Critical Illness ; therapy ; Humans ; Nutritional Support

Gait problems in cerebral palsy patients are usually caused by spasticity or contracture of two joints muscles,and the imbalance between synergic muscles and antagonistic muscles. The knee problems are the most common seen in cerebral palsy patients. The paper discusses the common abnormalities of the knee in cere-bral palsy and the development in treatment of the deformities.

Objective To analyze the relationship between volume,conductivity,laser light scatter (VCS) of lymphocytes and monocytes and atypical lymphocyte.Methods The clinical data of 129 patients with virus infection and 50 healthy controls received blood routine examination by Sysmex-800i hematology analyzer in our hospital were retrospectively analyzed.The lymphocyte volume (MLV),distribution width,(LDW),conductance rate (MLC),laser scattering(MLS) and monocyte cell volume (MMV),distribution width,(MDW),electrical conductivity (MMC),laser scattering(MMS) were analyzed.And according to the heterotypic lymphocyte ratio,the virus infection patients were divided into group 1 (abnormal rate 2％-5％),group 2 (abnormal rate ＞ 5％-10％),group 3 (abnormal rate ＞10％).The healthy controls were selected as control group.The VCS parameters of the four groups were compared.Results The LDW of group 1 was (17.2 ± 2.5) FL,that of the control group was (14.1 ± 2.7) FL,the difference was statistically significant(t =2.362,P ＜0.05).The MLV,LDW,MMV,MDW of group 2 were (85.3 ±5.6) ×109/L,(19 ±3.1) FL,(185.9 ±9.2) × 109/L,(22 ±2.9) FL,which were significantly higher than those of the control group (t =2.557,3.086,2.735,4.269,P ＜ 0.05).The MLV,LDW,MMV,MDW of group 3 were (89.5 ±6.8) ×109/L,(22.3 ±3.6) FL,(194.5 ±9.6) ×109/L,(24.5 ±3.4) FL,which were significantly higher than those in the control group (t =2.982,3.569,2.945,4.863,P ＜ 0.05).The MLC,MLS,MMC,MMS of group 1 were (112.3 ±7.8) μs/cm,(54.8 ±4.9) NTU,(112.3 ±7.8)μs/cm,(83.6 ±4.7) NTU,those in group 2 were (104.7 ±6.9)μs/cm,(52.6 ± 4.5) NTU,(104.7 ± 6.9) μs/cm; (81.1 ± 4.3) NTU,those in group 3 were (96.5 ± 6.2) μs/cm,(50.5 ± 4.3) NTU,(96.5 ± 6.2) μs/cm,(78.7 ± 3.8) NTU,those in the three groups were significantly lower than in the control group (t =2.623,3.195,2.247,5.829,2.457,2.956,2.371,6.715,2.573,3.044,4.395,7.386,P ＜ 0.05).Conclusion VCS parameters of lymphocytes and mononuclear cells of two types of white blood cells can reflect to a certain extent,peripheral blood heterotypic lymphocyte morphology changes of clinical infection,has the reference value of diagnosis and treatment of disease.

Program monitoring and evaluation (M & E) is the major method used in the international collaboration programs on disease control and prevention in China in recent years. It functions in the progress overseeing,problem finding and solving in terms of enhancing the program quality,managing the work plan,summing up the experiences,auditing the performance and finally achieving the expected goal. The indicators and implementation progress based on M & E serve as a scientific tool to measure the program implementation outcome periodically.

Objective To investigate the indications and clinical values of percutaneous transthoracic biopsy guided by different locating means respectively on pulmonary lesions. Methods Patients were divided into different groups according the locating methods,which included X -ray, type -B ultrasonography, and CT. Pathologic diagnosis and complications were retrospectively analysed between groups. Conclusion Each locating method has its own advantages and disadvantages. Results we should choose the optimistic one according the patients′ condition.

The responsibility system of attending doctors plays a positive role in raising hospital efficiency and optimizing medical resources deployment.For the change in the subject of medical liabilities following the introduction of this system,medical management needs to shift from department management to doctor management instead.In the meantime,appropriate rules and regulations are needed to normalize the roles and behavior of the medical office,department heads,and attending doctors in medical activities.This will ensure the successful operation of this responsibility system,and generate ideal medical,economic and social outcomes.

Objective To study the effect of adjuvant transcatheter arterial chemoembolization (TACE) on intrahepatic recurrence after curative liver resection for primary hepatocellular carcinoma (PHC).Methods 130 PHC patients who underwent curative liver resection from June 2010 to February 2013 were selected and randomly allocated to the study group (n =67) and the control group (n =63).The study group underwent adjuvant TACE for 1 ～ 4 times,and the control group did not receive any adjuvant therapy.On follow-up for 36 months,the postoperative recurrence rates,tumour free survival time and tumor free survival rates of the two groups were compared.Results At 6 months after surgery,the serum AFP level [(379.8 ±91.7) μg/L vs.(414.5 ±84.3) μg/L] and the IGFBP-2 level [(2 855.3 ±727.5) μg/L vs.(3 259.6 ± 894.1) μg/L] in the study group were significantly lower than the control group (P ＜ 0.05).The 1-year cumulative recurrence rate in the study group (10.4％ vs.28.6％) was significantly lower than the control group (P ＜ 0.05).However,the 2-year and 3-year cumulative recurrence rates were not significantly different between the two groups (P ＞ 0.05).The 3-year cumulative tumor free survival rate of the study group (81.0％ vs.73.2％) was significantly higher than the control group (P ＜ 0.05).Patients in the study group with portal vein tumor thrombus had an 1-year cumulative recurrence rate of (12.8％ vs.31.6％) and a 2-year rate of (28.2％ vs.50.0％).In patients with a preoperative AFP ≥400 μg/L,the 1-year cumulative recurrence rates were (8.8％ vs.30.6％).When the tumor diameter was ≥10 cm,the 1-year,2 year and 3-year cumulative recurrence rates were significantly lower than the control group (P ＜ 0.05,11.8％ vs.46.7％),(35.3％ vs.75.3％) and (47.1％ vs.86.7％),respectively.The recurrence rates in patients who had no cancer thrombus,a preoperative AFP ≤400 μg/L and a tumor diameter ＜ 10 cm were not significantly different between the two groups (P ＞ 0.05).The recurrent rates of patients who underwent TACE 1 time and those who did not receive TACE showed no significant difference (P ＞0.05).In patients who had TACE twice,the 1-year (4.3％ vs.28.6％),2-year (15.2％ vs.41.3％) and 3-year (26.1％ vs.49.2) cumulative recurrence rates were significantly lower than patients who did not receive TACE (P ＜ 0.05).In patients who had TACE for more than three times,the cumulative recurrence rate was similar to patients who had TACE twice (P ＞ 0.05).Conclusions Adjuvant TACE helped to reduce PHC recurrence after curative liver resection during the high-risk period for recurrence.A 1-time TACE did not significantly reduce postoperative recurrence rate,and ≥ 3 times TACE did not significantly improve tumor-free survival rates.Adjuvant TACE and the number of TACE should be reasonably carried out based on the indications and pathological characteristics.

Objective To optimize the formulation of controlled-onset extended-release tablets of nicorandilby central composite design-response surface method. Methods The tablets containing nicorandil were prepared bydry-compression coating technique.The influence factors included the amount of HPMC, the amount of EC, and the ratio of lactose/MCC in coating film. The evaluation parameter was Q4 h and Q5 h . The possibly optimal formulation was predicted by response surface method. Results The OD was simulated using second-order polynomial equation and the r2was 0.970 1.Optimal prescription was as follows:HPMC 89.96 mg, EC 46.21 mg, Lactose/MCC 1.87.Bias between the observed and predicted values of the OD was within 0.43%. Conclusion The controlled-onset extended-release tablets of nicorandil can release drug quickly in vitro at the predetermined time.Central composite design-response surface method can be used to optimize the formulation and the model developed in this study was proved highly predictable.

Objective To understand the situation of prevention and control knowledge and the relevant behaviors about cardiovascular and cerebrovascular disease among community residents in Guangdong Province in order to provide a basis for develop cardiovascular and cerebrovascular disease prevention and control work in the future.Methods Through a randomized sampling method chose community residents participating in cardiovascular and cerebrovascular diseases prevention and control among community residents in Guangdong Province consultation in Guangdong Province seven cities using questionnaire investigation.Results Total 1577 community residents were investigated, of which 50.4% were male, 49.6% female;the cardiovascular and cerebrovascular disease prevention and control knowledge different among the population with different gender, age and region, with statistic significance;according to investigation, 17.1%, 13.5% and 14.9% of the population investigated had the habit of smoking, drinking, and salty badly respectively;50.7% of population had health protection through dietary conditioning, which was 35.4% through the physical training.Conclusion Knowledge awareness situation of cardiovascular and cerebrovascular diseases prevention and control was poor among community residents in Guangdong Province, and risk factors of cardiovascular and cerebrovascular disease existed in the population;health education of cardiovascular and cerebrovascular diseases should be strengthened to change adverse behavior of community residents, develop a healthy and scientific way of life, prevent and control the disease.

OBJECTIVE: To evaluate the current situation and the trend of cardiovascular drugs used in 6 cities in the Yangtze river valley between 2002 and 2004.METHODS:Consumption of cardiovascular drugs used in 157 hospitals of 6 cities in the Yangtze river valley were analyzed by the way of sum and DDDs ranking. RESULTS:The total annual cost of the cardiovascular drugs used in 6 cities was 13.6 billion yuan in 2004, increasing by 58.8%, as compared with that in 2002.The total average consumption of anti-anginal and vasodilating agents, antithrombotic agents and antihypertensives accounted for 84.1% of the total cost in 3 years.CCB, ACEI, Nitrate esters,?-blockers and Chinese medicines dominated in the ranking of sum and DDDs.CONCLUSION: Right medicines with higher patient compliance rates, lower ADR occurrence, more certain therapeutic effect and economical daily cost have become the preferable choices for clinical physicians.