Drug Delivery Systems ; Evaluation Studies as Topic ; Gene Targeting ; methods ; Genetic Therapy ; Humans ; Magnetic Resonance Imaging ; methods ; Neoplasms ; diagnosis ; pathology ; therapy ; Positron-Emission Tomography ; Survival Analysis ; Tomography, X-Ray Computed

Objective To investigate the prediction value of procalcitonin and Cystatin C in the evaluation of patients with sepsis 28 day mortality.Method A total of 106 patients with sepsis in Ezhou central hospital.The expressions of PTC and CysC in the serums of the patients were measured on the first day of the hospitalization by microparticle enzyme immunoassay.Pearson correlation analysis was performed to test the correlation of PTC and Cys-C with PCIS.Logistic regression models were used to examine the risk factors of patients' death.The AUC curve was used to test the value of PTC and Cys-C in prognosis of patients with sepsis.Result After follow-up 28 days:①41.18 ％ patients (n=21) diedat the end of the follow up.②In the death group,the PCT concentration was 67.2 ± 20.6ng/ml,significantly higher than the survival group (44.5± 13 ng/ml,t=-5.57,P＜0.01);the Cys-C was 78.8±21.4 mg/ml,significantly higher than the survival group (64.2±16.9,t=-3.14,P＜0.01).③Pearson correlation analysis showed that the expression of PCT and Cys C in peripheral blood was negatively correlated with PCIS (r =-0.578,-0.761,all P＜ 0.05).④ Multivariate logistic regression showed PTC and Cys-C were the independent risk factors for prognosis of patients with sepsis (P＜0.05).⑤ROC analysis showedthe AUC value of PTC and Cys C were 0.866 (95 ％CI=0.749～0.93),0.87 (95％CI=0.77～0.94)respectly.The AUC value of (PTC & Cys-C) was 0.89 (95 ％CI,0.82～0.95),which wassignificantly increased compared with PTC or Cys-C (both P ＜0.05).Conclusion The combined detection of PCT and Cys-C has good predictive value in the evaluation of mortality in children with sepsis.

Objective To investigate the relationship among the levels of B-type natriuretic peptide (BNP) and the extent,prognosis of acute aortic dissection (AAD).Methods The serum levels of BNP were measured in 42 AAD cases.According to the increasing level of BNP,the patients were divided into two groups:group A ( BNP≥ 500 ng/L,n =23 ) and group B ( BNP ＜ 500 ng/L,n =19 ).The extent of the disease and cardiovascular events were compared between the two groups.Results All the patients have elevated levels of BNP.The incidence of lasting aortic dissection (47.83％ vs.15.79％,P =0.048 ) and mortality ( 26.09％ vs.0,P =0.024) were higher in group A compared with those of group B.Conclusion The lasting and higher levels of BNP predict the increasing risk of bad prognosis in acute aortic dissection.

Adolescent ; Female ; Humans ; Hypersensitivity ; microbiology ; Mitosporic Fungi ; Sinusitis ; microbiology

Base Sequence ; Carcinoma, Medullary ; genetics ; surgery ; Codon ; genetics ; Exons ; genetics ; Female ; Humans ; Middle Aged ; Mutation ; Proto-Oncogene Proteins c-ret ; genetics ; Thyroid Neoplasms ; genetics ; surgery ; Thyroidectomy

ObjectiveTo explore a method for reconstruction of the middle and lower facial tension system for surgical rejuvenation.MethodsFrom 2003 to 2011,257 female patients were treated with this procedure,in which superficial musclo-aponeurotic system (SMAS) of the cheeks were tightened and fixed to the deep temporal fascia and the temporal muscle fascia in muhidirectional and oblique toward the eye and ear rather than just toward the ear through purse string suture method to achieve the goals of facial rejuvenation.ResultsThe follow-up data were obtained in 50 cases,with time range of 3-60 months.Each case was evaluated by both the patient and the surgical team.Excellent or good results were achieved for 255 cases.In all we succeeded in correcting the nasolabial sulcal deformity,and the cheek ptosis,and the contour of the face were more smoothly than that of preoperative appearance.The outlines of lower face became narrow,and thinner than the preoperative.All the patients were without loss of facial identity.Complications occurred occasionally,including the tensional blister on the dermal suture point and local numbness.No incision scar,alopecia and facial nerve injury occurred.Effects of rejuvenation were obvious and natural in 3-6 months after surgery.Especially 12 months after operation the results were the best.ConclusionsThis technique addresses the multiple factors involved in the senescent changes of the midface.Proper patient selection,good aesthetic judgment,and surgical competence are required to restore the midface and lower face tension system reconstruction.This novel approach is safe and effective,and the result is stable and lasting.

Objective To analyze retrospectively the HRCT signs in the patients with invasive pulmonary aspergillosis and evaluate the value of HRCT in the diagnosis of invasive pulmonary aspergillosis.Methods The cilinical and HRCT images of 30 cases with invasive pulmonary aspergillosis diagnosed by fiber bronchoscopy, CT guided biopsy or sputum culture were collected.HRCT images were analyzed and the HRCT signs were summarized by two experienced chest imaging radiologists.Results 19 patients had a variety of CT signs, the sign of tree in bud was seen in 8 cases, bronchial stenosis 6 cases, bronchiectasis 8 cases, ground-glass opacity 8 cases, acinic nodules 10 cases, nodular lesions 12 cases, acinar nodules with halo sign 4 cases, nodules with halo sign 9 cases, cavity 10 cases.11 cases only had a single CT sign, the sign of tree in bud was seen in 2 cases, bronchiectasis 2 cases, ground-glass opacity 1 case, acinar nodules 2 cases, nodules with halo sign 2 cases, cavity 2 cases.The occurrence rates of various signs in 30 cases were as follows, the sign of tree in bud was 33.3%, bronchial stenosis 20%, bronchiectasis 33.3%, ground-glass opacity 30%, acinar nodule 40%, nodular lesion 46.6%, halo sign 53.3%,cavity 40%.Conclusion The main HRCT signs in the patients with invasive pulmonary aspergillosis includes tree in bud, bronchial stenosis, bronchiectasis, ground-glass opacity, acinar nodules, nodal lesions,pulmonary cavity and halo sign.The signs of bronchiectasis with tree in bud sign, acinar nodule and halo sign in the HRCT images are highly specific in the diagnosis of invasive pulmonary aspergillosis.

Objective To study the effect of low tidal volume ventilation in patients with respiratory failure due to neuromuscular disease. Methods Fifty-seven patients with neuromuscular disease and respiratory failure requiring mechanical ventilation were divided into low tidal volume ventilation group ( group A: 2 7 cases ) and routine tidal volume ventilation group (group B: 30 cases ). Indices of airway pressure and blood gas were recorded. The levels of TNF, IL-6, IL-8 in Bronchoalveolar Lavage Fluid (BALF) were measured after ventilation. The survival rates of 14 days and weaning success rates of 14 days were observed. Results The pH value in arterial blood gas at 0.5 and 24 hour after ventilation was 7.30 ± 0.08,7.40 ± 0.06 in group A,which were significantly lower than those of 7. 39 ± 0. 06,7.47 ± 0. 04 in group B at the same time point ( P ＜ 0. 05 ). The PaCO2 levels at0.5 and24 h were (60.4 ± 16.9)mm Hg and (38.2 ±7.3)mm Hg in group A,which were also significantly higher than those of (46. 6 ±8. 1 )mm Hg and (29.2 ±6.9)mm Hg at the same time point in group B (P ＜ 0.05 ). The airway peak pressure at 0.5 and 24 hour were (21.5 ± 4.5 ) mm Hg and ( 18.6 ± 3.8 ) cm H2O in group A,which were significantly lower than those of (29.4 ±5.1)cm H2O and (31.3 ±4.7)cm H2O at the same time point in group B (P ＜ 0. 05 ). The levels of TNF in BALF at 24 and 48 hour were ( 1385 ± 341 ) ng/L and (1345 ±411 )ng/L in group A,which were significantly lower than those of (1914 ± 501 )ng/L and (2214 ± 544)ng/L in group B at the same time point (P ＜0.01 ). The level of IL-6 in BALF at 24 and 48 hour were (249 ±64)ng/L and (209±49)ng/L in group A,which were significantly lower than those of (324 ±79) ng/L and (343 ±60)ng/L in group B at the same time point ( P ＜ 0. 01 ). The levels of IL-8 in BALF at 24 and 48 hour were (79. 4 ±23.6) ng/L and (92. 7 ± 32. 5)ng/L in group A,which were significantly lower than those of (143 ± 36)ng/L and (162 ±49)ng/L in group B at the same time point (P ＜0.01 ). No significant difference was found in the survival rates of these two groups (100% vs. 96. 7% ,P ＞0. 05). The higher weaning success rate was observed higher in group A (59. 3% ) than group B (33.3%, P ＜ 0. 05 ). Conclusions For patients with respiratory failure resulting from neuromuscular disease,low tidal volume ventilation can decrease ventilation-induced cytokine release, alleviate ventilator-induced lung injury, and increase the success rate of ventilator weaning.

Objective High-density porous polyethylene(Medpor)has been widely used in chin augmentation in recent years.The study aimed to observe the outcomes of clinical use of high-density porous polyethylene implant in chin augmentation in contour plastic surgery of low face.Methods From 2005 to 2008,149 cases of chin augmentations intraorally with Medpor implants combined with were collected.121 of them received bilateral mandibular angle osteotomy and 28 cases received bilateral mandibular angle osteotomy and bilateral malar reduction simultaneously.They wre all females aged from 17 to 46 years.The patients were followed up for 6 to 36 months(average 24 months)and photographs were taken before and after operations.Clinical outcomes were observed and analysed.Resuits 145 patients(97.3%)were satisfied with their chin and contour of low face.2 patients (1.3%)were not satisfied with the projection of their chin,and 1 of them were admitted to take out the implant and received sliding advancement genioplasty.1 patient(0.7 0A)felt the implants was too large to some extent and was admitted to modify the implant.1 patient(0.7%)received genioplasty 6months after operation because of the deviation of the implant.20 patients(13.4%)felt numbness of the lower lip which gradually disappeared 1 to 3 months postoperatively.Complications such as infection,edema and extrusion,break of the implant were not found during the following period.Conclusions Medpor is an excellent biomaterial with good biocompatibility.Simultaneously chin augmentation with Medpor combined with bilateral mandibular angle osteotomy intraorally shows a good result in contour plastic surgery of low face.

Objective To observe the efficacy and safety of liver decanoic sulfonic sodium in the treatment of elderly patients with acute coronary syndrome (ACS).Methods84 ACS patients over 70 years were randomly divided into the treatment and control groups.Two groups were treated on the basis of general,treatment 40 cases of liver of dibutyl sebacate with sodium sulfonated added 2.5 mg subcutaneous injection parumbilical,day 1,course 8 d ; control group 44 cases combined with low molecular weight heparin calcium 0.4 ml,2 times/day 1 time every 12 hours,according to body weight adjusted dose,Parumbilical shot in course of 8 days,observing the clinical effect of two groups during the treatment,as well as 4 weeks and bleeding during the treatment the incidence of cardiovascular events.Results The clinical effects of treatment and control groups was no significant difference (95％ and 91％,P ＞0.05) ; None of the two sets of death,myocardial infarction and recurrent malignant ventricular arrhythmia; none of the two sets of bleeding occurs,treatment of minor bleeding rates were significantly lower than those of control groups (7.5％ and 25％,P ＜ 0.05).Conclusion The study of dibutyl sebacate with sodium heparin and low molecular weight heparin calcium in the treatment of ACS are valid,but the former which significantly reduce the incidence of minor bleeding.Liver decanoic sulfonic sodium for acute coronary syndrome ACS)anticoagulation can not only effectively reduce cardiovascular events,but also significantly reduce bleeding risk,regardless of the patient's age,gender,renal function and risk stratification,especially for bleeding in high risk elderly patients with safe and clinical promotion.