Objective:To analyze and summarize adverse reactions such as hypoglycemia, lactic acidosis and pancytopenia caused by Linezolid in elderly patients, in order to enhance clinicians' awareness of adverse reactions of Linezolid.Methods:One case with Linezolid-induced lactic acidosis, pancytopenia and hypoglycemia was reported in a patient receiving long-term and repeated use of Linezolid for recurrent urinary tract infections(RUTI)in Beijing Hospital.National and international literature on the three severe and rare adverse reactions caused by Linezolid before December 2018 was reviewed, and the risk factors, clinical characteristics and prognosis of the three severe adverse reactions caused by Linezolid were summarized and analyzed.Results:A total of 86 cases with Linezolid-induced adverse reactions such as hypoglycemia, lactic acidosis and pancytopenia were analyzed.Among them, the ratio of males to females was 1.8∶1.0, the median age was 64.5 years, and 44 cases were over 65 years, accounting for 51.2%.Among the 57 patients with lactic acidosis, 25 lactic acidosis cases were combined with liver and kidney diseases, which were the most commonly involved organs(43.9%, 25/57). The time of onset for lactic acidosis was 4 h-109 d, with a median value of 32 d, and the peak values of blood lactate were 2.6-38.1 mmol/L, with a median value of 13.3 mol/L.Pancytopenia occurred 4 h-120 days after the treatment, and the median value was 21 days.The time of onset for hypoglycemia was 8 h-26, and the median time was 10.3 days.The lowest value of blood glucose was 0.2 mmol/L.Of the 86 cases, 61(70.9%)patients improved, and 12 cases of 51 patients with lactic acidosis died, with a mortality rate of 23.5%.Conclusions:Clinicians should be aware of serious adverse reactions including hypoglycemia, lactic acidosis and pancytopenia during Linezolid treatment in elderly patients.It is recommended to monitor changes in blood glucose, blood lactate and blood cell count during Linezolid treatment, and to avoid long-term use of Linezolid, so as to maximize the benefits for patients.

Objective To investigate clinical features and prognosis of patients with cancerrelated isolated distal deep vein thrombosis(IDDVT).Methods Data of 64 patients with malignant tumor complicated with IDDVT at our hospital from January 2003 to January 2013 were retrospectively analyzed for the clinical features and prognosis.Results Among the 64 patients,32 male and 32 female cases were involved,aged 37 to 87 years,average(66.0 ± 12.6) years.There were 42 cases aged 65 years and older and 22 cases aged under 65 years.The IDDVT involved veins of lower extremity in 64 patients,unilaterally (47/64)or bilaterally (17/64).The intermuscular veins were involved by IDDVT in 46 cases(71.9％).Posterior tibial veins were involved in 17 cases(26.6％),peroneal veins were involved in 14 cases(21.9％),anterior tibial veins were involved in 2 cases (3.1 ％).Common symptoms were swollen lower extremity and pain (53.1％).Bleeding occurred in 2 (3.6 ％) of the 55 patients(55/64,85.9 ％) who underwent anticoagulant therapy,and no major bleeding occurred.The cumulative incidence of IDDVT at 3,6,and 12 months after tumor diagnosis was 64.0％ (41/64 cases),75.0 ％ (48/64 cases) and 85.9 ％ (55/64 cases),respectively.The cumulative incidences of IDDVT at 3 and 6 months were higher after diagnosis of lung cancer than after diagnosis of digestive tract tumors(P =0.005 and 0.035).By the end of follow-up(a median follow-up of 13.0 months),30 patients(46.9 ％)died.The mortality rate was lower in the non-elderly group than in the elderly group (22.7％ vs.59.5％,x2 =7.850,P=0.005).The mortality rate was lower in patients with stage Ⅰ-Ⅲa than in patients with stage Ⅲb-Ⅳ(24.0％ vs.68.8％,x2=11.246,P=0.001).The mortality rate was lower in patients with gynecologic tumors(10.0％) than in patients with lung cancer(55.6％),digestive tract tumors (40.0％) and hematologic tumors (71.4％) (P =0.041,0.037 and 0.035,respectively).TNM Ⅲ b-Ⅳ (OR =8.42,95 ％ CI:1.93-30.00,P =0.004) and age ≥ 65 years (OR =6.28,95％CI:1.50-27.76,P=0.012)were independent risk factors for death.Conclusions Cancerassociated IDDVT most commonly involves the intermuscular veins.The incidence of hemorrhage after anticoagulant therapy is low.For patients without anticoagulation contraindications,active anticoagulant therapy should be recommended.The advanced cancer and old age are independent risk factors for cancer-related IDDVT death.

Objective To explore the incidence,clinical characteristic and outcome of malignancy surgical patients with venous thromboembolism (VTE).Methods The clinical data of sixty-eight malignancy surgical cases who suffered from VTE during the postoperative 90 days and hospitalized from January 2003 to April 2013 at Beijing Hospital were reviewed.Results There were 10 967 cases of malignancy surgeries during the observed ten years and 68 cases suffered from VTE during the postoperative 90 days (incidence was 0.62 ％),including gynecological malignancy,lung cancer,urinary system malignancy,digestive tract malignancy,breast cancer and hematological malignancy.Gynecological malignancy and lung cancer had the highest VTE incidence (1.03％ and 0.95％ respectively),there was significant difference with the other types (all P ＜0.05).Among 68 patients,31 cases of male and 37 cases of female were involved,with an average age of (63.94±10.50) years old,average postoperative time of (33 ± 30) days,average anesthesia duration of (172.75± 104.71) minutes,including 29 cases (42.65％) with cardiovascular diseases,34 cases (50.00％) immobilized more than three days after operation,40 cases (58.82 ％) with middle and low differentiation carcinoma in pathology,and 51 cases (75.00％) with Caprini score equal or greater than five.There were 36 cases in elderly group (≥65 years old)and 32 cases in non-elderly group (＜65 years old).Compared with non-elderly group,the body mass index was lower (t =-2.052,P =0.044),Caprini score (t =2.613,P =0.011),D-dimer (Z =-1.976,P =0.048),and incidence of late-onset VTE (occurring in postoperative 5-12 weeks)(x2=8.438,P =0.004) were higher in elderly group.All the three cases of fetal pulmonary thromboembolism were late-onset VTE patients in elderly group without any prophylactic measures.Conclusions The incidence of VTE in malignancy surgery patients during the postoperative 90 days is 0.62％.Gynecological malignancy and lung cancer are the most common types.The observation time for the VTE events should be extended to 12 weeks after surgery in elderly patients,as fetal pulmonary thromboembolism may occur during postoperative 5-12 weeks.

目的 分析伴有咯血的肺血栓栓塞(PTE)患者临床特征和住院期间预后.方法 纳入2010年1月至2015年1月北京医院住院的急性PTE患者220例,采集患者的基线特征、临床表现、实验室检查、影像学表现、治疗情况和住院转归(含病死率和出血发生率);按是否伴有咯血分为咯血组和无咯血组,比较两组患者临床特征和预后的差异.结果 220例患者中,16例(7.3％)伴有咯血,204例(92.7％)不伴咯血.咯血组年龄显著小于无咯血组[(59.7±16.6)岁对(67.2±13.6)岁,P=0.037],男性更多见(75.0％对44.6％,P=0.034).与无咯血患者相比,咯血组患者发热和胸痛发生率较高(分别为31.3％对11.3％,P=0.037;50.0％对26.0％,P=0.039).咯血组平均确诊时间为(8.91±6.09)d.咯血组患者放置下腔静脉滤器(IVCF)的比例更高(18.8％对3.4％,P=0.028).两组患者的危险程度和住院病死率差异无统计学意义.结论 PTE引起的咯血缺乏特异性,常导致误诊或诊断延误,尽早明确诊断,有助于正确的治疗,减少不当措施带来的不良后果.

Abstract Background Rapid stratification and appropriate treatment on admission are critical to saving lives of patients with acute pulmonary embolism (PE). None of the clinical prediction tools perform well when applied to all patients with acute PE. It may be important to integrate respiratory features into the 2014 European Society of Cardiology model. First, we aimed to assess the relationship between the arterial partial pressure of oxygen/fraction of inspired oxygen (PaO2/FIO2) ratio and in-hospital mortality, determine the optimal cutoff value of PaO2/FIO2, and determine if this value, which is quick and easy to obtain on admission, is a predictor of in-hospital mortality in this population. Second, we aimed to evaluate the potential additional determinants including laboratory parameters that may affect the in-hospital mortality. We hypothesized that the PaO2/FiO2 ratio would be a clinical prediction tool for in-hospital mortality in patients with acute PE. Methods A prospective single-center observational cohort study was conducted in Beijing Hospital from January 2010 to November 2017. Arterial blood gas analysis data captured on admission, clinical characteristics, risk factors, laboratory data, imaging findings, and in-hospital mortality were compared between survivors and non-survivors. The area under the receiver operating characteristic curve (AUC) for in-hospital mortality based on the PaO2/FiO2 value was determined, and the association between the parameters and in-hospital mortality was analyzed by using logistic regression analysis. Results Body mass index, history of cancer, PaO2/FiO2 value, pulse rate, cardiac troponin I level, lactate dehydrogenase level, white blood cell count, D-dimer level, and risk stratification measurements differed between survivors and non-survivors. The optimal cutoff value of PaO2/FiO2 for predicting mortality was 265 (AUC = 0.765, P < 0.001). Only a PaO2/FiO2 ratio < 265 (95% confidence interval [CI] 1.823–21.483, P = 0.004), history of cancer (95% CI 1.161–15.927, P = 0.029), and risk stratification (95% CI 1.047–16.957, P = 0.043) continued to be associated with an increased risk of in-hospital mortality of acute PE. Conclusion A simple determination of the PaO2/FiO2 ratio at <265 may provide important information on admission about patients’ in-hospital prognosis, and PaO2/FiO2 ratio < 265, history of cancer, and risk stratification are predictors of in-hospital mortality of acute PE.

针对金属矿山三维建模过程中数据量较小,难以精确还原矿体表面模型的问题,提出了一种穿脉数据约束下的三维矿体表面建模方法.通过分析钻孔数据缺失矿体的数据特征,以矿山工程图中穿脉图与矿体轮廓图为源数据,利用穿脉数据对矿体轮廓线进行约束;在讨论穿脉数据与矿体轮廓线匹配问题的基础上,提出了以穿脉上见矿点与矿体轮廓线的连接方法以及穿脉数据约束矿体表面建模的约束算法.以内蒙古油篓沟矿区为研究对象进行建模.研究结果表明:在穿脉数据约束下的矿体三维建模可以更好地模拟矿体表面形态、提高建模精度,矿体建模插值后的计算结果与生产详查报告进行的储量估算的储量值相差不大,结果较为准确.因此该算法有利于提高矿体储量估算的精度.

Objective To investigate the value of Neurally adjusted ventilatory assist mode (NAVA) in difficult weaning.Methods Discussed the value of NAVA in the difficult weaning by analyzing the weaning process using the NAVA model in one case,and then reviewed related literatures.Results The patient underwent a long-term mechanical ventilation and failure of weaning after intracerebral hemorrhage.The diaphragm function was evaluated by measuring diaphragm electrical action potential and gradually exercised after switching to NAVA mode.Finally weaning successed.Conclusions NAVA is an idealventilation mode close to physiologicaland at the same time to evaluate the function of diaphragm.It has a good application prospect in difficult weaning.

肺血栓栓塞症(PTE)是一种常见的疾病,具有潜在致死性,占心血管系统死亡原因第3位[1]. 其发病常隐匿,而加重过程又往往非常迅速,未经治疗的PTE患者致死率高达30%,如果临床医生能及时诊断和采取治疗措施,其病死率可降至2%~10%[2].

Objective To explore the clinical features and mechanisms of idiopathic hypereosinophilic syndrome(IHES) complicated with venous thromboembolism (VTE).Methods By analyzing two recent cases of idiopathic eosinophilia combined with pulmonary embolism in our hospital and 9 cases reported in the literature,we summarized the clinical features of the disease and explored its internal relations and pathogenesis.Results The clinical manifestations of the disease often show VTE first,accompanied by elevated blood eosinophils,decreased platelets,pulmonary infiltrates,which can be treatment effectively by glucocorticoids and anticoagulant therapy.Conclusion Idiopathic hypereosinophilic syndrome can lead to a hypercoagulable status,which may result in the occurrence of VTE.As this disease is little recognized,it is quite nessesary to except the possibilty of thrombotic diseases in patients with hypereosinophilic status.Besides the treatment of thrombosis with anticoagulation drugs,glucocorticoids can effectively relieve the hypereosinophilic status.

Objective To investigate the clinical features of pulmonary thromboembolism (PTE)combined with obstructive sleep apnea hypopnea syndrome (OSAHS) to improve the understanding of the disease.Methods The clinical manifestations,laboratory examination,imaging features,treatment and pharmacogenomics of two patients with PTE combined with OSAHS were analyzed retrospectively.Results The two cases of PTE combined with OSAHS had the following common characteristics.It happened in senior people with metabolic syndrome (obesity,hypertension,hyperlipidemia).PTE features were that massive-submassive PTE was common,multiple pulmonary segments were involved,the dose of warfarin increased,warfarin associated VKORC1 gene had mutation,and thromboemboIism was easy to relapse.OSAHS features were that severe obstructive sleep apnea with severe hypoxemia.Conclusions In patients with PTE combined with OSAHS,there may be common genetic and physiological mechanisms between PTE and OSAHS,which produce an overlap effect in the course of these diseases-increasing the severity of both diseases,and resistance to treatment.It is worthy to concern about it in clinic and further discuss in the future.

Objective To explore the clinical characteristics and prognosis of patients with malignant tumor of digestive system combined with venous thromboembolism(VTE).Methods The clinical data of 77 patients admitted in Beijing Hospital from January 2003 to April 2013 with digestive system malignant tumor complicated with VTE were retrospectively analyzed.The incidence,clinical features and prognosis of the patients with digestive system cancer were analyzed.Results Among 77 patients,57 cases of male and 20 cases of female were involved,with an average age of(68.7 ± 12.4)years,including 60 cases(77.9 ％)of adenocarcinoma.The pathological results showed that differentiated tumors accounted for 61.0％ (47/77).Among the 77 patients,pulmonary thromboembolism (PTE) accounted for 33.8 ％ (26 cases) and deep vein thrombosis(DVT)in the low extremities accounted for 66.2 ％ (51 cases).Among all the patients,the most common symptoms were dyspnea and swelling or pain in the extremities.The incidence of VTE was 24.7％ (19/77),13.0％(10/77),19.5％(15/77),5.2％(4/77),5.2％ (4/77),32.5％ (25/77) at 1,3,6,9,12,＞ 12 months after diagnosis of digestive system malignancies,respectively.By April 2013,the 54.5 ％ (42/77) patients died,among which 73.8 ％ (31/42) died of digestive system malignancies,11.9 ％ (5/42) died of PTE,14.3 ％ (6/42) died of other causes.The mortality rates at 1,3,6,9,12,＞ 12 months after the diagnosis of VTE were 20.8％ (16/77),6.5 ％ (5/77),13.0 ％ (10/77),5.2 ％ (4/77),2.6 ％ (2/77),6.5 ％ (5/77),respectively.The difference in VTE incidence between the group aged ≥65 years and group aged ＜65 years at 1,3,6,9 and 12 months after the diagnosis of tumors was not statistically significant(P =0.309).The differences in mortality(P =0.357) and in the median survival time(x2 =0.290,P =0.591) between the two groups were not statistically significant at 1,3,6,9 and 12 months after the diagnosis of VTE.Conclusions The risks for VTE are high in patients with digestive tract malignant tumor,advanced malignant tumor,poor histologic grade(poorly or moderately differentiation),and chemotherapy or surgery,which mostly occurs within 3-6 months after diagnosis.Most deaths occur within the 1st year after the diagnosis of VTE.

Objective To analyze and summarize the clinical features of Mycoplasma pneumoniae pneumonia complicated with acute respiratory distress syndrome (ARDS).Methods Two recent cases from Beijing Hospital,together with cases from literature both in China and abroad,were included for analysis.Results Twenty cases of (33±26) years of age were analyzed,among which 8 were male and 12 were female.Major symptoms included fever,cough,expectoration,and shortness of breath.Laboratory findings showed increased white blood cell count in 10 cases (50％),neutrophil percentage in 16 cases (80 ％),C reactive protein(CRP) levels in 8 cases,as well as procalcitonin(PCT) levels,to a much lesser extent though,in 3 cases.In terms of prognosis,13 cases were cured (65％),and 7 cases died (35％).Compared with the cured,no significant difference was found in the duration from disease onset to etiological diagnosis in the dead (P ＞ 0.05);Nevertheless,the initiation of effective treatment administration was significantly delayed (7-±-3 days in the cured group,13 ± 8 days in the death group) in the dead(P ＜0.05).Fifteen cases (75％) underwent mechanical ventilation (MV),of which 14 were invasive (all deaths experienced invasive MV before death,which accounted for 50％ of all invasive cases) and 2 were noninvasive.Corticosteroid therapy were applied in 8 patients (40％),of which 6 cases were cured (effective rate was 75％).The leading antibiotics used targeting M.pneumoniae in the dead group were macrolides.Conclusions M.pneumoniae infection can lead to ARDS,with high mortality in these cases.Unfortunately so far,the etiological diagnosis of M.pneumoniae infection is often delayed.The combined detection of white blood cells,neutrophil classification,CRP and PCT in infectious ARDS patients can contribute to early differentiation of M.pneumoniae infection from bacterial infection.In the settings of ARDS,there is notably greater clinical benefit in early administration of sensitive antibiotics targeting mycoplasma pneumonia rather than the confirmation of the etiological diagnosis.Given the high prevalence of macrolides resistance in M.pneumoniae,fluoroquinolones and tetracyclines can serve as promising options.The usage of corticosteroid therapy may has function to alleviate excessive inflammatory responses in the M.pneumoniae pneumonia complicated with ARDS cases.Respiratory support such as mechanical ventilation is also helpful.Therefore,early treatment is the key prognostic determinant in patients with M.pneumoniae pneumonia complicated with ARDS.

以三维模拟唐山世界园艺博览会系统为例,介绍系统设计与建设过程中的相关技术以及如何进行数据的准备处理、三维建模技术搭建博览会系统的概述.

Objective To investigate the clinical characteristics of exogenous lipoid pneumonia and to explore the characteristics of the elderly with the disease.Methods 14 cases of elderly patients with exogenous lipoid pneumonia in Beijing Hospital were analyzed.Results Among the 14 patients(7 male and 7 female),main symptoms included dyspnea (50.0 ％),cough (35.7 ％),and the common signs were crackles (28.6 ％) and wet rales (21.4 ％).For exogenous lipoid pneumonia,the most common causes of inhalation of lipoid substances included chronic constipation,nasal cavity diseases such as rhinitis (35.7％).Some of elderly dementia patients may wrong inhale lipoid substances(21.4 ％).X ray or CT features of exogenous lipoid pneumonia showed a tumor-like mass or lesions (42.9％)and the exudative plaque (64.3％),both of which were easily misdiagnosed as tumor.All of the 14 cases(100％) were misdiagnosed as "pneumonia" or "lung tumor",and finally confirmed by pathological diagnosis.Among the 14 cases,2 cases were diagnosed by cytopathology of bronchial alveolar lavage fluid or by transbronchial lung biopsy,10 cases were diagnosed by invasive examination methods like lobe resection,and 2 cases were confirmed by autopsy.At present,there is still a lack of effective treatment methods for exogenous lipoid pneumonia.Conclusions Due to the basal disease(such as constipation)action,the elderly may easily have access to exogenous lipoid pneumonia with atypical symptoms,might have more serious manifestations than younger adults,and may have X ray or CT imaging similar to lung cancer or pneumonia.So it is often misdiagnosed.If the patients cannot be timely diagnosed and the causes cannot be removed,it is likely to cause chronic interstitial fibrosis or death.Clinicians must increase the awareness of,and take into account the possibility of lipoid pneumonia,especially meeting the elderly patients with dry cough and dyspnea,rales or crackles and X-ray or CT tumor-like imaging as main manifestation resembling pulmonary inflammation or tumor without treatment futility after common antibiotic treatment.

Objective To describe the clinical characteristics of pulmonary thromboembolism (PTE) combining with primary antiphospholipid syndrome (PAPS).Methods We described a case of PAPS combining with PTE and reviewed 32 cases reported in literatures.Results 33 patients (eighteen males and fifteen females) had the most common symptoms such as dyspnea,chest pain,hemoptysis,and lower extremity pain.The ratio of triple syndrome of dyspnea,chest pain,and hemoptysis was 42.4%, while ratios of double lower limbs venous thrombosis and bilateral pulmonary embolism were 38.7% and 87.1%,respectively.The ratio of right atrium and (or) right ventricular enlargement was 56.3%,and that of pulmonary hypertension was 75.0%.The platelet level in some patients was decreased and activated partial thromboplastin time was significantly prolonged.Prompt diagnosis and treatment could achieve good therapeutic effect.Conclusions In patients with PTE combining with PAPS,the incidence rate of PTE triple syndrome is high,and moreover,right atrium and (or) ventricular enlargement, thrombocytopenia and abnormal clotting mechanism,and extensive thrombus are common.Prompt diagnosis and treatment can achieve good therapeutic effect.

通讯监察活动一直是我国台湾地区执法机关预防和打击犯罪的重要手段之一,其"双刃性"的特性决定了必须对其予以有效规管。随着《通讯保障及监察法》的颁布实施,以及相关配套细则的完善,台湾地区对通讯监察活动作出了详细明确的规范,明确了通讯监察的基本内涵,对通讯监察的事由、授权机制、终止机制、资料处理以及监督机制等内容作出了明确的规定,有效地规范了通讯监察活动。对大陆技术侦查规范化有着积极的借鉴作用。

截取通讯及秘密监察活动具有双刃性特征,一方面是执法机关执法调查的重要工具,另一方面又极易侵害公民私权,所以应对其有效规管,以求平衡。香港政府一贯重视对此类活动的规管,规管机制堪称典范。香港现行规管机制具有四大特征,即明确的授权制度,独立的监督机构,完善的材料处理机制,完备的保障制度。香港政府的这种规管机制对我国内地技术侦查的规范化有重要借鉴作用。

This paper proposes a long-distance driving test monitoring system of 3-lay architecture.This system collects the drivers' driving information by driving recorder.It establishes a model to judge the drivers' test performance through matching route,speed,driving time etc,builds the oracle database to save relevant data for enquiries and statistics.Test result shows that this system efficiently assess driver's actual driving ability,detectes the illegal activities of long distance driving test.

"Illegal investigation organization" is the products of the process of information society, which is a huge threat to the information security of the whole social. Recently the Ministry of Public Security deployed the special battle against the infringement of personal information, in which dealt with several illegal investigation organization. Based on the analysis of the relevant material and combined with the actual situation of the battle This passage makes a research of "illegal investigation organization" itself in first, defines the meaning, business scope and methods of "illegal investigation organization", then analysis its behavior, summarizes the characteristics and harmfulness of the behavior. At last, the author analysis the dilemma of the crime prevention and crime control from three aspects and puts forward the strategy of crime prevention and crime control.

On the basis of full understanding of road traffic,a detailed analysis is made for traffic survey,and a template-based framework for traffic survey analysis system is established.The specific implementation is described.Moreover,the concept of traffic survey organization template and its functional design and implementation are introduced.The pre-processing algorithms of detection data are improved.This system reduces the demands of user's technology of traffic survey,simplifies the steps,improves the reliability of data preprocessing,and extends the scope of application of the system.The system includes traffic survey organization template,data input and pre-processing,data analysis and processing,search and result display,output and system maintenance template.