ObjectiveTo seek the approach to the initial diagnosis of pulmonary embolism through analysis and conclusion of the clinical features of pulmonary embolism.MethodsThe high risk factors,clinical manifestation and results of common auxiliary examinations of 23 patients with pulmonary embolism were analyzed retrospectively.ResultsThere were 91.30％(21/23)patients with high risk factors.The common symptoms were dyspnea (91.30％,21/23) and chest tightness (69.57％,16/23 ),while the triad of pulmonary embolism merely accounted for 13.04％ (3/23).And other symptoms included palpitation,chest pain,hemoptysis and syncope,etc.Blood gas analysis indicated that there were hypoxemia and hypocarbia.The positive rate of D-dimer was 91.30％ (21/23).The abnormal rate of electrocardiogram was 91.30％( 21/23 ) and the abnormal rate of echocardiography was 86.96％(20/23).ConclusionAppropriate approach to the initial prognosis can help to establish the diagnosis of patients with suspected pulmonary embolism as early as possible,as well as differentiate other cardiopulmonary diseases.

Objective To determine the prevalence and influencing factors of urinary calculi,to explore the interIrelationships between urinary stone disease and various risk and protective factors,to determine the potential implications for intervention and prevention in Changsha,and to evaluate the relative importance of each risk factor,with the objective of providing scientific guidelines for urinary calculi prevention and diagnosis. Methods A case-control study was designed,and 66,772 people were surveyed.Ultrasound examination,blood biochemistry,general physical examination,gender and age were asked in a questionnaire to determine a diagnosis of urolithiasis.By means of SPSS software a x2 tendency test and non-condition Logistic regression were conducted. Results A multivariate Logistic regression analyses was conducted.The final factors entered into the model were sex,age,profession,dietary habits,drinking habits,smoking and level of uric acid. Conclusions Hazard factors associated with urolithiasis are male gender,age,profession,dietary and drinking habits,smoking and level of uric acid.

Objective:To explore the necessity of monitoring polysomnography (PSG ) in snoring children.Method:The PSG were monitored in 162 children with snoring or apnea.Acording to results of PSG,162 cases were separated into two groups:group obstructive sleep apnea hypopnea syndrome(OSAHS) and group primary snoring(PS),monitoring data including:apnea hypopnea index(AHI),snoring index(SI),lowest oxygen saturation(LSaO_2) and time of SaO_2<0.9,all data were undertaked statistical analysis. Result:In all 162 snoring cases,150 cases(92.6%) belong to group OSAHS,12 cases(7.4%) belong to group PS;Differences of data of age,sex and body mass index(BMI) are not significant but that of AHI,SI,LSaO_2 and time of SaO_2<0.9 are significant(P<0.05).Conclusion:It's necessary to monitor PSG in snoring children for early diagnosis and correct treatment to avoid disadvantage of OSAHS.

Objective To explore the effect of different speed of bladder irrigation after transurethral resection of prostate.Methods 477 cases of benign prostatic hyperplasia,who received transurethral resection surgery were collected.According to the date of surgery,they were divided into observation group(in a single day,249 cases)and control group(double day,228 cases).The normal saline was used in the two groups,and the control group was washed with the conventional bladder irrigation,and the observation group was treated with the early rapid(no speed limit opening)and the routine velocity alternating flushing.The incidence of bladder spasm,the incidence of bladder spasm,the bleeding of bladder and the changes of heart rate and the mean arterial pressure of 24h were compared. Results Urine turned clear time,the total fluid,postoperative 5d red blood cell count of the observation group[(19.8 ± 8.3)h,(44.7 ±6.1)L,(25.8 ±11.3)months/μL]were significantly lower than the control group[(25.4 ±9.0)h, (52.3 ±7.4)L,(33.4 ±10.1)months/μL],the differences between the two groups were statistically significant(t =-6.270,-2.417,-10.459,all P <0.05).The incidence rate of bladder spasm,seizure frequency and duration per capita of the observation group[24.5%,(2.2 ±0.6)times,(15.4 ±4.6)min]were significantly lower than the control group[46.9%,(6.7 ±1.2)times,(27.6 ±5.1)min],the differences between the two groups were statistically significant(χ2 =8.725,t =-13.250,t =-18.066,all P <0.05).The postoperative rinse 1h,2h and 24h heart rate,mean arterial blood pressure had no statistically significant differences(all P >0.05).Conclusion The early rapid and conventional alternating washing method can improve the seizure of bladder spasm after prostatectomy,and reduce the bleeding of bladder.

Objective:To explore the effect of sodium cantharidate vitamin B6 injections in the adjuvant treatment of advanced cer-vical cancers. Methods:Totally 60 cases of advanced cervical cancer patients were randomly divided into the observation group and the control group, and the control group was given common DP chemotherapy and radiotherapy, while the observation group was given sodium cantharidate vitamin B6 injections additionally. After the 6-week treatment, the short-term curative effect, bone marrow inhibi-tion adverse reaction, immune function and life quality were compared between the two groups. Results:The short-term curative effect in the observation group was 66. 7%, which was significantly higher than that in the control group (40%)(P<0. 05). The degree of adverse reaction was significantly lower than that in the control group with statistical significance (P<0. 05). After the treatment, CD8 +, NK cells and CD8 + / CD4 + in the two groups were significantly improved, and those in the observation group were all better than those in the control group (P<0. 05). The improvement of life quality in the observation group was more notable than that in the control group with statistical significance (P <0.05). Conclusion: Sodium cantharidate vitamin B6 injections can significantly in-crease the short-term curative effect and immune function, decrease bone marrow inhibition and improve life quality of advanced cervi-cal cancer patients.

OBJECTIVE:To analyze volatile oil from the roots and fruits of Kadsura longipedunculata. METHODS:GC-MS method was adopted. The determination was performed on HP-5MS quartz capillary column with nitrogen as carrier gas at the flow rate of 0.9 mL/min. The temperature of sample inlet was 250 ℃,the initial temperature of column was set at 50 ℃(temperature programming). The column pressure was 80 kPa;the ratio of split sampling was 40 : 1. The sample size was 1.0 μL. Mass chroma-tography was as follows:electron bombardment ion source as ion source;electron energy of 70 eV;inlet temperature was 230 ℃;scanning range of m/z 40-400,scanning interval time of 1.0 s. RESULTS:Totally 43 chromatographic peaks were detected in vola-tile oil from the roots of K. longipedunculata,and 24 peaks were identified,accounting for 91.5%;main components were sesqui-terpenes and monoterpenoids,among which the relative contents of (+)-delta-cadinene,γ-cadinene and isovalencene were in high level. Totally 52 chromatographic peaks were detected in volatile oil from the fruits of K. longipedunculata,and 36 peaks were iden-tified,accounting for 82.2%;main components were sesquiterpenes and monoterpenoids,among which relative contents of caroph-yllene,γ-cadinene and valencene were in high level. CONCLUSIONS:The study basically confirm main volatile components in volatile oil from the roots and fruits of K. longipedunculata,and the roots and fruits of K. longipedunculata have significant differ-ence.

Objective To observe the clinical effect of psychological intervention combined with somatostatin in the operation of pancreas. Methods From January 2016 to August 2017, 68 cases of pancreatic surgery were treated in our hospital. The patients were randomly divided into the observation group (n=34) and the control group (n=34). All patients were treated with somatostatin after the operation of pancreas. The patients in the observation group were treated with positive psychological intervention, and the effect of the application was observed. Results After the intervention, the two groups of patients with SAS and SDS were improved, the improvement is more obvious in the observation group (P<0.05);the observation group anal exhaust time, patients with gastrointestinal peristalsis time, bed time, hospitalization time were significantly shorter than the control group (P<0.05). Conclusion The combination of psychological intervention and somatostatin can improve the psychological status and promote postoperative recovery of patients after pancreatic surgery.

Objective To carry out patients' participation in promoting health care workers(HCWs) to improve hand hygiene (HH) compliance in the outpatient transfusion room, obtain real data of HH, and further provide basis for performing the activity in the whole hospital.Methods HH compliance of nurses in outpatient transfusion room during four stages was observed by using the healthcare-associated infection control toolkit mobile phone APP.Intervention was not implemented at the first stage, HH promotion was implemented at the second stage, simulation of patients participated in promoting HCWs to improve HH compliance was performed at the third stage, and patients actually participated in promoting HCWs to improve HH compliance at the fourth stage.A questionnaire about patients' willingness to participate in the promotion of HCWs to improve HH compliance was developed and filled out by patients and nurses.Results HH compliance rates of nurses in transfusion room at four stages were 21.43%, 44.27%, 61.48%, and 82.88% respectively, differences was significant(χ2=110.35,P<0.01);HH correct rates at four stages were 44.44%, 74.14%, 81.33%, and 81.82% respectively, differences was significant(χ2=18.50,P<0.01).Conclusion Patients participating in promotion of HH can significantly improve HH compliance of HCWs, which is simple and effective, and worth to be popularized.

Kawasaki disease(KD) is a childhood acute self-limiting systemic vasculitis.It is an autoimmune disease.It has replaced rheumatic fever as the most common disease of children with acquired heart disease.Further study of the pathogenesis of KD,help to improve the individualized treatment and prognosis of the disease.The current study on KD,corfirmed its susceptibility to disease and clinical symptoms associated with multiple gene loci,there may be multiple signal paths involved.This paper reviews the recent advances in the genetic and immunological mechanisms of KD.

Imatinib mesylate,as the first generation Bcr-Abl tyrosine kinase inhibitor,has brought revolutionary treatment for Philadelphia chromosome (Ph)-positive chronic myelogenous leukemia (CML);it has been recommended as the first-line treatment for CML by NCCN Practice Guidelines in Oncology in 2008 and European LeukemiaNet(ELN) criteria.However,imatinib has three limitations:first,it is expensive and can not be stopped if efficancy to be maintained;Second,some 20%~30% of patients develope resistance to imatinib;and third,the CML patients can not be cured with imatinib.Taking into consideration of the situation in China,we recommend individual therapy using TKI,HSCT,interferon and cytotoxic drugs for CML patients in China.