Objective:To explore the therapeutic effect and safety of direct and selective percutaneous coronary inter-vention (PCI)in patients with ST elevation myocardial infarction (STEMI).Methods:A total of 138 STEMI pa-tients were randomly divided into direct PCI group (n=69,received PCI immediately after diagnosis)and selective PCI group (n=69,received acute thrombolysis therapy and then PCI in a selected time).Left ventricular ejection fraction (LVEF),peak creatine phosphokinase (CPK),CPK peak time,peak creatine kinase isoenzyme (CK-MB), CK-MB peak time,cardiac rupture rate during hospitalization,re-infarction rate and mortality rate within 30d and one year were compared between two groups.Results:Compared with selective PCI group after treatment,there were significant rise in LVEF [(49.3±6.8)% vs.(58.2±7.7)%],peak CPK [(74.9±49.3)IU/L vs.(113.0± 59.3)IU/L ]and peak CK-MB [(1983.1±1251.2)IU/L vs.(2588.6±1592.3)IU/L],and significant reduction in CPK peak time [(19.4±6.5)h vs.(13.9±4.5)h ]and CK-MB peak time [(19.7±7.7)h vs.(12.7±7.2) h]in direct PCI group,P <0.01 all;there were significant reductions in cardiac rupture rate (5.8% vs.0),re-in-farction rate (17.5% vs.6.3%)during hospitalization;mortality rates within 30d (11.0% vs.2.2%)and one year (22.2% vs.8.2%)in direct PCI group,P <0.05 all.Conclusion:Direct PCI in STEMI patients possesses better therapeutic effect and safety,which is worthy extending.

Objective To study the clinical value of combined detection of CA125 and CA153 for diagnosis of endometrial carcinoma.Methods The combimed detection of CA125 and CA153 were performed in 36 patients with endometrial carcinoma,confirmed by pathological examination,on admission and 2-3 months after operation.Fifty-seven patients with uterine myoma,admitted for laparotomy in the same period and confirmed by pathology,were as controls.Results The sensitivity of combined detection of CA125 and CA153 for diagnosing endometrial carcinoma increased to 82.3% and the specificity decreased.Total accuracy rate of diagnosis reached 75.1%.There was statistical difference between the group of endometrial carcinoma and controls(P

Fifty postoperative patients who suf- fered esophageal carcinoma were divided randomly into two groups.They received either enteral nutrition(Group EN,n=2 7) or parenteral nutrilion(Group PN,n=2 3) . The provisions of calorie and nitrogen were equal in the two groups.Nutrition support was started on the first postoperative day and continued for8days.The weight plas- ma proteins,immunological parameters and nitrogen balance were evaluated.The re- sults showed that there was no significant difference in body weight and serum albu- min level between the two groups.The pos- itive nitrogen balance were reached in both groups on the8th day.The CD4+percents age,the ratio of CD4+/ CD8+and NK cell activity were elevated,The conclusion is that the values of both EN and PN are sati- factory.In contrast with PN,EN has the advantages of physiological concordance and low cost.

Objective To investigate the effects of prostaglandin E1 on proinflammatory and anti-inflammatory cytokines in sepsis patients.Methods One hundred and twenty cases of sepsis in ICU of our hospital were assigned to the groups:A,B,C and D,30 cases in each group.On the basis of conventional therapy,group A was added with prostaglandin El+ Xuebijing injection.The group was treated with prostaglandin E1,while the group C was treated with Xuebijing injection.The changes of APACHE Ⅱ score,Marshall score,anti-inflammatory and pro-inflammatory factors,mechanical ventilation time,ICU treatment time,28 d mortality rate in the 4 grups were observed and compared among 4 groups.Results The APACHE Ⅱ score and Marshall score after treatment in 4 groups were significantly decreased compared with before freatment (P＜0.05),Compared with the group B,C and D,The decrease of APACHE Ⅱ score,Marshace score,IL-1β,IL-6 and TNF-α levels was more significantly(P＜0.05),While the IL-10 level was significantly increastol(P＜0.05);duration of mechanical ventilation,length of stay ICU in were significantly shorter (P＜0.05),28 d mortality was significantly lower (P＜0.05).Conclusion Prostaglandin E1 combined with Xuebijing injection can effectively inhibit the inflammatory response in septic patients and promote the recovery of patients,reduces the mortality rate.

OBJECTIVE: To investigate the changes and determine the difference of electrode impedance and neural response telemetry ( NRT) value with cochlear implants in children with malformed inner ear and normal inner ear. METHOD: Eighty-eight children with multi-channel cochlear implants participated in this study. Children were divided into malformed inner ear group and normal inner ear group. To test the electrode impedance values and NRT value. RESULT: The changes of electrode impedance showed the similar changing pattern in two groups. There was not different in electrode impedance values between the two groups (P > 0.05). The changes of electrode neural response telemetry values showed the similar changing pattern in two groups. There was significantly different in electrode impedance values between the two groups (P < 0.05). The NRT were going up higher from electrode 22 to electrode 1. CONCLUSION The values vary are different programming sessions and electrodes during the first 3 months of cochlear implant use. To acquire better hearing frequent programming sessions are necessary.
Adolescent ; Case-Control Studies ; Child ; Child, Preschool ; Cochlear Implantation ; Cochlear Implants ; Cochlear Nerve ; Ear, Inner ; abnormalities ; physiopathology ; surgery ; Electric Impedance ; Electrodes ; Female ; Humans ; Infant ; Male

Adult ; Crown Lengthening ; Dental Restoration, Permanent ; Esthetics, Dental ; Female ; Humans ; Incisor ; Malocclusion ; therapy

Objective To assess whether AECOPD patients can breathe independently at the PIC window and thus whether NPPV was necessary after extubation.Methods We performed a prospective observational study, we used the spontaneous breathing trial (SBT)to assess whether each patient could breathe independently at the PIC window,then performed extubation.Patients who passed the SBT received oxygen therapy only,whereas those who failed received NPPV.However,if the former showed respiratory distress,they also received NPPV.The primary out-come variables were SBT pass/fail,the demand for NPPV and rate of reintubation within 72h following extubation. Results In all,23 patients were enrolled,15cases(65.2%)of which passed the SBT.Of these,12cases (80.0%) patients developed respiratory distress after extubation and required NPPV (one of whom required reintubation).Of the eight patients that failed,one received reintubation after NPPV.The reintubation rates within 72h following extuba-tion of SBT-pass(7.0%)and SBT-fail (13.0%)(χ2 =1.476,P>0.05)patients were comparable.Conclusion Most AECOPD patients can breathe independently at the PIC window,but nonetheless develop respiratory distress and thus require NPPV following extubation.

Objective To analyze the clinical characteristics of systemic lupus erythematosus (SLE) patients with septic arthritis.Methods Twelve SLE patients with septic arthritis admitted to Peking Union Medical College Hospital from January 1990 to December 2012 were retrospectively analyzed.Results The median duration from onset of SLE to septic arthritis was 8.5 months (ranged from 1 to 120 months).All patients had received higher doses of steroid therapy (equal to prednisolone 1 mg ·kg-1 ·d-1) and immunosuppressant,and 5 of them had received methylprednisolone pulse therapy.The infectious manifestations included joint pain (all cases),swelling (5 cases),reduced joint function (8 cases) and fever (10 cases).All patients were oligo-arthritis.The hip and knee joints were most commonly involved.Three patients were infected by Salmonella,4 patients were infected by S.aureus,and 3 patients were infected by tuber culosis.Conclusion When SLE patients with long term steroid and immunosuppressant therapy developedacute joint pain and swelling,septic arthritis should be considered.Synovial fluid Gram stain,culture,blood culture and arthroscopy should be performed promptly.Appropriate antibiotics should be administered,and early treatment can improve the outcomes.

Objective:To study the biological characteristics of new retrograde filling materials iRoot BP plus and iRoot FS.Methods:(1 )The roots were cut into 3 mm in length,and the root canals were pre-pared to 1 mm in diameter,followed by being filled with iRoot BP plus,iRoot FS,or mineral trioxide ag-gregate (MTA).The specimens were immersed in simulated body fluid (SBF).The ability of minerali-zation in vitro was detected through three studies.First,the mineralization of specimens was analyzed through scanning electron microscope observations and energy dispersive X-ray spectrometer.Then,the pH of SBF was monitored using pH meter.(2)The extracts were gained by immersing blocks of iRoot BP plus,iRoot FS,and MTA (8 mm diameter and 2 mm height)into dulbecco’s modified eagle medium (DMEM).The effects of the extracts on proliferation of MG63 cells were detected through MTT assay. The gene expression level of alkaline phosphatase (ALP)was analyzed by quantitative real-time PCR, and the expression of ALP activity was observed by ALP activity staining.Results:(1 )The formation of minerals could be observed on the surfaces of iRoot BP plus,iRoot FS,and MTA at the end of 24 h,and there were more amounts of apatite aggregated after 14 days.The values of Ca/P ratios of apatites were 1.43,1.39,and 1.51,respectively.(2)The pH of SBF could be raised to 8.09 ±0.07,7.91 ± 0.06,and 8.1 1 ±0.06,respectively,significantly higher than the blank.(3)The extracts of iRoot BP plus,iRoot FS,and MTA of dilutions of 1∶5 and 1∶10 presented no effect of proliferation of MG63 cells. (4)iRoot BP plus and iRoot FS could significantly up-regulated the levels of ALP messenger RNA ex-pression,while there was no obvious difference in ALP staining among the iRoot BP plus,iRoot FS, MTA,and the blank.Conclusion:The present study shows that iRoot has displayed good mineralization capability in vitro and capability to promote differentiation and mineralization of MG63 cells,inferring that iRoot may have good bioactivity.

ObjectiveTo explore the etiology of incisional hernia of abdomianal wall.Methods98 cases with incisional hernia were analyzed retrospectively in terms of incision type, technique of suture, suture materials,infection of incision, and the time of occurrence.ResultsLongitudinal incision, improper technique of suture,infection, increase of intraabdominal pressure, and diabetes mellitus were risk factors of incisional hernia. ConclusionsTransverse incision, prevention of infection of the incision, strict aseptic manipulation and hemostasis were effective in the prevention of incisional hernia. Most hernia developed within 6 months postoperatively.