Administration, Oral ; Anti-Inflammatory Agents, Non-Steroidal ; adverse effects ; Female ; Hematuria ; chemically induced ; Humans ; Infant ; Male ; Sulfonamides ; adverse effects

Objective To evaluate the efficacy of the parathyroidectomy (PTX) in the treatment of severe secondary hyperparathyroidism (SHPT) with Sagliker syndrome (SS). Methods A retrospective review was undertaken among 212 SS patients underwent PTX in our hospital and with more than 3 years' follow up. The definitions of the efficacy were based on the postoperative intact parathyroid hormone level (iPTH). Cure showed that the iPTH was ＜ 150 ng/L; marked effectiveness was 150-300 ng/L; effectiveness was 301-500 ng/L;ineffectiveness was ＞500 ng/L. The status was defined as persistent SHPT if iPTH was ＞ 150 ng/L after surgery. The status was considered as SHPT recurrence if iPTH was ＜ 100 ng/L in the first week after surgery, and gradually increased and ＞ 150 ng/L with the follow-up. Results ( 1) Ten patients were involved and the average dialysis time was 142 months [male/female: 4/6; age 30-54 (39. 3 ± 10. 4) years]. All patients had severe bone and joint pain, accompanied with progressive facial increases, chicken breast, kyphosis, hip bone deformities, and body height shortening. (2) Preoperative tests: the median of iPTH 2000(1800-2863) ng/L; serum calcium (2. 45 ±0. 21) mmol/L, phosphorus (2. 19 ±0. 51) mmol/L, alkaline phosphatase ( ALP) (1189. 8 ± 780. 0) IU/L. Two to four enlarged parathyroid glands were confirmed by ultrasound and 99Tcm-MIBI parathyroid scintigraphy. ( 3 ) Surgical procedures: local or general anesthesia for PTX. Supplement with calcium and calcitriol implemented low serum calcium after PTX. (4) Follow-up: symptoms, including bone pain, muscle weakness, skin itching, and insomnia, were significantly improved after surgery. Transient hoarseness occurred in 2 cases. The iPTHs of all patients were decreased significantly after surgery. The median of iPTH was 55.5 ( 10-967) ng/L at 1 month post PTX, and was significantly less than prior to PTX (P＜0. 001). Eight patients were cure , 1 marked effectiveness ,and 1 ineffectiveness. Two patients were persistent SHPT, and 1 died of heart failure in the 4th year after PTX. The development of bone deformities was stopped and malnutrition was improved in long-time follow up. The level of iPTH 135(28-390)ng/L(P＜0. 001 ) , serum calcium, phosphorus, and ALP showed normal in the third year. The SHPT recurrence was appeared in the 2nd and 3rd year in 2 out of 8 patients, respectively. Conclusions Total PTX can effectively treat SS by SHPT. It can improve prognosis for patients, such as bone pain disappearing, bone deformities stopping and malnutrition improving, etc. The level of iPTH may rise again in some patients in the future. Therefore, more attentions should be paid to monitoring.

Background Some researching results of sodium hyaluronate eye drops treating dry eye have been reported home and abroad.To evaluate these results using the method of evidence-based medicine (EBM) has an important clinical significance.Objective This secondary study was to systematically evaluate the efficacy of sodium hyaluronate eye drops for the treatment of dry eye.Methods Meta analysis was adopted in this study.The electronic bibliographic databases were searched according to the prescribed strategy,including Medline,PubMed,VIP,CBM,CNKI,Wanfang Data using the method of Cochrane systematic review.The literature published time was limited from the commencement of each database to December,2011.Randomized controlled trials (RCTs) of sodium hyaluronate eye drops treating dry eye were included and the methodological quality of the RCTs was assessed by two evaluators using Jadad measuring scale,and homogeneous evaluation by Meta-analysis was performed.Statistical analysis of clinical data was performed using RevMan 5.0 software provided by the Cochrane Collaboration.With odds ratio (OR) value as the effect index,the randomized effect model was used to analyze the clinical heterogeneity.Results A total of 4 RCTs involving 686 patients were included.Jadad scale evaluation showed 7 points in 2 literature,4 points in 1 literature and 2 points in 1 literature.In all the RCTs,344 patients with dry eye were treated using sodium hyaluronate as the sodium hyaluronate eye drops group,and 342 dry eyes applied placebo,normal saline solution,hydroxymethyl cellulose,hydroxypropyl methyl cellulose respectively as the control group.Meta-analysis indicated that the total effective rate (OR) was 2.55 with the 95％ confidence interval (CI) 0.94-6.93.The symptoms were improved in 183 cases in the experiment group and 130 cases in the control group.No significant difference was found in the OR between the sodium hyaluronate eye drops group and the control group (Z =1.84,P=0.07).Conclusions Meta-analysis indicates that sodium hyaluronate eye drops can improve the symptom of dry eye,but have no significence with the control group.However,owing to fewer number and uneven quality of included RCTs,the large sample size and multicenter of RCTs is still needed to verify the superiority of sodium hyaluronate eye drops for dry eye.

Female ; Hepatitis B ; prevention & control ; Hepatitis B Vaccines ; immunology ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Male ; Vaccination

In this paper,300 bacteria strains and 31fungi strain were isolated from Qinghai plateau.The numbers of cellulose degradation organisms in soil is 2.6?10 5/g. A strain Trichoderma koningii No.0143 which produces cellulase was isolated from 11 fungi in the east area in QingHai,its FPA activity was 15u/g. It can be used in enzymatic feed.

Transverse fracture is the most common in patella fracture and tension band fixation is one of the most effective methods. Surgical wire tension band technique is simple, the use of materials is also simple, but it is not strong and difficult to promote. Kirschner tension band technique can get satisfactory reduction with reliable fixation, but it is easy to complicate with steel wire breakage and Kirschner loosening. Screw tension band technique inherits the traditional advantages of simple manipulation and reliable fixation, also overcomes the disadvantages of early activity limitations caused soft tissue irritation of tension band around knee, the slippage and breakage of internal fixation, and the technique can be popularized generally.
Bone Wires ; Fracture Fixation, Internal ; methods ; Humans ; Patella ; injuries ; surgery ; Stress, Mechanical

Objective To evaluate the effects of normovolemic hemodilution (NH) with hetastarch starch 130/0.4 and electrolyte solution on blood coagulation during resection for liver cancer in the elderly patients.Methods Forty patients,of ASA physical status Ⅱ,aged 65-74 yr,scheduled for elective resection for liver cancer under general anesthesia,were randomly divided into NH group (n =20) and control group (group C,n =20).NH group underwent NH with 6％ hematocrit starch 130/0.4 and electrolyte solution after induction of anesthesia,while group C underwent routine fluid management.Before induction of anesthesia (T1),at 30 min after NH (T2),at 1 h during operation (T3),and at the end of operation (T4),venous blood samples were collected for measurement of the routine parameters of blood coagulation,and levels of soluble fibrin monomer complex (SFMC),and platelet membrane glycoprotein (PAC-1,platelet activation marker).Results Compared with group C,no significant changes were found in intraoperative blood loss,PT,APTT,and levels of SFMC and PAC-1,the volume of allogeneic blood transfused was reduced,and Fib was decreased at T2-4 in NH group.Compared with the baseline value at T1,Fib was decreased significantly at T2-4 in NH group,and PT and APTT were prolonged but still within the normal range,and no significant changes were found in the other parameters in both groups.Conclusion NH with hetastarch starch 130/0.4 and electrolyte solution exerts no effect on blood coagulation during resection for liver cancer and provides blood-saving effect to some extent in the elderly patients.

Objective To investigate the clinical value of cardiac troponin Ⅰ(cTnⅠ) and creatinine kinase MB(CK-MB) in early diagnosis of myocardial injury(MCI) in neonatal asphyxia.Methods The serum cTnⅠ and CK-MB in neonates [34 with asphyxia and MCI,38 with asphyxia but no MCI(NMCI)],and 30 cases of normal control(NC) were measured with direct immunoassay chemiluminometric technology and immunoinhibition enzymes-activated assay.Results The cTnⅠ level in NC group had no changes within 10 days after birth,MCI group were significantly higher than those in NMCI and NC groups(all P0.05).The diagnostic sensitivity,specificity and accuracy of cTnⅠ for neonates with MCI were 91%,88% and 89%,respectively;and of CK-MB were 85%,68% and 74%,respectively.Conclusions cTnⅠ and CK-MB can be taken as early diagnostic markers of MCI in neonates with asphyxia,(cTnⅠ) is better than CK-MB.

ObjectiveTo study the therapeutic effect and mechanisms of nourishing Piyin Remedy (nPR) on experimental rat spinal cord injury.MethodsThirty-two healthy SD rats were divided into 2 equal groups randomly: nPR group and injured group. Animal model of incomplete injury of spinal cord was made by Allen's equipment on rat's T8—T9 segment. The spinal nerve function,SEP,retrograde and label technique of horse radish peroxidase,gross observation,histological and morphometric analysis were taken as the observed indices.ResultsThe value of observed indices of nPR group were improved evidently compared with injured group.ConclusionNourishing Piyin Remede can hold back the secondary spinal cord injury and accelerate the recovery of spinal nerve function.

Objective To investigate the methods of ameliorating perioperative nursing management of elderly women according to the characteristics of gynecological surgery, clinical complications, and their physiological functions. Methods 16 cases out of 168 female patients with age no less than 60 years old who developed complications postoperatively were administered with nursing care and retrospectively studied.Results Those patients successfully underwent the given operation without any complications intraoperatively;16 cases developed complications postoperatively, while they were discharged after targeted treatment or better outcomes. There was not any death during the operation. Conclusions Strengthening nursing management of complications during perioperative period with fully understanding the physiological characteristics of elderly women could improve the quality and safety of nursing care, and promote their rehabilitation.