Recently,alveolar recruitment maneuver is one of effective management of mechanically ventilated patients with acute respiratory distress syndrome.Recruitment maneuvers are widely used in clinical practice to open the lung and prevent lung injury by derecruitment,improving the compliance,increasing PaO2,increasing the PaO2/FiO2 ratio,and reducing the pulmonary shunt fraction,although the evidence is still discussed.This review discussed recruitment maneuvers in pediatric patients with acute respiratory distress syndrome.

The problems in making PowerPoint slides include too many characters in a single slide,too many presentations in a class hour,lacking or impertinently employing of multimedia materials,deficiency in aesthetic feeling,etc.The problems in clinical theoretical teaching aided with PowerPoint include the teacher becoming a commentator for slides,teaching too many contents in a single hour,neglecting traditional teaching aid,etc.The combination of rich medical knowledge,super teaching skills and ability of good taste for slides is the key to make perfectly and use rightly PowerPoint.

Ubiquitin specific peptidases play important roles in controlling proteasome activity,organogenesis,tumorigenesis and transcriptional regulation.Ubiquitin specific peptidase 9X is able to remove ubiquitin from substrate proteins,so it may effectively regulate the proliferation,adhesion and signal transduction of tumor cells.It is a one of the most important factors in tumor progression.

Objective To explore the value of detecting serum cytokeratin 19 fragmen 21-1 (CYFRA21-1) and squamous cell carcinoma antigen (SCCAg) in the diagnosis of patients with nasopharyngeal carcinoma.Methods 79 patients with nasopharyngeal carcinoma from October 2013 to October 2015 as case group and 145 patients with nasopharyngeal chronic inflammation as control group were collected.The CYFRA21-1 level was detected by the electrochemical luminescence immunoassay and the SCCAg level was detected by the enzymoimmunoassay.Comparisons of diagnostic value of CYFRA21-1 and SCCAg to nasopharyngeal carcinoma were conducted according to pathological diagnosis.Results The serum CYFRA21-1 and SCCAg levels in case group were (12.37±1.65) g/L and (1.65±0.37) ng/ml,and the control group were (4.26±1.99) g/L and (1.22±0.45) ng/ml,with statistically significant differences (t =8.093,P =0.002;t =4.287,P =0.043).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of CYFRA21-1 combined with SCCAg in the diagnosis of nasopharyngeal carcinoma were higher than those of CYFRA21-1 and SCCAg respectively,and the difference all were statistically significant (all P ＜ 0.05).Conclusion Detecting serum CYFRA21-1 combined with SCCAg in the diagnosis of nasopharyngeal carcinoma has high sensitivity and good specificity,which can significantly improve the diagnostic accuracy.

Objective:To discuss the clinical value of CT-guided interstitial implantation of125I radioactive particle through the percutaneous puncture in the treatment of central-type lung cancer.Methods: 63 patients with the central-type lung cancer treated in Renmin Hospital of Wuhan University from November 2013 to July 2016 were randomly grouped (31 cases in the control group and 32 cases in the observation group). Patients in the control group were given the treatment of bronchial arterial perfusion with the chemotherapeutic drugs; while patients in the observation group were given the CT-guided interstitial implantation of125I radioactive particle through the percutaneous puncture. The clinical therapeutic effect and complications were observed of the two groups and the quality of life scores before and after the treatment were summarized between two groups as well.Results: The overall effective rate of observation group was 84.38% (27/32) that was higher than 61.29%(19/31) of control group, with statistical difference (x2=4.259,P<0.05); the complication rate of observation group was 9.38% (3/32) that was lower than 12.90% (4/31) of control group, with no statistical difference (x2=0.002,P>0.05); the quality of life score of observation group after the treatment was 84.57±3.27 that was higher than 70.38±3.20 of control group, with statistical difference (t=17.402,P<0.05).Conclusion: CT-guided interstitial implantation of125I radioactive particle through the percutaneous puncture in the treatment of patients with central-type lung cancer has the significant effect, and it can effectively improve the quality of life for patients and have the high degree of safety.

OBJECTIVETo investigate the therapeutic effects of manipulative reduction for calcaneal fractures.

METHODSFrom January 2009 to June 2012, 53 cases (60 affected feet) of Sanders type I-IV calcaneal fractures were treated by manipulative reduction and external fixation with cardboard splint,including 45 males and 8 females with an average age of (33.5 +/- 1.54) years old ranging from 18 to 65. The course of disease ranged 0.5 h to 7 d. Before treatment the feet were swelling, ache and activity limitation in evidence, some feet were wide flat deformity, the cortical bone was broken in the imaging examination. All selected cases were evaluated using Creighton-Nebraska health foundation assessment scale for fractures of calcaneus.

RESULTSAll cases were followed up at 12 months after treatment, 13 feet got excellent curative effect, 34 good, 11 moderate and 2 poor.

CONCLUSIONManipulative reduction for Sanders type I-IV calcaneal fractures could get excellent curative effect. Manipulative reduction for calcaneal fractures could avoid surgical trauma while assure high curative effects. Manipulative reduction is not only economical and easy therapy, but also can restore maximum function of the calcaneus with few complications and facilitate early rehabilitation of ankle and joint function.

Adolescent ; Adult ; Aged ; Calcaneus ; injuries ; surgery ; External Fixators ; Female ; Fractures, Bone ; rehabilitation ; surgery ; Humans ; Male ; Manipulation, Orthopedic ; methods ; Middle Aged ; Splints

OBJECTIVETo observe the clinical effects of essential hypertension treated with acupuncture at Siguan [Hegu (LI 4) and Taichong (LR 3)], Quchi (LI 11) and Xingjian (LR 2).

METHODSSixty cases of essential hypertension were randomly divided into an acupuncture group and a medication group, 30 cases in each group. Two groups of acupoint, which were (1) Siguan [Hegu (LI 4) and Taichong (LR 3)] and (2) Quchi (LI 11), Xingjian (LR 2), were selected alternatively in the acupuncture group, once everyday. In the medication group, captopril was prescribed for oral administration 25 mg per time, three times per day. Seven days made one session in both groups and totally three sessions were required.

RESULTS(1) After treatment, the blood pressure were decreased significantly in the two groups (all P < 0.01). Compared with the medication group, the diastolic pressure after 14 days, 21 days of treatment in the acupuncture group was decreased significantly (both P < 0.01). (2) In the terms of TCM syndrome score, the improvement of dizziness, soreness and weakness of waist and knees, palpitations was significant in the acupuncture group compared with that in the medication group(all P < 0.05). (3) The acupuncture group had less adverse reactions compared with the control group (P < 0.05).

CONCLUSIONAcupuncture at Hegu (LI4) and Taichong (LR 3), Quchi (LI 11) and Xingjian (LR 2) can effectively decrease blood pressure; the effect of controlling diastolic pressure is better than captopril. It can also improve the symptoms of dizziness, soreness and weakness of waist and knees, and palpitations.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Blood Pressure ; Essential Hypertension ; Female ; Humans ; Hypertension ; physiopathology ; therapy ; Male ; Middle Aged ; Treatment Outcome ; Yin Deficiency ; therapy ; Yin-Yang

Objective To explore the influence of comprehensive intervention on social support and quality of life of the family members of patients with schizophrenia.Methods 80 family members of patients with schizophrenia were randomly divided into the intervention group and the control group (40 cases for each group).Apart from general hygiene education,the intervention group received a 1-year targeted comprehensive intervention.Social support assessed scale (SASS) and comprehensive assessment of the quality of life questionuaire (GQOLI-74) were used to make assessment of social support and quality of life of the family members before and after the intervention.Results After intervention,the total score of SASS and scores of its three dimensions including objective support,subjective support and utilization of social support,the total score of GQOLI-74 and scores of its three dimensions including physical function,psychological function and social function were all significantly increased and higher than the same period of the control group.Conclusions The comprehensive intervention can improve the social function and quality of life of the family members of patients with schizophrenia..

Objective To evaluate the quality of life and influenced factors in epileptic adults. Methods 106 adults with epilepsy and 64 healthy people as control were studied and tested by using QOLIE-30.Results Compared with control group, QOL score was lower in epileptic group (54?16 vs 77?15). Worrying about the seizure attacks and side effect of antiepileptic medication, having memory problems, they are unsatisfied with their lives, in a blue mood, easy to be tired and their social activities are limited. Comparing the QOL of patients between different sexes, duration of seizure, AEDs taken and seizure frequency, it was found that their medication and seizure frequency play an important role. QOL was negatively associated with the number of the AEDs taken and their seizure frequency.Conclusion QOL was lower in epileptic adults. Medication and seizure frequency play an important role. Adequate medications to control the attack of seizures is a key to improve the quality of life in epileptic patients.

Objective To analyze the value of open tension -free hemiorrhaghy ( OTFH) and laparoscopic totally extraperitoneal prosthesis ( LTEP) repair in patients with bilateral inguinal hernia .Methods A retrospective method was used to compare the clinical data of 115 patients with bilateral hernias , of which 61 cases received LTEP and 54 cases underwent OTFH , from June 2011 to December 2013, in our hospital .Results The mean operative time of LTEP group (88.2 ±15.6 min) was longer than the OTFH group(75.7 ±21.6) min (p<0.05).The dura-tion of hospitalization in LTEP group(2.6 ±1.1) day was shorter than OTFH group(4.2 ±2.1) d (p<0.05).Hos-pitalization expense of LTEP group (12 012.0 ±2 325.2) yuan was higher than the OTFH group (9 291.3 ±2 010.1) yuan (p<0.05).The incision pain by VAS points was gradually decreased in 24 hours, 48 hours, 72 hours after op-eration, and LTEP group was significant lower than OTFH group in the same time point .In LTEP group 3 case had laceration of peritoneum but turn to no other prosthesis , and 2 cases had acute urinary retentions .11 acute urinary re-tentions occurred in OTFH group , and 2 cases had chronic pain in inguinal area and 1 cases of fat liquefaction .No recurrence was found during a follow -up period of 6 to 24 months in both of 2 groups .Conclusion Both LTEP and OTFH are safe and accessible techniques for patients with bilateral inguinal hernia .OTFH is feasible, and has short process and low cost which is suitable for primary hospitals to carry out .OTFH has the advantages of little trauma , faster postoperative recovery and less complications which is worth promoting in future .