Objective To observe the gastric intramucosal pH( pHi) and gastric intramucosal carbon dioxide tension (PgCO2) in patients, using an automated recirculating air tonometer during weaning from mechanical ventilation ,and to study the value of intramucosal PCO2 and pH measurements to predict weaning outcome from mechanical ventilation.Methods The study population included thirty -two adult critically patients who were mechanically ventilated because of acult respiratory failure and were considered ready to be weaned. Thirty-two patients were randomly assigned to synchronized intermittent mandatory ventilation combined with positive end-expiratory pressure and pressure support ventilation (SIMV+PEEP+PSV) group and continuous positive airway pressure with pressure support ventilation (CPAP+PSV)group,sixteen patients in each group . Respiratory and hemodynamic variables were measured during the weaning process. Simulaneously, the gastric intramucosal PCO2 and pH were measured. At the same time, an arterial blood sample was drawn for blood gas analysis.Results Eighteen patients were successfully weaned from mechanical ventilation and fourteen failed. The gastric intramucosal pH was initially 7.35?0.13 and decreased to 7.238?0.18 during the weaning process in patients who failed (P

Objective To investigate the therapeutic effect and its mechanisms on the treatment of subclinical hepatic encephalopathy(SHE)caused by hepatocirrhosis(compensatery phase)due to hepatitis B by Bifido(Haisi pharmacy).Methods 50 cases were randomized into therapeutic group and control group wtih twenty-five patients each.Patients in therapeutic group were given Bifido two capsule pills t.i.d in addifion to conventional therapy,while patients in controgroup were given the conventional therapy namely soft food with low salt,protective drugs for liver and supporting therapy.The therapeutic course in two groups was 8 weeks.We observed the changes of clinical symptoms,signs,arterial blood ammonia level,hepatic functions,number connection test(NCT) and other indexes prior to treatment and 4,8 weeks after treatment.Results It showed that Bifido capsules could not only improve the clinical symptoms,signs,Child-Turcotte-Pugh function grade,but also could decrease arterial blood ammonia,LPS level and time of number connection fest and the occurrence of HE(P

Abscess ; therapy ; Drainage ; Humans ; Mediastinal Diseases ; therapy ; Neck ; pathology

OBJECTIVE: To investigate method established and system evaluated in the model of SD rat with AR. METHOD: To establish AR model of SD rats by ovalbumin (OVA), 20 cases of SD rats were randomly divided into two groups, namely control group (10 cases) and AR group (10 cases). AR models were sensitized and challenged by OVA. Control group were used with normal saline instead of OVA. The score of pathology and praxiology were observed when the SD rats in AR group appeared typical symptom of allergic rhinitis, and levels of IL-4, IFN-γ, IgE in the serum were examined by ELISA. According to the behavioral score, nasal histology and content of IL-4, IFN-γ, IgE of serum, Rat allergic rhinitis model were judged successfully established or not. RESULT: Behavioral scores were significantly increased in OVA-challenged rats compared with the control group, P<0.05. Nasal epithelial goblet cells, eosinophils and lymphocytes in nasal mucosa in the AR rats exhibited obvious increase relative to the control group. IL-4, IgE levels in the AR rat exhibited obvious increase relative to control group while INF-γ levels exhibited obvious reduction (P<0.05). CONCLUSION The allergic rhinitis models in SD rat by OVA were successfully established. The levels of IgE, INF-γ and IL-4 in Serum can be used as objective evaluation of animal models of allergic rhinitis established successfully or not.
Animals ; Disease Models, Animal ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; immunology ; Goblet Cells ; immunology ; Immunoglobulin E ; blood ; Interferon-gamma ; blood ; Interleukin-4 ; blood ; Nasal Mucosa ; cytology ; pathology ; Ovalbumin ; Rats ; Rats, Sprague-Dawley ; Rhinitis, Allergic ; physiopathology

OBJECTIVE To investigate the epidemiology of bacterial infections in patients with severe liver disease in intensive care unit(ICU) and analyze the antimicrobial susceptibility of major pathogens to provide reference for clinical therapy.METHODS A retrospective survey was conducted in 206 patients with severe liver disease in ICU of our hospital from Oct 2005 to Dec 2006.Identification and susceptibility of pathogens were assayed by MicroScan Auto-4 System.RESULTS Infection was identified in 70.87% of the 206 patients with severe liver disease.Most infections were caused by single pathogen.The infection was frequently identified in respiratory tract,blood stream or intra-abdominal cavity.The top 5 pathogens were Escherichia coli(12.8%),Klebsiella pneumoniae(9.9%),Staphylococcus haemolyticus(8.5%),Pseudomonas aeruginosa(7.8%) and Stenotrophomonas maltophilia(6.4%).Gram-negative bacilli were usually resistant to multiple antimicrobial agents,but less resistant to piperacillin-tazobactam or imipenem.Most of S.haemolyticus isolates were meticillin-resistant(MRSH)(25%),which were susceptible to penicillin,ampicillin and vancomycin.CONCLUSIONS Pathogens of patients with severe liver disease in ICU are mostly multi-drug resistant.The microbiological surveillance is important for guiding clinical therapy.

Objective To compare retrospectively the clinical outcome of total knee replacement with and without patellar replacement. Methods From January 1994 to December 2000, 109 knees in 86 patients treated for osteoarthritis and rheumatoid arthritis were evaluated postoperatively using a questionnaire and physical examination. There were 17 males and 69 females with the age ranging from 37 to 80 years (average 65.7 years). The osteoarthritis was 8 knees and rheumatoid arthritis 69 knees. Forty-two knees underwent patellar replacement, and 67 knees with reserved patella. The patients were scored using HSS Score for knees and Feller Score for patella. AP and lateral views of the knee as well as 30? and 90? axial views of the patella were taken in radiography .The data were analyzed using SPSS software. Results Replacement and non-replacement groups showed no obvious difference in post-operative knee function and the incidence of complication. The two groups showed statistical significant differences in scoring on climbing and descending stairs and rising from sitting position, the results suggested the replacement group scored slightly better than the nonreplacement group. Post-operative anterior knee pain occurred more commonly in the non-replacement group and showed significant difference (P

OBJECTIVE To discuss the diagnosis and treatment of cholesterol granuloma of the middle ear and the choice and effect of surgical methods. METHODS A retrospective analysis was conducted on 18 cases of cholesterol granuloma of the middle ear confirmed by surgery and pathology. Different choices of surgical methods were made according to the lesion extension of this disease. RESULTS All patients were followed up for at least 6 months. Two cases with eustachian tube obstruction had ventilation tube inserted for a long time. One case who had recurrence and metastasis of nasopharyngeal carcinoma in the middle ear was transferred to oncology department for further treatment. Post-operative dry ears were obtained in the other cases whose pure tone thresholds were improved to different degrees. CONCLUSION Etiology of cholesterol granuloma of middle ear remains controversial. It's supposed to result from the bleeding, occlusion of ventilation and disturbance of drainage of the air cavity because of the middle ear inflammation, and bone marrow exposure. The middle ear and mastoid surgery can completely remove the disease tissues, and establish ventilation system of mastoid-tympani-eustachian, which is the key point of the middle ear surgery.

Objective To analyze the therapeutic effect of emergency surgery in the treatment of severe valvular heart disease and its influence on heart function.Methods 87 cases with severe valvular heart disease were selected,and they were given emergency surgical treatment.Before and after treatment,the cardiac function index[end -diastolic volume (EDV),end-systolic volume (ESV),left ventricular end systolic volume index (LVESVI),left ventricular end-diastolic volume index (LVEDVI),left ventricular ejection fraction (LVEF)],postoperative complications and survival rate were compared.Results After treatment,the EDV [(125.78 ± 31.67) mL],ESV [(71.30 ± 16.58) mL] and LVESVI [(50.39 ± 13.30) mL/m2],LVEDVI [(88.74 ± 13.51) mL/m2],LVEF [(51.48 ± 12.73) ％] were better than those before treatment [(116.48 ± 28.94) mL,(63.26 ± 15.47) mL,(33.27 ± 8.54) mL/m2,(64.47 ± 12.69)mL/m2,(47.53 ± 11.20)％],the differences were statistically significant (t =2.022,2.022,3.307,12.213,2.173,all P ＜ 0.05).The incidence rate of complications was 24.14％ (21/87),included arrhythmia in 4 cases,low cardiac output syndrome in 8 cases,acute renal failure in 9 cases.Postoperative 1 year,2 years,the survival rates were 91.95％ (80/87),85.06％ (74/87),respectively.Conclusion Emergency surgical treatment for severe valvular heart disease can effectively improve cardiac function index,improve the survival rate.

OBJECTIVE: To explore the clinical features and treatments of contact granuloma of larynx. METHOD: To find the best treatments by analyzing the clinical features, related causes and the treatments of the 13 contact granuloma of larynx cases, which have complete data, of our department from Jan 2005 to Dec 2012, also by comparing the effect of conservative treatment and operation treatment. RESULT: Contact granuloma of larynx is more common in men (84.6%). The main causes are gastro esophageal reflux, chronic cough, habitual hawk and endotracheal intubation disease. However, a big part (38.4%) gets the disease without any other disease history. The main clinical feature of the disease includes: sensation of foreign matter in throat, easy to get exhausted when talking and voice hoarse, but also 30.7% without any feature in throat. Among the 13 cases, 6 were treated by operation and the first recurrence was 66.6%. The cure rate was 50% after one or two operations. The other 7 were treated in conservative way, including anti- Gastro esophageal reflux, avoiding excessive talking, reducing habitual hawk ,or without any medical treatment. The cure rate was 57.1%. The total cure rate was 53.8%. However, it is nonsense to comparing the two different treatments (Chi2 = 0.066, P > 0.05). CONCLUSION There is still no standard treatment for contact granuloma of larynx and the effect is not good enough. The treatment should be depending on individual case. Conservative treatment is the first choice. However, operation should be considered if the patient has obviously hoarse and his granuloma is too large to breathe well.
Chronic Disease ; Female ; Gastroesophageal Reflux ; complications ; Granuloma, Laryngeal ; etiology ; therapy ; Hoarseness ; etiology ; Humans ; Intubation, Intratracheal ; Male ; Recurrence

Objective To observe the short-term visual effects of cataract surgery patients with 1CU accommodating intraocular lens (IOL) compared with aspheric monofocal IOL. Design Non-randomed comparative trial. Participants Consecutively 118 senile cataract patients (118 eyes). Methods 59 cataract patients (59 eyes) were implanted 1CU accommodating IOL (1CU group), and 59 cataract patients (59 eyes) were implanted aspheric monofocal IOL (Tecnis ZA9003 group). All patients were assessed at 3 months post-operation in the aberrations of crystalline, the modulation transfer function contrast sensitivity of 10/100 percent in three sorts distance(40, 63, 100 cm), uncorrected distanced visual acuity(UCDVA), uncorrected near visual acuity(UCNVA), best-corrected distance visual acuity(BCDVA), best-corrected near visual acuity(BCNVA), distance corrected near visual acuity(DCNVA), pseudo-accommodation, and the rate of off-near glasses. Main Outcome Measures Visual acuity, aberrations, modulation transfer function, contrast sensitivity, pseudo-accommodation, the rate of off-near glasses. Results At 3 months postoperatively, both UCNVA and DCNVA were significantly better in 1CU group than in the aspheric monofocal IOL group (t=8.85, P=0.00; t=13.05, P=0.00). The accommodative range was (2.58?0.37) D in 1CU group and (1.46?0.25) D in monofocal IOL group (t=14.33, P=0.00). In 3 mm and 5 mm pupil diameter the difference of the total aberration and spherical aberration in Tecnis ZA9003 group or 1CU group was significant (3 mm pupil t=18.48, P=0.00; t=5.70, P=0.00. 5 mm pupil t=19.98, P=0.00; t=6.70, P=0.00). At 40 cm and 63 cm, VA scores were higher in 1CU group (85%)than in Tecnis ZA9003 group (25%) (t=3.64, P=0.00; t=2.74, P=0.00; t=2.65, P=0.00; t=2.44, P=0.01). The rate of off-near glasses in 1CU group was better than in the aspheric monofocal IOL group(?2=41.95, P=0.00). Conclusions The 1CU accommodating IOL can provide better useful near visual acuity than aspheric monofocal IOL, especially for the patients who want to get rid of spectacles.