Objective To evaluate the efficacy of noninvasive positive pressure ventilation (NIPPV) in the treatment of early acute respiratory distress syndrome(ARDS) Methods 12 patients with early ARDS were errolled in the study All the patients pulltiled the criteria of ARDS and no improvement after high flow oxygen therapy via mask NIPPV was used because the patients and their family refused intubation Pressure support ventilation (PSV) and positive end expiratory pressure (PEEP) were used via facial mask with Vison or BiPAP ventilator PEEP were set at 8～12 cm H 2 O with 4～6 PSV level Results The baseline respiratory frequency(RR)was (36?4)bpm,PaO 2 was (55?9)mm Hg and oxygen index (OI)was (127?4)mm Hg At final,8 patients survived (S group) and 4 patients died (F group) After 4～6 h treatment with NIPPV,in S group,RR decreased to (32?1 2)bpm ( P

【Objective】To explore the role of cell cycle regulators in nasopharyngeal carcinoma (NPC) relapse.【Method】To assay p53,MDM2,p21ras and p21WAF1 proteins by LsAB immunohistochemical technique in 69 cases of primary and relapsing NPC tissues.【Results】As compared with primary NPC,the expression rate of p53 or MDM2 protein in relapsing NPC was similar (78% to 80%,84% to 83%),and the expression rate of p21ras or p21WAF1 protein in relapsing NPC was obviously descended (73% to 93%,52% to 84% );the high-expression rate of p53 protein in relapsing NPC was similar (42% to 51%),the high-expression rate of MDM2 protein in relapsing NPC was obviously risen (57% to 32%),and the high-expression rate of p21ras or p21WAF1 protein in relapsing NPC was obviously descended (16% to 65%,17% to 46%).Among of them,the significant rise of MDM2 protein expression level in relapsing NPC mainly occurred in the patients of group 2 which relapsing-interval was shorter than 34 months,P<0.05;the significant descent of p21ras or p21WAF1 protein expression level in relapsing NPC occurred in the patients of group 2 and group 1 which relapsing-interval was equal to or longer than 34 months,P<0.02,respectively.【Conclusions】The overexpression of p53 and MDM2 proteins and the low or negative expression of p21WAF1 protein after clinical cure might still play an important role in NPC relapse,the obvious rise of MDM2 protein level and the obvious descent of p21WAF1 protein level might further accelarate the process of NPC relapse.

Objective To study the dissociation of EDTA-dependent pseudo platelet aggregation by amikacin and to clarify the potential mechanism.Methods At different time points,two concentrations of amikacin (6.5 mg/ml and 10.0 mg/ml) were respectively added to EDTA-K2 anti-coagulated whole blood samples collected from two subjects with EDTA-dependent pseudothrombocytopenia.The aggregated-platelet dissociation was investigated by platelet count and microscopical examination.CD41,CD61,CD62p,PAC-1,and IgG on the platelets of the two patients and of a normal control were determined by the FCS under various conditions.Results When amikacin (6.5 mg/ml) was added within 1 hour after blood collection,it dissociated the EDTA induced platelet aggregation and the platelet counts returned to the normal level. The expression of CD62p,PAC-1,and PA-IgG on the platelets was decreased,yet the expression of CD41 and CD61 had no change.Conclusion Amikacin supplementation (6.5 mg/ml) within 1 hour after blood sampling may dissociate the aggregated platelets caused by EDTA. The mechanism may be associated that amikacin might inhibit the expression of CD62p,PAC-1,and PA-IgG on platelets. The amikacin supplementation would be an inexpensive,effective,and practical method to solve the platelet aggregation induced by EDTA.

The aim of this study is to investigate the critical factor affecting the properties of PLGA microspheres fabricated by a solid-in-oil-in-water (S/O/W) emulsion technique with BSA as a model protein. Prior to encapsulation, the BSA microparticles were fabricated by a modified freezing-induced phase separation method. The microparticles were subsequently encapsulated into PLGA microspheres by S/O/W emulsion method, then Motic BA200 biological microscope, confocal laser scanning microscope, scanning electron microscope were used to observe the structure of S/O/W emulsion and PLGA microspheres. The protein content extracted or released from BSA microspheres was measured by Bradford protein assay method. It was found that NaCl added in the outer aqueous phase effectively suppressed material exchange between the inner and outer phase of S/O/W emulsion. Then, the structure and permeability of obtained microspheres were influenced. As a result, with the increase of NaCl concentration in the outer aqueous phase, the encapsulation efficiency of microspheres significantly increased from 60% to more than 85%, the burst release of microspheres reduced from 70% to 20%, and the particle size decreased from 103 microm to 62 microm. Furthermore, the rehydration of encapsulated protein was also retarded and then integrity of BSA was successfully protected during encapsulation process. In vitro release test showed that BSA released from PLGA microspheres in a sustained manner for more than 30 days.

OBJECTIVE: To analyze social-psychological causes of acute exacerbation or re-decompensation of chronic tinnitus and provide theoretical basis for controlling and preventing tinnitus exacerbation and re-decompensation. METHOD: Systemic audiological tests and tinnitus handicap inventory were performed on 136 chronic tinnitus patients with acuteexacerbation or re-decompensation. For the patients with new hearing loss, a further investigation of living conditions and assessment of social support rating scale were utilized. The patients with relatively definite causes were treated accordingly. RESULT: (1) There were 89 patients complained of new changes of hearing, all of whom could tell the definite time point of tinnitus exacerbation, and 5 of them felt the exacerbation of hearing loss meanwhile. (2) Forty-two patients encountered adverse events on life or working, and tinnitus exacerbation occurred within several weeks to 3 months afterwards. Most of these patients could not tell the definite time point of tinnitus exacerbation or re-decompensation. Five cases of tinnitus exacerbation didn't tell any adverse events on life or working, but showed mood disorders, and the anti-anxiety treatment was effective to them. (3) Forty-seven cases without new hearing loss scored significantly lower in SSRS than healthy adults. CONCLUSION Emerging hearing loss is the main cause of acute exacerbation of chronic tinnitus. To find it in time and give effective treatment can save newly presented hearing loss, cure or relieve tinnitus. Adverse events in life(or working) and short of social support is another important cause of acute exacerbation of chronic tinnitus or decompensation recurrence, which suggests that social-psychological factors besides of hearing loss should be concerned in diagnosis and treatment of tinnitus.
Adult ; Disease Progression ; Hearing Loss ; Humans ; Social Support ; Tinnitus ; psychology

OBJECTIVETo investigate the emergency treatment for large amputated ear defect.

METHODSFrom Feb. 2010 to Oct. 2013, 5 cases with large unilateral amputated ear defects were treated. The amputated auricular cartilage was replanted subcutaneously in mastoid area at the first stage. Cranioauricular sulcus was reconstructed and skin grafting was performed at the second stage.

RESULTSAll cases were followed up for 3-6 months with satisfactory result. The reconstructed helix, scapha and cavity of auricular concha had similar color and elasticity as the ear at healthy side. Scar at donor sites, such as inguinal region and armpit, was inconspicuous.

CONCLUSIONSThe method of auricular cartilage replantation is an effective way for emergency treatment of large amputated auricular defect with less morbidity at donor site.

Adolescent ; Adult ; Ear Cartilage ; transplantation ; Ear, External ; injuries ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Replantation ; Treatment Outcome ; Young Adult

OBJECTIVE: To explore the clinical and audiological characteristics of children with congenital malformations of the external ear. METHOD: One hundred and ten patients with congenital malformations of the external ear ranged from 2002 to 2006 were involved in this study. The mean age was one year and four months. The children were divided into three groups according to the appearance of the external ear. The first group consisted of 94 patients with auricle malformation and atresia of the external auditory meatus. The second group consisted of 8 patients with abnormal external auditory meatus (no atresia) and auricle malformation. The other 8 patients only with auricle malformation were included in the third group. All children underwent ABR tests, while some of these children accepted DPOAE and Acoustic-immittance measurements. RESULT: (1) Severe abnormal results of ABR were observed in 79 abnormal ears (78.22%) in children of first group, while moderate or severe abnormal results of ABR were observed only in 8 opposite side ears (normal ears). (2) Sixty-two and a half percent (5 ears) of ears of the second group (8 ears) had severely abnormal ABR results. (3) Severe abnormal ABR results occurred in 44.44 percent (4 ears) of ears of the third group (9 ears). Moderate or severe abnormal results of ABR were not observed in the opposite side ears (normal ears) in second and third groups. CONCLUSION Congenital malformations of the external ear is an important factor affecting children's hearing. Auditory nerve impairment can be observed in children with congenital malformations of the external ear.
Adolescent ; Child ; Child, Preschool ; Ear, External ; abnormalities ; physiopathology ; Evoked Potentials, Auditory, Brain Stem ; Female ; Hearing Disorders ; congenital ; Hearing Tests ; Humans ; Infant ; Infant, Newborn ; Male

BACKGROUNDTo explore the correlation of microvessel density (MVD) and microvessel structure (MVS) features with the patients' prognosis in non-small cell lung cancer (NSCLC).

METHODSAnti-Von Willebrand factor antibody was used to stain microvessel endothelia by means of LsAB immunohistochemical technique, then the microvessel count and structure features were observed microscopically in 49 primary NSCLC tissues. MVS pattern A had scattered microvessels with relatively integral or thick wall and with relatively regular morphology and MVS pattern B had plexiform or network like microvessels with unintegral or thin wall and with irregular morphology.

RESULTSMVD in primary NSCLC tissues was closely correlated with pTNM stage or lymph node involvement, P=0.043 and P=0.038, respectively. MVS in primary NSCLC tissues was closely correlated with the size of primary carcinoma, P=0.002. The survival of patients (23.2± 18.4 months) with MVD > 52/200× was significantly shorter than that of patients (35.9±20.9 months) with MVD < 52/200× in primary NSCLC tisssues, P=0.01. The survival of patients with MVS pattern A (39.4±17.2 months) was significantly longer than that of patients with MVS pattern B (23.5±20.3 months) in primary NSCLC tisssues, P=0.008. The survival of patients with MVD < 52/200× and MVS pattern A (42.9±19.3 months) was significantly longer than that of patients with MVD > 52/200× and MVS pattern B (15.7±16.8 months) in primary NSCLC tissues, P=0.002.

CONCLUSIONSMVD and MVS are closely associated with prognosis of NSCLC patients and might be served as parameters estimating patients' prognosis and planning assistant therapy after operation.

BACKGROUNDTo investigate the distribution of TCR Vβ subfamily T clonal cells in peripheral blood lymphocytes (PBL), tumor infiltrating lymphocytes (TIL) and lymphocytes in non-cancerous lung tissues of patients with non-small-cell lung cancer (NSCLC) and to see the inclination of the T cell antigen receptor (TCR) Vβ subfamilies' expression.

METHODSComplimentarily determining region 3 (CDR3) of TCR 24 variable region genes was analyzed in PBL, TIL and lymphocytes in non cancerous lung tissues from 24 NSCLC cases with reverse transcriptase-polymerase chain reaction (RT-PCR) and gene scan techniques to identify the distribution and clonality of TCR Vβ subfamily T cells.

RESULTSOnly a portion of Vβ T cells were found in patients with NSCLC, whereas 24 TCR Vβ subfamily T cells were detected in 10 healthy controls. Vβ5 subfamily was expressed mostly in TIL and the frequency of Vβ5 in TIL (6/18, 33.3%) was much higher than that of PBL (1/24, 4.2%) and T cells infiltrating non-cancerous lung tissues (0/12) (P < 0.05). Oligoc lonal T cells were found in 2 cases with Vβ5 subfamily and polyclonal T cells in 4 cases.

CONCLUSIONSThere are dominant and clonal TCR Vβ subfamilies expressed in TIL of NSCLC patients, which may be the tumor associated antigens (TAA) specific.

Objective To study changes in the kinematics and joint coordination of the shoulder,elbow,and wrist joints during rolling manipulation performed by Tuina doctors.Methods The kinematic data of 10 beginners and 10 proficient Tuina doctors performing rolling manipulation were collected using a Vicon three-dimensional(3D)motion capture system,and the differences in movement patterns of the shoulder,elbow,and wrist joints between the two groups during Tuina rolling manipulation were compared.Results There was no difference in the elbow joint activity angle between the beginner group and proficient group during rolling manipulation(P＞0.05),and the main differences were in the angles of wrist flexion/extension and shoulder adduction/abduction.The proficient group had a smaller shoulder adduction/abduction angle(P＜0.05),and the maximum angle of palmar flexion of the wrist joint in the proficient group was significantly greater than that of the beginner group(P＜0.05).Conclusions The main kinematic characteristics of rolling manipulation are flexion/extension of the wrist and rotation of the elbow and shoulders.Rolling manipulation is mainly the composite movement of forearm rotation and wrist flexion/extension.The essential'sinking shoulder'operation was better mastered by the proficient group.