Objective To compare the accuracy of quantitative CT(QCT), perfusion scintigraphy and anatomical segmentation in predicting postoperative lung function in lung cancer patients. Methods Pulmonary functional tests, quantitative CT scan and perfusion seintigraphy in 12 cases before operation were performed. Forced vital capacity (FVC), the first second forced expiratory volume (FEV1.0) and diffusing capacity of carbon monoxide (DLco) were obtained from preoperative pulmonary functional tests. According to the corresponding formula for QCT, perfusion sintigraphy and anatomical segmentation method, the values of FVC, FEV1.0 and DLco were predicted. The correlation between the predicted values and postoperative values of FVC, FEV1.0 and DLco were assessed. The paired-t test,Pearson correlation test and Bland-Altman analysis were used for the statistics. Results The predicted values of QCT, perfusion sintigraphy and anatomical segmentation method were: FVC [(3.05±0.82), (2.98±0.75) and (2.98±0.86) L,respectively] , FEV1.0[(2.20±0.81), (2.17±0.78) and (2.16±0.84) L, respectively], DLco (FVC: r=0.87, 0.80 and 0.86; FEV1.0:r =0.93, 0.91 and 0.93; DLco:r =0.93, 0.95 and 0.93,respectively,P < 0.01). Conclusion QCT, perfusion sintigraphy and anatomical segmentation method can be used in predicting postoperative lung function. The predicted values are in concordance with the postoperative ones.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Cyclophosphamide ; administration & dosage ; Diagnosis, Differential ; Female ; Humans ; Panniculitis ; drug therapy ; pathology ; Panniculitis, Nodular Nonsuppurative ; pathology ; Prednisone ; administration & dosage ; Vincristine ; administration & dosage

Objective To investigate the influence of hydroxyethyl starch solution on exogenous coagulation and active protein C (APC) in the patients with septic shock.Methods A single-center prospective study was conducted.Eighty-four consecutive patients with septic shock admitted to intensive care unit (ICU) of Peking University People's Hospital from November 2009 to October 2014 were enrolled.The patients were randomized into two study groups by random digits table:Ringer lactate solution group (RL group,n =40) and hydroxyethyl starch group (HES group,n =44),and Ringer lactate solution or hydroxyethl starch 130/0.4 was used for resuscitation respectively.Peripheral blood was collected at four time points:before resuscitation,6,12,and 24 hours after resuscitation.The prothrombin time (PT),tissue factor (TF),tissue factor pathway inhibitor (TFPI) and APC were determined,and the length of ICU stay and the mortality were recorded.Results There were no significant differences in PT,TF,TFPI,and APC before and after resuscitation in RL group.No change in PT was found after resuscitation in HES group,and no significant difference was found as compared with RL group.TF after resuscitation in HES group was decreased gradually,and the level at the 24 hours after resuscitation was significantly lower than that before resuscitation (U/L:15.80±7.32 vs.31.40±2.75,P ＜ 0.05); but there was no significant difference at all time points when compared with that of RL group (all P ＞ 0.05).TFPI at 12 hours and 24 hours after resuscitation in HES group was increased when compared with before resuscitation (μg/L:1.32±0.22,1.14±0.09 vs.0.63±0.54).TFPI in HES group was significantly higher than that in RL group (μg/L:0.84 ± 0.69,0.95 ± 0.30),but there was no significant differences between two groups (both P ＞ 0.05).APC after resuscitation in HES group was decreased gradually,which was significantly lower than that in RL group at 6,12,24 hours after resuscitation (mg/L:3.38±3.00 vs.5.98±4.12,3.31 ± 1.94 vs.5.33 ± 3.71,3.42 ± 2.64 vs.7.53 ± 4.67,P ＜ 0.05 or P ＜ 0.01).The length of ICU stay in HES group was significantly shorter than that in RL group (days:12.50 ± 8.83 vs.17.10± 16.60,t =9.037,P ＜ 0.001),but there was no significant difference in mortality between HES group and RL group [40.9％ (18/44) vs.60.0％ (24/40),x 2=2.339,P =0.126].Conclusions Both RL and hydroxyethyl starch fluid resuscitation did not affect the PT of the patients.The use of hydroxyethyl starch probably inhibits excessive activation of the exogenous coagulation and hyper-coagulation in the early stage of sepsis,and inhibits activation of protein C as well.

To analyze one case of multi-organ involvement of immunoglobulin G4-related disease and to review the related literatures.Through investigating the clinical data of one case of multi-organ involvement of immunoglobulin G4 (IgG4)-related disease,many related references were retrospected.IgG4-related disease and multi-organ involvement are used as the key words to search on Pubmed and Wanfang Database.According to the clinical manifestations,including serology,imaging,histopathology,responses to steroid therapy,a 65-year-old female patient was diagnosed as IgG4-related disease.The patient exhibited salivary gland swelling,lacrimal glands,and orbital soft tissues.And multiple organs such as pancreas,liver,bile duct,retroperitoneum,the lymph node,lung,paranasal sinuses,kidney and ureter were affected in the patient.Glucocorticoids are the mainstay of therapy and the recommended dose is 0.5-1.0 mg · kg-1 · d-1.Immunosuppressive agents need to be used in relapsing patients or in the patients with multi-organ involvement and serious complications.IgG4-related disease usually affects many systems and involves multiple organs,which is always misdiagnosed to other diseases.Both the correct diagnosis with multidisciplinary fields and the early treatment with glucocorticoids are very important.

Abstract?Since the introduction of 25-gauge/23-gauge ( 25G/23G ) sutureless micro -incision vitrectomy surgery ( MIVS ) at the beginning of the 21 century, we have stepped into an era of micro-incision vitreoretinal surgery more than10a. The current 25/23G MIVS provide numerous advantages over the conventional 20G vitrectomy surgery including simplified surgical procedure, shortened operating time, decreased complications as well as smaller sclerotomy wound.As a result, vitreoretinal surgeons have been shifting gradually from 20-gauge to 25/23-gauge vitrectomy in the past decade. As the 25/23G MIVS adapted worldwide, however, its drawbacks were also increasingly reported. Most criticism regarding to current 25/23G MIVS are focusing on would sealing related complications.Based on stablished notion regarding vitrectomy -“the smaller the better”, researchers and doctors were keeping on exploring the next generation of vitrectomy system. Thanks to the innovation and development in new generation vitrectomy machines, high lumen output light source, more delicate manufacturing technology and clear wild angle fundus view system, Dr.Oshima from Japan launched the first 27-gauge vitrectomy surgery system.It provided us novel surgical experience with smaller sclerotomy wound and faster cut rate. Further development and refinement of vitrectomy with 27-gauge or more are still on its way and will continue in the future. Undoubtedly, MIVS would be heated debated regarding its pro/con, complications, indications and future development.Combined with our own experiences, here we briefly reviewed the 27-gauge vitrectomy surgery.

Objective To evaluate the quality of life (QOL)among patients with anti -TB treatment in Zhoushan city and to analyze the influence factors.Methods Our self -designed questionnaire and WHOQOL -BREF scale were used to investigate the general information and the quality of life among 187 tuberculosis patients.Scores of life quality under different conditions were compared.Results The scores of physiological domain,psychological domain,social relations and environmental domains were 61.13 ±13.12,53.24 ±16.59,59.91 ± 12.08 and 60.12 ± 15.68 respectively. The scores of all domains excluding the environmental relations were significantly lower than the normal level (P <0.05). The scores of males were significantly higher than females in psychological domain (P <0.05),and the score differences among age groups were of statistical significance both in physiological domain and psychological domain (both P <0.05). Those with high education levels scored higher than those with lower education level in psychological and social domains (both P <0.05).The scores of different economic income in 4 domains showed significant differences (all P <0.05). The first time treated,hospitalization time less than 1 month and effectively treated patients scored higher than those not (all P <0.05).Conclusion The quality of life among tuberculosis patients could be influenced by sex,age,income, education,and treatment factors,so appropriate health care such as psychological support and health education should be provided.

Fatal Outcome ; Female ; Fever ; Humans ; Infant ; Purpura, Schoenlein-Henoch ; diagnosis ; therapy

The discussion about the relationship between doctors and patients has been a hot topic in China for a long time and there are some biased views and even hostility to the doctors. Deep and multiple thoughts on this issue have been induced by the severe acute respiratory syndrome (SARS) event happened during the winter of 2002 and the spring of 2003. After the experience of SARS episode, most people believed that the selfless contribution and dedicated spirit and the brave and fearless behavior that the doctors and nurses manifested and practiced in front of SARS merit great respect. Since the work of medical care has high risk and is very tremendous to the strength of the body of the doctors and nurses, people should deeply understand and support their work. The cbjective report and appropriate focuses by the media constructed an important bridge for the good communication between doctors and patients. The understanding and support from the public and the media have been converted to powerfully spiritual energy for the doctors and nurses to combat SARS. SARS makes a specific expression of the "go through thick and thin together" spirit of the national spirits between doctors and patients and the dedicated contribution and sacrifice by the doctors and nurses created a harmony social environment for the improvement of doctor- patient relationship.

OBJECTIVE:To extract and purify organic acids with macroporous resins from Folium Isatidis.METHODS:Folium Isatidis was extracted with 70% aqueous ethanol(pH=2)by Soxhlet extraction.The process was optimized by employing orthogonal test design with the content of anthranilic acid as the index.RESULTS:The resin HPD100 had much better adsorption capacity and desorption ratio by using 3 BV 60% aqueous ethanol to extract organic acids in Folium Isatidis than other resins.The results showed that HPD100 possessed the better ecomic under the concentration of sample 0.18mg?mL-1,the condition of pH 3.5,and flowing rate of 2BV?h-1.CONCLUSION:Macroporous resin HPD100 may be value of isolating and purifying the organic acids from Folium Isatidis.