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ObjectiveTo investigate the protective effect of the extract of Liuwei Dihuangwan （LW） on mitochondrial damage in the Alzheimer's disease （AD） model of Caenorhabditis elegans （C. elegans）. MethodC. elegans transfected with human β-amyloid protein （Aβ） 1-42 gene was used as an AD model. The rats were divided into blank group， model group， metformin group （50 mmol·L-1）， and low， medium， and high dose （1.04， 2.08， 4.16 g·kg-1） LW groups. Behavioral methods were used to observe the sensitivity of 5-hydroxytryptamine （5-HT） in nematodes. Western blot was used to detect the expression of Aβ in nematodes. Total ATP content in nematodes was detected by the adenine nucleoside triphosphate （ATP） kit， and mitochondrial membrane potential was detected by the JC-1 method. In addition， the mRNA expression of Aβ expression gene （Amy-1）， superoxide dismutase-1 （SOD-1）， mitochondrial transcription factor A homologous gene-5 （HMG-5）， mitochondrial power-associated protein 1 （DRP1）， and mitochondrial mitoprotein 1 （FIS1） was detected by real-time fluorescence quantitative polymerase chain reaction （RT-PCR）. ResultThe extract of LW could reduce the hypersensitivity of the AD model of nematodes to exogenous 5-HT （P<0.05） and delay the AD-like pathological characteristics of hypersensitivity to exogenous 5-HT caused by toxicity from overexpression of Aβ in neurons of the AD model of nematodes. Compared with the blank group， in the model group， the mRNA expression of Aβ protein and Amy-1 increased （P<0.01）， and the mRNA expression of SOD-1 and HMG-5 decreased （P<0.01）. The mRNA expression of DRP1 and FIS1 increased （P<0.01）， and the level of mitochondrial membrane potential decreased （P<0.05）. The content of ATP decreased （P<0.01）. Compared with the model group， in the positive medicine group and medium and high dose LW groups， the mRNA expression of Aβ protein and Amy-1 decreased （P<0.05，P<0.01）， and the mRNA expression of SOD-1 and HMG-5 increased （P<0.01）. The mRNA expression of DRP1 decreased （P<0.05，P<0.01）， and that of FIS1 decreased （P<0.01）. The level of mitochondrial membrane potential increased （P<0.01）， and the content of ATP increased （P<0.05，P<0.01）. ConclusionThe extract of LW may enhance the antioxidant ability of mitochondria， protect mitochondrial DNA， reduce the fragmentation of mitochondrial division， repair the damaged mitochondria， adjust the mitochondrial membrane potential， restore the level of neuronal ATP， and reduce the neuronal damage caused by Aβ deposition.
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Objective:To explore the effect of goal-directed fluid therapy (GDFT) on the gastrointestinal function of patients after laparoscopic radical resection of cervical cancer.Methods:A total of 60 patients who were scheduled for laparoscopic radical resection of cervical cancer in Shanxi Provincial People's Hospital from October 2016 to September 2018 were selected. They were randomly divided into observation group and control group by random number table method, with 30 cases in each group. Patients in the observation group received GDFT, they were connected to the Flotrac/Vigile monitoring system, and the fluid supplementation was guided according to the changes in mean arterial pressure (MAP), stroke volume variability (SVV) and cardiac index, the goal was to maintain MAP≥60 mmHg (1 mmHg = 0.133 kPa), SVV≤13%, and cardiac index 2.5-4.0 L·min -1·m -2. The conventional fluid therapy was applied in the control group, and the liquid's input speed was adjusted according to the changes of MAP and central venous pressure (CVP) which were respectively maintained at 60-110 mmHg and 8-12 cmH 2O (1 cmH 2O = 0.098 kPa). The crystal/colloid input, bleeding volume and urine output were recorded. The first bowel sounds recovery time, exhaust time, postoperative hospitalization time, and the incidence of nausea and vomiting after surgery were recorded. Arterial blood and central venous blood were drawn before anesthesia induction and 12, 24 and 36 hours after operation to determine the concentrations of arterial blood lactate and central venous oxygen saturation (ScvO 2) as well as intestinal type fatty acid binding protein (IFABP). Results:Compared with the control group, the urine output was increased ( t = -7.738, P < 0.01), the crystal input was reduced ( t = -13.439, P < 0.01), the colloid input was increased ( t = -8.360, P < 0.01), the recovery time of first bowel sounds after surgery was shortened ( t = 6.694, P < 0.01), the exhaust time was shortened ( t = -10.326, P < 0.01), and the time of postoperative hospitalization was shortened ( t = -7.377, P < 0.01). The incidence of nausea and vomiting in the observation group were 10.0% (3/30) and 6.7% (2/30), which were lower than 33.3% (10/30) and 26.7% (8/30) in the control group ( χ2 = 4.812, P = 0.028; χ2 = 4.320, P = 0.038). Compared with the control group, the concentration of IFABP in the observation group was reduced at 12 h ( t = 2.983, P = 0.004), 24 h ( t = 6.452, P < 0.01), and 36 h ( t = -3.880, P < 0.01) after surgery; the concentration of lactate in the observation group was reduced at 12 h ( t = -7.377, P < 0.01), 24 h ( t = -6.036, P < 0.01), and 36 h ( t = -8.933, P < 0.01) after surgery; the value of ScvO 2 in the observation group was increased at 12 h ( t = 2.710, P = 0.009) and 24 h ( t = 2.387, P = 0.020) after surgery. Conclusion:GDFT can maintain the balance between oxygen delivery and oxygen consumption in the gastrointestinal mucosa cells, which can promote the recovery of gastrointestinal function of patients undergoing laparoscopic radical resection of cervical cancer.
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Objective:To determine the median effective dose (ED 50) of 0.5% ropivacaine based on femoral nerve cross-sectional area for ultrasound-guided femoral nerve block. Methods:Patients of both sexes, aged 18-64 yr, of American Society of Anesthesiologists physical status I or Ⅱ, with body mass index of 20-30 kg/m 2, scheduled for elective open reduction and internal fixation for patella fracture or removal of patella fracture by internal fixation, were enrolled in this study.Ultrasonic localization of femoral nerve was performed for measurement of the femoral nerve cross-sectional area, and 0.5% ropivacaine was injected based on the area.ED 50 was determined by Dixon′s up-and-down sequential method.The initial dose was 0.22 ml/mm 2, and the difference between the two successive doses was 0.02 ml/mm 2.The effective block was defined as complete loss of pain sensation in the areas of anterior skin of knee joint, skin on the inner side of the calf and dorsal medial skin of the foot and the degree of motor block was in stages 1-3 assessed using Brunnstrom motor function within 30 min after nerve block.Nerve block was considered ineffective if pain occurred in any nerve distribution area mentioned above.The study was terminated if 7 effective and ineffective alternating waves occurred.ED 50 and 95% confidence interval (CI) were calculated using Probit analysis. Results:Twenty-seven patients were enrolled in the study with the femoral nerve cross-sectional area (75±5) mm 2.ED 50 (95%CI) of 0.5% ropivacaine for ultrasound-guided femoral nerve block was 0.106 (0.069-0.125) ml/mm 2. Conclusion:ED 50 of 0.5% ropivacaine based on femoral nerve cross-sectional area for ultrasound-guided femoral nerve block is 0.106 ml/mm 2.
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Objective:To investigate the effect of early enteral nutrition (EN) standardized treatment process management on the ventilation treatment effect and prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) on invasive mechanical ventilation.Methods:Forty-three patients with AECOPD on invasive mechanical ventilation admitted to Shenzhen Baoan District People's Hospital from January 2017 to December 2018 were enrolled. According to the start time of the continuous quality improvement project of nutritional support treatment for critically ill patients in the hospital, 20 patients from January 1st to December 31st in 2017 were enrolled in the routine EN group, and 23 patients from January 1st to December 31st in 2018 were enrolled in the early EN group. In the early EN group, when the patient was hemodynamically stable within 24 hours after intensive care unit (ICU) admission and there was no contraindication for EN, early trans nasal intestinal EN was started, and the infusion rate was adjusted or parenteral nutrition was added according to the EN tolerance score. The target feeding amount was 104.6-125.5 kJ·kg -1·d -1, and achieve complete EN. The conventional EN group started EN after patients had experienced the early stress stage, the vital signs were stable, and 48 hours after ICU admission. The management process was the same as the early EN group. The ventilation indicators including rapid shallow breathing index (RSBI), arterial blood pH value, arterial oxygen partial pressure (PaO 2), arterial partial pressure of carbon dioxide (PaCO 2), and base excess (BE) at weaning, PaCO 2, CO 2 retention rate at 2 hours after weaning, as well as critical management indicators including the incidence of ventilator-associated pneumonia (VAP), duration of invasive mechanical ventilation, length of ICU stay, total hospitalization cost and re-intubation rate between the two groups were compared. Results:After the early EN standardized treatment process management, the RSBI at weaning of the patients in the early EN group was significantly lower than that in the conventional EN group (times·min -1·L -1: 36.68±16.12 vs. 52.63±14.81, P < 0.05), but no significant difference in pH value, PaO 2, PaCO 2 or BE was found as compared with the conventional EN group. The PaCO 2 and CO 2 retention rate at 2 hours after weaning in the early EN group were significantly lower than those in the conventional EN group [PaCO 2 (mmHg, 1 mmHg = 0.133 kPa): 52.48±7.62 vs. 58.32±8.43, CO 2 retention rate: (10.25±2.86)% vs. (18.46±3.21)%, both P < 0.05]. Compared with the conventional EN group, the incidence of VAP [8.7% (2/23) vs. 15.0% (3/20)], duration of invasive mechanical ventilation (hours: 52.64±14.81 vs. 53.78±12.75), length of ICU stay (days: 4.92±1.26 vs. 5.24±1.84), total hospitalization costs (thousand Yuan: 20.9±4.8 vs. 21.0±6.9) and re-intubation rate [13.0% (3/23) vs. 20.0% (4/20)] were slightly decreased in the early EN group without statistically significance (all P > 0.05). Conclusion:The management of early EN standardized treatment process for patients with AECOPD on invasive mechanical ventilation may alleviate the respiratory muscle fatigue status, and does not increase the complications.
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Objective:To discuss the diagnostic methods, clinical features and treatment options of bronchogenic cysts.Methods:A total of 86 patients with bronchogenic cysts and 5 patients with esophageal cysts and esophageal cysts were selected from January 2011 to May 2020 in the Affiliated Tumor Hospital of Harbin Medical University. There were 37 males and 49 females with bronchogenic cysts, aged 23 to 70(49.27±10.70)years old. According to the location of the disease, the patients were divided into mediastinal type(65 cases, 75.6%); intrapulmonary type(21 cases, 24.4%); bronchogenic cyst originating from the esophagus(9 cases, 10.5%).Results:The preoperative diagnosis coincidence rate was 9.3% in 8 cases. The rate of thoracoscopic surgery(59.3% in 51 cases), compared with the indwelling time of thoracic drainage tube after thoracotomy[(3.80±1.25) days vs.(4.97±1.54)days, P<0.001] and hospital stay[(7.08±1.75) days vs.(9.60±2.58)days, P<0.001] significantly shortened. 65 cases(71.4%, 65/91) were successfully followed up, with a median follow-up time of 34(2-111) months, and no recurrence was found. Conclusion:Bronchial cysts have no characteristic clinical manifestations, and it is difficult to make a clear diagnosis before surgery. Chest MRI has a great advantage in the diagnosis of cysts. For most cases, thoracoscopic surgery can achieve better clinical treatment results and has minimally invasive advantages. It is difficult to distinguish between bronchogenic cysts that originated in the esophagus and esophageal cysts, and there is no significant difference in clinical characteristics.
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Objective The objective of this study was to investigate the relationship between CYP2D6 gene polymorphisms and the concentrations of tamoxifen metabolites in breast cancer patients. Methods Peripheral blood samples from breast cancer pa-tients were collected to detect the single nucleotide polymorphism(SNP)of s16947,rs1065852 and rs28371725 gene sites on CYP2D6 gene from January 2010 to December 2012. Genotypes of the three SNPs of CYP2D6 and the concentrations of tamoxifen metabolites were detected in breast cancer patients. Statistical analysis was performed using an independent sample Kruskal-Wallis test in a non-parametric test. Results There was a statistical difference in the concentrations of tamoxifen metabolites 4-OH-N-D-TAM and 4′OH-N -D -TAM in the blood in different CYP2D6 gene genotype carriers at rs16947 site ( P =0. 049), indicating that the rs16947 site of CYP2D6 gene affected the metabolism of tamoxifen drug in breast cancer patients. Conclusion The genotype of CYP2D6 gene at rs16947 site is related to the blood concentration of tamoxifen metabolites in breast cancer patients.
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Objective To investigate the clinical efficacy of laparoscopic Roux-en-Y gastric bypass on type 2 diabetes mellitus(T2DM) with different body mass index (BMI).Methods 62 T2DM patients were collected and divided into low BMI,medium BMI,and high BMI groups respectively according to BMI 25-28(kg/m2),28-33(kg/m2),≥33(kg/m2).All patients received laparoscopic Roux-en-Y gastric bypass and the clinical curative effects were monitored and analyzed subsequently.Results At 12 months postoperatively,the levels of total cholesterol(TC),triglyceride(TG) and BMI in medium and high BMI group were lower compared with those before surgery (P＜0.05).In low,medium BMI,and high BMI groups,the therapeutic effective rate was 81.8％(9/11),97.4％ (38/39),and 100％(12/12) respectively.The levels of fasting C-peptide and postprandial 1 h C-peptide were higher compared with those before surgery (P＜0.05).Conclusion Laparoscopic Roux-en-Y gastric bypass has good clinical curative effect for T2DM with different BMI,but for low BMI patients,the selection should be more cautious.
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Objective:To investigate the relationship of expression of vascular endothelial growth factor (VEGF) and clinical features in patients with intracranial aneurysm and arteriovenous malformation (AVM).Methods:A total of 64 patients with AVM and intracranial aneurysm,who were treated in First Hospital of Shijiazhuang from February 2011 to November 2015,were chosen as research subjects,AVM were 32 cases and intracranial aneurysm were 32 cases.The samples were sectioned for VEGF immunohistochemical staining;the location and intensity of staining were recorded;the positive indexes were computed.The VEGF expression of different age and Hunt&Hess classification in patients with intracranial aneurysms were analysed;the VEGF expression of different diameters,ages,Spetzler classification in patients with AVM were analysed.Results:There were no statistical differences in the VEGF expression of different ages in patients with intracranial aneurysms (P＞0.05);the VEGF expression of different Hunt&Hess classification in patients with intracranial aneurysms was statistical difference (P＜0.05).The positive rate of VEGF in the artery of AVM was lower than that in the vein,the difference was statistically significant (P＜0.05).There were no statistical differences in the VEGF expression of the different Spetzler classification,different diameters and different ages in patients with AVM (P＞0.05).Conclusion:The expression of VEGF in the vein and the artery of patients with AVM is different,the expression of VEGF is not correlated with the age of intracranial aneurysm and the size and age of AVM.VEGF cannot be used as a predictor in the patients with intracranial aneurysms and AVM.
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Objective:To explore the effects of Chinese medicine clinical pharmacists participating in the formulation and imple-mentation of traditional Chinese medicine clinical pathway in orthopaedics department. Methods: Totally 60 cases of radius fracture patients were selected from 2009 to 2011 as the control group, and 54 cases of radius fracture patients were selected as the observation group in our hospital during 2015 and 2016. The observation group was instructed by both Chinese medicine clinical pharmacists and doctors;meanwhile, Chinese medicine clinical pharmacists were responsible for the entire pharmaceutical care. The clinical curative effect of the two groups, the rational use rate of traditional Chinese medicines, the average length of stay, the average cost of traditional Chinese medicines and the incidence of ADR between the groups were compared. The effect of Chinese medicine clinical pharmacists participating in the formulation and implementation of clinical pathway was evaluated. Results:After the formulation and implementa-tion of clinical pathway, the total effective rate was improved from 80. 0% to 92. 6%, the rational use rate of traditional Chinese medi-cines increased significantly from 60. 0% to 85. 2%, and the differences were statistically significant (P<0. 05). The average length of stay decreased significantly from (14.0 ±2.3) d to (11.0 ±3.1) d and the difference was statistically significant (P<0.05). Meanwhile, the average cost of traditional Chinese medicines decreased from (887. 07 ± 186. 44) yuan to (437. 14 ± 127. 32) yuan and the difference was statistically significant (P<0. 05). Moreover, the incidence of ADR decreased from 16. 7% to 11. 1%. Con-clusion:Chinese medicine clinical pharmacists should participate in the whole process of clinical pathway, which can play an important role in ensuring the implementation of clinical pathway and standardizing the rational drug use. It can significantly make the clinical medication safer,and more effective and economical. It can shorten the hospital stay and reduce the hospitalization costs as well.
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Objective To investigate the single nucleotide polymorphisms ( SNP) of IL-13G+2044A and IL-13A-1512C and to analyze their relationships with the occurrence of bronchial asthma in chil-dren in Guiyang city. Methods Sequenom MassArray platform, a newly developed genotyping assay, was used to detect the G+2044A locus and the A-1512C locus in 153 subjects with asthma and 103 healthy sub-jects. Then the results were statistically analyzed with chi-square test and t-test. Results Three genotypes of IL-13G+2044A locus including GG, GA and AA were detected in the subjects with or without asthma. There were significant differences in the genotype distribution between the subjects with or without asthma (χ2 =7. 691, P<0. 05). The subjects carrying the variant allele A at IL-13G+2044A locus were more likely to have asthma than those not harboring the variant allele A. There were significant differences in allele fre-quency between the subjects with or without asthma (χ2 = 7. 458, P<0. 01). Three genotypes of IL-13A-1512C locus including AA, AC and CC were detected in the subjects from both of the two groups. There were significant differences in the genotype distribution between the two groups (χ2 = 12. 906, P<0. 01). The variant allele C at IL-13A-1512C locus was associated with lower risk for asthma. Significant differences in allele frequency were observed the two groups (χ2 =10. 407, P<0. 01). Conclusion Both of the alleles at IL-13G+2044A and IL-13A-1512C loci were associated with asthma. The variant allele A at IL-13G+2044A locus might be the gene predisposing children to asthma in Guiyang city. Children carrying the variant allele C at IL-13A-1512C locus showed a lower risk for asthma in Guiyang city.
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OBJECTIVE:To study on the effect of iodine (I2) on the acid content titration in the preparations,and establish a method of eliminating I2 for accurate determination of total acid content. METHODS:Taking an example of Onychomycosis paint,I2 was reduced by sodium sulfide(Na2S)before titration analysis and compared with the standard method of traditional titration. Ac-cording to the two methods of consumption of different sodium hydrate(NaOH)volume,the effect of I2 on the determination of to-tal acid content in preparation was explored. RESULTS:Reduction method of Na2S can eliminate the effect of I2,the color of indica-tor changed acutely. The determined total acid and theoretical values were the same;the linear range of the concentration of total ac-id in onychomycosis paint was 3.926-7.290 mol/ml(r=0.9999);RSDs of precision,stability and reproducibility tests were no more than 0.04%;average recovery was 99.91%-100.10%(RSD=0.036%,n=6). CONCLUSIONS:I2 has effect on the determina-tion of total acid content,the disproportion reaction of I2 can generate hydriodic acid that can interfere acid-base titration's results, and the generated hydriodic acid can oxidize indicator to make the end point is not sensitive or even invariant color. Using Na2S can eliminate the effect of iodine on the preparation of acid titration,which has improved precision and reproducibility with accurate and reliable determination results.
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Objective To compare cardiac output continuously measured by transesophageal echocardiograph (TEE)with Flotrac /Vigileo system.Methods Thirty -six patients,aged 30 -60years,of American Society of Anesthesiologists physical status ⅠorⅡscheduled for laparoscopic hysterectomy (LH )were included in this study.The radial artery puncture on the left connecting the Flotrac /Vigileo system monitoring was established before anesthesia and ultrasonic probe was inserted into the esophagus after anesthesia induction.The depth of the probe was located at the middle esophagus with monitoring of transesophageal echocardiography(tee).At the same time the value of CO after anesthesia,before and after pneumoperitoneum were recorded and the application of SPSS 13.0 software package for statistical analysis was made.Monadic linear correlation and regression analysis were both used in measured CO. Results Each point,the determination of transesophageal echocardiography(tee)between the CO and the determination of the Flotrac /Vigileo CO,had high correlation(r =0.850,P =0.002).The CO at the time of T2 monitored by TEE group and Flotrac /Vigileo group were (3.3 ±0.2)L/min,(3.2 ±0.2)L/min,which were significantly lower than (5.6 ±0.3)L/min,(5.4 ±0.3)L/min(t =2.248,2.178,P =0.032,0.029).But there were no statistically significant differences at other time respectively(tT =0.102,0.199,0.201,0.124,0.198,PT =0.918,0.887,0.894, 0.908,0.898;tF =0.098,0.189,0.214,0.119,0.112,PF =0.953,0.874,0.898,0.913,0.932).Conclusion The correlation of CO monitored by transesophageal echocardiography(tee)and Flotrac /Vigileo was good,which can be safely and efficiently used in intraoperative monitoring of patients.
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Objective To study the characteristic and manifestations in the middle aged and elderly peoplewith discoid meniscus injury and the outcome of the arthroscopic surgery. Methods Twenty-nine patients with discoid meniscus injury were treated by the arthroscopic surgery from January 2009 to May 2013. According to the injury of discoid meniscus in operation, 6 cases (6 knees , 20.69%) underwent meniscal plasty, 16 cases (16 knees, 55.17%) underwent subtotal meniscectomy, and 7 cases (7 knees, 24.14%) underwent meniscectomy. The Ikeuchi and Lysholm evaluation system was used to assess knee joint function and compared. Results All the postoperative patients were followed up for 12-18 months, and the average was 14 months. According to Ikeuchi knee rating, 5 cases were excellent, 17 cases were good, 4 cases were fair, 4 cases were poor and the rate of excellent and good was 75.86%. Lysholm scores 3, 6 and 12 months after operation were (65.76 ± 5.35), (70.27 ± 4.73) and (77.81 ± 6.24) scores, and before operation was (55.47 ± 3.63) scores. Three, 6 and 12 months after operation, Lysholm scores were significantly higher than those before operation (P<0.05). Conclusions The middle aged and elderly people discoid meniscus injury has its own characteristics compared with adolescent patients in symptoms, signs, and treatments. Arthroscopic surgery is an effective treatment for discoid meniscus with minimal.
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Objective To evaluate the effects on the mineral bone disorder using different calcium concentration citrate-based dialysate in maintenance hemodialysis (MHD) patients.To compare the concentrations of intact parathyroid hormone(PTH) with biointact PTH(1-84) in these patients.Methods Citrate dialysate with different calcium concentration (DCa 1.75,DCa 1.5,DCa 1.25 mmol/L)were used in turn in 15 stable MHD patients each week.Serum tCa and iCa were measured by automatic biochemistry analyzer.The concentrations of iPTH and bio-iPTH were compared.Results (1) The patients treated with DCa 1.75 citrate dialysate had increased serum iCa and tCa after dialysis,and PTH did not change significantly as compared to those findings before the dialysis.With the DCa 1.5 citrate dialysate,serum iCa and tCa were kept stable and PTH level was increased.With DCa 1.25 citrate dialysate,serum iCa and tCa decreased significantly and PTH decreased.(2)iPTH and bioPTH had excellent correlations.Variation of bio-iPTH was more correlated with the changes of calcium than iPTH.Conclusions Serum levels of iPTH,tCa and iCa can be kept stable in MHD patients treated with DCa 1.75 ～ 1.5 citrate dialysate.Bio-iPTH is a more sensitive marker for mineral bone disease than iPTH.
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Objective To explore the effect of different states of the environment to the rehabilitation process and complications of preterm infants in the different environment in neonatal intensive care unit (NICU). Methods 120 premature infants were divided into observation group and control group with 60 cases in each group by random digital table method. The control group was treated with routine nursing model, while observation group was treated with bird nest nursing, lower noise and using cyclic lights. Oxygen time and hospitalization time, increasing about body weight, sleeping time on the twenty-eighth days and the incidence of complications between the two groups were compared. Results The hospitalization and oxygen time were (41.79±2.51)days and (11.45±5.22)days respectively in the observation group, those were shorter obviously than that in the control group [(45.32±3.85)days and(15.52±5.89)days, t=5.95, 4.01, P<0.01].The growth of body weight was (17.36±2.94) g/d, the sleeping time on the twenty-eighth day was (21.18 ±0.39)hours in the observation group. It was increased than that in the control group [(13.48±4.63)g/d and(19.56±0.45)hours], and the difference was significant(t=5.48, 21.07, P<0.01). The incidences of nosocomial infection and feeding intolerance in the observation group were reduced significantly, the difference was significant ( X2=7.06, 8.71, P<0.01). Conclusions Improving the environment in NICU can prevent the adverse factors on premature infants, promote the recovery and growth of premature infants.
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Objective To establish the quality standard of Huangqi-Changyu'an capsule. Method Thin layer chromatography was used to identify psoralen, evodia mtaecarpa, and nutmeg in Huangqi-changyu'an capsule. HPLC was used to determine the content of psoralen. A Hypeisil BDS C18 column(200 mm×4.6 mm,5 μm) was used with mobile phase consisted of acetonitrile-water (30:70) at the rate of 1 ml/min. The detection wavelength was set at 245nm with the column at room temperature. Results The liner range of psoralen was 3.572~53.58 μg/ml (r=0.999 9) with average recoveries of 99.04%, and the RSD was 0.8%. The liner range of isopsoralen was 3.796~56.94 μg/ml (r=0.999 9) with average recoveries of 99.20%, and the RSD was 0.6%. Conclusion This method is sentivive, accurate and rapid for the quality control of Huangqi-Changyu'an capsule.
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Objective To review the clinical and laboratory characteristics of the hemohemocytopenia diseases in children ,in or-der to improve the understanding of the related diseases and the level of diagnosis and treatment .Methods A total of 217 children with hemocytopenia diseases with one ,two or three series of cell reducing ,and the degree of blood cells reduce with anemia and common diseases in children .Results In 185 cases with the hemocytopenia diseases ,1 series reduce were mainly in idiopathic thrombocytopenic purpura(ITP ,37 .2% )、thrombocytopenia (19 .8% ) ,granulocytopenia or agranulocytosis (9 .1% ) .2 series re-duces mainly in acute leukemia (43 .6% ) ,the IT P (21 .7% ) and aplastic anemia (6 .5% ) .3 series reduce mainly in acute leukemia (38 .9% ) and aplastic anemia(33 .6% ) .Common cause of anemia in children with 180 cases of hemohemocytopenia diseases were a-cute leukemia (20 .0% ) ,the ITP(19 .4% ) and no clinical diagnosis of anemia (16 .1% ) .Conclusion After analyzing the character-istics of the patient′s clinical and laboratory in 217 cases of hemocytopenia diseases ,improve the clinical blood disease related knowl-edge ,help understand the laboratory data and proportion .
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Objective To explore the value of procalcitonin (PCT) in diagnosis and treatment of neonatal ventilator associated pneumonia(VAP).Methods Sixty neonates needed invasive mechanical ventilation admitted to our NICU from Jan 2012 to Dec 2013 were divided into VAP group (30 cases) and nonVAP group (30 cases),depending on whether the neonates developed to VAP or not in 7 days.The VAP group then was randomly divided into PCT group (15 cases) and control group(15 cases) according to random number table.The levels of serum PCT,C-reactive protein(CRP) and WBC count were detected when the neonates suspected VAP before and after mechanical ventilation.Besides,the sensitivity,specificity,positive and negative predictive values for PCT,CRP and WBC were calculated in the diagnosis of VAP.Results The serum levels of PCT in VAP group had significant difference before and after mechanical ventilation (t =1.58,P =0.000),the levels of PCT were (0.37 ± 0.25) μg/L and (2.17 ± 1.46) μg/L respectively.The levels of PCT in non-VAP group had no significant difference (t =3.67,P =0.055).The levels of CRP and WBC showed no significant differences between VAP and non-VAP group before mechanical ventilation (P ＞ 0.05).Taking PCT ≥0.40 μg/L,CRP≥ 28 mg/L and WBC ≥ 10 × 109/L as the cut off value,the sensitivity of the three indicators diagnosis of VAP were 93.3％,73.3％ and 66.7％ respectively.PCT had the highest sensitivity 93.3 ％,specificity 73.3％,positive predictive 77.8％ and negative predictive 91.7％.The antibiotic duration of PCT group was (12.6 ± 5.6) d compared with (15.1 ± 9.1) d in control group (P =0.018).Conclusion Serum PCT has high sensitivity and specificity in the diagnosis of VAP,PCT combined with clinical pulmonary infection score can improve the diagnostic accuracy of VAP,early diagnosis and timely monitoring of serum PCT is helpful in VAP.PCT guidance substantially reduces antibiotic use in VAP,so that timely surveillance of PCT is necessary for patients on ventilator.
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BACKGROUND:The choice of schwannoma resection is strongly associated with whether the tumor was completely resected, whether stretch during resection injures spinal nerves, and final y with the prognosis of treatment. OBJECTIVE:To evaluate the spinal stabilization after laminectomy combining unilateral or bilateral nail-rod system for schwannoma in the spinal canal or intervertebral foramen. METHODS:A total of 48 cases of schwannoma in the spinal canal or intervertebral foramen of neck, chest and waist underwent laminectomy combining unilateral or bilateral nail-rod system. 34 cases in spinal canal received bilateral nail-rod system, and 14 cases in the intervertebral foramen received unilateral nail-rod system. RESULTS AND CONCLUSION:At 3 days and 3, 6, 12 months after internal fixation, radiograph results demonstrated that location of implants was good. Bone graft fusion was found. No spinal instability and vertebral slippage occurred. Neural functional score Bodford (1997) and quality of life score were significantly increased after treatment (P<0.01). Muscle strength assessed by Lovett grade was significantly elevated after treatment (P<0.01). Pain evaluated by Virtual Rescan grade was significantly lessened after treatment (P<0.01). Schwannoma was completely resected in 48 patients. After treatment, six patients affected leakage of cerebrospinal fluid. One case experienced infection of cerebrospinal fluid. One case had to undergo secondary operation due to the infection. Three cases received nerve root resection due to tumor erosion. These experimental results confirmed that laminectomy combining unilateral or bilateral nail-rod system for schwannoma in the spinal canal or intervertebral foramen has the advantage of the tumor ful y exposed to the operator, which can help completely resect schwannoma and effectively avoid spinal nerve injury. Even more important thing is that the spinal stability is reconstructed by unilateral or bilateral nail-rod system, which prevents the occurrence of vertebral slippage and vertebral destabilization. Long-term effect stil needs further research.
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Objective Two-incision video-assisted thoracic surger relieved post operative pain when compared with open thoractomy ,while it is rarely reported worldwide ,most thoracic surgeons think it is hard to finish the complicated operation and it is not safe .We compared the safety between open and two -incision VATS.Methods Bwteen Febrary 2009 to December 2011 ,a total of 334 cases with clinical early -staged lung cancer of open thoracotomy were performed ,66 cases were completely performed with 2-incision VATS,17 cases were transferred to open thoracotomy defined as two -incision VATS assisted thoracotomy .We compared and ana-lyzed open thoracotomy with two -incision VATS in operating time ,and pre,post and total period of hospitaliza-tion,postoperative chest tube removal time ,postoperative complications .Results Operating time in the left lower lobe of both traditional open thoracotomy and two -incision VATS was 162.5 ±6.5 and 185.8 ±12.8 minutes re-spectively(P=0.1228),there was no statistical significance for the remaining parts of the lobectomy ,the operat-ing time of open thoracotomy was shorter than two -incision VATS.The overall complication and perioperative mortality rate of open thoracotomy and two -incision VATS were 10.2% and 15.0%(P=0.238),and 2.0%and 0.0%(P=1.000)respectively,there was no statistical significance.Conclusion The lobectomy and lymph node dissections for 2-incision VATS in treating clinical stage I lung cancer is feasible and safe .