) for the treatment of patients with lumbar disc herniation (LDH) compared with longitudinal traction (LT) as control. Method: This prospective, single-blind, randomized clinical trial was performed in Qi Lu Hospital, Shandong University from January 2008 to December 2008. One hundred and twenty outpatients with LDH were randomly divided into MT group or LT group. MT group was treated with computer-controlled multi-directional mechanical traction.LTgroupwastreatedwithlongitudinaltraction.RolandMorrisLowBackPainandDisability Questionnaire (RMDQ), visual analogue scale (VAS), and straight leg raising (SLR) angle were measured for every patient pre-, 4 weeks post-, and 1 year post-treatment.Result: The results of clinical observations showed significant improvements inRMDQ, VAS, and SLR angle assessments (all P＜0.05) in both groups 4 weeks post- and 1 year post-treatment compared with pre-treatment. Score of RMDQ in MT group was significantly lower than that in LT group(P＜0.05), however, there was no significant difference between two groups in VAS score and SLR angle (P＞0.05). The differences in improvement ratios between two groups were not significant (all P＞0.05). The clinical outcomes were negatively correlated with patient's age and disease duration.Conclusion: The effect of MT is equivalent and probably superior to that of LT in improving the symptoms and clinical findings of patients with LDH.

Objective To assess the changes of left ventricule and analyze the influential factors in pulmonary hypertension (PH) by comparing the changes of left ventricular volume and function using single cardiac cycle real-time three dimensional echocardiography ( sRT-3DE ) and two-dimensional echocardiography (2DE).Methods In case group,there were 30 inpatients diagnosed as PH,systolic pulmonary artery pressure(PASP)≥40 mmHg estimated by echocardiography,excluding left heart disease or congenital systemic-pulmonary circulation shunt.There were 30 healthy people as control group.Conventional 2DE and sRT-3DE were performed in both groups and obtained 2D and 3D parameters.Results ①In case group,the 2D-LVEF were significantly larger than 3D-LVEF (P ＜ 0.01 ).There was less agreement of 2DE and 3DE in case group than in control.②Comparing with the control group,left ventricular EDV,ESV and SV in ease group decreased ( P ＜0.01 ),so as to 3D-LVEF ( P ＜0.05).The left ventricular spherical index(SIs,SId)and eccentric index (EId,EIs ) in case group were significantly larger than those in control group ( P ＜0.01 ).③LVEDV in case group was negatively correlated with PASP (r =- 0.47),and positively correlated with RVSV and RVEF ( r =0.84,0.66) ;3D-LVEF in case group was negatively correlated with PASP ( r =- 0.54),and positively correlated with RVSV and RVEF ( r =0.58,0.53); there was no significant correlation between LVEDV and RVEDV.LVEDV was negatively correlated with SIs and SId ( r =-0.65,-0.61),so as to EId and EIs ( r =-0.67,0.67).LVEF was negatively correlated with SIs and SId ( r =-0.64,-0.61),so as to EId and EIs ( r =-0.66,-0.68),and the corresponding P all above were less than 0.01.Conclusions PH can result in reductions of left ventricular volume and systolic function,and the variations of which have the correlations with the severity of PH and the increase in SI and EI.sRT-3DE can provide a method to get more accurate information of left ventricle.