0.05).The smoking group had a higher TG level and a lower HDL-C level than the control one with statistical significance(P0.05).The HL activities in serum,lung and liver of smoking group were lower than those of control group(P

Adult ; Aged ; Female ; Fluorodeoxyglucose F18 ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; Neoplasm Recurrence, Local ; diagnostic imaging ; Neoplasm, Residual ; diagnostic imaging ; Positron-Emission Tomography

Adult ; Facial Neoplasms ; Facial Nerve ; Humans ; Male ; Neurilemmoma

Objective To analyze the risk factors of pulmonary embolism in patients with negative Ddimer in serum in order to determine the need of pulmonary computed tomography angiograph (CTA) to confirm the final diagnosis in those patients for avoidance of misdiagnosis.Methods A retrospective analysis of 106 patients suspected to suffer from pulmonary embolism (PE) with serum negative D-dimer checked with pulmonary CTA was carried out.According to the results of CTA, the patients were divided into two groups, namely PE group (n =41) and non-PE group (n =65).The difference in clinic presentation, the time elapsed from onset to visit, N-terminal pro-brain natriuretic peptide (NT-proBNP), high risk factors (such as immobilization for 3 weeks, leg swelling and pain to palpation, history of deep vein thrombosis, malignancy) and Wells score (≥ 4 points indicates probability of PE).And logistic regression analysis was made to investigate the risk factors in PE with negative D-dimer.Results The analysis study showed that 38.6％ of total patients suspected to suffer from PE with serum negative D-dimer were checked by CTA to confirm the presence of PE.One important characteristics of the D-dimer negative PE patients was the longer time consumed from onset to visit [(9.51 ±2.01) d vs.(4.01 ±1.92) d, P＜ 0.05], and majority of the CTA positive patients suspected to suffer from PE with negative D-dimer had high risks of PE (P ＜0.01).Compared with the non-PE group, the Wells score ≥4 points and the level of serum NT-proBNP significantly increased in the PE group (P ＜ 0.01).Logistic regression analysis revealed that dyspnea, high NT-proBNP level and Wells sore ≥ 4 points were risk factors for D-dimer negative PE.Conclusion Delayed treatment was the main cause of misdiagnosis of D-dimer negative PE.Dyspnea, high NT-proBNP level and Wells sore ≥4 points were risk factors for suspected PE patients with negative D-dimer, and these patients should be confirmed by pulmonary CTA.On the contrary, PE could be excluded if patients with D-dimer negative had no these risk factors.

Objective To investigate role of reverse digital artery island flap combined with dig- ital nerve end to side anastomosis.Methods Reverse digital artery island flaps were used for recon- struction of 65 fingertip defects in 57cases,in which the restoration of the flap sense was attained via dig- ital nerve end to side anastomosis.Results After primary repair,all flaps survived,with good appear- ance and wear-resisting as well as satisfactory two-point discriminations.Conclusion Digital artery re- verse island flap combined with digital nerve end to side anastomosis is a simple and effective procedure for repair of finger defect.

Objective To evaluate the safety and effectiveness of vitrectomy combined with internal limiting membrane (ILM) tamping on macular hole and retinal detachment (MHRD) in highly myopic eyes.Methods 23 patients (23 eyes) were retrospectively reviewed,who were diagnosed as MHRD through examination of the ocular ftmdus,optic coherence tomography (OCT) and B-mode ultrasonography.There were 5 males (5 eyes) and 18 females (18 eyes).The mean age was (62.35 ± 8.28) years.The mean course of disease was 1.1 months.The logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) was 2.31 ± 0.72.The mean axial length was (28.66 ± 1.99) mm.All patients underwent 23G microincision vitrectomy.After vitreous gel and cortex were gently resected,the ILM around the edges of the macular hole was stained with indocyanine green,and was folded and pushed to fill the macular hole gently.Then silicone oil or C3F8 gas tamponade was applied in 18 eyes and 5 eyes,respectively.The silicone oil was removed after 3 months.The follow-up was 6 months.The BCVA,macular hole closure,retinal anatomical reattachment were retrospectively observed,and were used to evaluate the safety and effectiveness of the surgery.Results At the 6 months after surgery,the logMAR BCVA was improved to 1.13 ± 0.38,the difference was significant (t=l 5.33,P=0.00).The postoperative macular hole closure rate and retinal anatomical reattachment rate were 100％.There were no ocular or systemic adverse events observed in all patients.Conclusion Vitrectomy combined with ILM tamping is an effective and safe treatment for the high myopic eyes with MHRD.

Objective To explore the advantages and disadvantages of helicopter emergency medical services of South China in the long-distance transport for critical patients.Methods A total of 30 patients who received helicopter emergency medical services by Guangdong Generral Hospital from August 2004 to December 2014 were selected as the observation group,and the other 30 patients with similar conditions who received ground emergency medical services were selected as the control group.To analyses the difference between the two groups in the disease,transport distance,transportation time,costs and compliction by χ2-test,t-test and nonparametric test according types of data.Results There were significantly difference between two groups in transport distances (km) [578.0 (313.0,707.5)vs.214.5 (101.5,313.5),P <0.05],set-up time (min) [95.7 (56.7,133.4)vs.10.7 (6.8,15.7),P <0.05],transportation time (min) [112.3 (64.3,152.4) vs.146.8 (67.8,217.5),P <0.05],costs (yuan/h) [14378.5 (9887.0,16348.5)vs.557.0 (356.5, 787.5),P <0.05]and the distance/total time value [2.8 (1.3,4.8)vs.1.4 (0.8,2.8),P <0.05]. There was no significantly difference in the incidence of complications between two groups (χ2 =0.058,P >0.05).Conclusions Helicopter emergency medical services could shorten the transportation time of critical patients on long distance transportation,and improve the efficiency of first-aid.However,there were many disadvantages that need to be improved in the helicopter emergency medical service of China.

Objective To evaluate the value of NT-proBNP in predicting weaning outcomes of the patients with mechanical ventilation by using the receiver operating characteristic (ROC)curve. Method The data of patients after the weaning of mechanical ventilation and spontaneous breathing trial (SBT) in the intensive care unit,from July 2008 to January 2010, were retrospective reviewed. All patients were divided into the success group and failure group as per the outcomes of weaning. Demographics and the serum NT-proBNP levels measured before weaning were compared between two groups with Student t -test and Chi-square test. The ROC curve was drawn to evaluate the value of serum NT-proBNP in predicting outcomes after weaning. Results A total of 160 patients were eligible for inclusion in the study, and there were 106 cases in success group and 54 cases in failure group.Compared with the failure group, the patients of success group were younger (63.17 ± 17.00 vs. 71.28 ± 12.56,t = 2.063,P =0.024), and no difference in gender (χ2 = 0.06, P ＞ 0.05). The NT-proBNP levels of failure group were significantly higher than those of success group (Lg NT-proBNP 2.80 ± 0.72 vs. 3.75 ± 0.56, t =2.351,P =0.014). The area under cure (AUC) of the ROC cure of NT-proBNPto predict the failure of weaning was 0.855 ±0.036 (95%CI0.784 ～ 0.925) when the cut-off level of NT-proBNP was 3635.5 pg/mL. And, this NT-proBNP level had a followed predictive efficiency in weaning outcome (Youden's index: 0. 60, accuracy:82.5%, sensitivity: 75%, specificity: 84.7%, positive likelihood ratio: 4.90, negative likelihood ratio:0.295,Kappa value: 0.62). Conclusions The levels of NT-proBNP before weaning have predictive value in weaning outcome, and it may be used as one of the screening indicators for weaning.

Objective To evaluate and analyze the clinical effect of comprehensive rehabilitation therapy after arthroscopic rotator cuff repair using suture-bridge technique for full-thickness rotator cuff tears.Methods Forty-one patients (20 males,21 females; mean age 52.2 years) with full-thickness rotator cuff tears were treated with arthroscopic rotator cuff repair using suture-bridge technique between June 2010 and January 2012 in our hospital.After arthroscopic rotator cuff repair,the patients were randomly assigned to a treatment group (21 patients) or a control group (20 patients).The treatment group received systematic rehabilitation therapy including rehabilitation education,physical modalities treatment and rehabilitative training additionally,while the control group only accepted the routine rehabilitation therapy including stretching and muscle strength training.The outcome was evaluated at 6 months after surgery,by employing visual analogae scale (VAS),the range of motion (ROM) testing of shoulder joint flexion and rotation,the rating scale of University of California at Los Angeles (UCLA),and the shoulder index of American shoulder and elbow surgeons (ASES).Results The mean follow-up period was 15.6 months (8-24 months).Prior to intervention,there was no significant difference in any parameter between the two groups (P ＞ 0.05).Six months later,all scores of assessments changed:in treatment group VAS (1.7 ± 1.5),ROM [flexion (168.3±31.3)°,rotation (47.2±11.2)°],UCLA(30.7 ±4.13) and ASES (85.1 ±15.67); in control group VAS(3.8±2.2),ROM[flexion (121.2 ±53.6)°,rotation (32.9 ±14.9)°],UCLA(18.3 ±4.94) and ASES (36.4 ± 17.70).Significant changes occurred in both groups in all the parameters after treatment when compare to baseline (P ＜ 0.05).Conclusions Comprehensive rehabilitation therapy is an effective approach for improving motor ability of the shoulder in patients after arthroscopic rotator cuff repair with suture-bridge technique for their full-thickness rotator cuff tears.

Objective To investigate the method and clinical effect of interventional treatment on placenta increta.Methods Fifteen patients with placenta increta were treated interventionally through uterine artery.and Methotrexate 50-100 mg were superselectively infused.Then gel foam particulate or stripes were used for embolization of uterine artery.The therapeutic effect,prognosis and side effects were observed and analyzed.Results All patients underwent uterine artery embolization (UAE) .One week after UAE,curettage was successfully performed.No heavily hemorrhage nor hysterectomy occurred.Conclusion Transcatheter uterine artery intervention is simple,safe and effective with highly successful rate and has little side effects for the treatment of placenta increta.