Objective To assess the effects on volume of uterine and the dominant fibroid by a re-new radiofrequency ablation ( RFA ) on uterine myomas and disemboweling them from uterine after RFA . Methods Three hundred and eight -three patients were treated by RFA and followed up at 1, 3, 6 and 12 months,165 of them by usual RFA , 163 by improved RFA.To them which myomas diameters were >5cm, 55 cases were added by disemboweling the myomas out of the body after one month of improved RFA .But 66 were not disemboweled.The pre-and postoperative uterine and myoma volumes were measured by 3D ul-trasonography .Results The volume of uterine and the dominant fibroid were reduced in usual and im-proved RFA groups , especially in improved group ,but the difference was no significantly ( P >0.05 ) .In the groups of which myomas diameters were >5cm , the median reduction rates of uterine and myoma vol-ume was more significantly in disemboweling group than un -disemboweling one after 3 and 6 months ( P <0.05 , P <0.01 ) .The overall effective rates were 90.90%,93.25%,100%and92.42%respectively in u-sual and improved RFA groups( P >0.05),and in disemboweling and un -disemboweling groups ( P >0.05).But the obvious effective rates have significant difference in disemboweling (81.82%)and un-dis-embowelin(41.94%)group ( P <0.01).Conclusion Disemboweling myomas from uterine after RFA can increase the clinical effects significantly .

Objective To investigate the changes of plasma activated protein C(APC)in the pediatric leukemia patients with acute lung injury(ALI),and the relationship with the outcome.Methods During the study period(from Jan to Dec 2009),17 pediatric leukemia patients with ALI were selected.They were divided into neutropenic(n =10)and non-neutropenic(n =7)group.We collected the basic data including the age,gender,stage of chemotherapy,pediatric critical illness score,mechanical ventilation time,ICU time.The blood gas and plasma APC levels were detected on day 1 and day 4 of ALI onset.Results Compared with the non-neutropenic group,the neutropenic group had a significantly longer mechanical ventilation time [(16.60 ± 1 0.83)d vs(3.79 ± 4.08)d,P =0.009 6],lower PaO2 level on day l[(54.90 ± 17.05)mm Hg vs (92.70 ± 27.53)mm Hg,P =0.009 7],and lower APC level on day 4[(193.06 ± 63.19)pg/mlvs(286.28 ±25.12)pg/ml,P =0.007 7].Conclusion The APC generation is severely impaired in the neutropenic group,especially in those who died.The lower APC level is,the longer is the mechanical ventilation time,the worse is oxygenation,the poorer is the prognosis.APC replacement therapy may be promising in these patients.

Aim To study the change of mutant pre- vention concentration (MPC) in carbapenem-resistant Acinetobacter baumannii (CRAB) treated with moxi- floxacin ( MFX ) and/ or cefoperazone/ sulbactam (CFS) in vitro, and provide a theoretical support for preventing the bacterial resistance. Methods To cal- culate the fractional inhibitory concentration (FIC) in- dex, the minimum inhibitory concentration (MIC) of 20 clinical isolates of CRAB treated with MFX and/ or CFS was determined by checkerboard microdilution as- say. In addition, to calculate the selection index (SI), the MPC of 20 clinical isolates of CRAB treated with MFX and/ or CFS was determined by agar plate di- lution assay. Results Our study showed that there was synergistic/ addictive action, rather than antago- nism action against clinical isolates of CRAB when treated with MFX + CFS. The SI of the 20 isolates trea- ted with MFX or CFS alone was 4 ~128 and 8 ~64 re- spectively, but reduced to 1 ~8 and 4 ~16 when trea- ted with MFX + CFS, which decreased by 2 ~16 and 2 ~4 times respectively compared with the single treat- ment. Conclusion These results suggest that the combination treatment of MFX + CFS against clinical isolates of CRAB might lower the MPC of the isolates treated with MFX/ CFS alone, narrow the mutant selec- tion window, and prevent the generation of drug - re- sistant mutants.

ObjectiveTo assess the energy expenditure status in critically ill children on mechanical ventilation.MethodsFifty critically ill children on mechanical ventilation were enrolled in this study.Resting energy expenditure (REE) on days 1,3,5,and 7 were measured.The predictive REE was calculated for each subject using age-appropriate equations (Schofield-HTWT).ResultsREE on day 1 and Schofield-HTWT equation predictive REE were (96.80 ± 42.63 ) and ( 110.67 ± 38.35 ) kJ/d,respectively.REE on days 1,3,5,and 7 were (100.53 ±50.24),(113.80 ±49.19),(117.99 ±50.57),and (115.05±50.18) kJ/d,respectively (F =1.267,P =0.292).The REE of day 1 in children with congenital heart disease (CHD) and without CHD was (75.66 ± 31.23 ) and ( 113.40 ± 28.40) kJ/d,respectively ( F =10.423,P =0.002).ConclusionsThe hypometabolic response is apparent in critically ill children with mechanical ventilation,and the energy expenditure shows no time-specific change within the first week.The energy expenditure in children with CHD is lower than those without CHD.

Objective To investigate the clinical manifestations of the febrile neutropenia cancer children,explore the relationship between the clinical data and sepsis.Methods A prospective observation study was employed,and 66 cancer children complicated with febrile and neutropenia after chemotherapy were enrolled.Sixty-six cases were divided into two groups:septic group ( n =26 ) and non-septic group ( n =40).Clinical and laboratory data were collected and compared.Results Body temperature,neutropenia duration,absolute neutrophic count ( ANC ),C-reactive protein ( CRP ),procalcitonin (PCT) and culture positive rate showed statistically differences between the septic and non-septic groups ( P ＜ 0.05 ).Body temperature ＞40 ℃,ANC ＜ 0.1 × 109/L,increases of serum CRP and PCT levels and positive culture were correlated with sepsis.Body temperature ＜ 39 ℃,neutropenia duration ＜ 5 ds,ANC ＞ 0.5 × 109/L were less correlated with sepsis.Conclusion High initial temperature,long duration of neutropenia,severely reduced ANC,increases of CRP and PCT,and culture-positive are correlated with sepsis in cancer children.

0.05),but the t1/2 was longer and the AUC and the Cmax were lower in group B than in other groups(P

Objective To investigate the protective effect of fibrauretin injection against acute lung injury induced by lipopolysaccharide (LPS) in mice.Methods Seventy-two healthy male adult Kunming mice were randomly divided into 6 goups:normal control group,LPS group (intratracheal instilation of 5 mg/kg of LPS),hydrocortisone group (intraperitoneal injection of 3.3 mg/kg of hydrocortisone,once daily for 3 days,and intratracheal instilation of 5 mg/kg of LPS on the 4th day) and low dose,medium dose and high dose of fibrauretin groups (intraperitoneal injection of 2,10 and 50 mg/kg of fibrauretin,respectively,once daily for 3 days,and intratracheal instilation of 5 mg/kg of LPS on the 4th day).The mice in each group were sacrificed by dislocation 24 h after intratracheal instilation of LPS.The lung tissues of partial mice in each group were extracted and weighed to calculate the lung coefficients,and bronchoalveolar lavage (BAL) was performed in partial mice in each group to collect the BALF for counting the inflammatory cells.Results The lung cofficients of mice in LPS group were significantly higher than those in the normal control group (P＜0.05).The lung cofficients of mice in hydrocortisone group,low dose,medium dose and high dose of fibrauretin groups were significantly lower than those in LPS group (P ＜ 0.05).For the percentage of inflammatory cells in BALF and the percentage of neutrophils in inflammatory cells,LPS group was significantly higher than the normal control group (P＜0.01),and compared with LPS group,hydrocortisone group,low dose,medium dose and high dose of fibrauretin groups were significantly decreased (P＜0.01).Conclusion Fibrauretin injection can significantly ameliorate the inflammatory reaction degree in mice with acute lung injury induced by LPS.

OBJECTIVETo evaluate the therapeutic effect of pedicled muscular flaps combined with partial thoracotomy for treatment of pythorax-resulted wounds and defects.

METHODS35 cases with pythorax-resulted refractory infected wound and dead space, were retrospectively analyzed. The wound and dead space were eliminated with pedicled muscular flaps, including latissimus dorsi muscular flaps and serratus anterior muscle flaps in 21 patients, pectoralis major muscle flaps with rectus muscle flaps in 8 patients, latissimus dorsi muscul flaps and vertical rectus muscle flaps in other 6 patients.

RESULTS34 flaps survived completely except for 1 verticle rectus muscular flap with partial necrosis at distal end. Primary healing was achieved in 29 cases. The other 6 cases were discharged with drainage. Among the 6 cases, 3 cases healed spontaneously, 2 cases underwent reoperation, 1 case need long-term drainage in the fistula.

CONCLUSIONPedicled muscular flap, combined with partial thoracotomy can effectively treat refractory wound and dead space resulted by pythorax.

Combined Modality Therapy ; methods ; Empyema, Pleural ; surgery ; Humans ; Myocutaneous Flap ; transplantation ; Pectoralis Muscles ; transplantation ; Reoperation ; Retrospective Studies ; Superficial Back Muscles ; transplantation ; Thoracotomy ; methods ; Wound Healing

Objective To investigate the levels of Th1 and Th2 cell in the peripheral and the cytokines (IFN-γ,TNF-α,IL-12,IL-10,IL-4) in the culture medium at different time in the porcine model with multiple organ dysfunction syndrome(MODS) after continuous blood purification(CBP). Methods Twenty-four young porcines were given intravenous infusion of endotoxin to induce MODS, then were randomly divided into 2 groups:CBP group(n = 12) and MODS group without CBP(n = 12). Continuous venovenous hemodiafiltration (CVVHDF) was the main mode for CBP. At baseline, onset of MODS, and 2 h,4 h,6 h after treatment of CVVHDF,we picked the blood respectively to separate the T helper cell using the beads,detected the Th1 and Th2 cell by FACS and detected the cytokines (IFN-γ,TNF-α,IL-12,IL-10,IL-4) in the culture medium by ELISA. Results The MODS group showed a obvious rise in TNF-α,the drop tendency in IL-12,IFN-γ,IL-10,Th1/Th2 ratio, and no significant change in IL-4. After the treatment, the CBP group showed the drop in TNF-α and IL-4;and increase in IL-12,IFN-γ,IL-10 and Th1/Th2 ratio. Conclusion CBP helps to dear immune function,and restore the balance of Th1/Th2 in porcine MODS model.

Objective To study the alveolar macrophages (AM) activation in neutropenic ARDS in children with hematologic malignancy. Methods Thirteen patients of ARDS were prospectively enrolled into the study and divided into two groups,neutropenic (5 cases) and nonneutropenic (8 cases). Bronchoalveolar lavage fluid (BALF) samples were analyzed for differential and total cell counts, and alveolar activation marker expression (HLA-DR) was determined. Results In neutropenic patients,the BALF total cell count and the macrophage absolute count were significantly lower compared to those in nonneutropenic group ((62. 6 ±9. 6)/μl vs ( 124. 0 ± 6. 7)/μl,P ＜ 0. 01 and (40. 8 ±4. 3)/μl vs (67. 6 ± 10. 7)/μl,P ＜ 0. 01,respectively). As compared with the nonneutropenic group, the percentage of AM in neutropenic patients was significantly higher (65.9% ±9. 0% vs 54. 6% ± 8. 7% ,P ＜0. 05) ,the mean percentage of AM HLA-DR expression was significantly lower (35. 3% ± 5.8% vs 62. 2% ± 5. 8%, P ＜ 0. 01 ). Conclusion These results suggest an alveolar hypocellularity and a deactivation of AM in neutropenic ARDS in children with hematologic malignancy.