80 and further did Spearman correlation analysis and Logistic regression analysis to all patients for the prognosis and its factors(age,gender,SIRS,infection,blood sodium/potassium/free calcium,CRP,PLT and PCIS value as well as blood sugar level).Results the SIRS rate of the subject patients in PICU was 48.3%.SIRS group featured higher MODS rate,lower PCIS value and worse prognosis than those in Non-SIRS group(Pa80(P

Adolescent ; Adult ; Dermatitis, Occupational ; etiology ; immunology ; Female ; Humans ; Male ; Middle Aged ; T-Lymphocyte Subsets ; drug effects ; immunology ; Trichloroethylene ; adverse effects ; Young Adult

Adult ; Endocarditis ; complications ; Endocarditis, Bacterial ; complications ; Heart Defects, Congenital ; complications ; Humans ; Male ; Pulmonary Valve ; microbiology

Adenoma ; Diagnosis, Differential ; Hamartoma ; Humans ; Nasal Cavity ; surgery ; Paranasal Sinuses ; Respiratory Mucosa

Funnel Chest ; complications ; Humans ; Infant, Newborn ; Kidney ; abnormalities ; Male ; Prune Belly Syndrome ; complications ; Situs Inversus ; complications ; Spleen ; abnormalities

Objective: To evaluate the initial pain and influential factors in orthodontic treatment by VAS(visual analogue scales),and explore the way to alleviate the pain. Methods:107 subjects(47 male and 60 female) were selected. Following insertion of the first archwire (0.36 mm Chinese NiTi wire), visual analogue scale(VAS) was used to record the severity of pain at 4,12,24 h and on day 3,5,7. All the subjects were randomly divided into two groups by ligature with elastomeric rings (in 51 patients) or stainless steel wires (in 56 patients).In all the 107 patients, 30 people need to extract their tooth for relieving crowding while the other 77 were non-extraction cases. Results:No significant differences of pain were found between elastomeric rings ligature cases and stainless steel wires ligature cases at each stage; as well as between extraction and non-extraction cases. But the adults perceived more pain than the adolescents. Patients who were asked to chew gum or to do something (watching TV or listening to music) for distraction perceived less pain.The differences were statistically significant between different groups. Conclusion:The orthodontist should make a good communication with patient about initial pain before the orthodontic treatment, especially for adults.

AIM: To evaluate the clinical effect and the rotational stability of AcrySof Toric intraocular lens ( IOL ) implantation to correct preexisting corneal astigmatism in cataract surgery.
METHODS: Twenty-three patients ( 28 eyes ) were enrolled from the department of ophthalmology in the first Affiliated Hospital of Nanjing Medical University. All patients underwent similar phacoemulsification procedure combined with AcrySof Toric IOL implantation from June 2012 to December 2013. The uncorrected visual acuity ( UCVA ) , best corrected visual acuity ( BCVA ) , anticipated residual astigmatism, postoperative residual astigmatism, and Toric IOL axis were detected and measured.
RESULTS:Three months after operation, the UCVA of all eyes were 0. 75±0. 16 and the BCVA were 0. 84±0. 15, there was no significant difference between UCVA and BCVA ( t = 1. 036, P>0. 05 ). The anticipated residual astigmatism was ( 0. 28±0. 12 ) D. The actual residual astigmatism after 3mo of the operation was (0. 42±0. 17) D. There was no significant difference between anticipated and actual residual astigmatism (t=1. 259, P>0. 05). The mean axis rotation of Toric IOL was 3. 02o±1.56o (0o-7o) after 1d of operation and 3. 28o±1. 85o (0o-7o) after 3mo. Among all the eyes, 25 eyes ( 89%) rotated <5o, in 3 eyes (11%) rotated 5o-7o.
CONCLUSION: The AcrySof Toric IOL implantation shows good effectiveness, predictability and stability in correcting pre-existing astigmatism in cataract patients.

Rheumatoid arthritis (RA) is an autoimmune disease, which is characterized by synovial inflammation. Hyperplasia sublining macrophages found in synovium is an early hallmark of RA and effective treatment results in their diminution. However, the origin of these sublining macrophages in synovium (including infiltrated macrophages and tissue-resident macrophages) are still unknown both in animal models of arthritis and RA patients, let alone the differences and feature of these macro?phages. In rheumatic synovium, macrophages are submitted to a large variety of micro-environmental signals which influence the phenotypic polarization and activation of macrophages. Understanding the mechanisms and functional consequences of the heterogeneous macrophages will contribute to confirm their potential role in synovial inflammation development. Furthermore, research on macrophage plasticity to soft-control their phenotypic polarization could lead to novel therapeutic approaches.

Objective To evaluate clinical effect and safety of direct hemoperfusion with neutral resin (NS-DHP) on patients with septic shock caused by Gram-negative bacteria infection.Methods A total of 42 patients were enrolled in the study and randomly ( random number) divided into two groups.Patients of control group ( n =24) received sepsis bundle therapy,and patients of group D ( n =18 ) were treated with NS-DHP in addition to sepsis bundle therapy.HA330 hemoperfusion device were used in each patient of group D.The procedure of hemoparfusion lasted 2.5 hours and carried out trice a 24 hours.Clinical data including APCHE Ⅱ score,PO2/FiO2 (OI),mean arterial pressure (MAP),dopamine usage (DA),plasma level of endotoxin (ET),C-reactive protein (CRP),TNF-α,IL-6 and IL-10 were recorded during the treatment.Results Patients well tolerated NS-DHP without any complication in group D.All patients in both two groups did not receive long-term renal replacement therapy.At 24 h,48 h and 72 h after the initiation of treatment,APACHE Ⅱ score,O1,MAP,DA,ET,CRP,TNF-α and IL-6 improved obviously both groups (P ＜0.05),but there was no significant ditterence in serum levels of IL-10 in both groups.In the group D,APCHE Ⅱ score,OI,MAP,DA,CRP,TNF-α and IL-6 were improved more obviously than those in the group C (P ＜0.05) ).There was no significant difference in plasma levels of ET in both groups during the treatment.Conclusions NS-DHP can improve APACHE Ⅱ score,PO2/FiO2 and MAP in patients with septic shock caused by gram-negative bacteria infection and reduce the levels of CRP,TNF-α and IL-6,but has no effect on the levels of ET and IL-10 as well as on 28-day mortality and ICU stay.

Objective To investigate the relation between positive fluid balance and the prognosis in severe sepsis patients with acute kidney injury (AKI).Methods A retrospective analysis of clinical data of 90 patients in our department was carried out.According to the final outcome,patients were divided into survival group (n =26) and non-survival group (n =64),in which the relation between patients' positive fluid balance and the prognosis was evaluated.Results (1) There was no statistically significant difference in the age and severity between survival group and non-survival group of patients with severe sepsis and consequent AKI,but the patients in non-survival group had greater volume overload.Compared with the survival group,higher mean fluid balance [(1 112.12±546.85) mLvs.(644.69±474.93) mL,P=0.00],and less urine output [(1 224.07 ± 708.79) mL vs.(2 032.36 ± 723.53) mL,P =0.00) in non-survival group.(2) There was no significant difference in mortality between early and late continuous renal replacement therapy (CRRT) during ICU care.However,the average daily fluid load in late CRRT patients was significantly greater than that in early CRRT patients [(1178.81 ±397.03) mLvs.(287.22 ± ± 433.53) mL,P =0.00] and the lung oxygenation index in late CRRT patients was significantly worse thanthat in early CRRT patients [(211.22±42.56) vs.(169.46±57.40),P=0.04] (3) The relevant variables to 28-day mortality in AKI patients with severe sepsis included CRRT treatment,oxygenation index and the average daily fluid balance ＞ 500 mL.Among them,fluid balance ＞ 500mL was an independent risk factor for AKI patients with severe sepsis.Their prognosis was worse if they had greater positive fluid balance.CRRT was the protective factor which could affect the prognosis of patients with severe sepsis complicated by AKI.Conclusions Patients with severe sepsis complicated by AKI has a high mortality.Persistent fluid overload can lead to increased mortality in patients with severe sepsis complicated by AKI.Early CRRT can reduce fluid retention in patients with renal failure and improve oxygenation index.