Objective:To evaluate the effect of CBL(case-based learning)combined with case analysis in the teaching of clinical anesthesia.Methods:From June 2018 to June 2020,a total of 100 clinical anesthesia interns in Shaanxi ...Objective:To evaluate the effect of CBL(case-based learning)combined with case analysis in the teaching of clinical anesthesia.Methods:From June 2018 to June 2020,a total of 100 clinical anesthesia interns in Shaanxi Provincial People’s Hospital were selected as the research subjects.They were divided into two groups,the reference group(50 interns)and the study group(50 interns),by random sampling method.The reference group was under the traditional teaching method,whereas for the study group,CBL combined with case analysis was implemented.The teaching satisfaction and achievement of the interns in both the groups were evaluated.Results:The teaching satisfaction of the study group was 98%,which was significantly higher than that of the reference group(86%)(P<0.05);before teaching,there was no significant difference in the theoretical and clinical practice scores between the two groups(P>0.05);however,after teaching,the theoretical and clinical practice scores of the two groups increased significantly,in which the change of the research group was significantly greater than that of the reference group(P<0.05).Conclusion:The application of CBL combined with case analysis in the teaching of clinical anesthesia has an ideal effect,improving the teaching satisfaction and achievement.It is a high-quality teaching method and is worthy of application.展开更多
The building energy consumption is an important part among the total society energy consumption,in which the energy consumption for air conditioning occupies almost 70%.The energy consumption of the air conditioning s...The building energy consumption is an important part among the total society energy consumption,in which the energy consumption for air conditioning occupies almost 70%.The energy consumption of the air conditioning system for fresh air handling can be saved effectively when the exhaust air energy could be recovered to preheat or precool the fresh air.Considering the install locations requirements on field,the pump-driven heat pipes(PHP)were developed as heat recovery ventilators(HRVs)and used in an existing experiment building in Beijing Urban.The thermal performance of the PHP HRVs was tested in real operation time periods under winter running mode.Both the power and heat consumption of the modular air handling units with and without HRVs were monitored and obtained,as well as the hourly power and heat consumption.The energy savings of HRVs were analyzed.The results indicate that the PHP HRVs can work steadily and meet the energy recovery need well.The temperature effectiveness of the HRVs can be kept from 60%to 70%.The test total energy saving rate was 24.48%,and the average hourly heat consumption reduced by 28.54%.The daily energy consumption can be saved by 118 kWh,and the energy savings can reach to 9440 kWh for a whole winter.展开更多
Objective:we want to explore values and methods of public participation in land use planning through analysis on values of public participation and case of Ji'an County in Jiangxi Province.Methods:document and dat...Objective:we want to explore values and methods of public participation in land use planning through analysis on values of public participation and case of Ji'an County in Jiangxi Province.Methods:document and data method,case analysis method,qualitative and quantitative combined methods.Results:public participation in land use plays a positive role in improving science and practice of planning.Conclusions:preparation and implementation of land use planning should manifest human-oriented,public participation,wisdom of the masses,scientific demonstration,and democratic decision-making.展开更多
In today's education and teaching reform,the traditional teaching method in the teaching of polymer materials has been gradually replaced with various new teaching methods.Among them,the case analysis method is a ...In today's education and teaching reform,the traditional teaching method in the teaching of polymer materials has been gradually replaced with various new teaching methods.Among them,the case analysis method is a very efective teaching method,which has been applied to the teaching of polymer materials.Through example-based teaching,students 125 participation can be effectively improved,and their theoretical knowledge can be fully utilized.This would have a positive role in promoting the improvement of students'knowledge system and their learning ability.In regard to this,this article analyzes the application of case analysis in the teaching of polymer materials so as to improve its efficiency and quality.展开更多
Objective To study the profit model of Chinese pharmaceutical O2O enterprises.Methods A case study of three typical pharmaceutical O2O enterprises was conducted,and their profit models were compared.Results and Conclu...Objective To study the profit model of Chinese pharmaceutical O2O enterprises.Methods A case study of three typical pharmaceutical O2O enterprises was conducted,and their profit models were compared.Results and Conclusion The pharmaceutical O2O enterprises in China are divided into three categories according to the profit models.It is found that the current pharmaceutical O2O enterprises have problems such as simple profit model and low corporate profits.Based on these problems,it is recommended that relevant enterprises develop various business models to increase profit channels.Besides,they should establish and improve internal cost control systems.展开更多
Service-oriented manufacturing is an emerging innovative development model,and its core is the deep integration of products and services.It has become a hot issue in current research.In order to deeply explore the evo...Service-oriented manufacturing is an emerging innovative development model,and its core is the deep integration of products and services.It has become a hot issue in current research.In order to deeply explore the evolution path of servitization transformation of manufacturing enterprises,ShaanGu Group is taken as a case,and discusses practical application of service-oriented manufacturing model in different development processes of ShaanGu Group.Thus,four stages of transformation of ShaanGu Group through servitization are summarized:specialized after-sales service stage,rental service stage,engineering complete service stage and financial service stage.Through comparative research,it is found that general evolution path of manufacturing enterprises to service transformation is:the primary stage(providing product-oriented product service system)→the intermediate stage(providing application-oriented product service system)→the advanced stage(providing utility-oriented product service system)→the completed stage(providing pure service).On this basis,some suggestions are provided for manufacturing enterprises to integrate productive services in the process of transformation.展开更多
Since coffee is gradually becoming popular in China,the promising market prospect that China’s coffee market has is appealing to multiple companies.Starbucks,a successful business magnate in the coffee market around ...Since coffee is gradually becoming popular in China,the promising market prospect that China’s coffee market has is appealing to multiple companies.Starbucks,a successful business magnate in the coffee market around the globe,occupies a huge market share in China’s coffee market.Nevertheless,numerous competitors,especially domestic coffee brands in China,and the hit caused by the COVID-19 epidemic put great pressure on the company.Furthermore,the company itself also has some weaknesses currently,which can affect the corporation negatively.As a result,based on the background of China’s coffee market and the enterprise’s own situation,this article mainly pays attention to three vulnerabilities,giving an analysis of these problems,and some suggestions will be provided correspondingly.展开更多
Through the combing of relevant literature and the analysis of relevant psychological students’cases,the composition of family factors affecting college students’mental health is analyzed,the specific manifestations...Through the combing of relevant literature and the analysis of relevant psychological students’cases,the composition of family factors affecting college students’mental health is analyzed,the specific manifestations of college students’psychological problems are summarized,and the influence of family factors on college students’mental health status is analyzed in detail.The article finally puts forward suggestions and recommendations for strengthening college students’family education and tries to explore how to promote college students’mental health through improving family education.展开更多
AIM: To retrospectively analyze the pathogenesis, clinical characteristics, treatment and prognostic characteristics in patients with traumatic basal ganglia hematomas (TBGH). METHODS: A retrospective analysis of the ...AIM: To retrospectively analyze the pathogenesis, clinical characteristics, treatment and prognostic characteristics in patients with traumatic basal ganglia hematomas (TBGH). METHODS: A retrospective analysis of the clinical data was performed in 40 patients with TBGH who were selected from 1 250 patients with closed brain injury, who admitted to the Department of Neurosurgery of Shangqiu First People’s Hospital from January 1990 to January 2004. The pathogenesis, clinical characteristics and signs, results of radiological examination, treatment and prognostic characteristics were analyzed. The patients all had definite history of brain injury, manifested by neurological functional disturbance to different extent after brain injury, and basal ganglia hemorrhage was identified by CT after brain injury, and hemorrhagic volume were more than or equal to 2 mL. Totally 34 males and 6 females were enrolled, aged 16-72 years and 28 cases of them were younger than 40 years old. The prognosis of the patients was evaluated with Glasgow outcome scale (GOS) at 6 months after injury, and GOS scoring standard was 1-5 points (1 for dead; 2 for vegetative survival, long-term coma, manifestations of decorticate rigidity or decerebrate rigidity; 3 for severely disabled, should be look after by others; 4 for moderately disabled, be able in self-care; 5 for good recovery, adults can work and study). RESULTS: The enrolled cases accounted for 3.20% of the 1250 patients with closed brain injury admitted at the same period. ① The causes of injury included traffic accident in 36 cases, fall in 2 cases, and assault in 2 cases. ② At admission, the Glasgow coma scale (GCS) scores were as follow: 13-15 scores (mild) in 10 cases, 9-12 scores (moderate) in 20 cases, and 3-8 scores (severe) in 10 cases. Hemiplegia presented in 37 cases, aphasia in 20 cases, conscious disturbance in 10 cases, unilateral mydriasis in 6 cases, and decerebrate rigidity in 2 cases. ③ TBGH was detected by CT within 30 minutes to 24 hours after injury in 37 cases, and delayed TBGH was diagnosed by serial CT reexamination at 24 to 48 hours after injury in 3 cases. Apart from the TBGH, signs of diffuse axonal injury (DAI) were observed in 22 cases and the criterion of CT diagnosis was that apart from TBGH, small hemorrhagic foci were found in the deep white matter of the hemisphere, corpus callosum, dorsolateral quadrants of the midbrain and the upper pons, internal capsule, basal ganglia area, intraventricle, and cerebellum, etc., but there was no obvious mass effect (clinically manifested by conscious disturbance immediately after brain injury, and primary coma lasted for longer than 6 hours). Secondary intraventricular hemorrhage occurred in 19 cases, acute subdural hematoma in 3 cases, acute epidural hematoma in 1 case, cerebral contusion in 7 cases, and diffuse cerebral swelling in 3 cases. TBGH located at contralateral to the side of impact in 29 cases. The volume of TBGH was 3-9 mL in 8 cases, 10-19 mL in 10 cases, 20-29 mL in 12 cases, and more than 30 mL in 9 cases. ④Ten patients underwent surgical treatment, including TBGH were evacuated by craniotomy in 7 cases, drained by drilling hole in 2 cases, and hematoma drainage combined with extraventricular drainage in 1 case. 30 patients received conservative treatment, including hyperbaric oxygen treatment in 22 cases. ⑤ At 6 months after injury, good recovery obtained in 10 cases (25%), moderately disabled in 17 cases (42.5%), severely disabled in 2 cases (5%) and dead in 11 cases (27.5%) respectively. CONCLUSION: In our study, the proportion of TBGH in closed brain injury was 3.2%, and it had a higher incidence of disability. Most of the patients were young people and injured in traffic accident, and TBGH mostly occurred at contralateral to the side of impact. The patients suffered from hemiplegia and long-term coma, incidence rate of diffuse axonal injury was higher, but conscious disturbance was milder. Conservative treatment was mainly applied in our study. CT scan can not only establish the position, volume of TBGH, but also establish if it combines with other intracranial injury, and it is helpful to detect delayed TBGH.展开更多
This report describes a hepatocellular carcinoma (HCC) with concomitant focal nodular hyperplasia (FNH) in a 56 years old Chinese man. There were two well circumscribed tumours measuring 3×2.5×2 cm and 2...This report describes a hepatocellular carcinoma (HCC) with concomitant focal nodular hyperplasia (FNH) in a 56 years old Chinese man. There were two well circumscribed tumours measuring 3×2.5×2 cm and 2×1.5×1.5 cm. The larger mass was grey and soft with a small area of bleeding and necrosis and an intact capsule. The smaller mass was yellow and had no capsule. Clonal analysis was carried out to clarify the relation between the HCC and the adjacent FNH. The clonal analysis was based on the methylation pattern of the polymorphic X chromosome linked androgen receptor gene (HUMARA). In FNH, after Hpa Ⅱ digestion, the allelic bands showed two well defined peaks. The intensity of the two peaks in the DNA from cirrhotic tissue did not differ significantly, consistent with a random pattern of X chromosome inactivation. However, in HCC, after Hpa Ⅱ digestion, the allelic bands differed significantly in intensity. Therefore, there was a typical polyclonal pattern of inactivation in FNH but the HCC was interpreted as being monoclonal.展开更多
Objective: To analyse the clinical features and prognosisof liver injury caused by heat stroke.Methods: The clinical data of 10 patients with severe liverinjury caused by heat stroke were analysed retrospective-ly.Res...Objective: To analyse the clinical features and prognosisof liver injury caused by heat stroke.Methods: The clinical data of 10 patients with severe liverinjury caused by heat stroke were analysed retrospective-ly.Results: In 4 patients the level of ALT was over 1000 U/L, in 3 patients ranged from 300 to 1000 U/L, and in 3patients 50-300 U/L. The level of TBIL in 2 patientswas over 400 μmol/L and in 5 varied from 20 to 75μmol/L. Two patients showed jaundice and petechia展开更多
1.Patient's conditionsA 29-year-old man,was infected with nongonococcal urethritis(NGU).He complained that he had dysuria and discomfort in the urethra and mucopurulent discharge,which appeared one week after inte...1.Patient's conditionsA 29-year-old man,was infected with nongonococcal urethritis(NGU).He complained that he had dysuria and discomfort in the urethra and mucopurulent discharge,which appeared one week after intercourse.展开更多
BACKGROUND: Peroneal muscular atrophy (PMA) is characterized by insidious onset, gradually progressive course of disease, very mild disability degree and easily subjecting to missed diagnosis and misdiagnosis. Nerve c...BACKGROUND: Peroneal muscular atrophy (PMA) is characterized by insidious onset, gradually progressive course of disease, very mild disability degree and easily subjecting to missed diagnosis and misdiagnosis. Nerve conductive velocity is helpful in the diagnosis of atypical cases. OBJECTIVE: To retrospectively analyze the characteristics of clinical manifestation, electromyogram (EMG), motor and sensory nerve conduction velocity of patients with PMA. DESIGN: Retrospective case analysis. SETTING: Department of Neurology, Guangzhou First People's Hospital. PARTICIPANTS: Twenty-four patients with PMA, including 16 males and 8 females, aged 5-68 years old, admitted to Guangzhou First People's Hospital between March 1996 and January 2006 were recruited. Informed consents were obtained from all the patients. METHODS: All the patients subjected to EMG and detection of nerve conduction velocity at distal end of four extremities with a Keypoint evoked potential/ EMG instrument (Denmark). Sensory and motor conduction velocity, EMG changes of upper and lower extremities were observed, and relationship of neuroelectrophysiological characteristics and clinical symptoms was analyzed. MAIN OUTCOME MEASURES: Changes in sensory and motor conduction velocity, EMG and clinical manifestations of 24 patients. RESULTS: ① All the patients suffered from insidious onset and gradually progressive course of PMA. Muscular atrophy of lower extremity was found in 14 patients, and that of upper extremity in 5 patients. ②Routine nerve conduction study showed that sensory and motor conduction velocity were stepped down, especially in 16 patients with typeⅠPMA (demyelinating pattern, nerve conduction velocity below normal level 50%). Motor nerve conduction velocity of median nerve, ulnar nerve, common peroneal nerve and tibial nerve averaged 34.8 m/s, 37.2 m/s, 16.5 m/s and 17.4 m/s, respectively; Sensory nerve conduction velocity of median nerve, ulnar nerve and sural nerve averaged 27.9%, 24.6 m/s and 3.1 m/s, respectively. Slowing conduction velocity and muscular strength involvement were disproportionate, i.e. myasthenia was relatively lessened, sensory and motor conduction velocities were greatly decreased. Nerve conduction velocity in distal end of two lower extremities was not detected in 8 patients, but who could still walk. CONCLUSION: ①PMA of patients is characterized by insidious onset and gradually progressive course of disease. Clinical symptom is the base to diagnose PMA. ②Neuroelectrophysiological study is a simple and easy-to-operate means with good reproducibility in diagnosing PMA. Patients with abnormal myasthenia in lower extremity can be detected in the early stage.展开更多
Objective To explore the therapeutic principles and prognostic factors of soft tissue sarcoma. Methods Two hundred and fifty-one patients with soft tissue sarcoma (STS) treated at Shanghai Cancer Hospital during 1986 ...Objective To explore the therapeutic principles and prognostic factors of soft tissue sarcoma. Methods Two hundred and fifty-one patients with soft tissue sarcoma (STS) treated at Shanghai Cancer Hospital during 1986 -1990 were reviewed retrospectively. Results The 1-, 3 - , 5 - , 10 - year tumor-free survival rates were 67. 74% , 57. 16% , 52, 41% , 38. 60% , respectively.The overall survival rates for 1,3,5 and 10 years were 81. 01 % ,67.75% ,60.79% ,and 49.23% respectively. Log-rank test showed that the patients with different pathological findings, histological grades,mass location and size, anatomical depth, and surgical margin showed different outcomes. Whether the sarcomas invaded the vessels or metastasized would influence the survival rates. The patients who underwent different interventions or operations also had different outcomes. The prognosis of STS was associated with age,histological type,histological grade, tumor size, surgical margin and metastasis according to the Cox regression展开更多
Objective To review the cadaveric kidney transplantations at our center in the past 22 years and to analyze the causes and the influencing factors on death in 176 patients who died after renal transplantation. Methods...Objective To review the cadaveric kidney transplantations at our center in the past 22 years and to analyze the causes and the influencing factors on death in 176 patients who died after renal transplantation. Methods A total of 1 039 patients received cadaveric kidney graftings between October 1977 and June 1999. Patient’ s mortality was calculated by the Kaplan-Meier method. The factors which might lead to patients’ death,including age and sex of the donors and recipients, frequency of transplantation, dialysis time and transfusion volume before transplantation, cold ischemic time(CIT),delayed graft function(DGF),rejection, immunosuppressive regimen, and post-transplant complications, were analyzed by log-rank and Cox model. Results Total mortalities of the patient at 1 - ,5 - , 10 - , and 15-year were 6.9%, 19.7%, 32.1% and 34.7%, respectively. The leading causes of patients’ death were infection, cardiocerebral vascular diseases, and hepatic failure. The factors of transplant times, dialysis time展开更多
Objective To estimate the indications,operative technique,perioperative treatment,postoperative complications and the outcome of lung transplantation ( LTx) for end - stage pulmonary diseases. Methods The clinical dat...Objective To estimate the indications,operative technique,perioperative treatment,postoperative complications and the outcome of lung transplantation ( LTx) for end - stage pulmonary diseases. Methods The clinical data of 100 patients with end - stage lung diseases receiving LTx in our hospital were retrospectively ana-展开更多
文摘Objective:To evaluate the effect of CBL(case-based learning)combined with case analysis in the teaching of clinical anesthesia.Methods:From June 2018 to June 2020,a total of 100 clinical anesthesia interns in Shaanxi Provincial People’s Hospital were selected as the research subjects.They were divided into two groups,the reference group(50 interns)and the study group(50 interns),by random sampling method.The reference group was under the traditional teaching method,whereas for the study group,CBL combined with case analysis was implemented.The teaching satisfaction and achievement of the interns in both the groups were evaluated.Results:The teaching satisfaction of the study group was 98%,which was significantly higher than that of the reference group(86%)(P<0.05);before teaching,there was no significant difference in the theoretical and clinical practice scores between the two groups(P>0.05);however,after teaching,the theoretical and clinical practice scores of the two groups increased significantly,in which the change of the research group was significantly greater than that of the reference group(P<0.05).Conclusion:The application of CBL combined with case analysis in the teaching of clinical anesthesia has an ideal effect,improving the teaching satisfaction and achievement.It is a high-quality teaching method and is worthy of application.
基金supported by the Project of Science and Technology Program of Beijing Municipal Chao Yang District(CYSF2005,Zhun Li,http://www.bjchy.gov.cn/dynamic/notice/8a24fe83722fa7180172360a3f46044c.html).
文摘The building energy consumption is an important part among the total society energy consumption,in which the energy consumption for air conditioning occupies almost 70%.The energy consumption of the air conditioning system for fresh air handling can be saved effectively when the exhaust air energy could be recovered to preheat or precool the fresh air.Considering the install locations requirements on field,the pump-driven heat pipes(PHP)were developed as heat recovery ventilators(HRVs)and used in an existing experiment building in Beijing Urban.The thermal performance of the PHP HRVs was tested in real operation time periods under winter running mode.Both the power and heat consumption of the modular air handling units with and without HRVs were monitored and obtained,as well as the hourly power and heat consumption.The energy savings of HRVs were analyzed.The results indicate that the PHP HRVs can work steadily and meet the energy recovery need well.The temperature effectiveness of the HRVs can be kept from 60%to 70%.The test total energy saving rate was 24.48%,and the average hourly heat consumption reduced by 28.54%.The daily energy consumption can be saved by 118 kWh,and the energy savings can reach to 9440 kWh for a whole winter.
文摘Objective:we want to explore values and methods of public participation in land use planning through analysis on values of public participation and case of Ji'an County in Jiangxi Province.Methods:document and data method,case analysis method,qualitative and quantitative combined methods.Results:public participation in land use plays a positive role in improving science and practice of planning.Conclusions:preparation and implementation of land use planning should manifest human-oriented,public participation,wisdom of the masses,scientific demonstration,and democratic decision-making.
文摘In today's education and teaching reform,the traditional teaching method in the teaching of polymer materials has been gradually replaced with various new teaching methods.Among them,the case analysis method is a very efective teaching method,which has been applied to the teaching of polymer materials.Through example-based teaching,students 125 participation can be effectively improved,and their theoretical knowledge can be fully utilized.This would have a positive role in promoting the improvement of students'knowledge system and their learning ability.In regard to this,this article analyzes the application of case analysis in the teaching of polymer materials so as to improve its efficiency and quality.
基金2021 General Scientific Research Project of Liaoning Provincial Department of Education(No.LJKR0298)Liaoning Provincial Social Science Planning Fund Office(2019)(No.L19BGL034).
文摘Objective To study the profit model of Chinese pharmaceutical O2O enterprises.Methods A case study of three typical pharmaceutical O2O enterprises was conducted,and their profit models were compared.Results and Conclusion The pharmaceutical O2O enterprises in China are divided into three categories according to the profit models.It is found that the current pharmaceutical O2O enterprises have problems such as simple profit model and low corporate profits.Based on these problems,it is recommended that relevant enterprises develop various business models to increase profit channels.Besides,they should establish and improve internal cost control systems.
基金Western and Frontier Region Project of Humanities and Social Sciences Research of the Ministry of Education(20XJA630001)Research project of Shaanxi Provincial Key Think Tank on Major Theoretical and Practical issues of Philosophy and Social Sciences(2021ZD1011)+2 种基金Research Project on Major Theoretical and Practical Problems in Social Science Circles of Shaanxi Province(2020Z394)Soft Science Project of Xi'an Science and Technology Plan(2019111713RKX001SF005-3)Key Scientific Research Program of Shaanxi Provincial Department of Education(new think tank project)(20JT025).
文摘Service-oriented manufacturing is an emerging innovative development model,and its core is the deep integration of products and services.It has become a hot issue in current research.In order to deeply explore the evolution path of servitization transformation of manufacturing enterprises,ShaanGu Group is taken as a case,and discusses practical application of service-oriented manufacturing model in different development processes of ShaanGu Group.Thus,four stages of transformation of ShaanGu Group through servitization are summarized:specialized after-sales service stage,rental service stage,engineering complete service stage and financial service stage.Through comparative research,it is found that general evolution path of manufacturing enterprises to service transformation is:the primary stage(providing product-oriented product service system)→the intermediate stage(providing application-oriented product service system)→the advanced stage(providing utility-oriented product service system)→the completed stage(providing pure service).On this basis,some suggestions are provided for manufacturing enterprises to integrate productive services in the process of transformation.
文摘Since coffee is gradually becoming popular in China,the promising market prospect that China’s coffee market has is appealing to multiple companies.Starbucks,a successful business magnate in the coffee market around the globe,occupies a huge market share in China’s coffee market.Nevertheless,numerous competitors,especially domestic coffee brands in China,and the hit caused by the COVID-19 epidemic put great pressure on the company.Furthermore,the company itself also has some weaknesses currently,which can affect the corporation negatively.As a result,based on the background of China’s coffee market and the enterprise’s own situation,this article mainly pays attention to three vulnerabilities,giving an analysis of these problems,and some suggestions will be provided correspondingly.
文摘Through the combing of relevant literature and the analysis of relevant psychological students’cases,the composition of family factors affecting college students’mental health is analyzed,the specific manifestations of college students’psychological problems are summarized,and the influence of family factors on college students’mental health status is analyzed in detail.The article finally puts forward suggestions and recommendations for strengthening college students’family education and tries to explore how to promote college students’mental health through improving family education.
文摘AIM: To retrospectively analyze the pathogenesis, clinical characteristics, treatment and prognostic characteristics in patients with traumatic basal ganglia hematomas (TBGH). METHODS: A retrospective analysis of the clinical data was performed in 40 patients with TBGH who were selected from 1 250 patients with closed brain injury, who admitted to the Department of Neurosurgery of Shangqiu First People’s Hospital from January 1990 to January 2004. The pathogenesis, clinical characteristics and signs, results of radiological examination, treatment and prognostic characteristics were analyzed. The patients all had definite history of brain injury, manifested by neurological functional disturbance to different extent after brain injury, and basal ganglia hemorrhage was identified by CT after brain injury, and hemorrhagic volume were more than or equal to 2 mL. Totally 34 males and 6 females were enrolled, aged 16-72 years and 28 cases of them were younger than 40 years old. The prognosis of the patients was evaluated with Glasgow outcome scale (GOS) at 6 months after injury, and GOS scoring standard was 1-5 points (1 for dead; 2 for vegetative survival, long-term coma, manifestations of decorticate rigidity or decerebrate rigidity; 3 for severely disabled, should be look after by others; 4 for moderately disabled, be able in self-care; 5 for good recovery, adults can work and study). RESULTS: The enrolled cases accounted for 3.20% of the 1250 patients with closed brain injury admitted at the same period. ① The causes of injury included traffic accident in 36 cases, fall in 2 cases, and assault in 2 cases. ② At admission, the Glasgow coma scale (GCS) scores were as follow: 13-15 scores (mild) in 10 cases, 9-12 scores (moderate) in 20 cases, and 3-8 scores (severe) in 10 cases. Hemiplegia presented in 37 cases, aphasia in 20 cases, conscious disturbance in 10 cases, unilateral mydriasis in 6 cases, and decerebrate rigidity in 2 cases. ③ TBGH was detected by CT within 30 minutes to 24 hours after injury in 37 cases, and delayed TBGH was diagnosed by serial CT reexamination at 24 to 48 hours after injury in 3 cases. Apart from the TBGH, signs of diffuse axonal injury (DAI) were observed in 22 cases and the criterion of CT diagnosis was that apart from TBGH, small hemorrhagic foci were found in the deep white matter of the hemisphere, corpus callosum, dorsolateral quadrants of the midbrain and the upper pons, internal capsule, basal ganglia area, intraventricle, and cerebellum, etc., but there was no obvious mass effect (clinically manifested by conscious disturbance immediately after brain injury, and primary coma lasted for longer than 6 hours). Secondary intraventricular hemorrhage occurred in 19 cases, acute subdural hematoma in 3 cases, acute epidural hematoma in 1 case, cerebral contusion in 7 cases, and diffuse cerebral swelling in 3 cases. TBGH located at contralateral to the side of impact in 29 cases. The volume of TBGH was 3-9 mL in 8 cases, 10-19 mL in 10 cases, 20-29 mL in 12 cases, and more than 30 mL in 9 cases. ④Ten patients underwent surgical treatment, including TBGH were evacuated by craniotomy in 7 cases, drained by drilling hole in 2 cases, and hematoma drainage combined with extraventricular drainage in 1 case. 30 patients received conservative treatment, including hyperbaric oxygen treatment in 22 cases. ⑤ At 6 months after injury, good recovery obtained in 10 cases (25%), moderately disabled in 17 cases (42.5%), severely disabled in 2 cases (5%) and dead in 11 cases (27.5%) respectively. CONCLUSION: In our study, the proportion of TBGH in closed brain injury was 3.2%, and it had a higher incidence of disability. Most of the patients were young people and injured in traffic accident, and TBGH mostly occurred at contralateral to the side of impact. The patients suffered from hemiplegia and long-term coma, incidence rate of diffuse axonal injury was higher, but conscious disturbance was milder. Conservative treatment was mainly applied in our study. CT scan can not only establish the position, volume of TBGH, but also establish if it combines with other intracranial injury, and it is helpful to detect delayed TBGH.
文摘This report describes a hepatocellular carcinoma (HCC) with concomitant focal nodular hyperplasia (FNH) in a 56 years old Chinese man. There were two well circumscribed tumours measuring 3×2.5×2 cm and 2×1.5×1.5 cm. The larger mass was grey and soft with a small area of bleeding and necrosis and an intact capsule. The smaller mass was yellow and had no capsule. Clonal analysis was carried out to clarify the relation between the HCC and the adjacent FNH. The clonal analysis was based on the methylation pattern of the polymorphic X chromosome linked androgen receptor gene (HUMARA). In FNH, after Hpa Ⅱ digestion, the allelic bands showed two well defined peaks. The intensity of the two peaks in the DNA from cirrhotic tissue did not differ significantly, consistent with a random pattern of X chromosome inactivation. However, in HCC, after Hpa Ⅱ digestion, the allelic bands differed significantly in intensity. Therefore, there was a typical polyclonal pattern of inactivation in FNH but the HCC was interpreted as being monoclonal.
文摘Objective: To analyse the clinical features and prognosisof liver injury caused by heat stroke.Methods: The clinical data of 10 patients with severe liverinjury caused by heat stroke were analysed retrospective-ly.Results: In 4 patients the level of ALT was over 1000 U/L, in 3 patients ranged from 300 to 1000 U/L, and in 3patients 50-300 U/L. The level of TBIL in 2 patientswas over 400 μmol/L and in 5 varied from 20 to 75μmol/L. Two patients showed jaundice and petechia
文摘1.Patient's conditionsA 29-year-old man,was infected with nongonococcal urethritis(NGU).He complained that he had dysuria and discomfort in the urethra and mucopurulent discharge,which appeared one week after intercourse.
文摘BACKGROUND: Peroneal muscular atrophy (PMA) is characterized by insidious onset, gradually progressive course of disease, very mild disability degree and easily subjecting to missed diagnosis and misdiagnosis. Nerve conductive velocity is helpful in the diagnosis of atypical cases. OBJECTIVE: To retrospectively analyze the characteristics of clinical manifestation, electromyogram (EMG), motor and sensory nerve conduction velocity of patients with PMA. DESIGN: Retrospective case analysis. SETTING: Department of Neurology, Guangzhou First People's Hospital. PARTICIPANTS: Twenty-four patients with PMA, including 16 males and 8 females, aged 5-68 years old, admitted to Guangzhou First People's Hospital between March 1996 and January 2006 were recruited. Informed consents were obtained from all the patients. METHODS: All the patients subjected to EMG and detection of nerve conduction velocity at distal end of four extremities with a Keypoint evoked potential/ EMG instrument (Denmark). Sensory and motor conduction velocity, EMG changes of upper and lower extremities were observed, and relationship of neuroelectrophysiological characteristics and clinical symptoms was analyzed. MAIN OUTCOME MEASURES: Changes in sensory and motor conduction velocity, EMG and clinical manifestations of 24 patients. RESULTS: ① All the patients suffered from insidious onset and gradually progressive course of PMA. Muscular atrophy of lower extremity was found in 14 patients, and that of upper extremity in 5 patients. ②Routine nerve conduction study showed that sensory and motor conduction velocity were stepped down, especially in 16 patients with typeⅠPMA (demyelinating pattern, nerve conduction velocity below normal level 50%). Motor nerve conduction velocity of median nerve, ulnar nerve, common peroneal nerve and tibial nerve averaged 34.8 m/s, 37.2 m/s, 16.5 m/s and 17.4 m/s, respectively; Sensory nerve conduction velocity of median nerve, ulnar nerve and sural nerve averaged 27.9%, 24.6 m/s and 3.1 m/s, respectively. Slowing conduction velocity and muscular strength involvement were disproportionate, i.e. myasthenia was relatively lessened, sensory and motor conduction velocities were greatly decreased. Nerve conduction velocity in distal end of two lower extremities was not detected in 8 patients, but who could still walk. CONCLUSION: ①PMA of patients is characterized by insidious onset and gradually progressive course of disease. Clinical symptom is the base to diagnose PMA. ②Neuroelectrophysiological study is a simple and easy-to-operate means with good reproducibility in diagnosing PMA. Patients with abnormal myasthenia in lower extremity can be detected in the early stage.
文摘Objective To explore the therapeutic principles and prognostic factors of soft tissue sarcoma. Methods Two hundred and fifty-one patients with soft tissue sarcoma (STS) treated at Shanghai Cancer Hospital during 1986 -1990 were reviewed retrospectively. Results The 1-, 3 - , 5 - , 10 - year tumor-free survival rates were 67. 74% , 57. 16% , 52, 41% , 38. 60% , respectively.The overall survival rates for 1,3,5 and 10 years were 81. 01 % ,67.75% ,60.79% ,and 49.23% respectively. Log-rank test showed that the patients with different pathological findings, histological grades,mass location and size, anatomical depth, and surgical margin showed different outcomes. Whether the sarcomas invaded the vessels or metastasized would influence the survival rates. The patients who underwent different interventions or operations also had different outcomes. The prognosis of STS was associated with age,histological type,histological grade, tumor size, surgical margin and metastasis according to the Cox regression
文摘Objective To review the cadaveric kidney transplantations at our center in the past 22 years and to analyze the causes and the influencing factors on death in 176 patients who died after renal transplantation. Methods A total of 1 039 patients received cadaveric kidney graftings between October 1977 and June 1999. Patient’ s mortality was calculated by the Kaplan-Meier method. The factors which might lead to patients’ death,including age and sex of the donors and recipients, frequency of transplantation, dialysis time and transfusion volume before transplantation, cold ischemic time(CIT),delayed graft function(DGF),rejection, immunosuppressive regimen, and post-transplant complications, were analyzed by log-rank and Cox model. Results Total mortalities of the patient at 1 - ,5 - , 10 - , and 15-year were 6.9%, 19.7%, 32.1% and 34.7%, respectively. The leading causes of patients’ death were infection, cardiocerebral vascular diseases, and hepatic failure. The factors of transplant times, dialysis time
文摘Objective To estimate the indications,operative technique,perioperative treatment,postoperative complications and the outcome of lung transplantation ( LTx) for end - stage pulmonary diseases. Methods The clinical data of 100 patients with end - stage lung diseases receiving LTx in our hospital were retrospectively ana-
