Objective Analysis of clinical features and treatment of nasal type NK/T cell lymphoma, to improve the understanding of this special type of lymphoma.Method The clinical data of 34 patients with nasal type NK/T cell lymphoma confirmed by pathology were retrospectively analyzed.Result In 31 cases, 26 cases were EB virus (EBV) infection positive, recent Treatment Effectiveness in the positive group was significantly lower than the negative group (38.46%vs. 87.50%;P<0.05) . Follow up showed until October 2015, 19 of 34 patients died. Among them, 17 cases died of disease relapse or progression, 2 cases died of other diseases. 15 patients survived (11 of them were disease-free) and the median overall survival time was 37 months. The 2 year overall survival was related to clinical stage, B symptoms, EBV infection (the P values were 0.017/0.001, 0.005, and 0.039 respectively).Conclusion EBV infection is associated with patient's treatment response in NK/T-Cell Lymphoma; and the prognosis is associated with clinical features such as clinical stage, B symptom, and EBV infection.

Objective To investigate the imaging diagnosis and surgical treatment of intestinal malrotation in adult patients. Methods The clinical data of 11 adult patients with intestinal malrotation who had been admitted to General Hospital of PLA from January 2003 to December 2007 were retrospectively analyzed. Multiple imaging modalities, including barium enema, gastrointestinal radiography, B sonography, computed tomography (CT) scan and mesenteric angiography were applied for diagnosis. All patients received Ladd procedure. Results Two patients were diagnosed by gastrointestinal radiography +B sonography, 4 by gastrointestinal radiography +CT scan, 1 by angiography, 1 by B sonography + CT scan, 1 by iodine radiography + CT scan and 2 by intraopera-tive examination. After the operation, 2 had renal insufficiency, 1 had intestinal fistula and 1 had short bowel syndrome and died at the third month after operation. Conclusion Combined application of multiple imaging modalities can improve the diagnostic rate, and Ladd procedure is effective and safe for adult patients with intes-tinal malrotation.

Objective To evaluate the clinical effectiveness of perioperative fast-track surgery(FTS)program and nutrition support in the elderly patients with gastric cancer.Methods Totally 42 patients were equally randomized into FTS group(receiving perioperative FTS program)and control group(receiving a conventional therapy).The postoperative first defecation time,postoperative hospital stay,hospitahzation expenditure,and postoperative complications were compared between these two groups.Results The postoperative first defecation time and postoperative hospital stay were(75.4±24.3)hours and(11.2±3.2)days in FIS group and(98.0±22.6)hours and(14.4±4.6)days in control group(P=0.0165,P=0.0004;respectively).The hospitalization expenditure was significantly lower in FTS group than in control group[(3.66±0.48)×104 vs.(4.56±0.78)×104 RMB yuan;P=0.0001].The incidence of postoperative complications in FTS group was also significantly lower than that in control group(9.5% vs.28.6%,P=0.0422).Conclusion Perioperative FTS program can accelerate postoperative rehabilitation,shorten hospital stay,lower hospitalization expenditure,and reduce the incidence of postoperative complications.

Objective To summarize the treatment experiences in gastrointestinal leaJcage atter gastrectomy for gastric cancer. Mehods From January 1997 to December 2006 the clinical data of 37 cases of gastrointestinal leakage including anastomotic leakage in 19 cases and duodenal stump leakage in 18 after gastrectomy for gastric cancer in People's Liberation Army General Hospital were analyzed retrospectively. Results All of the Cases were treated with abdominal drainage,continuous gastrointinal decomnression and parenteral nutrition combined with enteral nutrition.There were 32 cases receiving glutamine enrichment nutrition support,31 ases used somatostatin,13 cases received supplemented recombinarlt human growth hormone.Fistula healed in 21～30 d in 9 cases after gastrectomy,in the other 24 cases fistula healed in 30-60 d,while it healed in 60～81 d in the remaining 2 cases.Two died of leakage associated complications after gastrectomy for gastric cancer including anastomotlc leakage follwing esophagojejunostomy complicated by severe thoracic and lung infection in one and duodenal stump leakage complicated by severe abdominal cavity sepsis and hemorrhage in the other. Conclusion Patent and effective abdominal cavity drainage,continuous gastrointestinal decompression,parenteral nutrition combined with enteral nutrition,glutarnine,somatostafin and recombinant human growth hormone are the'mportant factors for the healing of gastrointestinal leakage after gastrectomy tor gastric cancer.

Age Factors ; Cardiopulmonary Bypass ; Child ; Child, Preschool ; Humans ; Infant ; Infant, Newborn ; P-Selectin ; blood ; Platelet Glycoprotein GPIb-IX Complex ; analysis

OBJECTIVETo compare clinical efficacy of anatomic locking plate and Gamma nail in treating unstable femoral intertrochanteric fractures with external wall fractures.

METHODSFrom June 2010 to June 2014,clinical data of 44 patients with intertroehanteric fractures associated with lateral wall fractures (type 31A2.2-3.3) followed more than 12 months,which treated with Gamma nail or anatomic locking plate,were retrospective analyzed. Sixteen patients were treated with anatomic locking plate, including 6 males and 10 females aged from 32 to 83 years old with an average of 56.5 years old. Twenty-eight patients were treated with Gamma nail including 17 males and 11 females aged from 26 to 87 years old with an average of 60.4 years old. Operative time, intraoperative fluoroscopy times, blood loss (intraoperative and hidden blood loss), hospital stays were observed and compared. PPMS and HHS scoring were used to evaluate postoperative clinical effect.

RESULTSAll patients were followed up from 12 to 24 months with an average of 16.2 months. Operative time in Gamma nail was shorter than anatomic locking plate; while blood loss( intraoperative and hidden blood loss) and intraoperative fluoroscopy times in anatomic locking plate were less than that of in Gamma nail. There was no significant meaning in hospital stays between two groups. Postoperative full weight-bearing time in anatomic locking plate was prolonged than Gamma nail. At the final following-up, PPMS in Gamma nail was 7.50 ± 1.78 and 6.82 ± 1.38 in anatomic locking plate, and there was no obvious meaning between two groups (t = 2.341, P = 0.132); there was no significant differences in HHS score between Gamma nail (83.25 ± 11.18) and anatomic locking plate (86.14 ± 12.36) (t = 1.923, P = 0.243). The incidence of complications in Gamma nail was less than anatomic lock-ing plate (P = 0.005).

CONCLUSIONAnatomic locking plate for intertrochanteric fractures with external wall fractures could avoid re-injury of external wall, especially for severe comminuted fractures, difficult for intramedullary nailing, and there was no significant meaning in hip joint function compared with Gamma nail, while postoperative incidence of complications was higher than Gamma nail, so early weight-bearing was not stress.

Adult ; Aged ; Bone Nails ; Bone Plates ; Female ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Hip Fractures ; surgery ; Hip Joint ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

Objective To explore the effect of preservation of inclined fractured permanent molars by transverse fixation with screw post,and provide a practical method for reserving the inclined fractured permanent molars.Methods Clinical data of 50 patients with inclined fractured permanent molars by transverse fixation with screw post in the Department of Stomatology of Tianjin First Central Hospital between January 2010 to December 2011 were reviewed retrospectively.After fixing the crown with steel-wire binding and root canal treatment,the molars were drilled a hole buccolingually and placed screw post.The flowable light-curing composite resin was used to seal the crack and bond screw post to prevent the relative movement.All treated molars were restored with full crown.All patients were followed up for 10-60 months.The therapeutic effects were observed.Results After 5 year-follow-up,41 cases were cured completely,6 cases were cured clinically,and 3 cases failed treatment.Conclusion The transverse fixation with screw post and bonding technique can preserve the inclined fractured molars to gain chewing function and avoid or reduce the extraction of affected teeth,which provides a better restoration effect.

Objective To compare the effects of methylprednisolone and dexamethasone individually combined with tropisetron on the prevention of postoperative nausea and vomiting (PONV) of high risk in patients with thyroid surgery.Methods One hundred and sixty patients of high risk of postoperative nausea and vomiting scheduled for radical operation of thyroid with general anesthesia were randomly divided into four groups with 40 cases each.Four groups of the patients were intravenously injected methylprednisolone 40 mg plus tropisetron 5 mg at the end of the operations (group MT),dexamethasone 7.5 mg before anesthesia induction,and tropisetron 5 mg at the end of the operations (group DT),tropisetron 5 mg at the end of the operations (group T),and normal saline (group C).Incidence and severity of nausea,vomiting and adverse reactions were recorded during 24 hours after end of the operations.Results Compared to group DT,the incidences of PONV during the 0 ～ 2 h and 2 ～ 6 h,and the visual analogue scale (VAS) of PONV at 2 h after the operations in group MT were significantly lower (P ＜ 0.05).Compared to group C,the incidences of PONV and VAS score during the 0 ～ 24 h after the operations in group MT and group DT were significantly lower (P ＜0.05),the incidences of PONV during the 2 ～6 h and 6 ～ 12 h after the operations,and VAS score of PONV at 6 h and 12 h after the operations in group T were significantly lower (P ＜0.05).Compared to group C,incidences of headache in group MT and group DT were significantly lower (P ＜ 0.05),and incidence of swim in group T was also significantly lower (P ＜ 0.05).Incidence of adverse reactions in group MT and group DT were no significant difference.Conclusions Preventive effect of methylprednisolone combined with tropisetron for PONV in high-risk patients within 6 hours after thyroid surgery was significantly better than that of dexamethasone combined with tropisetron.

Objective To investigate the change in antimicrobial susceptibility of Enterococcus faecalis (E.faecalis) and Enterococcus faecium (E.faecium) isolated from clinical urine specimens, so as to provide laboratory evidence for clinical anti-infective treatment.Methods Antimicrobial susceptibility of E.faecalis and E.faecium isolated from urine specimens from 20 tertiary hosptials in China between 2004 and 2014 were analyzed, drug-resistant genes of vancomycin-resistant Enterococcus(VRE)were detected with polymerase chain reaction (PCR).Results A total of 788 Enterococcus strains were isolated in 2004-2014, 371 strains were E.faecalis strains, 417 were E.faecium strains.Susceptibility rates of E.faecalis to ampicillin, nitrofurantoin, fosfomycin, vancomycin, and teicoplanin were all>90%, susceptibility rates to rifampin, minocycline, and erythromycin were all<20%, there was significant difference in the susceptibility rate of E.faecalis to fosfomycin betwen July 2011-June 2012 and July 2009-June 2010(P<0.0167).Susceptibility rates of E.faecium to vancomycin and teicoplanin were 96.9% and 97.4% respectively, susceptibility rates to nitrofurantoin, minocycline, and fosfomycin were 41.7%, 51.8%, and 78.2% respectively, susceptibility rates to ampicillin, levofloxacin, rifampicin, and erythromycin were all<10%;susceptibility rates of E.faecium to nitrofurantoin had decreased tendency in different years (any two group comparison, all P<0.0167), susceptibility rates to fosfomycin in July 2011-June 2012 and July 2013-June 2014 both decreased compared with July 2009-June 2010(both P<0.0167),there were no significant changes in antimicrobial usceptibility rates in different years.14 strains of VRE all carried vanA resistance gene.Conclusion E.faecalis strains isolated from urine are susceptible to ampicillin, nitrofurantoin, and fosfomycin, E.faecium are not susceptible to most antimicrobial agents;E.faecalis and E.faecium are both susceptible to vancomycin and teicoplanin, only a few strains are resistant to antimicrobial agents.

Objectve To explore the application of exercise test use in diagnosis of periodic paraly sis.Methods Forty five cases of hypokalemic periodic paralysis were collected,and 40 health persons as control group.Both groups were measured serum potassium,serum creatase and thyroid function tests.All of them were taken exercise test (ET) and observe 50 minutes,measured before and after the test to seek the changes of compound muscle action potentials (CMAP),and its decreased more than 33％ were considered abnormal.The application of exercise test use was analyzed in diagnosis of periodic paralysis.Results In patients with periodic paralysis,the incidence of ET positive was higher than the control subjects (80％ vs 3.3％,P ＜ 0.001).This trend was significant after 20 minutes,such as 30 min[(37.8 ± 13.2)％ vs (6.2±3.2)％,P＜0.01],40min [(40.3 ±17.6)％ vs (3.2±1.9)％,P＜0.01],50min [(45.26 ± 19.9) ％ vs (-5.1 ± 2.6) ％,P ＜ 0.01].Moreover,linear correlation analysis showed that the serum potassium had negative correlation with serum creatase (r =-0.483,P =0.024).ALL of symptoms improved after a week treatment,the ET positive rate was still higher in patients with periodic paralysis than the control subjects (80.0％ vs 71.1％,P =0.824).Conclusions Exercise test was one of the important objective basis in the diagnosis of low potassium type periodic paralysis,and was not affected by treatment and testing time.