End-tidal carbon dioxide tension or concentration monitoring is characterized with noninvasive,convenient and fast reaction,which Can be continuously monitored and dynamically displayed On electrocardiogram monitor.The technique has been extensively applied in the operation room,intensive care unit and emergency room.

Objective To study the distribution and changes of the purulent meningitis in gender,age,region,season and pathogens in children during the past 20 years.Methods All the basic clirical features of purulent meningitis patients less than 17 years old in Children's Hospital of Chongqing Medical University from Jan.1993 to Jan.2013 were analyzed retrospectively.A total of 1 855 patients were divided into 2 groups according to their date of admission.Group A included 666 patients admitted from Jan.1993 to Dec.2002,and group B included 1 189 cases admitted from Jan.2003 to Jan.2013.Then,they were divided into 5 groups according to their ages,including neonate group,＞ 1 month-1 year old aoup,＞ 1-3 years old group,＞ 3-10 years old group,＞ 10-17 years old group.Results Of the 1 855 cases,there were 1 054 cases (56.82％) admitted in the spring and summer,and 1 123 cases (60.54％) were younger than 1 year of age.The ratio of male to female cases was 1.82 to 1.00 and that of country patients to urban patients was 1.40 to 1.00.The distributions were female patients (443 cases,37.26％),urban patients (517 cases,43.48％),and the ratio of patients admitted in the autumn (265 cases,22.29％) and patients younger than 1 year of age (606 cases,50.97％) in group B,which were significantly higher than those [215 cases (32.28％),256 cases (38.44％),102 cases (15.32％),272 cases (40.84％)] of group A (x2 =4.62,4.47,25.51,25.52,all P ＜ 0.05).The predominant isolated bacteria from cerebrospinal fluid were coagulase negative staphylococcus (43/196 cases,21.94％),Streptococcus pneumoniae (32/196 cases,16.33％),Neisseria meningitidis (17/196 cases,8.67％) and Escherichia coli (15/196 cases,7.65％).Coagulase negative staphylococcus and Escherichia coli both accounted for higher rates of pathogenic bacteria in 1 year old than that of pathogenic bacteria more than 1 year old (x2 =4.57,14.37,all P ＜ 0.05),while Streptococcus pneumoniae and Neisseria meningitidis both had higher rates of pathogenic bacteria more than 1 year old and more than 3 years old,respectively (x2 =14.93,19.76,all P ＜ 0.05).Onfly cases in group B with Streptococcus pneumoniae were higher than those in group A (x2 =11.78,P ＜ 0.05),while the other common bacteria in each age group were of no difference between group A and group B.Conclusions There had been some changes in the epidemiological distribution of purulent meningitis during the past 20 years.The main risk factors were male in gender,patients in rural areas,onset in the spring or summer and infants in early age.The predominant isolated bacteria from cerebrospinal fluid were some opportunistic pathogens,including coagulase negative staphylococcus,Streptococcus pneumoniae,and Escherichia coli.Streptococcus pneumoniae meningitis was increased during the past 10 years.

Objective: Simulating the photon transport process, recording the distribution of the dose which is caused by various of interactions and secondary particles, summarizing and analyzing the weightiness of each contribution. Methods: The PENELOPE package provides the basic Monte Carlo(MC) code which simulates the processes of photon and electron transport Considering the concerned physical problems, the author modifies the PENELOPE program to simulate the track of photon transport process, meanwhile records the contribution of dose which is provided by various of interactions and secondary particles in this article. Results: Firstly, in the same condition, recording the distribution from 4 source different energies(30 keV, 40keV, 50 keV, 60 keV), the distribution of the central axis total dose and the distributions which are caused by secondary Soft collision and secondary hard inelastic collision, and the distribution of the central axis dose provided by secondary particles. Secondly, in the same condition, recording the distribution of the central axis dose caused by secondary Compton scattering and secondary Photonelectric scattering. Conclusion: In different source of energy, the distribution of the central axis dose proffered by secondary soft collision play a major role; the contribution of secondary Photonelectric scattering decreased with the ascent of energy; the contribution from the first generation secondary particles is stronger than others.

Objective To explore the clinical value of total hemihepatic vascular exclusion (THHVE) in right hepatectomy for hepatocellular carcinoma (HCC). Methods One hundred and twenty-three consecutive patients who underwent right hepatectomy for HCC between February 2006 and December 2008 were studied retrospectively. THHVE was used in 58 patients (group A) and Pringle maneuver in 65 patients (group B). The patient's demographics,surgical procedure and outcome were collected and compared between the two groups.ResultsThe tumor size was significantly bigger in group A than group B (7.69±3.70 cm vs.6.08±4.07 cm,P＜0.05).The vascular occlusion time in group A was significantly longer than groupB (28.55±8.67 min vs.19.85±6.71 min,P＜0.05). However, intraoperative blood loss in group A was significantly less than group B (304.31±270.36 ml vs.542.62±876.84 ml,P＜0.05),and the elevation of serum alanine aminotransferase (ALT) on day- 1,-3 and- 7 after operation in group A were significantly lower than group B (P＜0.05).The postoperative complication rate in group A was lower than group B (18.97％ vs.38.46％,P＜0.05).ConclusionTHHVE was a safe and efficacious technique in right hepatectomy for HCC.It significantly decreased blood loss,alleviated liver injury and reduced postoperative morbidity and mortality.

Objective To investigate the effects of combination of propofol and whole-body hypoxic preconditioning on lung ischemia-reperfusion(I/R)injury in rats and the mechansim involved.Methods Ninety male SD rats weighing 250-320 g,were randomly divided into 5 groups(n=18 each): sham operation group(group S),lung I/R group(group I/R),propofol preconditioning group(group P),whole-body hypoxic preconditioning group(group WBHP),and combination of propofol and whole-body hypoxic preconditioning group(group PW).The animals were anesthetized with intraperitoneal 3% pentobarbital 30 mg/kg,tracheostomized and mechanically ventilated.Lung I/R injury was produced by occlusion of hilum of the left lung for 45 min followed by reperfusion.Propofol was continuously infused iv at 30 mg·kg-1·h-1 30 min before ischemia in group P.In group WBHP,5 times of WBHP were performed before ischemia.In group PW,propofol was infused iv at 30 mg· kg-1·h- 1 and 5 times of WBHP were performed 30 min before ischemia.Six rats from each group were killed at 30 min,1 h,and 4 h of reperfusion(T1-3).The lungs were then removed for determination of the contents of TNF-α,IL-1,IL6 and MDA,and activities of SOD.The W/D lung weight ratio was calculated.Results Compared with group S,the contents of TNF-α,IL-1,IL-6 and MDA and W/D ratio were significantly increased at T1-3,and SOD activity was significantly decreased at T1-3 in the other four groups(P＜0.05).The contents of TNF-α,IL-1,IL-6 and MDA and W/D ratio were significantly lower at T1-3 ,and SOD activity was significantly higher at T1-3 in group P,WBHP and PW than in group I/R(P ＜ 0.05).The contents of TNF-α and IL-6 and W/D ratio at T2,3 and contents of IL-1 and MDA at T3 were significantly lower,and SOD activity was significantly higher at T2,3 in group PW than in group P and WBHP(P＜0.05).There was no significant difference in the parameters metioned above between group P and WBHP(P＞0.05).Conclusion The combination of propofol and WBHP can protect the lungs from I/R injury,the efficacy is better than that of either of them alone,and it may be related to the enhancement in the inhibiton of inflammatory reaction and improvement in the antioxidant effect.

Objective To evaluate the techniques and the effects of resection of giant hepatic tumors in the caudate lobe of the liver. Methods The clinical data of 33 patients with primary liver carcinoma or benign tumor (>10 cm) in the caudate lobe of the liver surgically treated in our hospital from January 2000 to January 2007 were retrospectively analyzed. Results The total of 33 huge liver tumors with a median diameter of 12.3 cm (10.2-15.3cm) were successfully resected. The types of the hepatectomies conducted were as follows:isolated total caudate lobectomy in 7cases, partial cau-date lobectomy in 8, caudate lobectomy plus other extended hepatectomy in 18. The median operative time was 218 min (120-360 min) and the median intraoperative blood loss 958 ml (400-7000 ml),with operative mortality and morbidity being 0 and 27%, respectively. The postoperative 1-, 3- and 5-year survival rates for the patients with primary liver cancer were 76 %,52% and 24%, respectively. Con-clusion The hepatic tumors of caudate lobe, when larger than 10 cm in diameter, frequently involves all the hepatic portal,hepatocaval confluence and retrohepatic IVC. Though it is sophisticated in tech-nique, surgical resection of this kind of tumor is safe, effective and of the first choice.

Objective To observe and comparatively analysize the effect of intraperitoneal injection of hydrogen and hydrogen-rich saline in neonatal rats with hyperoxia-induced lung injury.Methods Sprague-Dawley(SD) newborn rats were randomly divided into six groups(n=10).air group(A),air+ hydrogen-rich saline group(B),air+hydrogen group(C),hyperoxia group(D),hyperoxia+hydrogen-rich saline group (E) and hyperoxia+ hydrogen group(F).The group A,B and C were exposed to air and group D,E and F were exposed to 95 ％ oxygen.The group B and E were intraperitoneally injected with hydrogen-rich saline (10 mL/kg,twice daily),while the groups C and F with hydrogen (10 mL/kg,twice daily).The group A and D were injected with normal saline(10 mL/kg,twice daily).Lung tissue and serum samples were collected on 15 d of experiment.The pathological changes of lung tissue and radiate alveoli count (RAC) were observed by HE staining.The content of HYP in lung tissue was detected by the alkaline hydrolysis method,serum SOD and MDA levels were measured.The expression of α-SMA in lung tissue was detected by immunohistochemistry SP method.Results Compared with the A group,RAC and SOD activities in the D group were significantly decreased,while the HYP and MDA levels and α-SMA expression were significantly increased.Hydrogen intervention could significantly alleviate these changes caused by hyperoxia.while intraperitoneal injection of hydrogen got better effect than intraperitoneal injection of hydrogen-rich saline.Conclusion Hydrogen can extenuate the indexes of hyperoxia-induced lung oxidative damage,impairment development and fibrosis to a certain extent.Intraperitoneal injection of hydrogen has slightly better effect than hydrogen-rich saline.

Objective To observe the distribution and the effect of the quantum dots(QDs) on mouse abdominal cavity macrophages.Methods The QDs were co-cultured with mouse abdominal cavity macrophages in vitro.The differentiation and effect of the QDs on macrophage ultrastructures were observed under electronic microscope. Results The QDs were enveloped with unit membrane and internalized in the cytoplasm of the macrophage under transmission electron microscope.And it formed vacuolelike structures in the macrophage.There were many lamellar processes on the surface of the macrophage under scanning electron microscope.Conclusion The QDs can promote macrophage activation,and make its surface projection increased.The QDs were internalized by the macrophage,distributed in the cytoplasm,and formed vacuolelike structures enveloped with unit membrane.

Objective To investigate the effects of tirofiban application time on middle-term clinical prognosis in patients with acute ST segment elevation myocardial infarction (STEMI)treated by primary percutsneous coronary intervention (PCI). Methods The study of tirofiban was carried out in 50 patients with STEM[in cardiology department from January to December 2006. Twenty-nine patients were randomized to receive tirofiban after PCI for 24 - 36 hours(short time group, STG) and 21 patients for 48 - 72 hours (long time group,LTG). Clinical characteristics, angiography data, main adverse cardiovascular events (MACE) and coronary restenosis rate in 6-month follow-up of the two groups were. compared. Results Follow-up data showed that there was less intractable angina pectoris (14.3% vs 24.1%, P< 0.05) in LTG. But there was no significant difference in coronary restenosis rate between two groups. Conclusion Long time application of tirofiban following PCI in patients with STEMI could improve middle-term clinical prognosis by alleviating the incidence of intractable angina pectoris.

OBJECTIVETo investigate the protective effect of hydrogen against hyperoxia-induced oxidative stress injury in premature rat type II alveolar epithelial cells (AECs).

METHODSThe type II AECs isolated from premature rats were randomly divided into air (21% oxygen) control group, hyperoxia (95% oxygen) control group, air + hydrogen group, and hyperoxia+ hydrogen group. The cells with hydrogen treatment were cultured in the presence of rich hydrogen. After the corresponding exposure for 24 h, the cell morphology was observed microscopically. MTT assay was used to evaluated the cell proliferation ability, and JC-1 fluorescence probe was used to detect the mitochondrial membrane potential (δφ) changes of the type II AECs. The concentration of maleic dialdehyde (MDA) and superoxide dismutase (SOD) activity in the cell supernatant were detected using colorimetric method.

RESULTSNo significant differences were found in cell growth or measurements between air control and air + hydrogen groups. Compared with air control group, the cells exposed to hyperoxia showed significantly suppressed proliferation, reduced mitochondrial membrane potential, increased MDA content, and decreased SOD activity. Intervention with hydrogen resulted in significantly increased cell proliferation and SOD activity and lowered MDA content, and restored the mitochondrial membrane potential in the cells with hyperoxia exposure (P<0.05).

CONCLUSIONHydrogen can significantly reduce hyperoxia-induced oxidative stress injury in premature rat type II AECs, improve the cellular antioxidant capacity, stabilize the mitochondrial membrane potential, and reduce the inhibitory effect of hyperoxia on cell proliferation.

Animals ; Animals, Newborn ; Antioxidants ; metabolism ; Cell Proliferation ; Cells, Cultured ; Epithelial Cells ; drug effects ; Female ; Hydrogen ; pharmacology ; Male ; Malondialdehyde ; metabolism ; Membrane Potential, Mitochondrial ; Oxidative Stress ; drug effects ; Oxygen ; adverse effects ; Pulmonary Alveoli ; cytology ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase ; metabolism