NICE classification in diagnosis and treatment of colorectal lesions / 中国内镜杂志

Objective To evaluate the efficacy of NICE classification in non-magnifying narrow band imaging for real-time histologic prediction and therapeutic guidance of colorectal lesions. Methods According to NICE classification, histologic prediction and therapeutic guidance were given for raised or flat raised colorectal mucosal lesions. According to pathology following biopsy, endoscopy or surgery, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of NICE classification were valued. The observation consistency test was also carried out. Results 241 patients with 307 lesions were studied. The non-neoplastic lesions were 12.07%, adenomatous lesions were 82.07%, carcinomas were 5.86%. The lesions ranged from 0.1 cm to 6.0 cm in diameter. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of NICE classification in differentiating non-neoplastic and neoplastic lesions were 97.04%, 89.19%, 96.09%, 98.50%, 80.49%. The Kappa of non-neoplastic and neoplastic lesions was 0.795. The Kappa of submucosal deep infiltrating lesions and lesions above superficial submucosa was 0.875. The total Kappa was 0.814. Conclusion NICE classification can accurately predict the histology of colorectal lesions and guide treatments. It is help to the moderate treatment mode in which merely neoplastic lesions are included in endoscopic resections or surgical procedures.

The analysis of differet nutrition support treatment and nursing in patients with severe acute pancreatitis / 肠外与肠内营养

Objective:To explore the effect and nursing measures of parenteral nutrition support treatment and nasal jejunum nutrition support treatment in patients with acute severe pancreatitis.Method:85 cases of acute severe pancreatitis were divided into the study group and the control group.The patients in the control group were given routine parenteral nutrition support therapy and clinical nursing.The patients in the study group were treated with nasal jejunum tube for enteral nutrition support,and the corresponding clinical nursing intervention was given during the treatment.The clinical indexes of two groups were compared and analyzed.Result:Before treatment,there were no significant difference in serum CRP,ALB,TP levels between the two groups (P ＞ 0.05).After nutritional treatment and clinical nursing,the above indexes of the two groups were improved,but the indexes of the study group improved significantly more than the control group (P ＜ 0.05).The BMI index in the study group was not significantly different compared with the control group (P ＞ 0.05).In the study group,the first time of get out of bed,mechanical ventilation time,abdominal distension remission time,sserum amylase and urine amylase recovery time were significantly lower than those of the control group (P ＜ 0.05).The incidence of complications including abdominal distension,diarrhea,nausea and vomiting,upper gastrointestinal bleeding in the study group were significantly lower than those in the control group (P ＜ 0.05).Conclusion:nasal jejunum nutrition support treatment can not only play a vital role in treatment of acute severe pancreatitis patients with malnutrition,but also protect the patient gastrointestinal tract.The individualized nursing intervention can effectively reduce the incidence of complications and ensure the successful implementation of enteral nutrition.

Clinical manifestation and laboratory examinations of invasive Scedosporium infection / 临床检验杂志

Objective To investigate the clinical manifestation and the characteristics of laboratory examinations of invasive Scedocporium infection.Methods The clinical data of 8 patients infected with Scedosporium from January 2011 to April 2017 were collected and retrospective analysis combined with related literatures was performed.Results Among the 8 patients,6 strains of S.apiospermum,1 strains of Peudallescheria boydii and 1 strains of S.prolificans were detectable.The predisposing factors of Scedosporium infection were trauma,environmental exposure and hypoimmunity.The septahypha in specimens could be direcdy observed under microscopic examination with positive rate 100％.The growth speed of cultured colony was relatively fast and the invasiveness was strong.The colony of Scedosporium displayed various forms from white cashmere to black yeast sample.The color was gradually become dark from the center of colony with lengthening time of cultivation.Scedosporium could be identified by microscopic morphology combining culture technique.Conclusion The course of invasive Scedosporium infection may progress rapidly with serious and dangerous illness state.The most common infection of Scedosporium should be induced by S.apiospernum.The knowledge and understanding for Scedosporium infection should be strengthened to improve the level of diagnosis and treatment.

Study on the maternal mortality ratio from 1995 to 2004 among residential and migrant women in Beijing / 中华流行病学杂志

<p><b>OBJECTIVE</b>To analyze the maternal mortality ratio (MMR) of residential and migrant women in Beijing.</p><p><b>METHODS</b>A retrospective study from 1995 to 2004 was performed to analyze data from the maternal death cases.</p><p><b>RESULTS</b>The MMR of resident and migrant of Beijing from 1995 to 2004 were 17.9 and 51.3 per ten thousand respectively. The main reasons of maternal deaths among residents were embolism (21.2%), hypertensive disorder complicating pregnancy (18.3%), postpartum hemorrhage (14.4%) and ectopic pregnancy/heart disease (9.6%). The main reasons of migrant maternal deaths were postpartum hemorrhage (25.2%), embolism (19.7%), hypertensive disorder complicating pregnancy (17.3%) and liver disease (9.5%). The avoidable deaths were accounted for 18.9%.</p><p><b>CONCLUSION</b>The MMR in Beijing local residents was close to that in developed countries. To further reduce MMR in Beijing would depend on the better administration of related issues among floating population. Poor quatily delivery must be banned together with strengthening the training programs on health workers. It is also important to improve the knowledge and skills of medical staff for rescuing the complications of pregnancy and ectopic pregnancy.</p>

Blood lead level and related risk factors among children aged 0-6 years in Beijing / 中华流行病学杂志

<p><b>OBJECTIVE</b>To observe blood lead level and related risk factors among children of 0 - 6-year old in Beijing.</p><p><b>METHODS</b>Stratified-clustered-random sampling and simple random sampling were used. A total of 2 262 children of 0 - 6 years old were investigated from May to July 2001. They were permanent residents in Beijing. Blood lead level was tested by graphite atomizer absorption spectrophotometer. At the same time, related factors were investigated using a standardized questionnaire.</p><p><b>RESULTS</b>The mean lead level of children in Beijing was 96.8 micro g/L with 35.7% of those >/= 100 micro g/L, and 2.5% >/= 200 micro g/L. The proportion of lead poisoning was significantly higher in rural children (P < 0.01). The proportion of lead poisoning in 2-year-old group was higher than that in other age groups. The proportion of lead poisoning in boys was significantly higher than that in girls (P < 0.01). The following factors might serve as major risk factors related to child lead poisoning, such as, never or rarely drinking milk, living in nearby highways (less than 50 meters) or living in the first floor/bungalow, and so on.</p><p><b>CONCLUSION</b>The blood lead level of >/= 100 micro g/L among Beijing children appeared to be a big problem. Decision-makers should pay more attention to prevent blood lead level being high, and to cure these children who suffered in lead poisoning. Effective intervention measures on these target populations should be taken.</p>