ObjectiveTo discuss the values of fiber bronchoscopy with three-way laryngeal mask airway continuous ventilation in 1-6 month old infants with oxygen-dependent respiratory diseases.MethodsFrom January 2010 to May 2011, 29 cases of 1-6 month old infants with oxygen-dependent respiratory diseases who underwent conventional ifber bronchoscope and 148 cases of 1-6 month old infants with oxygen-dependent respiratory diseases who underwent ifber bronchoscopy with three-way laryngeal mask airway continuous ventilation were enrolled in control and treatment groups respectively. The success rate of ifber bronchoscope and the incidence rate of complications were compared between two groups.ResultsIn the treatment group, the success rate of ifber bronchoscope was 89.2% which was signiifcantly higher than 58.6% in the control group and the rate of laryngeal edema was 9.1% which was signiifcantly lower than 35.3% in the control group. The rates of endotracheal intu-bation ventilation and postoperative hemorrhage were lower than those in the control group, but the difference was not statistical ly signiifcant.ConclusionFiber bronchoscopy with three-way laryngeal mask airway continuous ventilation is superior to the traditional ifber bronchoscope in 1-6 month old infants with oxygen dependent respiratory system diseases.

Purpose: To describe the clinical manifestations of hepatic myelopathy (HM) after transjugular intrahepatic portosystemic stent shunts (TIPSS)in five patients. Materials and Methods: Four men and one woman, age ranging from 41 to 54 years, had history of hepatitis B and recurrent bleeding from gastroesophageal varices. Obvious liver atrophy was found in the five patients before TIPSS procedure and shunt patency was by color Doppler US after TIPSS. Spinal cord MRI was performed in 4, CT and myelography were performed in lcase. Lumbar puncture was done in 5 patients. Results: Spastic paralysis in the lower extremities occurred progressively during 4 weeks to 4 months after TIPSS in the five patients. Weakness of the upper extremities presented in one patient, and urinary incontinence was in another one. HE following TIPSS occurred more than once (1~6 times) in these patients. Physical ex- amination revealed that hyperreflexia of tendons and positive reaction of ankle clonus were seen in all patients. Superficial sensation was normal in 5, decreasing in deep sesation in 1. Muscular atrophy in the paralytic lower extremities was not obvious in all but one patient. No mass effect or other abnormalities were found in the suspected spinal cords on the imaging studies. Lumbar puncture and cerebrospinal fluid examination were normal. The abnormalities of laboratory tests included hyperammonemia and hypoal- buminemia. Conclusion: Spastic paralysis with intact of superficial sensation in the lower extremity fol- lowing TIPSS should be considered as HM. The potential risk factors of TIPSS related HM were obvious liver atrophy, refractory hyperammonemia and HE follwing TIPSS.

Objective:To investigate the clinical effects of deanxit in the treatment of post-stroke depression and anxiety.Method:65 stroke patients with depressive and anxious disorder were randomly divided into two groups which were treated with deanxit(as deanxit group) and without deanxit(as controlled group) respectively.SDS and SAS scales were used to evaluate the changes of clinical symptoms.Result:The scores of SDS and SAS scales in the deanxit group after 2 weeks'treatment were 36.37?7.07 and 32.91?5.28,which were significantly lower than those of the controlled group (P

Objective To explore the application value of pulse indicator continuous cardiac output (PiCCO) monitoring in the fluid management of children with acute respiratory distress syndrome (ARDS).Methods Thirty-two children with ARDS admitted to Pediatric Intensive Care Unit(PICU) of Zhengzhou Children's Hospital,from April 2013 to April 2016,were divided into intervention group (15 cases) and control group (17 cases) by adopting random number table method.Fluid management of intervention group by PiCCO,control group by central venous pressure,the 2 groups' oxygenation index (OI),acute lung injury score,mechanical ventilation time and 28 days mortality were statistically compared.The categorical data were analyzed by using SPSS 11.0 software,and the t test was used for the measurement data.The categorical data and mortality comparison were analyzed by adopting x2 test.The difference was statistically significant at P ＜ 0.05.Results After 3 days of mechanical ventilation,the changes of OI in the intervention group were significantly higher than those in the control group [(175.0 ±-43.7) mmHg vs.(143.0 ± 42.8) mmHg (1 mmHg =0.133 kPa),t =2.090 0,P ＜ 0.05].The intervention group was significantly shorter than the control group [(10.45 ± 3.12) d vs.(12.63 ± 2.87) d,t =2.058 7,P ＜ 0.05].There was no significant difference between 2 groups in acute lung injury score,PICU length of stay and 28 days mortality (all P ＞ 0.05).Conclusions PiCCO monitoring and guidance in the fluid management of pediatric ARDS can improve oxygenation after 3 days,reduce mechanical ventilation time,but can not significantly reduce the 28-day mortality.

ObjectiveTo observe the changes of the blood lipid levels in patients with sepsis,and reveal the clinical significance of the blood lipid level in the prognosis of patients with sepsis.MethodsThe blood lipid levels and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) of 40 patients with sepsis(sepsis group) were recorded.The blood lipid levels were compared with those of 25 healthy people (control group).The correlation of the blood lipid level with APACHE Ⅱ score and prognosis of sepsis was analyzed.ResultsIn sepsis group,plasma total cholesterol(TC),high density lipoprotein (HDL),low density lipoprotein (LDL),apolipoprotein B (ApoB) was (3.92 ±0.96) mmol/L,(1.10 ±0.39) mmol/L,(2.44 ± 0.81 ) mmol/L and ( 1.03 ± 0.27) g/L respectively,which were significantly decreased compared with those in control group [ ( 4.40 ± 0.55 ) mmol/L,( 1.61 ± 0.42) mmol/L,(2.79 ± 0.47 ) mmol/L,( 1.13 ± 0.12 ) g/L] (P ＜0.05).In sepsis group,26 cases survived and 14 cases died.TC,triacylglycerol (TG),HDL,LDL,apolipoprotein A Ⅰ (ApoA Ⅰ ),ApoB,platelet count and albumin level of death patients was (3.33 ±0.92) mmol/L,(0.81 ±0.39) mmol/L,(1.03 ±0.27) mmol/L,(1.83 ±0.68) g/L,(1.03 ±0.27) g/L,(0.86 ±0.27) g/L,(140.0 ±82.3) × 109/L,and (32.00 ±5.52) g/L,respectively,which were significantly decreased compared with those of survival patients [ (4.24 ± 0.84) mmol/L,( 1.21 ± 0.44) mmol/L,( 1.25 ±0.30) mmol/L,(2.77 ±0.68) mmol/L,(1.25 ±0.13) g/L,(1.13 ±0.23) g/L,(215.9 ± 101.0) × 109/L,(36.12 ±6.30) g/L](P＜0.05).APACHEM Ⅱ score of death patients was (20.5 ±4.2) scores,which was increased compared with that of survival patients [ ( 13.8 ± 4.8) scores ] ( P ＜ 0.05 ).Multivarisble Logistic regression analysis showed plasma HDL and APACHE Ⅱ score was independent risk factor (standard regression coefficient,HDL =-6.222,APACHE Ⅱ score =0.337).Conclusions Disorders of lipid metabolism exist in patients with sepsis.Plasma HDL level is a good indicator in assessment of prognosis in patients with sepsis and it shows better results combined with APACHE Ⅱ score.

Objective: To investigate the protective effect of human lipoxin A4 (LXA4) on N2a cell damage induced by β-amyloid protein 25-35 (Aβ25-35) and the underlying mechanism. Methods: Aβ25-35 was used to treat N2a cells to establish Alzheimer's disease (AD) cell injury model. Meanwhile, LXA4 was added to the experimental group at different concentrations (50, 100 and 200 nmol·L-1 ). MTT assay was used to detect the activity of N2a cells. The apoptosis was detected by Hoechst 33258-PI staining, the expression of P62 and TRAF6 mRNA was detected by RT-PCR, and the expression of P62 and TRAF6 protein was detected by Western blot. Results: Compared with that of the model group, the cell survival rate of LXA4 protective group (50,100 and 200 nmol·L-1 ) increased (P <0. 01) and the apoptosis of N2a cells induced by Aβ25-35 was reduced by LXA4 (100 and 200 nmol·L-1 ) . Compared with that of the model group, the expression of P62-mRNA and protein-P62 of N2a cells treated with Aβ25-35 increased (P <0. 05 or P <0. 01) and the expression of TRAF6-mRNA and protein-TRAF6 of N2a cells treated with Aβ25-35 were reduced (P <0. 05 or P <0. 01). Conclusion: LXA4 has protective effect on N2a cell damage induced by Aβ25-35 , and its mechanism may be related to the up-regulation of P62 gene and down-regulation of TRAF6 gene.

Objective To assess the capability of monochromatic energy images of Gemstone spectral imaging(GSI) in reducing artifacts caused by metallic implants. Methods Twelve subjects with metallic implants underwent GSI (Discovery CT750 HD, GE Healthcare, Milwaukee ). The metallic orthopedic implants included 3 patients of dentures, 2 patients of cervical spinal vertebraplasty, one clavicle fracture fixation, one lumbar spinal vertehraplasty, 3 patients of artificial femoral head, one iliac fracture fixation and one tibial fracture fixation. GSI was performed by using a single source ultra-fast dual energy X-ray switching (80 kVp and 140 kVp). Following GSI scanning, thin slice images were reconstructed into 1.25 mm slice thickness. The monochromatic energy images were set to the same window width and level (window width 1500 HU,window level 500 HU). The artifact indexes (AI) at different kiloelectronvolts (keV) images were measured and compared. 3D reconstruction was performed using images with minimal AI. Result The artifacts index on monochromatic energy images varied with the change of keV. Of the images from 12 subjects, the maximal AI ranged between 145-225 at 40 keV, and minimal AI ranged between 15-90 at the 95-140 keV. The artifacts are clearly visible on polychromatic energy images and the artifacts are reduced markedly on the monochromatic energy images with minimal AI. Conclusion The artifacts caused by metallic implants can be reduced significantly by GSI with high keV monochromatic energy images.

Objective To explore the effect of thrombelastography in sepsis and septic shock with disseminated intravascular coagulation (DIC) condition in children.Methods Ninety-one cases of children admitted to the Pediatric Intensive Care Unit,Zhengzhou Children's Hospital between January 2013 and December 2016 were enrolled in this study.Fifty-eight cases of sepsis,17 cases of severe sepsis and 16 cases of septic shock (including 7 cases DIC and 9 cases non-DIC) were included in 91 cases of children.After admission,they were given conventional treatment according to their condition of illness,such as expansion of rehydration,applying vascular active drags,anti-infection,mechanical ventilation,maintaining internal environment,nutrition support,etc.Thrombelastography of all the patients were detected for 6 hours after admission.The test indexes included blood coagulation reaction time (R),blood clot formation time (K) and blood clot formation rate (alpha),maximum width (MA),coagulation index (CI),etc.And pediatric critical illness scores(PCIS) were also evaluated for 6 hours after admission.Results With the progression of sepsis severity,R value,K value increased dramatically (F =3.629,4.237,all P ＜ 0.05),alpha angle,MA value,CI value decreased (F =32.631,19.938,10.849,all P ＜ 0.05);R value,K value and PCIS scores showed a significant positive correlation (r =0.591,0.827,all P ＜ 0.05),alpha angle,MA value,CI and PCIS scores showed a significant negative correlation (r =-0.793,-0.827,-0.839,all P ＜ 0.05).R and K values in DIC group were significantly greater than the values of non-DIC group (t =4.381,2.613,all P ＜ 0.05),alpha angle was less than that of DIC group obviously (t =5.627,P ＜ 0.05).In DIC group MA and CI levels were significantly less than those of non-DIC group (t =5.416,2.951,all P ＜ 0.05).R value,K value,alpha Angle,MA,CI levels between the dead and surviving patients in the septic shock group had no significant difference (all P ＞ 0.05).Conclusions TEG has a great significance in evaluating severity of children with sepsis.It can also guide clinical assessment in children with septic shock DIC so as to give accurate effective intervention and improve the rescue success rate and the prognosis.

Objective:To investigate the clinical characteristics and prognosis of silicosis complicated with cavity-pulmonary tuberculosis.Methods:The clinical data of 63 patients with silicosis complicated with cavity-pulmonary tuberculosis (group A) and silicosis patients (group B) admitted to Yantaishan Hospital from July 2018 to July 2022 were collected and analyzed.Results:Patients in group A were all male, and the common symptoms were cough, expectoration, chest tightness, shortness of breath, and hemoptysis. CT cavity lesions involving the lung, often occurs in the lung after the tip section, after the back section and basal segment, thick-walled cavity, may be accompanied by satellite lesions, endobronchial spread focal, pneumothorax, pleural effusion, etc. 1225 cases of group B patients haemoptysis of 59 patients, cavity in 3 patients, haemoptysis and/or cavity rate was lower than that in group A, the difference was statistically significant ( P<0.05) . In group A, CT reexamination 6-24 months after anti-tuberculosis treatment showed that 52 cases (82.5%) had cavity reduction/healing, 8 cases (12.7%) had recurrence, and 3 cases (4.8%) had damaged lung (2 died) . Conclusion:Silicosis patients with hemoptysis and/or CT in cavity should be more vigilant about combined tuberculosis, anti-tuberculosis treatment and/or dynamic CT follow-up helps laboratory diagnosis negative patients.

Objective:To investigate the clinical characteristics and prognosis of silicosis complicated with cavity-pulmonary tuberculosis.Methods:The clinical data of 63 patients with silicosis complicated with cavity-pulmonary tuberculosis (group A) and silicosis patients (group B) admitted to Yantaishan Hospital from July 2018 to July 2022 were collected and analyzed.Results:Patients in group A were all male, and the common symptoms were cough, expectoration, chest tightness, shortness of breath, and hemoptysis. CT cavity lesions involving the lung, often occurs in the lung after the tip section, after the back section and basal segment, thick-walled cavity, may be accompanied by satellite lesions, endobronchial spread focal, pneumothorax, pleural effusion, etc. 1225 cases of group B patients haemoptysis of 59 patients, cavity in 3 patients, haemoptysis and/or cavity rate was lower than that in group A, the difference was statistically significant ( P<0.05) . In group A, CT reexamination 6-24 months after anti-tuberculosis treatment showed that 52 cases (82.5%) had cavity reduction/healing, 8 cases (12.7%) had recurrence, and 3 cases (4.8%) had damaged lung (2 died) . Conclusion:Silicosis patients with hemoptysis and/or CT in cavity should be more vigilant about combined tuberculosis, anti-tuberculosis treatment and/or dynamic CT follow-up helps laboratory diagnosis negative patients.