Objective To investigate the prevalent condition of endotracheal cuff pressure and risk factors for under inflation. Methods A prospective cohort study was conducted. Patients admitted to the Department of Critical Care Medicine of Fuxing Hospital Affiliated to Capital Medical University,who were intubated with a high-volume low-pressure endotracheal tube,and had undergone mechanical ventilation for at least 48 hours,were enrolled. The endotracheal cuff pressure was determined every 8 hours by a manual manometer connected to the distal edge of the valve cuff at 07:00,15:00,and 23:00. Measurement of the endotracheal cuff pressure was continued until the extubation of endotracheal or tracheostomy tube,or death of the patient. According to the incidence of under inflation of endotracheal cuff,patients were divided into the incidence of under inflation lower than 25%group(lower low cuff pressure group)and higher than 25% group(higher low cuff pressure group). The possible influencing factors were evaluated in the two groups,including body mass index(BMI),size of endotracheal tube,duration of intubation,use of sedative or analgesic,number of leaving from intensive care unit(ICU),the number of turning over the patients, and aspiration of sputum. Logistic regression analysis was used to determine risk factors for under-inflation of the endotracheal cuff. Results During the study period,53 patients were enrolled. There were 812 measurements,and 46.3%of them was abnormal,and 204 times(25.1%)of under inflation of endotracheal cuff were found. There were 24 patients(45.3%)in whom the incidence of under inflation rate was higher than 25%. The average of under inflation was 7(4,10)times. Compared with the group with lower rate of low cuff pressure,a longer time for intubation was found in group with higher rate of low cuff pressure〔hours:162(113,225)vs. 118(97,168),Z=-2.034,P=0.042〕. There were no differences between the two groups in other factors,including size of endotracheal tube,the time from intubation to first measurement of endotracheal cuff pressure,number of leaving from ICU during admission, use of sedative agent or analgesic,and the number of body turning and aspiration(all P>0.05). No risk factor was found resulting from under inflation of the endotracheal cuff by logistic regression analysis. No significant difference was found in the incidence of ventilator associated pneumonia,duration of mechanical ventilation,successful rate of weaning on 28th day,or 28-day mortality after weaning from mechanical ventilation,and ICU mortality between the two groups. However,patients in the group of higher rate of low cuff pressure had a longer ICU stay compared with that in the group of lower rate of low cuff pressure group〔days:13(8,21)vs. 10(6,18),Z=-2.120,P=0.034〕. Conclusions Abnormal endotracheal cuff pressure is common in critically ill patients with intratracheal intubation. Duration of intubation is associated with under inflation of the cuff,and it calls for strengthening monitoring and management.

Adult ; Chromosome Aberrations ; drug effects ; Ethylene Oxide ; poisoning ; Humans ; Lymphocytes ; drug effects ; pathology ; Male ; Micronuclei, Chromosome-Defective ; drug effects

Objective:To investigate the cognitive status of socialist core value among medical students, and to provide reference for the core value education in medical colleges and universities. Methods: 1024 medical students were selected with random cluster sampling method, and the socialist core value was investigated using self-designed questionnaire. Results:It was shown that 69 percent of medical students recognized the importance of socialist core values, but the contents had not been mastered. Social atmosphere, medical student's own short-coming and school education were all the factors leading to the weakness of socialist core values. Conclusion:It is quite necessary to cultivate medical students′socialist core values. Class, school, and society should play the main role to guide the medical students to establish the correct socialist core value.

OBJECTIVE:To evaluate the antihypoxic effect of orientoside on hypoxia model rats.METHODS:The hy-poxia rats model was established through normobaric hypoxia,poisoning with sodium nitrite,potassium cyanide and lidocaine,trachea occlusion,decapitation,etc.20minutes prior to the modeling,the rats were administered with the corresponding drugs with the anti-hypoxic effects observed.RESULTS:As compared with placebo group,the survival time of rats under nor-mobaric hypoxia,poisoned by sodium nitrite,potassium cyanide and lidocaine,and the electrocardiograph extinction time after trachea occlusion and the gasping time of mice after decapitation were all significantly prolonged by orientoside.CONCLU-SION:Orientoside has antihypoxic effect on hypoxia model rats.

Breast Neoplasms ; pathology ; surgery ; Carcinoma, Ductal, Breast ; pathology ; surgery ; Cryoultramicrotomy ; Cytodiagnosis ; methods ; Female ; Histocytological Preparation Techniques ; methods ; Humans ; Intraoperative Care ; methods ; Precancerous Conditions ; pathology ; surgery

Stress ulceration are common occurrence in patients with severe traumatic brain injury, which can result in alimentary tract hemorrhage, perforation and obviously increase mortality. To prevent the occurrence of stress ulceration and control upper gastrointestinal hemorrhage is meaningful for prognosis of critical disease. This article reviews pathogenesis of stress ulceration as well as the relationships preventive treatment, early enteral nutrition, hospital acquired pneumonia and related complications.

Objective:To explore effect of relevant training on understanding of theory of naive biology for plant reproduction in 5- and 6-years old,and to attempt to provide demonstration for a debate of different views between domain universality and domain specificity cognitive development.Methods:48 preschoolers who did not comprehend concept of plant reproduction screened from 64 preschoolers ages 5 to 6 were surveyed by clinical method.Half of the 48 children were assigned to intervention group,the other to control group.The effects of intervention were compared by the experimental before-after design.Results:Relevant biological knowledge might widely accelerate 5- and 6-year-olds' understandings for plant reproduction,and 6-year-olds had more enhancement than 5-year-olds.Pass rates of intervention group were more 29.2% than control group in 5 year olds,and more 54.1% in 6 year olds.Conclusion:Acquiring specific knowledge will generally improve preschoolers' cognition on plant reproduction.Children' cognitive development is influenced jointly by both domain-specific and domain-general thinking.

OBJECTIVE To investigate the ?-lactamases gene of multi-drug resistant Acinetobactor baumannii(MDR-ABA).METHODS The blaTEM,blaSHV,blaPER,blaGES,blaIMP,blaVIM,blaSIM,blaOXA-23,blaADC and blaDHA genes of 20 MDR-ABA strains were detected by PCR.RESULTS Among 20 MDR-ABA strains,18 strains were with positive blaADC,11 strains were with positive blaTEM;the others were negative.Totally 19 strains were with genes correlated to ?-lactam antibiotics.The results indicated that the blaADC DNA sequence was a new subtype type compared with the blaADC sequence which had registered on America GenBank.CONCLUSIONS blaADC Gene and blaTEM gene have spread in the MDR-ABA group and a new blaADC subtype has been found.

Objective To measure the thickness of the iliotibial band(ITB)in normal adult volunteers and to evaluate the value of ultrasonography in the diagnosis of ITB injury.Methods Ultrasonography was used to measure the thickness of the ITB in 20 normal adult volunteers,which were compared with the sonographic findings in 11 patients with iliotibial band friction syndrome(ITBFS).Results The thickness of the ITB in normal volunteers was(1.55±0.40)mm at the level of the femoral condyle and(2.05±0.30)mm at the insertions of tibial tubercle(Gerdy's tubercle).There were no significant differences between the right and left sides.In each of 11 patients with ITBFS,there was a more ITB thickness in symptomatic side than that of asymptomatic side(more than 30% in the difference between two sides).The ITB had a area of decreased echoginicity in symptomatic side.The thickened position of ITB were at insertion resion in 6 cases,at the level of femoral condyle in 3 cases and diffuse in 2 cases.Bursa fluid were found in 4 cases.Conclusions Ultrasonography can effectively evaluate the degree and range of ITB injury,and can give important information for clinical theraphy.

Objective To explore the efficacy and safety of low-dose heparin in the treament of children with primary nephrotic syndrome (PNS). Methods It was an open and comparative trial. Eightyeight children with PNS in the hypercoagulable state,on the basis of administrating with glucocorticosteroid,were administrated with low-dose heparin that infused by micro pump oriented to time ( group A). Eighty patients only treated with glucocorticosteroid were chosen as control (group B). Results Serum-albumin and activated partial thromboplastin time (APTT) increased,but fibrinogen (Fib) decreased after therapy in the group A,and they all showed significant differences (P ＜ 0. 01 ). Serum-albumin increased after therapy in the group B and there was significant difference (P＜0. 01 ). However,APTT and Fib in the group B showed no significant difference( P ＞ 0. 05 ) between post-treatment and pretherapy. Post-treatment serum-albumin and APTT in the group A were significantly higher than those in group B, and Fib was significantly lower than that in group B ( P ＜ 0. 01 ). The rate of urine protein remission in group A (82/88) was significantly higher than that in group B (63/80). Urine protein remission time and edema disappearance time were significantly shorter in group A than group B ( P ＜ 0. 01 ). APTT of group A at the peak concentration of heparin after therapy was significantly higher than that of pretherapy ( P ＜ 0. 01 ), and the ratio was 2. 38. However, there was no significant difference in APTT at the valley concentration of heparin between post-treatment and pretherapy ( P ＞ 0.05 ). Conclusion Low dose-heparin infused by micro pump oriented to time in the treatment of children with PNS has an obvious anticoagulative effect. It can improve the rate of urine protein remission and shorten edema disappearance time. Meanwhile it is safety ,requires no laboratory monitor and has few drug side effects,thus it deserves further clinical application.