Objective To evaluate the efficacy and safety of the conscious analgesia/sedation scheme with remifentanil and propofol on the elderly patients under gastroenterological endoscopic procedure. Methods Retrospective analysis was performed on 3 500 cases with remifentanil and small?dose propofol under gastroenterological endoscopic procedures, and the procedure achievement, effects of the narcotic, adverse reactions and satisfactory results were summarized. Results All procedures were completed successfully. The ratio of the patients whose intended sedation depth arrived at referential induction was up to 91?3%(3 196/3 500).Hemodynamic change was slight and almost all patients could open eyes in no time, with short hospital stay. No serious adverse effects were observed except several patients complaining about mild bucking, abdominal distension and stomachache. The degree of patients′ satisfaction was high. Conclusion The conscious analgesia/sedation scheme with remifentanil and propofol can be effectively and safely used on gastroenterological endoscopic procedure among the elderly, but precise monitor and timely treatment of complications are still needed.

20?10 9/L) was observed (mean 41 days, range 12 to 118 days). There w as the association between the number of CD34 +CD44 + cells infusion and time to neutrophic recovery (?= -0.657 , P

OBJECTIVE: To investigate the treatment compliance and basic health needs of rural patients with gastric ulcer. METHODS: One hundred and sixteen patients with gastric ulcer were measured with treatment compliance questionnaire. The questionnaire contained 3 aspects: chemical therapy, regular callback, and improvement in life style, and had another part of questions which were designed to investigate the basic health needs of the patients. RESULTS: The patient compliance rate in the aspect of improvement in life style was 4.3% (n=5). Both of the counterparts in the other 2 aspects were 7.8% (n=9). The main correlative factor with treatment compliance of the investigated patients was economic income. There were 105 patients (90.5%) needing health consultation, 98 patients (84.5%) needing diet instruction and 93 patients (80.2%) needing regular physical examination among the 116 patients investigated. CONCLUSION The treatment compliance rate of rural patients with gastric ulcer was very low. It is necessary to emphasize health education.
Adolescent ; Adult ; Aged ; Female ; Health Services Needs and Demand ; Humans ; Male ; Middle Aged ; Patient Compliance ; statistics & numerical data ; Peptic Ulcer ; Rural Health Services ; Surveys and Questionnaires ; Young Adult

The objective of this research was to explore whether the number of CD34(+)CD38(+) cells infused affects hematopoietic reconstitution after cord blood transplantation. The number of CD34(+)CD38(+) cells in cord blood was analysed with flow cytometry after freezethawing. The body weight and time for neutrophil and platelet recovery were measured in 20 children with acute leukemia. The results showed that the median number of CD34(+)CD38(+) cells infused was 29.47 (9.85 - 325.71) x 10(4)/kg. A median time for neutrophil recovery (> 5 x 10(8)/L) in 20 patients was 18.5 (11 - 32) days, and time for platlet recovery (> 2 x 10(10)/L) in 19 of 20 patients was 45 (12 - 118) days. The number of CD34(+)CD38(+) cells infused correlated with time to neutrophil and platelet recovery (r = -0.577, P < 0.01 and r = 0.503, P < 0.05, respectively). In conclusion, the number of CD34(+)CD38(+) cells infused is correlated with the time for hematologic recovery.
ADP-ribosyl Cyclase ; analysis ; ADP-ribosyl Cyclase 1 ; Adolescent ; Antigens, CD ; analysis ; Antigens, CD34 ; analysis ; Child ; Child, Preschool ; Fetal Blood ; cytology ; transplantation ; Hematopoiesis ; Hematopoietic Stem Cell Transplantation ; methods ; Humans ; Leukemia, Myeloid, Acute ; blood ; therapy ; Membrane Glycoproteins ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; blood ; therapy

OBJECTIVESeveral studies have shown that L-selectin on CD34-positive cells play a role in hematopoietic reconstitution after peripheral blood stem cell transplantation and allograft bone marrow transplantation. This study sought to investigate whether the numbers of CD(34)(+)CD(62L)(+) cells infused affect the engraftment of hematopoietic stem cells (HSC) and the time to neutrophil and platelet recovery after unrelated umbilical cord blood transplantation for the treatment of childhood acute leukemia.

METHODSTwenty-three children with acute leukemia who received unrelated umbilical cord blood transplantation of mostly mismatched HLA locus were included in this study. Flow cytometry was used to count the numbers of CD(34)(+)CD(62L)(+) cells after freezing-thawing by labelling the cells with anti-CD(34) and anti-CD62L. The patients' clinical data including body weight, engraftment of the HSC, times to neutrophil and platelet recovery were evaluated.

RESULTSTwenty-one patients who received CD(34)(+)CD(62L)(+) cell infusion at a number ranging from 1.37 x 10(5)/kg to 2.68 x 10(6)/kg (median, 3.567 x 10(5)/kg) had successful engraftment of the unrelated umbilical HSC. The numbers of CD(34)(+)CD(62L)(+) cells infused were statistically different between patients who had successful engraftment of the umbilical HSC and those who had not (P < 0.05). The engraftment occurred more commonly in patients who received > 1.3 x 10(5) CD(34)(+)CD(62L)(+) cells/kg. The time of neutrophil recovery (> 500/ microl) ranged from 11 days to 32 days (median, 17.5 days). The data of the time to platelet recovery (> 2 x 10(5)/ microl) were obtained in 18 patients, and it ranged from 12 days to 118 days (median, 14 days). There seemed to be a tendency of correlation between the numbers of CD(34)(+)CD(62L)(+) cells infused and time to platelet recovery (gamma = -0.324, 0.05 < P < 0.1), whereas the numbers of CD(34)(+)CD(62L)(+) cells infused correlated with the time to platelet recovery (gamma = -0.470, P < 0.05).

CONCLUSIONThis study suggests that the numbers of CD(34)(+)CD(62L)(+) cells infused might be involved in the engraftment of HSC and hematologic reconstitution after umbilical cord blood transplantation.

Acute Disease ; Adolescent ; Antigens, CD34 ; blood ; Blood Platelets ; metabolism ; Child ; Child, Preschool ; Cord Blood Stem Cell Transplantation ; methods ; Female ; Humans ; Infant ; Infusions, Intravenous ; L-Selectin ; blood ; Leukemia ; immunology ; therapy ; Male ; Neutrophils ; metabolism ; Treatment Outcome

The study was aimed to establish a protocol of isolating and culturing adult mesenchymal stem cells (MSC) from human bone marrow aspirate and identify them by surface antigen analysis and committed differentiation in order to provide an experimental foundation for achieving a therapeutic benefit in applying MSC in hematopoietic stem cell transplantation. MSCs were obtained from fresh human bone marrow aspirate by gradient centrifugation with Percoll (1.073 g/ml) and anchoring culture in L-DMEM with 10% fetal bovine serum by a full medium exchange every 3 days. The MSC surface antigens, including CD34, CD45, CD73, CD105, CD166, were analyzed on FACScan flow cytometer. Under culture in conditioned medium for osteogenesis (the hormone cocktail containing 0.1 micromol/L dexamethasone, 10 mmol/L glycerol-2-phosphate and 50 micromol/L ascorbic acid) and adipogenesis (the cocktail containing 1 micromol/L dexamethasone, 5 mg/L insulin, 0.5 mmol/L 1-methyl-3-isobutylxanthine and 60 micromol/L indomethacin), MSCs committedly differentiated into osteoblasts and adipocytes. The differentiated mesenchymal stem cells were identified by morphological observation and immunohistochemical staining. The results showed that by gradient centrifugation and adhesion culture, MSCs could be isolated and culture-expanded from human bone marrow aspirate. These cells were uniformly negative for CD34, CD45 and positive for CD73, CD105 and CD166. The osteogenic differentiated cells were positive for alkaline phosphatase (ALP) and the adipogenic differentiated cells displayed accumulation of lipid vacuoles, as detected by oil red O. It is concluded that MSC can be isolated and expand-cultured from adult human bone marrow aspirate and committedly differentiate into osteoblasts and adipocytes. MSC primary identification can be accomplished by flow cytometry and induced differentiation. The set of methods in current experiment shows somewhat practical value for basic research and clinical application.
5'-Nucleotidase ; metabolism ; Antigens, CD ; metabolism ; Bone Marrow Cells ; cytology ; Cell Adhesion Molecules, Neuronal ; metabolism ; Cell Culture Techniques ; Cell Differentiation ; physiology ; Cell Separation ; methods ; Endoglin ; Fetal Proteins ; metabolism ; Humans ; Mesenchymal Stromal Cells ; cytology ; Receptors, Cell Surface ; metabolism

OBJECTIVETo observe the clinical efficacy and safety of Tiaozhi Yanggan Decoction (TZYGD) in treating non-alcoholic fatty liver.

METHODSOne hundred and thirty-eight patients were enrolled and randomized into two groups according to the random number table in a ratio of 3:1, with 8 cases eventually dropping out. The symptoms, signs, liver function markers, blood lipids, iconographic indices and clinical comprehensive efficacy after a 12-week treatment course were assessed in 101 patients treated with TZYGD in the treated group and 29 patients treated with Thiola in the control group.

RESULTSThe total effective rate in the treated group and the control group was 81.19% and 68.97%, respectively, showing a significant difference between the two groups with the former being significantly higher than the latter (P<0.05). Moreover, the improvements in the symptoms, signs, liver function, blood lipids and iconographic indices in the treated group were favorable with no serious adverse reactions.

CONCLUSIONTZYGD is effective and highly safe in treating non-alcoholic fatty liver.

Adult ; Body Mass Index ; Body Weight ; drug effects ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Fatty Liver ; blood ; drug therapy ; physiopathology ; Female ; Humans ; Lipids ; blood ; Liver ; physiopathology ; Male ; Medicine, Chinese Traditional ; adverse effects ; methods ; Middle Aged ; Phytotherapy ; adverse effects ; Treatment Outcome

OBJECTIVETo compare the differences in intrapulmonary shunt (Qs/Qt) and arterial oxygenation between selective left lower lobar blockade by Coopdech endobronchial blocker tubes (BB) and one lung ventilation (OLV) by left-sided double-lumen endobronchial tubes (DLT) in patients with normal pulmonary function.

METHODSThirty-six patients (aged 32-64 years) scheduled for lower esophageal surgery were allocated randomly into BB and DLT groups (n=18). Anesthesia was induced and maintained with Propofol by target controlled infusion with intravenous administration of sufentanil and cisatracurium if needed. A 35 to 39 French tube was placed in the DLT group, and an 8.0-mm (internal diameter) single-lumen endotracheal tube was used in the BB group where a 9 French Coopdech BB was advanced into the left lower lobar bronchus guided by a fiberoptic bronchoscope. The variables recorded were blood gas analysis data from the venous and arterial blood samples at 20 min after two-lung ventilation in supine position (T(1)), 20 min after initiation of one-lung ventilation or selective left lower lobar blockade by inflating BB balloons in the right lateral decubitus position (T(2)), total collapse of the left lung or the left lower lobe after the pleura was opened (T(3)), and before tracheal extubation (T(4)). Qs/Qt was calculated using a standard formula based on the three-compartment model. Upon pleura opening, the effectiveness of lung collapse was evaluated by the surgeon who performed the surgery. Chest radiograph and arterial blood gas analyses were performed the day after the operation.

RESULTSBoth of the groups were similar with regard to rank of the surgical exposure, pH, PaCO(2), hemoglobin from T(1) to T(4), Qs/Qt, PaO(2), PO(2), and oxygenation index at T1. In BB group, a significant reduction of Qs/Qt and greater improvements in PaO(2), PO(2), oxygenation index at T(2), T(3) and T(4) were observed in comparison with those in DLT group (P<0.05 or <0.01). No lobe collapse was observed postoperatively in BB group, but 2 patients in DLT group showed left lower lobe atelectasis. The patients in BB group showed better postoperative arterial oxygenation and shorter postoperative hospital stay (P<0.01).

CONCLUSIONSelective left lower lobar blockade by Coopdech endobronchial blocker tube during lower esophageal surgery provides a lower intraoperative intrapulmonary shunt and a better intra- and postoperative arterial oxygenation..

Adult ; Blood Gas Analysis ; Bronchoscopes ; Continuous Positive Airway Pressure ; instrumentation ; methods ; Esophageal Neoplasms ; surgery ; Female ; Fiber Optic Technology ; Humans ; Intubation, Intratracheal ; methods ; Lung ; physiology ; Male ; Middle Aged ; Oxygen ; administration & dosage ; blood ; pharmacology ; Pulmonary Ventilation ; Thoracic Surgical Procedures ; methods

OBJECTIVETo investigate the changes of serum reproductive hormones with male aging and to compare the differences in the hormone levels among different age groups or between township and rural males of the same age group.

METHODSUsing cluster and stratified sampling, we recruited 434 healthy old and middle-aged (40-69 years) males, 198 from the township and 236 from the rural communities. We determined the concentrations of serum total testosterone (tT), luteinizing hormone (LH) and sex hormone binding globulin (SHBG), free testosterone (fT), bio-available testosterone (Bio-T), and obtained the testosterone secretion index (TSI) and free testosterone index (fTI). Meanwhile, we included fifty-nine 20-39 years old males from the same communities in a control group.

RESULTSWith the increase of age, the serum tT levels did not change significantly, while the levels of serum LH and SHBG increased, and those of fT, Bio-T, TSI and fTI decreased gradually. Statistically significant differences were found among the four different age groups in all the parameters of reproductive hormones (P < 0.01), except in the serum tT level (P > 0.05). The serum tT level was not significantly correlated with aging and LH (P > 0.05). Serum LH and SHBG had a marked positive correlation with aging, and SHBG with LH (P < 0.01), while fT, Bio-T, TSI and fTI were negatively correlated with aging and the LH level (P < 0.01). Serum LH, TSI and fTI showed statistical differences (P < 0.05), while fT and Bio-T exhibited extremely significant differences (P < 0.01) between the township and rural males in the 40 -49 yr group, and in the same age group, the increase rates of serum LH and SHBG and reduction rates of fT, Bio-T, TSI and fTI were higher in the rural men than in the township residents. However, the results were just the opposite in the 50 - 59 and 60 - 69 yr groups.

CONCLUSIONThe levels of serum LH, SHBG, fT, Bio-T, TSI and fTI changed with aging in a gradientmanner in the old and middle-aged males, but no significant changes were observed in the level of serum tT. There were statistical differences in many parameters of serum reproductive hormones among different age groups or between township and rural males.

Adult ; Age Factors ; Aged ; Aging ; metabolism ; China ; Humans ; Luteinizing Hormone ; blood ; Male ; Middle Aged ; Rural Population ; Serum Albumin ; metabolism ; Sex Hormone-Binding Globulin ; metabolism ; Testosterone ; blood ; Urban Population ; Young Adult

OBJECTIVETo compare the detection rates of Mycoplasma pneumoniae (MP) from nasopharyngeal aspirates (NPA) and bronchoalveolar lavage fluid (BALF) in children with pneumonia.

METHODSA total of 164 hospitalized children with pneumonia were enrolled. NPA and BALF of these children were collected within 24 hours of admission, and MP-DNA was detected by fluorescence quantitative PCR. Venous blood samples of all these children were collected within 24 hours of admission and on days 7-10 of treatment, and serum MP-IgM was detected using ELISA.

RESULTSThe positive rate of MP-DNA in NAP of the 164 cases was 51.8% , which was lower than 63.4% as the detection rate of MP-IgM in serum (P=0.044), and the two detection rates were moderately consistent with each other (Kappa=0.618, P<0.01). The positive rate of MP in BALF was 71.3%, which was not significantly different with that of MP-IgM in serum (P>0.05), and the detection rates were well consistent (Kappa=0.793, P<0.01). The detection rate of MP in NPA was lower than that in BALF (P<0.01), with moderate consistency between two of them (Kappa=0.529, P<0.01). The median MP copy number in BALF was significantly higher than that in NPA (P<0.01). The MP detection rates in NPA and BALF were significantly different among different courses of disease (P<0.05). As the course of disease extended, the MP detection rates in both NPA and BALF showed a declining trend; children with MP pneumonia of 1-2 weeks' duration and 2-4 weeks' duration had a higher MP-DNA detection rate in BALF than in NPA (P<0.05).

CONCLUSIONSMP-DNA in BALF has a high sensitivity, with a great significance for early diagnosis of MP pneumonia, while NPA MP-DNA tests may lead to a missed diagnosis.

Adolescent ; Bronchoalveolar Lavage Fluid ; microbiology ; Child ; Child, Preschool ; DNA, Bacterial ; analysis ; Female ; Humans ; Infant ; Male ; Nasopharynx ; microbiology ; Pneumonia, Mycoplasma ; diagnosis