Objective To promote preventive and therapeutic measures for osteoporosis by investigating the prevalence of low bone mineral density (BMD) in connective tissue disease patients who were taking corticosteroid and identify the associated risk factors of osteoporosis.Methods Thirty-eight female patients who had connective tissue diseases and were taking corticosteroid in PU MCH rheumatology outpatient clinic were studied and followed up from Oct 2006 to April 2007.Lumber spine and right femoral bone mineral density were determined bv dual energy X ray absortiometry (DEXA).Clinical information was obtained from a questionnaire of history and medical records.Duration and accumulative dosage of glucocorticoid intaking.menopause time were obtained retrospectively.Correlation analysis between BMD and clinical information was conducted.Results ① In 38 patients,23 (61%) patients showed a normal BMD,10 (26%) were osteopenia,3 (8%) were iu the osteoporotic range,while 2 patienLs (53%) had fragile fracture.② Compared with patients with normal BMD,subjects with low BMD had significantly older age,longer period after menopause and higher accumulated dose of corticosteroids.③ Postmenopausal women had significantly lower BMD in lumber and hip than premenopausal women.④ Either of vertebral and right hip BMD correlated negatively with the accumulated dosage of cortieosteroids by simple linear regression.⑤ The correlation between BMD and accumulated dosage of corticosteroids improved after correcting for the effect of age by partial correlation analysis (Pearson partial vertebral r=-0.8,P=0.009;right hip r=-0.3,P=0.010).⑥ A stepwise multivariate linear regression model was constructed to explore the relationship between the different clinicsl factors studied and a low BMD.Two statistically significant variables were menopause status (P=0.0000) and a higher steroid accumulated dosage (P=0.008).Conclusion Low BMD is common in connective tissue disease patients receiving corticosteroid.Risk factors for low BMD are postmenopause.duration and the accumulated dosage of glucocorticosteroid.The high prevalence of low BMD implies that more attention should be paid to the prevention and treatment of osteoporosis and fractures in connective tissue disease patients who are taking corticosteroids.

Objective To explore a kind of biomedical signal pattern (BSP) with a new method called as state representation methodology (SRM ) .Methods Based on the heart sound signals ,ECG signals ,breathing ,as the important research problem for BSP description ,with some comparisons on several traditional methods ,in which support vector machines (SVM ) and response sur-face methodology (RSM ) etc .,using frequency slice wavelet transform (FSWT ) method to extract the BSP signal dynamic damping characteristics ,thus ,this paper proposes a new idea of SRM analysis .In the case of heart sound signal analysis ,the general steps of SRM evaluation method is given .Results In 40 cases of normal heart sounds SRM model is set up ,with 80 cases of abnormal heart sounds are compared ,the obvious differences of the SRM state distributions of the two groups are found .Conclusion The combi-nation of SRM with FSWT can provide a novel approach for BSP analysis ,and provide powerful development tool for the analysis of BSP .

Objective To explore the methods of identifying factitious/fraudulent disorders (M?n-chausen syndrome), enhancing the understanding of their predisposing factors, clinical features, and underlying psychopathology. Method After a final diagnosis of factitious fever was made, data of 4 patients presenting with a puzzling fever of unknown origin were analyzed and compared with those of other cases reported in the English literature. Result It was confirmed that the elevated temperature recorded in the clinical charts of the 4 patients was faked by manipulating of the thermometer. Conclusion These 4 cases show the existence of factitious/fraudulent disorders in China, possibly related to an abnormal psychology, but the tricks employed by the patients are relatively simple compared with those used abroad.

Objective To systematically review the efficacy of dexmedetomidine or midazolam for sedation in critically ill patients. Methods We searched the PubMed, EMBaes, Cochrane Library, Wanfang Database,CNKI and VIP for all randomized controlled trials (RCTs) about the efficacy of dexmedetomidine versus midazolam for sedation in severe cases. The quality of the studies was evaluated by the method recommended by Cochrane Collaboration. Meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.0 software. Results Six RCTs involving 613 patients were included in our Meta-analysis. The results of Meta-analysis showed that the length of ICU stay was significantly shorter in group dexmedetomidine than in group midazolam. There were no significant differences in the duration of mechanical ventilation, incidences of bradycardia, hypotension and delirium and mortality rate between the two groups. Conclusion Dexmedetomidin can shorten the length of ICU stay and is beneficial for the outcome in critically ill patients.

Antineoplastic Protocols ; Child ; Humans ; Neoplasm, Residual ; therapy ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; therapy

Adult ; Ear Canal ; Foreign Bodies ; Humans ; Male ; Mandibular Condyle

Objective To evaluate the effects and safety of closed tracheal suction system(CTSS)versus open tracheal suction system (OTSS) for mechanically ventilated patients.Methods All randomized controlled trials (RCTs) comparing CTSS with OTSS for mechanically ventilated patients home and abroad were identified via manual and computer retrieval.All related data were extracted.Meta analysis was conducted using the statistical software RevMan 5.1 on the basis of strict quality evaluation with the methods recommended by the Cochrane Collaboration.Results Fifty-one related papers were found and 12 RCTs involving 1205 patients in CTSS group and 1179 patients in OTSS group were included.The results of meta analysis showed that CTSS was associated with a significant reduction in the duration of mechanical ventilation (WMD =-0.73,95％ CI-1.07--0.40,P＜0.0001),but the incidence of ventilator associated pneumonia and microbial colonization,mortality and length of ICU stay exhibited no difference between the two groups (P ＞ 0.05).However,compared with OTSS,CTSS reduced the incidence of arrhythmia (RR =0.23,95％ CI 0.07-0.74,P =0.01) and minimized the disturbance to heart rate (WMD =-1.97,95％ CI-3.03--0.91,P =0.0003),mean arterial pressure (WMD =-2.01,95％ CI-3.02--1.01,P ＜ 0.0001) and oxygen saturation (SpO2) (WMD =-1.00,95％ CI-1.14--0.86,P ＜ 0.000 01).Conclusions Compared with OTSS,CTSS could reduce disturbance to respiratory and circulatory system by sputum suction and shorten the duration of mechanical ventilation.However,CTSS has no advantage in prevention of ventilator associated pneumonia or microbial colonization,nor does it shorten the length of ICU stay or improve the outcome of mechanically ventilated patients.

Objective:To evaluate the role of hemopexin (HPX) in cerebral ischemia-reperfusion (I/R) injury in rats.Methods:One hundred and twenty healthy male Sprague-Dawley rats, aged 7-8 weeks, weighing 250-280 g, were divided into sham operation group (S group, n=36), cerebral I/R group (I/R group, n=36), vehicle group (V group, n=24), and HPX group ( n=24). The model of cerebral I/R injury was established by 120 min middle cerebral artery occlusion followed by reperfusion in anesthetized rats.At 6, 12 and 24 h of reperfusion, 4 rats in S group and I/R group were sacrificed, and the ischemic penumbra of the ipsilateral cerebral cortex was obtained to detect the expression of HPX by Western blot.In I/R, V and HPX groups, 0.9% normal saline 10 μl, 0.1% NaN 3 10 μl, and 1.86 mg/ml HPX 10 μl were injected into the lateral ventricle, respectively, immediately after reperfusion.Eight rats in each group were selected, and neurological deficit was scored at 1-7 days of reperfusion.Eight rats in each group were sacrificed at 1 and 7 days of reperfusion, brains were removed, and brain tissues were obtained for measurement of infarct size, and the percentage of infarct size was calculated. Results:Compared with S group, the expression of HPX in cerebral ischemic penumbra was significantly up-regulated at 24 h of reperfusion in I/R group, and the neurological deficit scores were significantly decreased at 1-7 days of reperfusion, and the percentage of cerebral infarct size was increased at 1 and 7 days of reperfusion in I/R, V and HPX groups ( P<0.05). Compared with I/R group, the neurological deficit scores were significantly increased at 1-7 days of reperfusion, and the percentage of cerebral infarct size was decreased at 1 and 7 days of reperfusion in HPX group ( P<0.05), and no significant change was found in the above indicators in V and I/R groups ( P>0.05). Conclusion:Up-regulation of HPX expression is the endogenous protective mechanism of cerebral I/R injury in rats.

Objective : To assess the health risks of polycyclic aromatic hydrocarbons（PAHs）exposed through cereal,fried and grilled foods in Hangzhou. Methods : A cross-sectional study was conducted to collect food consumption data of three inconsecutive days among 1 769 subjects selected by probability proportional to size sampling method from two districts in Hangzhou.Fifty samples of fried and grilled food and twenty samples of cereal were collected from five districts in Hangzhou. They were tested for B（a）P,PAH2,PAH4 and PAH8 by high performance liquid chromatography coupled with triple quadrupole gas chromatography-tandem mass spectrometry. The probabilistic models were established for the evaluation of PAHs exposure by @risk software and then margin of exposure（MOE）was calculated. Results : The contents of B（a）P in one sample of fried and grilled food exceeded the limit. The median contents of PAHs ranged from 0.20 to 3.64 μg/kg. The median exposures of B（a）P,PAH2 and PAH4 from both two kinds of foods were 1.54,3.54 and 8.13 ng/（kgbw·d）in the mixed model,1.61,3.76 and 8.09 ng/（kgbw·d）in the non-parameter model. The MOEs of≤95% PAHs exposure level in one kind of food or ≤90% PAHs exposure level in both kinds of foods were more than 10 000. The MOEs of ≥97.5% exposure level of B（a）P,≥95% exposure levels of PAH2 and PAH4 in both kinds of foods in the mixed model,and ≥95% exposure levels of B（a）P,PAH2,PAH4 in both kinds of foods in the non-parameter model were less than 10 000. Conclusion The health risk of PAHs exposure was very low in more than 90% of the population in Hangzhou. However,for high-end consumers,97.5% or 99% exposure level in one kind of food and 95% exposure level in both kinds of foods had a potential health risk.

Objective To observe the intervention with electroacupuncture(EA) through regulating protein kinase(MAPK/ERK) pathway for cerebral ischemia rats.Methods SD rats were randomized into pseudo-operation group,model group and EA group.And the three groups were divided into 2-hour,one-day and 3-day subgroups according to the observation time.Focal cerebral ischemia(FCI) rat models were established by middle cerebral artery occlusion(MCAO) with heat-coagulation method.EA group received EA on Baihui(GV20) and Dazhui(GV14),qd,for 2 hours,one day and 3 days respectively.The learning and memory abilities of the rats in Y maze test and their neuroethological score were observed.Immunohistochemical method was used to observe the expression of phosphorylated extracellular signal-regulated kinase(p-ERK) after ischemia in CA1 area and CA3 area.Results In the model group,the neuroethological score was markedly increased,time for arriving the safe area in Y maze was prolonged(P