Objective To explore the preventive effect of feedforward control on unexpected extubation in patients with cerebral apoplexy.Methods The clinical data of 42 cerebral apoplexy patients during May 2010 and May 2011 were retrospectively reviewed to find out the risk factors of unexpected extubation.The feedforward control was used to manage 49 cerebral apoplexy patients during June 2011 to June 2012 to control the risk factors.The incidence of unexpected extubation was compared between pre-and post-use of feedforward control. Results After application of feedforward control,the incidences of unexpected extubation of gastric tube,deep vein tubes and urinary tubes reduce were significantly decreased compared to pre-use of feedforward control(all P<0.01).Conclusion The feedforward control on patients with cerebral apoplexy is effective in reducing the incidence of unexpected extubation and ensuring the intubation safety.

Objective To explore the influence of middle cerebral artery blood flow on mechanical ventilation in very low birth weight premature after using Budesonide(BUD) mixed with pulmonary surfactant(PS),and to explore the protection mechanism of cerebral injury.Methods Forty premature infants (gestational age ＜ 34 weeks,birth weight ＜ 1 500 g) with respiratory distress syndrome(RDS) were randomly assigned into study group and control group in Nanjing Maternal and Child Health Hospital from Aug.2010 to Mar.2012.PS and BUD mixture was used in study group (Per 70 mg PS adding BUD 0.25 mg),PS dose of 70 mg/kg,BUD dose of 0.25 mg/kg.Control group was only administered with PS,dose 70 mg/kg.It was administered intratracheally after 30 to 60 minutes of birth in both groups.The index of blood flow rate and blood vessel elasticity of arteria cerebri media [including systolic velocity (Vs),diastolic velocity (Vd),mean velocity (Vm),resistant index (RI) and elasticity index (PI)] were monitored by using transcranial Doppler.Results The Vs increased steadily in study group,but instability in control group,and there were of statistical differences on the 4 d,5 d,6 d and 7 d (t =3.21,2.95,3.12,3.43,all P ＜ 0.05).The Vd increased steadily in study group,but unsteadily in control group,and there were statistical differences on the 4 d,5 d,6 d and 7 d (t =4.21,3.10,3.98,4.56,all P ＜0.05).The Vm of study group was higher than that in the PS group,and there were statistical differences on the 4 d,5 d,6 d and 7 d (t =2.68,2.98,3.98,3.57,all P ＜ 0.05).The RI of study group was higher than that in the control group,and there were statistical differences in the 5 d,6 d and 7 d(t =3.10,3.98,4.06,all P ＜ 0.05).PI steadily in study group,but instability in control group,and there were statistical differences in the 5 d,6 d and 7 d (t =4.18,3.23,3.02,all P ＜ 0.05).The overall incidence of periventricular/intraventricular hemorrhage showed no significant difference,but severe periventricular/intraventricular hemorrhage (grade Ⅲ,Ⅳ) of study group was less than that in the control group (x2 =4.80,P ＜ 0.05).The incidence of periventricular leukomalacia was reduced in the study group compared with that in the control group (x2 =3.31,P ＜ 0.05).Conclusion The very low birth weight infants treated with mechanical ventilation show steady cerebral blood flow and lower incidence of brain injury after using BUD mixed with pulmonary surfactant.

The paper introduces application and development of medical information technologies and elaborates the overall reform of medical science undergraduate curriculum made by Oregon Health and Science University including the reform method and the curriculum provision after reform.It points out the enlightenment for medical informatics curriculum reform of China from the perspectives of intensif-ying utilization of computing devices, valuing interaction with patients, enhancing combination with clinical practices, etc.

Objective:To investigate the inhibition of Streptococcus oligofermentans(So)on Streptococcus mutans(Sm)and the hydro-gen peroxide(H2 O2 )producibility by So under different sucrose concentration environment.Methods:The inhibition of So on Sm was observed by plating method under different sucrose concentration environment.The initial synthesis rates and production of H2 O2 by So were determined by 4-aminoantipyine-horseradish peroxidase method.Results:Under 500 mmol/L of H2 O2 ,the inhibition of So on Sm was not observed.Under the other sucrose concentration environment,the inhibition of So on Sm was as following:50 mmol/L >0 mmol/L and 1 mmol/L(P <0.05);the initial synthesis rates of H2 O2 by So under different sucrose concentrations were as following:50 mmol/L >0 mmol/L and 1 mmol/L >500 mmol/L(P <0.05);the total production of H2 O2 by So:0 mmol/L and 1 mmol/L >50 mmol/L >500 mmol/L(P <0.05).When So was inoculated before Sm,the inhibition of So on Sm was stronger than that when the two species were inoculated at the same time.Conclusion:The capability of the inhibition of So on Sm and the production of H2 O2 by So are influenced by sucrose concentration.

Objective To study the effects of radical surgical treatment for early esophageal cancer, and to investigate the prevention and cure of their complications,cancer recurrence and metastasis.Methods Treatments of 240 patients with early esophageal cancer of Chinese PLA General Hospital from January 2005 to January 2009 were retrospectively analyzed.The patients were treated by left thoracotomy,thoracic or cervical mechanical anastomosis surgical methods of treatment.Their postoperative adverse reactions,complications and 1 -,3-,5-year survival rates were observed and analyzed.Results The surgical resection rate was 1 00.00%. Complications included postoperative pulmonary infection (1 2 patients,5.00%), cardiac arrhythmias (1 patient,0.42%),delayed gastric emptying (2 patients,0.83%),pleural hemorrhage (1 patient, 0.42%),recurrent laryngeal nerve injury (2 patients,0.83%)and anastomotic fistula (1 patient,0.42%). One-year,3-year and 5-year survival rates after surgery were 1 00.00% (240 /240),97.9% (235 /240)and 95.8% (230 /240)respectively.The main causes of postoperative death were tumor recurrence and metastasis. Conclusion Timely surgery for early esophageal cancer can bring in good effect and long-term outcome,with little complication,which can obtain a good forward curative effect.

BACKGROUND AND OBJECTIVEVideo-assisted thoracoscopic surgery (VATS) has been widely used in the diagnosis and treatment of chest diseases. The aim of this study was to explore the feasibility and clinical value of lobectomy with single utility port complete VATS.

METHODSFrom September 2009 to December 2009, 21 cases underwent lobectomy with single utility port complete VATS. Of 21 patients, right upper lobectomy was 12 cases, left lower lobectomy 5 cases, right lower lobectomy 2 cases, left upper lobectomy 1 case, right middle lobectomy 1 case.

RESULTSThe operation process were smooth in all patients and without conversion to thoracotomy. The mean operative time was (132.7 +/- 16.2) min and the mean intraoperative blood loss was (110.5 +/- 24.6) mL. The average chest tube drainage time was (3.1 +/- 1.3) d, and the mean hospitalization day was (5.2 +/- 3.2) d. All patients recovered smoothly and without severe complications. There were no post-operative deaths.

CONCLUSIONLobectomy with single utility port VATS is technically feasible and has the advantages of minimal invasive and rapid recovery.

Adult ; Aged ; Female ; Humans ; Lung Neoplasms ; surgery ; Male ; Middle Aged ; Pneumonectomy ; methods ; Thoracic Surgery, Video-Assisted ; methods ; Treatment Outcome

Background and objective Localization of pulmonary ground glass small nodule is the technical dif-ficulty of minimally invasive operation resection. The aim of this study is to evaluate the value of intraoperative computed tomography (CT)-guided localization using a hook-wire system for small ground glass opacity (GGO) in minimally invasive resection, as well as to discuss the necessity and feasibility of surgical resection of small GGOs (<10 mm) through a minimally invasive approach.MethodshTe records of 32 patients with 41 small GGOs who underwent intraoperative CT-guided double-thorn hook wire localization prior to video-assisted thoracoscopic wedge resection from October 2009 to October 2013 were retrospectively reviewed. All patients received video-assisted thoracoscopic surgery (VATS) within 10 min atfer wire localiza-tion. hTe effcacy of intraoperative localization was evaluated in terms of procedure time, VATS success rate, and associated complications of localization.Results A total of 32 patients (15 males and 17 females) underwent 41 VATS resections, with 2 simultaneous nodule resections performed in 3 patients, 3 lesion resections in 1 patient, and 5 lesions in a patient. Nodule di-ameters ranged from 2 mm-10 mm (mean: 5 mm). hTe distance of lung lesions from the nearest pleural surfaces ranged within 5 mm-24 mm (mean: 12.5 mm). All resections of lesions guided by the inserted hook wires were successfully performed by VATS (100% success rate). hTe mean procedure time for the CT-guided hook wire localization was 8.4 min (range: 4 min-18 min). hTe mean procedure time for VATS was 32 min (range: 14 min-98 min). hTe median hospital time was 8 d (range: 5 d-14 d). Results of pathological examination revealed 28 primary lung cancers, 9 atypical adenomatous hyperplasia, and 4 nonspe-ciifc chronic inlfammations. No major complication related to the intraoperative hook wire localization and VATS was noted. Conclusion Intraoperative CT-guided hook wire localization is useful, particularly in small GGO localization in VATS wedge resection and has a signiifcantly low rate of minor complications. Lung GGOs carry a 90% risk of malignancy. Aggressive surgi-cal resection of these GGOs is necessary and feasible through the guidance of intraoperative CT localization technique.

OBJECTIVETo establish RP-HPLC method for determination of atropine sulphate, diphenhydramine hydrochloride, capsaicin and dihydrocapsaicin in pain-relieving plaster for arthritis.

METHODThe sample were separated on an Alltima C18 Column (4.6 mm x 250 mm, 5 microm) with the moblie phase of CH3 CN-0.1% H3 PO4. Flow rate was 1 mL x min(-1). The detective wavelength was set at 210 and 280 nm. Column temperature was 30 degrees C.

RESULTThe calibration curve for atropine sulphate, diphenhydramine hydrochloride, capsaicin and dihydrocapsaicin revealed linearity in the range of 2.01-50.25, 15.08-377.00, 5.02-125.50, 5.03-125.75 mg x L(-1), respectively. The recoveries of atropine sulphate, diphenhydramine hydrochloride, capsaicin and dihydrocapsaicin were 99.00% with RSD of 0.95%, 99.89% with RSD of 1.2%, 100.1% with RSD of 1.5% and 99.51%, with RSD of 1.4%, respectively.

CONCLUSIONThe method is simple, rapid and accurate, which is suitable for the quality control of pain-relieving plaster for arthritis.

Arthritis ; drug therapy ; Atropine ; analysis ; therapeutic use ; Capsaicin ; analogs & derivatives ; analysis ; therapeutic use ; Chromatography, High Pressure Liquid ; methods ; Diphenhydramine ; analysis ; therapeutic use ; Drugs, Chinese Herbal ; analysis ; therapeutic use ; Humans ; Pain ; drug therapy

Objective:To explore the feasibility and clinical effect of the infrared vascular imager in the transplantation of free arterialized venous flaps.Methods:A retrospective analysis was conducted with patient data of hand microsurgery using free arterialized venous flaps to repair hand wounds in the Second Affiliated Hospital of Wenzhou Medical University from March 2019 to November 2020. An arterialized venous flap was designed according to the Goldschlager’s Type Ⅲ flap design with the aid of a magnifying glass following the venous course. The flap was transfer to cover the wound of the recipient area. The reconstructive effect was observed postoperatively, including the blood supply, color, texture, survival of the flap, the flexion and extension of the affected finger, and the appearance of the forearm donor site. The hand function was evaluated by the Chinese Medical Association Hand Surgery Society’s upper limb function evaluation trial standard.Results:A total of 17 patients were included, including 11 males and 6 females, ranging in age from 19 to 68 years old, with an average age of 34.6 years. A total of 18 skin flaps were designed and elevated, and the flap size ranged from 2.0 cm × 3.0 cm to 8.0 cm × 9.0 cm. The patients were followed up 3 to 12 months after the operation, with an average follow-up of 6 months. Blisters appeared on the second day after the operation in 8 flaps, and the affected limbs were raised to maintain the integrity of the blisters. The blisters of the flaps subsided one week after the operation. Congestion occurred on the second day after operation in 7 flaps, which subsided after two weeks after routine treatment, such as raising the affected limb and removing some sutures. One flap developed progressive hypoperfusion one week after the operation, and eventually necrosis. Seventeen flaps survived, and one flap failure was observe. All the surviving skin flaps were free of bloat and had a good appearance. In two cases, the skin graft area was pigmented, and the flexion and extension activities of the affected fingers were suitable. Using the Chinese Medical Association Society of Hand Surgery’s upper limb function evaluation trial standard, 16 patients (excluding one flap failure) were evaluated for hand function, showing 11 cases were excellent and 5 cases were good.Conclusions:Infrared vascular imaging technology enables free arterialized venous flap transplantation to realize non-contact, non-invasive, simple operation, intuitive and accurate, and truly realizes rapid flap design under direct vision. Infrared vascular imaging technology is an effective auxiliary tool for free arterialized venous flap transplantation.

Objective:To explore the feasibility and clinical effect of the infrared vascular imager in the transplantation of free arterialized venous flaps.Methods:A retrospective analysis was conducted with patient data of hand microsurgery using free arterialized venous flaps to repair hand wounds in the Second Affiliated Hospital of Wenzhou Medical University from March 2019 to November 2020. An arterialized venous flap was designed according to the Goldschlager’s Type Ⅲ flap design with the aid of a magnifying glass following the venous course. The flap was transfer to cover the wound of the recipient area. The reconstructive effect was observed postoperatively, including the blood supply, color, texture, survival of the flap, the flexion and extension of the affected finger, and the appearance of the forearm donor site. The hand function was evaluated by the Chinese Medical Association Hand Surgery Society’s upper limb function evaluation trial standard.Results:A total of 17 patients were included, including 11 males and 6 females, ranging in age from 19 to 68 years old, with an average age of 34.6 years. A total of 18 skin flaps were designed and elevated, and the flap size ranged from 2.0 cm × 3.0 cm to 8.0 cm × 9.0 cm. The patients were followed up 3 to 12 months after the operation, with an average follow-up of 6 months. Blisters appeared on the second day after the operation in 8 flaps, and the affected limbs were raised to maintain the integrity of the blisters. The blisters of the flaps subsided one week after the operation. Congestion occurred on the second day after operation in 7 flaps, which subsided after two weeks after routine treatment, such as raising the affected limb and removing some sutures. One flap developed progressive hypoperfusion one week after the operation, and eventually necrosis. Seventeen flaps survived, and one flap failure was observe. All the surviving skin flaps were free of bloat and had a good appearance. In two cases, the skin graft area was pigmented, and the flexion and extension activities of the affected fingers were suitable. Using the Chinese Medical Association Society of Hand Surgery’s upper limb function evaluation trial standard, 16 patients (excluding one flap failure) were evaluated for hand function, showing 11 cases were excellent and 5 cases were good.Conclusions:Infrared vascular imaging technology enables free arterialized venous flap transplantation to realize non-contact, non-invasive, simple operation, intuitive and accurate, and truly realizes rapid flap design under direct vision. Infrared vascular imaging technology is an effective auxiliary tool for free arterialized venous flap transplantation.