Objective To explore the clinical effect and safety of high frequency oscillatory ventilation (HFOV) combined thoracic close drainage for the treatment of mechanical ventilated neonates with pneumothorax.Methods Twenty-two neonates were enrolled in this study,who needed mechanical ventilation diagnosed with neonatal pneumothorax and received treatment of HFOV combined thoracic close drainage from Jan.2012 and Jun.2014 in the People's Hospital of Dongguan.We recorded blood gas analysis and parameters of breathing machine before using HFOV and 2,12,24,48 hours after using HFOV respectively.Results There were significant differences between HFOV before use (0) and 2,12,24,48 hours after using HFOV in terms of blood pH value,arterial partial pressure of oxygen(PaO2),partial pressure of arterial carbon dioxide (PaCO2),oxygenation index (OI),the inspired oxygen concentration (FiO2),mean airway pressure (MAP) (F =6.606,17.760,8.387,17.242,25.185; P ＜ 0.05).Compared with before using HFOV combined thoracic close drainage,PaO2 was significantly increased from (51.25 ± 13.16) mmHg to (62.60 ± 15.95) mmHg.PaCO2 was significantly dropped from (63.57 ± 13.81) mmHg to (54.02 ± 11.58) mmHg and OI was dropped sharply from (16.57 ± 9.09) to (11.28 ± 4.67) at 2 hours after using HFOV combined thoracic close drainage (P ＜ 0.05).FiO2 significantly decreased from (0.76 ± 0.15) to (0.60 ± 0.13),as well as MAP from (9.91 ± 1.44) cm H2 Oto (8.50 ± 1.68) cm H2O.Furthermore,pH was significantly improved from (7.24 ± 0.15) to (7.34 ±0.10) at 12 hours later(P ＜0.05).PH,PaO2,PaCO2 were roughly back to normal at 48 hours after treatment.The main complications were intraventricular hemorrhage (2 cases),subarachnoid hemorrhage (2 cases),ventilator associated pneumonia (1 case) and pulmonary hemorrhage (1 case) (not during the time of HFOV treatment).Conclusion HFOV combined thoracic close drainage for the treatment of neonates with pneumothorax is safety and effective methods.

Objectives To investigate and evaluate the preventive and therapeutic effects of celecox ib,a selective cyclooxygenase-2(COX-2)inhibitor,on multiple colorectal adenorna and compare it with aspirin.Methods Ninty-six patients with colorectal multiple adenoma were randomly divided into A,B and C groups.Adenomas in all patients were removed with high-frequency eleetrocoagulation,electroexci- sion or argon plasma coagulation(APC)under colonoscopy.Then,group A were administered celecoxib 200 mg twice daily,group B aspirin 50 mg twice daily,group C served as control.Colonoscopy was per formed every 6 months in the first year,and every year in order to observe and evaluate the recurrence rate of adenoma and the side effects after the treatment.Results Twenty-seven patients in group A,26 pa- tients in group B and 27 patients in group C had completed the treatment.At the end of the treatment, on PP/ITT analysis,the cure rate of the eolorectal adenoma were 84.4%/100% ,78.1%/96.2% and 75.0%/88.9% in group A,B and C,respectively.During the first year of follow-up,there were 1 ,1 and 6 cases which were found recurrences of the adenomas in group A,B and C,respectively.The recurrence rates of coloreetal adenomas in group A(3.7%)and group B(4.0%)were significantly low er than that in group C(24.0%) (P＜0.05 and＜0.05,respectively).At the end of follow-up,the total recurrence rate of colorectal adenomas in group A(14.80%)and group B(19.2%)were significant- ly lower than that in group C(46.2%)(P＜0.05 and＜0.05).While the side-effective rate regroup A (3.3%)was significantly lower than that in group B(22.5%)(P＜0.05).Conclusions After re- section of the multiple colorectal adenomas,both the selective inhibitor of COX-2,celeeoxib and the non- selective inhibitor of COX-2,aspirin,may reduce its recurrence rate,but the former has a good tolerance and lower side-effects.

ObjectiveTo explore the predictive effect of serum TC/HDL-C ratio on ischemic and hemorrhagic stroke incidence in middle aged Chinese population.MethodsA prospective study was conducted based on the PRC-USA Collaborative Study on Cardiovascular and Cardiopulmonary Epidemiology. A total of 10 121 individuals (4921 men and 5200 women), aged 35—59 years were selected from 4 cohorts, in Beijing and Guangzhou, urban and rural. The average following up time was 15.9 years. During the follow-up period, 277 ischemic and 125 hemorrhagic stroke cases were diagnosed.ResultsThe age adjusted incidence rate of ischemic stroke was 144.1,169.4,166.7,226.9 and 282.2 in the group of TC/HDL-C ratio

Objective The plasma levels of interleukin 6 (IL-6),high sensitive C reactive protein (hs-CRP) and the level of T cell activation were detected in the peripheral blood inflammatory factors of acquired immunodeficiency syndrome (AIDS) patients,and the relationship with opportunistic infection and prognosis was analyzed.Methods 79 human immunodeficiency virus (HIV)-positive/aids cases from May 2014 to January 2015 in first hospital of Changsha were enrolled in the study.They were divided into three groups:HIV-infected without opportunistic infections group (n =20),HIV-infected with infections group (n =43,including HIV-infected with tuberculosis group,HIV-infected with merge fungus group.HIV combined hepatitis C),death group (n =16).Serum IL-6 and the concentration of hs-CRP were detected by enzyme-linked immunosorbent assay (ELISA).Flow cytometry was used to test the CD3 + CD4 + cell count,the percentage of CD4 + CD38 + cell and CD8 + CD38 + cell in peripheral blood mononuclear cell (PBMC).Compare the differences among the three groups.Results The results showed that:the concentration of hsCRP and IL-6 in peripheral blood of HIV death group was significantly higher than that in other three groups (P ＜ 0.05).The concentration of hs-CRP and IL-6 in the peripheral blood of the HIV-infected with tuberculosis group and HIV-infected with merge fungus group were significantly higher than that in the HIV-infected without opportunistic infections group (P ＜ 0.05),and the hs-CRP in the peripheral blood of the HIV combined with the hepatitis C group was higher than that in the HIV-infected without opportunistic infections group (P ＜ 0.05).The number of CD3,CD4T lymph nodes in the death group and the combined opportunistic infection group was significantly lower than that in the HIV-infected without opportunistic infections group (P ＜ 0.05).The HIV-RNA expression in peripheral blood of the death group and the combined opportunistic infection group was significantly lower than that in the HIV-infected without opportunistic infections group (P ＜ 0.05).The expression of CD8+CD38+ on PBMC in the HIV-infected without opportunistic infections group was significantly lower than that in the death group,the tuberculosis group,the fungus group and the hepatitis C group (P ＜ 0.05).The expression of CD4+ CD38 + on PBMC in the HIV-infected without opportunistic infections group was higher than that in the death group (P ＜ 0,05).Conclusions The concentration of inflammatory cytokines (IL-6,hs-CRP) and the expression level of T cell surface CD8 + CD38 + related to immune activation were associated with opportunistic infection and prognosis of AIDS.

OBJECTIVE: To investigate the surgical techniques and clinical outcomes of total hip replacement for patients with end-stage osteoarthritis secondary to developmental dysplasia of the hip. METHODS: From May 2004 to March 2008, a total of 36 total hip replacements were performed in 32 patients with end-stage osteoarthritis secondary to developmental dysplasia of the hip. The acetabulum cup was reconstructed in the corresponding anatomical position in all cases. Cemented components were used in 16 hips, and cementless components in the other 20 hips. The mean follow-up was 31.3 months. Clinical outcomes were determined with Harris hip score. Radiographs were taken after the surgery and in every follow-up examination for further reference. RESULTS: All patients postoperatively gained a limb lengthening with an average of (3.4+/-1.3) cm. Three patients had complications, 2 had nondisplaced fractures of the proximal part of the femur,and 1 sciatic nerve palsy which disappeared after 3 months. There was no infection, dislocation and symptomatic deep vein thrombosis. Compared with preoperation, the mean Harris hip scores on the 3rd day, the 14th day after the operation and at the last follow-up were all improved significantly (all P<0.05). There was no loosening, migration, heterotopic ossification radiographically, and no revision during the follow-up. CONCLUSION Total hip replacement is an effective treatment for patients with end-stage osteoarthritis secondary to developmental dysplasia of the hip. The key is to place the acetabulum cup in the corresponding anatomical position, and choose proper prosthesises during the surgery.
Adult ; Arthroplasty, Replacement, Hip ; adverse effects ; methods ; Female ; Hip Dislocation, Congenital ; complications ; surgery ; Humans ; Male ; Middle Aged ; Orthopedic Procedures ; methods ; Osteoarthritis ; etiology ; surgery ; Treatment Outcome

Objective::To explore the effect of modified Longdan Xiegantang in treatment of anal sinusitis patients with syndrome of interior dampness-heat and on immune response, oxidative stress. Method::A total of 80 cases of anal sinusitis patients with syndrome of interior dampness-heat treated in our hospital from May 2017 to May 2018 were randomly divided into two groups, with 40 cases in each group. The control group was treated by enema with Metronidazole injection combined with gentamicin sulfate injection. In addition to the therapy of the control group, the treatment group was also given modified Longdan Xiegantang. The symptoms and signs score, interleukin (IL)-2, IL-4, IL-6, IL-10, tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), procalcitonin (PCT), CD3⁺, CD4⁺, CD8⁺, immunoglobulin A(IgA), IgG, IgM, IgE, SOD, propylene glycol (MDA) levels of two groups were observed before and after treatment, and the curative effect, reactions and relapse were observed. Result::The clinical efficacy of treatment group was significantly better than that of control group, and the rank-sum test showed statistically significant differences (Z=1.981, P<0.05). After treatment, the scores of symptoms, such as anal distension and pain, and signs, such as anal sinus tenderness, hyperemia and edema in the treatment group were lower than those in control group (P<0.05). The levels of TNF-α, PCT, IL-2, IL-6 and MDA in treatment group were lower than those in control group (P<0.05). The levels of IL-4, IL-10, IFN-γ and SOD in treatment group were higher than those in control group (P<0.05). The recurrence rate was 5.13%in treatment group, and 21.05%in control group, indicating a significant difference (χ²=4.319, P<0.05). Conclusion::Modified Longdan Xiegantang is effective in treating syndrome of interior dampness-heat anal sinusitis. It can effectively relieve symptoms, regulate pro-inflammatory/anti-inflammatory balance and Th1/Th2 balance, improve cellular immune function and humoral immune function, inhibit oxidative stress response, and reduce recurrence rate, with a high safety.