简介：AIM:ToanalyzetheassociationbetweenHelicobacterspp.andsomecommongutbacteriainpatientswithcholecystitis.METHODS:Anested-polymerasechainreaction(PCR),specificto16SrRNAofHelicobacterspp.wasperformedonparaffin-embeddedgallbladdersamplesof100cholecystitisand102controlcases.ThesampleswerealsoanalyzedforsomecommongutbacteriabyPCR.Positivesamplesweresequencedforspeciesidentification.RESULTS:HelicobacterDNAwasfoundinsevenoutof100casesofacuteandchroniccholecystitis.SequenceanalysisdisplayedHelicobacterpullorum(H.pullorum)insixcasesandHelicobacterpyloriinone;H.pullorumwasonlyfoundincaseswithmetaplasia.Controlsam-pleswerenegativeforHelicobacterspp.andsomecommongutbacteria.Therewasasignificantdifference(P=0.007)betweencholecystitisandcontrolsamplesforHelicobacterDNA.CONCLUSION:ApossiblerelationshipwasdetectedbetweenHelicobacterDNAandcholecystitis.Furtherserologicalandimmunohistochemicalstudiesareneededtosupportthesedata.

简介：尽管非小的细胞肺癌症(NSCLC)能转移到几乎任何东西器官，到有重要临床的表明的胆囊的转移是相对稀罕的。这里，我们报导作为尖锐胆汁介绍的NSCLC的胆囊转移的一个案例。在恰好上面的象限和发烧疼痛地介绍的一个79岁的人。胸和腹部的计算断层摄影术(CT)扫描在胆囊变厚的肺和不规则的墙的恰好更低的脑叶显示出一个cavitary团。肺团的开的胆囊炎和针活体检视被执行。胆囊的组织学的检查揭示了显示象针活体检视估计的肺团的一样的形态学的中等区分的有鳞的房间癌。胆囊和肺织物的随后的immunohistochemical检查证明肿瘤房间为P63是积极的但是为cytokeratin否定7，cytokeratin20并且甲状腺抄写factor-1。胆囊的第二个主要肿瘤被immunohistochemical方法排除，并且最后的病理学的诊断是NSCLC的胆囊转移。尽管发生是极其稀罕的，尖锐胆汁能与肺癌症转移联合发生到胆囊。

简介：玩游戏之前，先龄听光碟，留意国画及相关英文生字的读音。请把以下词汇填在适当的空格里，把蓝色格子内的安母组成另一个生字，把这生字写在最下面的格子里。

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简介：Thispaperpresentsahumandetectionsysteminavision-basedhospitalsurveillanceenvironment.Thesystemiscomposedofthreesubsystems,i.e.backgroundsegmentationsubsystem(BSS),humanfeatureextractionsubsystem(HFES),andhumanrecognitionsubsystem(HRS).ThecodebookbackgroundmodelisappliedintheBSS,thehistogramoforientedgradients(HOG)featuresareusedintheHFES,andthesupportvectormachine(SVM)classificationisemployedintheHRS.Bymeansoftheintegrationofthesesubsystems,thehumandetectioninavision-basedhospitalsurveillanceenvironmentisperformed.Experimentalresultsshowthattheproposedsystemcaneffectivelydetectmostofthepeopleinhospitalsurveillancevideosequences.

简介：Thisarticlediscussestheadequatetreatmentofearlygallbladdercancer(T1a,T1b)andisbasedonpublishedstudiesextendingovernearly3decades.Randomizedstudiesandmetaanalysescomparingdifferentsurgicaltreatmentsdonotexist.Theliteratureshowsthatinupto20%ofpatientslymphnodemetastasisarefoundinT1bgallbladdercancer.Duetohighmalignancywithearlyangiolymphaticspreadandresistancetochemotherapyandradiationontheonehand,andtherelativelowoperativeriskofextendedcholecystectomy(cholecystectomyandregionallymphadenectomy)ontheotherhand,webelievethatthisprocedureismandatoryinearlygallbladdercancer.

简介：AbstractObjective:The prevalence of midline birth defects, such as gastroschisis, has increased worldwide, over the last few decades. This study aims to explore the prevalence, maternal epidemiological characteristics, and natural history of neonates affected by gastroschisis at the University Hospital of León city, Nicaragua.Methods:Data were collected from the birth defect surveillance system of the Hospital Oscar Danilo Rosales (HEODRA). The analysis included all pregnancies that had gastroschisis complications between January 1 and December 31, 2020. The prevalence of gastroschisis was calculated according to maternal age. The mothers were interviewed, and the clinical records of the newborns were reviewed.Results:Among the 4,460 deliveries included in this study, four cases of gastroschisis were identified, including three live births and one stillbirth. The gastroschisis rate was 8.9 per 10,000 live births (95% confidence interval [CI]: 0.18-17.8). The prevalence among mothers younger than 20 years and those older than 20 years was 26.4 (95% CI: -3.43 to 56.25) and 3.01 (95% CI: 2.89-8.90)/10,000 births, respectively. Mothers of gastroschisis-affected fetuses were of rural origin (n = 3), had normal body mass indexes (n = 3), were exposed to tobacco and wood smoke (n = 2), and one was exposed to pesticides during the periconceptional period. Primary closure of the gastroschisis was performed on one patient, and complex gastroschisis for intestinal perforation was observed in another patient. The mean hospitalization duration was 33 days, and two patients were discharged alive.Conclusions:Gastroschisis was a significant birth defect among children delivered at HEODRA in 2020. Its prevalence in Nicaragua was higher than that in other countries in the region. All complicated pregnancies were young women with unplanned pregnancies, from rural areas, with exposure to secondhand smoke, and without vitamin supplements before or during the first trimester of pregnancy. Only 67% of infants survived after hospital discharge.

简介：PracticehasprovedthatHospitalCultureandEnvironmentinfluenceseconomiceffectsdi-rectly.Soadaptingthenewlydirectedpatientmarketandcreatingagoodhospitalcultureandenvironmentwilltakeanactiveeffectonstrengtheningthecompetitiveadvantage.Besides,appropriateformsofartisticmovementworkindifferentaspectsofpatients.Theyrecuperatepatientsphysiologically,mentally,sociallyandpsychologically,anddispeltheirmisgivingsandhelpthemregainhealth.

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简介：AIMTocomparesurvivalandrecurrenceinhepatocellularcarcinoma（HCC）patientswhodidordidnotreceiveadjuvanttransarterialchemoembolization（TACE）.METHODS：Aconsecutivesampleof229patientswhounderwentcurativeresectionbetweenMarch2007andMarch2010inourhospitalwasincluded.Ofthese229patients,91（39.7%）underwentcurativeresectionfollowedbyadjuvantTACEand138（60.3%）underwentcurativeresectionalone.Inordertominimizeconfoundsduetobaselinedifferencesbetweenthetwopatientgroups,comparisonswereconductedbetweenpropensityscore-matchedpatients.SurvivaldataandrecurrencerateswerecomparedusingtheKaplan-Meiermethod.IndependentpredictorsofoverallsurvivalandrecurrencewereidentifiedusingCoxproportionalhazardregression.RESULTS：Among61pairsofpropensityscorematchedpatients,the1-,2-,and3-yearoverallsurvivalrateswere95.1%,86.7%,and76.4%intheTACEgroupand86.9%,78.5%,and73.2%inthecontrolgroup,respectively.Atthesametime,theTACEandcontrolgroupsalsoshowedsimilarrecurrenceratesat1year（13.4%vs24.8%）,2years（30.6%vs32.1%）,and3years（40.1%vs34.0%）.MultivariateCoxregressionidentifiedserumalpha-fetoproteinlevel≥400ng/mLandtumorsize〉5cmasindependentriskfactorsofmortality（P〈0.05）.CONCLUSION：AspostoperativeadjuvantTACEdoesnotimproveoverallsurvivalorreducerecurrenceinHCCpatients,furtherstudyisneededtoclarifyitsclinicalbenefit.

简介：AIMToinvestigatetheimpactofsurgicalproceduresonprognosisofgallbladdercancerpatientsclassifiedwiththelatesttumor-node-metastasis（TNM）stagingsystem.METHODS：Aretrospectivestudywasperformedbyreviewing152patientswithprimarygallbladdercarcinomatreatedatPekingUnionMedicalCollegeHospitalfromJanuary2003toJune2013.Postsurgicalfollow-upwasperformedbytelephoneandoutpatientvisits.ClinicalrecordswerereviewedandpatientsweregroupedbasedontheneweditionofTNMstagingsystem（AJCC,seventhedition,2010）.Prognoseswereanalyzedandcomparedbasedonsurgicaloperationsincludingsimplecholecystectomy,radicalcholecystectomy（orextendedradicalcholecystectomy）,andpalliativesurgery.Simplecholecystectomyis,bydefinition,resectionofthegallbladderfossa.Radicalcholecystectomyinvolvesawedgeresectionofthegallbladderfossawith2cmnonneoplasticlivertissue;resectionofasuprapancreaticsegmentoftheextrahepaticbileductandextendedportallymphnodedissectionmayalsobeconsideredbasedonthepatient＇scircumstance.Palliativesurgeryreferstocholecystectomywithbiliarydrainage.DataanalysiswasperformedwithSPSS19.0software.Kaplan-MeiersurvivalanalysisandLogranktestwereusedforsurvivalratecomparison.P〈0.05wasconsideredRESULTS：Patientsweregroupedbasedonthenew7theditionofTNMstagingsystem,including8casesofstage0,10casesofstageⅠ,25casesofstageⅡ,21casesofstageⅢA,21casesofstageⅢB,24casesofstageⅣA,43casesofstageⅣB.Simplecholecystectomywasperformedon28cases,radicalcholecystectomyorexpandedgallbladderradicalresectionon57cases,andpalliativeresectionon28cases.Thirty-ninecaseswerenotoperated.Patientswithstages0andⅠdiseasedemonstratednostatisticalsignificantdifferenceinsurvivaltimebetweenthosereceivingradicalcholecystectomyandsimplecholecystectomy（P=0.826）.TheprognosisofstageⅡpatientswithradicalcholecystect

简介：AbstractPurpose:Road traffic accidents (RTAs) are a public health issue and cost a lot to individuals, families, communities and nations. Trauma care systems in India are at a nascent stage of development. There is gross disparity between trauma services available in various parts of the country. Rural area in India has inefficient services for trauma care, due to the varied topography, financial constraints, and lack of appropriate health infrastructure. The present study is to study the trends of occurrence of RTA cases by month, week and time of accident occurrence as well as to research the types of vehicle involved in accidents and other various risk factors related to them.Methods:During 1st January 2017 to 31st December 2017, a hospital-based and cross-sectional study of RTA victims was conducted. The patients were admitted in emergency department of Uttar Pradesh University of Medical Sciences, Saifai, Etawah, when stabilized, they were shifted to the orthopaedics and surgery ward.Results:In the study, 654 road accident victims were included, of which the majority were males (77.5%) and the most of them belonged to rural (67%). RTA victims according to the month of occurrence majority were found in January (12.5%) and evening was time of a day with maximum accidents (32.1%). Mortality cases of RTA victims based on type of road user and it shows decreasing trend of mortality of motor-cyclists (54.2%) followed by pedestrian (25.1%).Conclusion:There should be control over people driving vehicles under the influence of alcohol and drivers over-speeding and rash driving on urban roads as well as rural village roads.

简介：Objective:ToelucidategeneralcharacteristicsofHIV/AIDSpatientsseekingcareatDitanHospitalinanattempttoguideearlydiagnosisinroutinemedicalcare.Materialsandmethods:Aretrospectiveanalysisof185HIV/AIDScasesfromJanuary1990toJune2002wascompletedusingSPSSstatisticalanalysis.Results:Maletofemaleratiowas1.8:1.Subjectsrangedinagefrom1yearoldto64yearsold.16caseswereyoungerthan20yearsoldwiththemedianageamongtheyoungersubsetat7.7years.169caseswereolderthan20yearsoldwithamedianageof36yearsold.29%ofthesubjectswerepeasants.Theremaining71%,wereofotherunspecifiedoccupations.90.8%ofindividualswereofHandescentwhile3.7%ofindividualswereofaminorityheritage.50.3%ofsubjectsweremarried;23.8%havenevermarried;8.1%weredivorced;andtheremaining17.8%wereofunknownmaritalstatus.Ofthoserepresentedinthisstudy,36.8%camefromtheHenanprovince;17.8%werefromBeijing;8.6%werefromShanxi;31.4%fromtheother20provincesofChina;and5.4%fromoutsideofChina.Modeoftransmission:40.0%(74/185)contractedHIVthroughunprotectedsexualcontact;29.2%(54/185)throughreceivingbloodorplasmatransfusions;21.1%(39/185)throughdonatingplasma;7caseswereintravenousdrugusers;7caseswereverticallytransmitted.Modeoftransmissionwasunknownin4cases.Clinicalcategories:Anincluded45cases;Bincluded85cases:Cconsistedof76cases.12casesweredeceased.Initialpresentation:39casespresentedwith_fever,coughanddiarrhea.37caseshadfeverandcoughonly-38casespresentedwithchronicdiarrhea.16caseswerediscoveredincidentallyattimeofoperation.8casespresentedwithfungalinfectionoftheoralcavityorinesophagus.ThecommonHIVassociatedsymptomsandopportunisticinfectionswere:weightlossanddiarrhea,respiratorydiseases,dermatologicdiseases,anemia,neutropenia.Diseasesofotherorgansystemswerelesscommon.Commonmisdiagnosesincluded

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简介：Alongwiththeincreasinglyurgentmanagementneedsofintranetterminalsinhospital,andlargescaleddeploymentofterminalmanagementsystem,terminalaccesscontrolhasbecomeoneofthestandardfunctionsofterminalmanagement.Thispapermainlyaimsatsomesimpleresearchforthesystemconstructionofhospitalintranetterminalaccesscontrol.

简介：Objective:Tostudytheemergencymanagementprinciplesofseveretraumainhospital(injuryseverityscore≥16).Methods:Weused'ATPprinciple'tomanageseveretraumaticpatients.TheATPprincipleiscomposedof:1)attendingsurgeonsofferinginitialmanagement(A);2)teamworkcommencementimmediatelyafterpatientsadmittedtohospital(T);3)parallelprinciple,ie,emergencyresuscitation,evaluationandlaboratorytestperformedsimultaneously(P).ClinicaleffectsbeforeandafterapplyingATPprinciplewereretrospectivelyanalyzedandcompared.Results:DuringJanuary1,2002toDecember31,2003,338patientsweretreatedwithoutapplyingATPprinciple,inwhichISSwas25.9±6.4,152casesdiedwiththemortalitybeing39.2%,andthetimestayedinemergencydepartmentandthetimetooperationroomafteradmissionwere(102.8±16.7)min,(140.3±20.6)min,respectively.DuringJanuary1,2004toDecember31,2005,438patientsweretreatedbasedonATPprinciple,inwhichISSwas28.6±7.8,87casesdiedwiththemortalitybeing19.9%,andthetimeinemergencydepartmentandthetimetooperationroomafteradmissionwere(69.5±11.5)min,(89.6±9.3)min,respectively.ISSshowednosignificantdifferencebetweenthetwogroups(P>0.05),butthemortality,thetimestayedinemergencydepartmentandthetimetooperationroomafteradmissionweregreatlyreducedandshowedsignificantdifferencebetweenthetwogroups(P<0.05).Conclusions:ApplyingATPprincipletotreatseveretraumaticpatientscanshortenemergencytreatmenttimeinhospitalanddecreasemortality.

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简介：AbstractBackground:Gallbladder and biliary tract cancer (GBTC) has greatly damaged the health of patients and is accompanied by a dismal prognosis. The worldwide distribution of GBTC shows extensive variance and the updated data in China is lacking. This study was to determine the current status, trends, and predictions in the burden of GBTC over the past 30 years in China.Methods:This was a descriptive, epidemiological, secondary analysis of the Global Burden of Disease, Injuries, and Risk Factor Study 2019 data. Data including incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of GBTC in China by year, age, and sex were assessed. Joinpoint regression analysis was conducted to evaluate trends of disease burden due to GBTC from 1990 to 2019. Nordpred age-period-cohort analysis was applied for the projection of mortality and incidence due to GBTC from 2019 to 2044.Results:Nationally, there were 38,634 (95% uncertainty interval [UI]: 27,350–46,512) new cases and 47,278 (95% UI: 32,889–57,229) patients due to GBTC, causing 34,462 (95% UI: 25,220–41,231) deaths, and 763,584 (95% UI: 566,755–920,493) DALYs in 2019. Both cases and rates of burden owing to GBTC were heavier among males and at old age. From 1990 to 2019, the age-standardized rates of incidence, prevalence, mortality, and DALYs of GBTC generally increased from 1990 to 2019, with average annual percentage change at 0.8% (95% confidential interval [CI]: 0.6–1.0%), 1.3% (95% CI: 1.1–1.5%), 0.4% (95% CI: 0.2–0.6%), and 0.2% (95% CI: 0.1–0.4%), respectively. Even though the age-standardized incidence rate and age-standardized mortality rate in both sexes were predicted to decline gradually from 2019 to 2044, the number of new cases and deaths were expected to grow steadily.Conclusions:GBTC is becoming a major health burden in China, particularly among males and older individuals. Given the aging population and increasing burden, effective strategies and measurements are urged to prevent or reduce the number of new cases and deaths of GBTC.