Neonatal respiratory distress syndrome (RDS) is most common in premature infants,the smaller the gestational age,the higher the incidence.Continuous positive airway pressure (CPAP) started in the delivery room has been shown in multicentre randomized controlled trials to reduce the need for mechanical ventilation (MV) and surfactant.The European Consensus Guidelines on the Management of Neonatal Respiratory Distress Syndrome in Preterm Infants-2013 Update recommended that CPAP should be started from birth in all babies at risk of RDS and a starting pressure of at least 6 cmH2O(1 cmH2O =0.098 kPa)should be applied.CPAP with early rescue surfactant should be considered the optimal management for babies with RDS.Using CPAP immediately after birth with subsequent selective surfactant administration may be considered as an alternative to routine intubation with prophylactic or early surfactant administration in preterm infants.If endotracheal intubation is needed,early administration of surfactant is preferable.Nasal intermittent positive pressure ventilation may reduce the risk of extubation failure in babies failing on CPAP.Several strategies have been employed specifically to improve the success of noninvasive ventilation and shorten the duration of MV.Caffeine should be used to facilitate weaning from MV and to reduce bronchopulmonary dysplasia.A short tapering course of low-or very low-dose dexamethasone should be considered to facilitate extubation in babies who remain on MV after 1 ～ 2 weeks.Very early steroid treatment and treatment with high doses cannot be recommended.

Objective:To study influence study of near and long term survival rate on different resection regions for patients with gastric cancer in M region.Methods:110 patients with M region gastric cancer received treatment in our hospital were divided into observation group(with total gastrectomy) 57 cases and control group (with subtotal gastrectomy) 53 cases,compared with clinical pathology data and radical degree,two groups of patients' operation index,and local recurrence rate and near and long term survival rate in the two groups.Results:Two groups of patients were compared with clinical pathology data and radical degree,the difference was not statistically significant (P＞0.05).The observation group's nearly cutting edge outside distance and lymph nodes were significantly higher than the control group,the difference was statistically significant (P＜0.05).There was no significant difference between the two groups(P＞0.05).The recurrence rate(3.51％) and recurrence rate (15.79％) of the observation group were significantly less than the control group of 16.98％ and 33.96％,and the difference was statistically significant (P＜0.05).The 1 and 3 year survival rates of the observation group were compared with the control group,the difference was not statistically significant (P＞0.05).But the 5 year survival rate of the observation group was 57.89％,which was significantly higher than that in the control group of 35.85％,the difference was statistically significant (P＜0.05).Conclusions There is no significant difference in the survival rate of total gastrectomy in patients with gastric cancer in M region and total gastrectomy,but the long-term survival rate is higher,it is worthy of clinical attention.

Sepsis is systemic inflammatory response syndrome associated with infection.Early recognition of severe sepsis or septic shock,early hemodynamic resuscitation and the immediate initiation of effective intravenous anti-infective therapy are the cornerstones in the management of patients with sepsis.The infectious microorganisms associated with sepsis in pediatric patients vary with the patient's age and immune status.Initial empirical antimicrobial therapy should include one or more drugs that have activity against all likely pathogens and that penetrate in adequate concentrations into the presumed source of sepsis.Empirically therapy should be de-escalated to the most appropriate single therapy as soon as the susceptibility agent is known.

With two recipes,i.e.nodule disease treated with revised Maimengdong Decoction and Xiaoluo Pill,sub-acute thyroid inflammation of granuloma treated with Haizao Yuhu Decoction and Xiaoluo Pill,it makes clinical research to discuss the causa morbi,mechanism,differentiation thought and the experiences of removing toxin,stasis,swelling,sputum,and softening mass in treating such refractory diseases.

Objective To investigate the correlation between the changes of left ventricle and age,duration,blood-pressure,hemoglobin,serum creatinine level and glomerular filtration rate (GFR) in lupus nephritis (LN) patients.Methods One hundred and thirty-two patients with systemic lupus erythematosus (SLE) were divided into LN group and non-LN group,the clinical data were analyzed with t test,x2 test,Pearson correlation analysis and multiple regression analysis.Results Compared with non-LN patients (4/67,6％ ),the incidence of concentric hypertrophy was significantly increased in LN patients ( 14/65,22％ ) (x2=6.790,P＜0.05 ).Left ventricular end systolic internal dimension (LVESd) was correlated positively with blood uric acid (BUA) level (B=0.014,P＜0.01 ).Left ventricular mass index (LVMI) was correlated positively with blood urea nitrogen (BUN) level (B=2.977,P＜0.01 ).lnter-ventricular septal thickness (IVST) was correlated positively with systolic blood pressure (B=0.022,P＜0.01 ).Conclusion Compared with non-LN patients,the incidence of concentric hypertrophy is significantly increased in LN patients.It may be one of the mechanisms that SLE could involve kidney,which consequently lead to hypertension,higher BUN and BUA level,which may further aggravate heart damage in turn.

No abstract available.
Humans ; Young Adult*

No abstract available.
Humans ; Young Adult*

No abstract available.
Carcinoma, Hepatocellular* ; Recurrence*

[Objective]To observe the bone repairing efficacy of large segmental femur defects in rabbits with calcium phosphate cement(CPC)combined with bone morphogenetic protein(BMP)and massive bone allograft,which may benefit the clinical application of large segmental bone allograft transplantation.[Method]Fifty-four New Zealand white rabbits were divided into three groups and a 2 cm femur defect was created on one side of each rabbit,followed by implantation with:CPC combined with BMP and massive bone allograft(Group A),bone allograft only(Group B)and autograft transplantation(Group C).Intramedullary nails with a 3 mm diameter fixed all the grafts transplanted.The bone defect repair efficacy was evaluated by radiology and histology exam at 4,8 and 12 weeks after operation.[Result]The bone reparation capacities of allograft with CPC/BMP complex was better than that of the allograft alone after 4 ~8 weeks of transplantation,which were similar to the result of autograft transplantation.Complete bone union was achieved for all the groups after 12 weeks of operation,with better bone remodeling for group A and group C transplantation.The healing process of CPC/BMP combined with allograft transplantation was featured with large amount of bone callus forming surrounding the graft-host bone union area and the surface of allograft,which composd the extra cortical bone bridge and ingrowth(EBBI).Bone invasion,resorption as well as new bone genesis were seen in the surface of bone allograft at early stage,companied by expansion of Haversians canal,with more lanner cells,osteoblasts,osteoclasts and blood cells inside the allograft.CPC was slowly biodegraded with the bone graft resorption and new bone regeneration.[Conclusion]CPC combined with BMP can improve the bone reparation and substitution process in massive bone allograft transplantation for the treatment of large segmental bone defects.

Objective To study the early diagnosis of cutaneous T-cell lymphoma(CTCL).Methods DNA from39formalin-fixed,paraffin-embedded tissues of24cases of CTCL,2cases of dubious lymphoma,and4cases with non-specific erythroderma,was amplified by polymerase chain reaction(PCR),with special primers of TCR V?1-8,V?9,and J?1/?2to analyze T-Cell receptor?gene clonal rearrangement(TCR-GR clonal).The specimens from30patients with non-specific dermatitis were taken as negative control.Results Clonal of TCR V?1-8was demonstrated in38of39paraffin-embedded specimens.V?9-GR was shown in37of39specimens TCR?-GR was shown especially in13patients with MF of early stage,2patients with dubious CTCL,and4patients with non-specific erythroderma,as well as in6of30patients with histiologically nonspecific dermatitis which suggested that these6cases were"clonal dermatitis".Conclusion Clonal TCR?-GR may be detected in patients with early CTCL,even when the histologic findings are not unequivocally diagnostic.