Humans ; Otitis Media

Informed consent right is not just for basic ethical consideration, but is important for protecting patient's right by law, which is expressed through informed consent contract. The appraised individuals of forensic clinical examination have the similar legal status as the patients in medical system. However, the law does not require informed consent right for the appraised individuals. I recommend giving certain informed consent right to the appraised individuals in the forensic clinical examination. Under the contracted relationship with the institution, the appraised individuals could participate in the examination process, know the necessary information, and make a selected consent on the examination results, which can assure the justice and fairness of judicial examination procedure.
Forensic Medicine ; Humans ; Informed Consent ; Patient Participation

After comparing the varieties of parameters in batch culture under different dissolved oxygen tension by Bacillus pumilus, we found that the demand of cell on oxygen in different phase isn' t consistent. Based on the analys is of the metabolic pathway of oxygen and the mechanism of the effect of dissolved oxygen tension on fermentation of D-ribose, a two-stage oxygen-supply control mode was proposed and experimentally proved to be available. High ribose yield and high glucose consumption rate were achieved during whole process for 44h, and the ultimate ribose concentration and cell concentration were 5.0% and 18.8% higher than former respectively.

OBJECTIVETo investigate the incidence of needlestick and sharps injuries among the medical staff in an upper first-class hospital and its risk factors and to provide a basis for the infection control department of hospital and health administration department to establish the policies for safe injection.

METHODSA questionnaire survey was conducted in 800 healthcare professionals in an upper first-class hospital in Nanjing, China to investigate the incidence of needlestick and sharps injuries in the past year. A total of 641 persons completed the questionnaire, including 239 doctors, 348 nurses, and 54 other healthcare workers. The obtained data were subjected to chi-square test and logistic analysis.

RESULTSNeedlestick and sharps injuries occurred in 373 of 641 healthcare professionals, with an incidence rate of 58.19%. There were significant differences in the incidence of needlestick and sharps injuries among the medical staff of different types or in different departments (P < 0.01). The syringe needles, glass, scalp infusion needles, and suture needles were the major medical apparatus that caused needlestick and sharps injuries; the incidence rate of injury caused by suture needles in doctors (48.21%) was significantly higher than that in nurses (6.72%) (P < 0.01), and the incidence rates of injuries caused by syringe needles, scalp infusion needles, and glass in nurses (71.15%, 59.68%, and 49.04%) were significantly higher than those in doctors (46.43%, 6.25%, and 16.96%) (P < 0.01); compared with nurses, the doctors had higher incidence rates of injuries due to body fluid or tissue sample collection, wound flushing, suture, and cutting (P < 0.05); compared with doctors, the nurses had higher incidence rates of injuries due to injection, intravenous infusion, heparin cap sealing, intravenous infusion line connection, and venous or arterial blood collection (P < 0.05).

CONCLUSIONNeedlestick and sharps injuries are common in medical staff. The results of the study on risk factors provide a basis for the infection control department of hospital and health administration department to establish the policies for safe injection.

Accidents, Occupational ; statistics & numerical data ; China ; Female ; Health Personnel ; Humans ; Incidence ; Male ; Needlestick Injuries ; epidemiology ; Risk Factors ; Surveys and Questionnaires

Objective To assess the clinical values of MR angiography(MRA)in the detection of deep vein thrombosis of the lower limbs.Methods Two-dimensional time of flight(2D TOF)MRA was performed in thirty patients who were suspected of having deep vein thrombosis in the lower limbs.The findings of MRA were compared to that of digital subtraction angiography(DSA).Results twenty-five cases showed deep vein thrombosis in the lower limbs,the MRA findings included venous filling defect (14 cases),occlusions and interruptions of veins(8 cases),venous recanalizations(3 cases),collateral veins(25 cases).Taking the results of DSA as a golden standard,MRA detected all of the affected cases with only one case as the false positive.Conclusion 2D TOF MRA is a method of choice in the diagnosis of deep vein thrombosis of the lower limbs.

BACKGROUNDIntraoperative Doppler sonography has been used in the neurosurgical operating room for the localization and description of cerebral arteriovenous malformations (AVMs). This study aimed to investigate the clinical value of contrast-enhanced intraoperative Doppler sonography, including its ability to assess the location and identify of feeding arteries in patients with AVMs and to compare this method with angiography.

METHODSTwenty-three patients with cerebral AVMs who were diagnosed using angiography, were examined with contrast-enhanced intraoperative Doppler sonography. As an echo-enhancing agent, Sulphur Hexafluoride Microbubbles for Injection ("SonoVue") was administered intravenously in all patients. Sonogram results were reviewed and correlated with angiographic findings. For statistical analysis, the Wilcoxon signed-rank test was applied.

RESULTSAngiography identified 20 AVM lesions in the anterior or middle fossa and 3 in the posterior fossa. Contrast-enhanced intraoperative Doppler was somewhat less sensitive for only detecting 21/23 (91.3%) of the AVM lesions. Additionally, contrast-enhanced intraoperative Doppler slightly underestimated AVM size compared with angiographic findings but showed feeding arteries with sufficient acoustic properties. In 15 patients, angiography revealed a coincidental blood supply from another intracranial vessel, which was missed by contrast-enhanced intraoperative Doppler sonography.

CONCLUSIONSIn a limited group of patients with AVMs, contrast-enhanced intraoperative Doppler sonography was a less sensitive but useful and simple method for the detection of AVMs in contrast to angiography. No specific untoward effects were attributed to the use of "SonoVue" as a contrast-enhancing substance.

Adolescent ; Adult ; Cerebral Angiography ; methods ; Contrast Media ; Humans ; Image Enhancement ; Intracranial Arteriovenous Malformations ; diagnosis ; Male ; Middle Aged ; Phospholipids ; Sulfur Hexafluoride ; Ultrasonography, Doppler, Transcranial ; methods

OBJECTIVETo study on growth characteristics of Curcuma wenyujin, and provide theoretical basis for the development of high-quality and high-yield medical material.

METHODThe morphological change of the plant was observed periodically, the content of volatile oil and dry matter in leaves, rhizome, root tuber was determine.

RESULTThe growth of C. wenyujin could be divided into 5 stages, i. e. seed germination, seedling, leaf growth, rhizome expansion, accumulation of dry matter, respectively. Before the stage of rhizome expansion, over 70% dry matter was accumulated in the aerial part of the plant, and during the stage of leaf growth, the maximum increase rate of dry matter in aerial part was 3.90 g/p/d. During the stage of rhizome expansion, the ratio of dry matter of rhizome increased quickly and reached above 33% , and the increase rate of dry matter of rhizome rise up to 3.83 g/p/d, in the end of the stage, the content of volatile oil in the rhizome also rose up to 1.20 mL x 100 g(-1).

CONCLUSIONDuring the whole growth stage, there are two growth centers, when the two curves of dry matter increase of aerial part and rhizome intersect, it is regarded as a signal that the growth transformed form the aerial part to rhizome. When the rate of dry matter from rhizome rise, the content of volatile oil in rhizome rises quickly with the increase of dry matter in rhizome. The optimal harvest time is in mid-December.

Curcuma ; anatomy & histology ; chemistry ; growth & development ; Germination ; Oils, Volatile ; analysis ; Plant Components, Aerial ; chemistry ; growth & development ; Plant Leaves ; chemistry ; growth & development ; Plant Roots ; chemistry ; growth & development ; Plants, Medicinal ; anatomy & histology ; chemistry ; growth & development ; Rhizome ; chemistry ; growth & development ; Seasons ; Seedlings ; chemistry ; growth & development ; Seeds ; growth & development

BACKGROUNDThe precise mechanisms responsible for the development and growth of intracranial arteriovenous malformations (AVMs) remain unclear. Osteopontin (OPN) is a phosphorylated glycoprotein with diverse functions. This study aimed to analyze the expression of OPN in human brain AVMs.

METHODSThe AVM nidus was surgically obtained from patients with AVM, whereas control brain artery specimens were surgically obtained from patients with epilepsy. Reverse transcription-polymerase chain reaction (RT-PCR) was used to examine the expression of OPN mRNA in biopsy specimens. OPN protein expression was localized by immunohistochemistry. The statistical differences between different groups were assessed by two-way analysis of variance (ANOVA).

RESULTSWe analyzed 36 brain AVM specimens and 8 control brain artery specimens. Eleven patients with brain AVM received embolization treatment, and five underwent gamma knife radiotherapy before resection. Nineteen patients with brain AVM had a history of hemorrhage from AVMs. The expression of OPN mRNA was significantly higher in AVMs than that in the control specimens (25.76 ± 2.71 vs. 21.46 ± 2.01, P < 0.01). There was no statistically significant difference in the extent of OPN mRNA expression between the AVM group with and that without history of hemorrhage (26.13 ± 2.45 vs. 25.34 ± 2.99) or gamma knife radiotherapy (24.39 ± 2.10 vs. 24.53 ± 1.85). However, the difference between the AVM group with and that without embolization treatment history was statistically significant (24.39 ± 2.10 vs. 28.80 ± 1.13, P < 0.01). In the group with gamma knife radiotherapy history, OPN expression was found in arteries with early-stage radio-effect.

CONCLUSIONSOPN may contribute to the vascular instability of brain AVMs. It may play an important role in the pathophysiological process related to embolization treatment.

Analysis of Variance ; Brain ; metabolism ; pathology ; Immunohistochemistry ; Intracranial Arteriovenous Malformations ; genetics ; metabolism ; pathology ; Osteopontin ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction

OBJECTIVETo present 4 cases of hemophilic pseudotumor and to investigate the treatment outcome.

METHODSFour cases of hemophilic pseudotumor were reviewed. The patients were treated by internal medicine combined with surgery and followed up for two years. The feature and diagnosis of the disease were analyzed and the treatment outcome was evaluated.

RESULTSAll of the 4 cases were misdiagnosed with a history of bleeding before operation. One patient was bleeding after biopsy without replacement therapy. One patient was presented with gingival bleeding and anaemia. The final diagnosis of hemophilia A in all the 4 cases was confirmed by the blood test (VIII deficiency). After infusion of factor VIII, operation was performed on all cases. There was no recurrence after two years of follow-up.

CONCLUSIONSIt should be aware of the rarely encountered disease which is prone to be misdiagnosed. Under factor-deficient replacement therapy, surgical management is the most effective way in preventing from bleeding and avoiding progressive expanding of pseudotumor.

Child ; Diagnostic Errors ; Hematoma ; surgery ; Hemophilia A ; diagnosis ; surgery ; Humans ; Infant ; Male ; Middle Aged ; Young Adult

OBJECTIVETo compare the curative effect, safety and survival of Nedaplatin combined with docetaxel and docetaxel alone as a second line treatment for advanced NSCLC.

METHODSFrom Sep 2005 to Mar 2009, fifty-eight patients with NSCLC treated in the Shanghai Chest Hospital who failed first-line chemotherapy and receiving docetaxel or docetaxel combined with nedaplatin were retrospectively analyzed. Survival analysis was evaluated by Kaplan-Meier and Log-Rank test. There were 20 patients in the combination group, and 38 in the single-agent group.

RESULTSThe PFS was 4.35 months for combination group and 4.0 months for single-agent group, there was a significant difference between the two groups (P < 0.05). The mean survival time and 1-year survival rate were 13.5 months vs. 10.6 months and 29.0% vs. 22.0%, respectively, with no significant difference. The Hematological toxicity in the combination group was higher than that in the single-agent group, 15.0% vs. 10.5% (P = 0.003), and no renal toxicity was noted in this study.

CONCLUSIONSCompared with the treatment with docetaxel alone, Nedaplatin combined with docetaxel as a second line treatment for NSCLC has a better curative effect and acceptable toxicity.

Antineoplastic Agents ; adverse effects ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; pathology ; Disease-Free Survival ; Female ; Humans ; Leukopenia ; chemically induced ; Lung Neoplasms ; drug therapy ; pathology ; Male ; Middle Aged ; Nausea ; chemically induced ; Neoplasm Staging ; Neutropenia ; chemically induced ; Organoplatinum Compounds ; administration & dosage ; adverse effects ; Retrospective Studies ; Survival Rate ; Taxoids ; administration & dosage ; adverse effects ; therapeutic use ; Vomiting ; chemically induced