0.05).CONCLUSION:Mecobalamin and buflomedil hydrochloride are more economic than alprostadil,while mecobalamin more economic than bu?flomedil hydrochloride.

Objective:To retrospectively analyze the routine clinical laboratory parameters for hepatocellular carcinoma,in an attempt to search for parameters for diagnosis of hepatocellular carcinoma(HCC).Methods:The pre-operation clinical labo- ratory data,such as tumor makers,and serological biochemical indices,hepatitis B virus(HBV)infection markers,and HBV DNA titers,were collected from 828 patients who were pathologically diagnosed as having HCC;then the correlation between these data with tumor size and the pathological grades of HCC was analyzed.Results:It was found that 97.9% of the 828 pa- tients were infected with HBV and 70.9% of them were accompanied by liver fibrosis.We also found that the tumor size was correlated with albumin(ALB),globulin(GLB),A/G,aspartate aminotransferase(AST),ratio of aspartate to alanine amin- otransferase(AST/ALT),gamma-glutamyl transferase(GGT),alkaline phosphatase(ALP),alpha-L-fucosidase(AFU),al- pha-fetoprotein(AFP)and tumor grades;meanwhile,the pathological grades of tumor was correlated to prealbumin(PALB), GGT and tumor size(all P

Adolescent ; Biopsy ; Cough ; etiology ; Diagnosis, Differential ; Female ; Fever ; etiology ; Humans ; Lung ; diagnostic imaging ; pathology ; Sarcoidosis, Pulmonary ; diagnosis ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed

Objective To explore the value of multislice spiral computed tomography ( MSCT ) in predicting the resectability of pancreatic cancer ( PC) .Methods The MSCT images of 102 PC patients ( 62 men, mean age, 61 ±9 years;40 women, mean age, 60 ±9 years) confirmed by postoperative pathology were analyzed retrospectively .The images were analyzed and evaluated by 2 senior radiologists who were double blinded.The relationship between tumor and vessels was investigated based on consensus statement on the radiological diagnosis of PC of the Society of Abdominal Radiology and the American Pancreatic Association in 2014 .The diagnostic criterion on the resectability of PC was based on the 2015 NCCN Clinical Practice Guidelines on PC . Image analysis included the lesion location , size and density , the characteristics of pancreatic and bile ducts , relationship of tumor and adjacent vessels , the extrapancreatic findings as well as T staging and resectability.Results The locations of PC were found in the pancreatic head (n=71,69.6%), body (n=23, 22.5%) and tail (n=8, 7.8%).The long-and short-axis diameter were (28.9 ±8.8)mm and (23.8 ±8.0)mm in head, and respectively, (31.2 ±11.0)mm and (23.8 ±6.3)mm in body and tail, respectively.The imaging findings included hypo-(n=98, 96.1%) and iso-density masses (n=4, 3.9%) on pancreatic phase, intra-and extrahepatic bile duct dilation (n=63, 61.8%), main pancreatic duct cut-off with dilation (n=46, 45.1%), the pseudocyst (n=4), acute pancreatitis (n=1) and chronic pancreatitis (n=2).T staging evaluation by MSCT observed T1 (n=3), T2 (n=7), T3 (n=78) and T4 (n=14), respectively.MSCT assessment for T staging was correct in 98 (96.1%), but wrong in 4 (3.9%), which was quite consistent with pathological T staging (K=0.88, P<0.05).MSCT assessment for the resectability was correct in 98 (96.1%), but wrong in 4 (3.9%).Sensitivity, specificity, positive and negative predictive values, and area under curve of MSCT in the assessment of the resectability were 96.8%, 87.5%, 98.9%, 70.0%and 92.2%, respectively.Conclusions MSCT could improve the diagnostic accuracy for T Staging and resectability of PC .

Objective To explore the non-bacteria etiology of pneumonia in children under 12 years old in southwest Shanghai,and investigate clinical characteristic of pneumonia caused by different pathogens.Methods The serum of 187 children with pneumonia from July 2002 to December 2004 in hospital were investigated for respiratory syncytial virus(RSV),adenovirus 3 influenza viruses(IFV) A and B,parainfluenza viruses(PIV)type 1,2,3,4 and coxsackievirus A 1.7,echovirus 7 by employing the indirect immunofluorescence assay(IFA)for the identification of nearly 8 different viruses,and 3 different enteroviruses.Based on the principle that sensitized particles were agglutinated by the pressence of antibodies to mycoplasma pneumonia in human serum.Results Examination for 8 kinds of conventional respiratory virus infected,a total of 90 positive results in 187 cases(48.13%),Firstly was RSV(19.79%),(secondly) was IFV B(16.58%).Out of these 1084 children,154 cases(14.21%)showed positive in anti-mycoplasma pneumonia.Conclusions RSV is still the leading cause of pneumonia in children during winter and spring in southwest in Shanghai.Mycoplasma pneumonia is having been the major pathogens of the school-aged children with pneumonia.

Objective To explore the diagnostic value of DWI after secretin stimulation for the diagnosis of mild chronic pancreatitis (CP). Methods This was a prospective study. Ninety-nine consecutive individuals including 23 healthy volunteers, 11 risk volunteers, 15 mild CP patients, 14 moderate CP patients and 36 severe CP patients underwent secretin DWI and faecal elastase 1(FE-1) testing. The subjects were grouped by Cambridge classification about endoscopic retrograde cholangiography (ERCP), CT and ultrasonography. Secretin stimulated diffusion weighted imaging(S-DWI), the ADCs, time to peak ADCs and FE-1 were performed on all subjects. The changes of pancreatic ADC values were observed before and after the injection of secretin. All ADCs and FE-1 were compared between groups with single factor analysis of variance, and the correlation between ADCs and FE-1 was determined with Pearson analysis. ROC curves were performed to identify the diagnostic efficacy of DWI related measures. Results Eight patients with severe CP were excluded because the significant atrophy of the pancreatic parenchyma prohibited the evaluation of ADC measurement. Ninety-one individuals were divided into five groups including 23 healthy volunteers, 11 risk volunteers, 15 mild CP patients, 14 moderate CP patients and 28 severe CP patients. The mean baseline and peak ADCs were higher in the healthy volunteers than in other groups, with significant differences (P<0.05). There was no ADC peak in severe CP patients. There were significant differences between the mean baseline ADCs and the peak ADCs in the other groups (P<0.05). The mild and moderate CP groups showed a delayed peak. The area under curve (AUC) of the mean baseline and peak ADCs, time to peak ADCs for differentiating mild CP was 0.818, 0.912 and 0.965, respectively. Using 4.67 min as the cutoff value, time to peak ADCs were most accurate for differentiating healthy from risk patients and those with evident pancreatitis, yielding a sensitivity of 80.0%and a specificity of 100.0%. Good correlations between baseline and peak ADCs, time to peak ADCs, and FE-1 were shown(r=0.57, 0.72 and-0.84, P<0.01). Conclusions Using the peak and time to peak ADCs may improve the detection of risk and mild CP. Secretin-enhanced DWI is a noninvasive, convenient and accurate method.

Objective To evaluate the CT findings and classification of the Le Fort fracture. Methods Sixty-two cases with Le Fort fractures were studied with thin-slice high-resolution CT scanning and analyzed with three-dimensional(3D)imaging reconstruction.Results Of the 62 patients,10 had Le Fort type Ⅰ fracture,9 had Le Fort type Ⅱ fracture,8 had Le Fort type Ⅲ fracture,and 35 had various combinations of the three types of Le Fort fractures,including 18 Le Fort Ⅰ+Ⅱ fracture,7 Le Fort Ⅰ+ Ⅱ+Ⅲ fracture and 10 Le Fort Ⅱ+Ⅲ fracture.Fifty-five cases had associated multiple fractures in the maxillofacial region.On 2D CT images,Le Fort fracture manifested as multiple and complex fractures. Though 2D image was better than 3D image in accurately defining tiny fractures and fractures of deep structures,the diagnosis of Le Fort fracture could not be correctly made solely on 2D image.3D CT clearly and stereoscopically demonstrated the entire shape and orientation of Le Fort fracture,thus facilitating the correct classification of Le Fort fracture.Conclusion 3D CT image is important in providing information about the space relationship of Le Fort fracture,thus very valuable for the preoperative planning.

OBJECTIVETo subjectively and objectively assess the effect of Jiawei Xiaoyao Powder (JXYP) on sleep in patients with psychological stress insomnia. METHHODS: A randomized controlled study was conducted in 33 patients with psychological stress insomnia. They were assigned to 4 groups, 4 in the TCM group treated with JXYP, 5 in the Western medicine (WM) group treated with Estazolam, 9 in the integrated medicine (IM) group treated with JXYP plus Estazolam, and 10 in the control group treated with placebo. Quality of sleep in patients was assessed subjectively and objectively before treatment and 6 weeks after treatment by Pittsburgh sleep quality index (PSQI), self-rating scale of sleep (SRSS) and polysomnography (PSG), respectively.

RESULTSSubjective assessment on sleep showed that after 6-week treatment, the scores of PSQI and SRSS remarkably reduced in the TCM, IM and control groups (P < 0.05), while the decrease was insignificant in the WM group (P > 0.05), but no significant difference between groups was shown. The objective assessment by PSG showed that no significant change was found after treatment in parameters of total sleep time (TST), sleep time of phase 1 and 2, slow wave phase, rapid-eye-movement (REM) phase, sleep latency, REM sleep latency, also in long waking and short waking times in all group (P > 0.05), but a significant increase of sleep efficacy (P < 0.05) and an increasing trend of TST (P > 0.05) were shown in the IM group, and an increasing trend of both in the TCM group (P > 0.05).

CONCLUSIONJXYP, combined with or without Estazolam, can improve the quality of sleep subjectively, and the combination of the two could enhance the efficacy of sleep in patients with psychological stress insomnia.

Adult ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Estazolam ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Sleep Initiation and Maintenance Disorders ; drug therapy ; psychology ; Stress, Psychological ; complications ; Young Adult

BACKGROUND:For patients in intensive care unit (ICU), mechanical ventilation is an effective treatment to survive from acute illness and improve survival rates. However, long periods of bed rest and restricted physical activity can result in side effects. This study aimed to investigate the feasibility of early rehabilitation therapy in patients with mechanical ventilation. METHODS:A randomized controlled trial was carried out. Sixty patients, with tracheal intubation or tracheostomy more than 48 hours and less than 72 hours, were admitted to the ICU of the Affiliated Hospital of Medical College, Qingdao University, from May 2010 to May 2012. These patients were randomly divided into a rehabilitation group and a control group. In the rehabilitation group, rehabilitation therapy was performed twice daily, and the training time and intensity were adjusted according to the condition of the patients. Early rehabilitation therapy included heading up actively, transferring from the supine position to sitting position, sitting at the edge of the bed, sitting in chair, transferring from sitting to standing, and ambulating bedside. The patient's body mass index, days to first out of bed, duration of mechanical ventilation, length of ICU stay, APACHE Ⅱ score, highest FiO2, lowest PaO2/FiO2 and hospital mortality of patients were all compared between the rehabilitation group and the control group. The differences between the two groups were compared using Student's t test. RESULTS:There was no significant difference in body mass index, APACHE Ⅱ score, highest FiO2, lowest PaO2/FiO2 and hospital mortality between the rehabilitation group and the control group (P>0.05). Patients in the rehabilitation group had shorter days to first out of bed (3.8±1.2 d vs. 7.3±2.8 d; P=0.00), duration of mechanical ventilation (5.6±2.1 d vs. 12.7±4.1 d; P=0.005) and length of ICU stay (12.7±4.1 d vs. 15.2±4.5 d; P=0.01) compared with the control group. CONCLUSION:Early rehabilitation therapy was feasible and effective in improving the outcomes of patients with mechanical ventilation.

Objective To analyze the imaging findings and misdiagnosis of intraductal papillary mucinous neoplasm (IPMN),to improve diagnosis level and decrease misdiagnosis rate.Methods The images of 130 patients were suspicion or diagnosis of IPMN, and the other pancreatic lesions but confirmed IPMN by pathology.Two radiologists collected materials, analyzed the reasons of misdiagnosis, and found out countermeasures.Results A total of 130 patients confirmed by pathology were available for analysis, in which there were 105 (80.7%) of IPMN, and 25 (19.2%) of other pancreatic lesions.The most misdiagnosed patients were between IPMN and chronic pancreatitis(CP),serous cystadenoma(SCN).All patients were divided into mild to moderate group and severe to infiltrating carcinoma group based on pathologic grades.There was significant difference between two groups in cystic diameter, wall nodule, separation and dilation, the diameter of main duct, and intra-or extrahepatic biliary tract(P<0.05).The most common causes of misdiagnosis included that the radiologists didn't combined with the patient's clinical features,and didn't reconstruct images or perform MRCP scan when the relationship between the lesions and the pancreatic duct was unclear.Conclusion It is important that the radiologists need to combine with the patient's clinical features, clear the relationship between the lesions and the pancreatic duct, and fully master imaging findings.The recurrent pancreatitis maybe result from IPMN, and IPMN for a long time would lead to CP.