Acute Coronary Syndrome ; therapy ; Angioplasty, Balloon, Coronary ; Humans ; No-Reflow Phenomenon ; prevention & control

Coronary Disease ; therapy ; Humans ; Percutaneous Coronary Intervention

Objective To compare the effect of midazolam pretreatment on propofol sedation using closed-loop target-controlled infusion (TCI) between two age groups - the adult and the aged. Methods Forty-eight ASA Ⅰ-Ⅱ patients of both sexes weighing 45-81 kg undergoing elective lower abdominal or lower extremity operation under epidural anesthesia were divided into two age groups : (A) the adult group (18-39 yrs) and (B) the aged group (66-79 yrs). The two groups were further divided randomly into 2 subgroups : midazolam subgroup ( n=12) received midazolam 0.04 mg?kg-1 10 min before propofol TCI and placebo subgroup ( n = 12) received normal saline instead of midazolam 10 min before propofol TCI. The patients were unpremedicated. An intravenous line was established before operation, which was connected to a TCI system comprising a Graseby 3500 infusion pump and a closed-loop TCI automatic control system. BP, HR, SpO2 and BIS were continuously monitored during operation. During epidural anesthesia the patients were sedated with propofol administered by TCI. The initial target blood concentration of propofol was set at 1.5?g?ml-1 . The level of sedation was assessed by OAA/S scale (5 = alert,0 = no response to prodding). The target blood propofol concentration was then increased or decreased in 0.5?g?ml-1 increment to maintain OAA/S score at 3. The BIS value at this level of sedation (OAA/S=3) was used as feedback in controlling TCI of propofol. The induction dose and the total dose of propofol, induction time and emergence time (OAA/S=5) were recorded. Results Midazolam premeditation significantly reduced the induction dose and total dose of propofol, shorten the induction time and prolonged the emergence time compared with placebo in both groups, especially in the aged group (P

OBJECTIVETo investigate the clinical application of free superficial iliac circumflex artery skin flaps, as well as the management of donor site defects.

METHODS17 free superficial iliac circumflex artery skin flaps were applied for the traumatic defects or deformities on face, neck, foot, hand, ankle and lower leg, respectively. The donor site defects were closed directly or covered by paraumbilical island flaps.

RESULTSThe 17 flap size ranged from 5 cm x 3 cm to 19 cm x 14 cm. 16 flaps survived completely except 1 flap with partial necrosis, which was closed by free skin graft. The donor site defects were closed directly in 10 cases, and covered by paraumbilical island flaps in 7 flaps without no flap necrosis. The abdomen had a good appearance.

CONCLUSIONSGood appearance can be achieved with free superficial iliac circumflex artery skin flaps for the defects on face, neck, foot, hand, ankle and lower leg. Paraumbilical island flap can be used for the donor site defects.

Arteries ; Foot ; Free Tissue Flaps ; blood supply ; transplantation ; Humans ; Reconstructive Surgical Procedures ; Skin ; Skin Transplantation ; Transplant Donor Site ; surgery ; Wounds and Injuries ; surgery

Objective To improve the knowledge and diagnostic ability of imagiology on neonatal respiratory distress syndrome (NRDS) computed radiograph(CR).Methods The doubtful patients were done to photographs bedside using the high resolution imaging plate, 50 cases of newborn with NRDS were selected whose clinical diagnosed clearly and had been treated and had the complete CR image documents.The CR change and clinical characteristics were observed dynamically.Results Nine of 50 cases were combined with aspirated pneumonia,8 cases with infective pneumonia,3 cases with intra-alveolar hemorrage,and 2 cases with pneumothorax.Accoding to X-ray manifestations,all cases were divided into four stages:Ⅰ stage(n=5), Ⅱ stage(n=20),Ⅲ stage(n=22),Ⅳstage(n=3).Typical CR signs included:the pulmonary lucency decreasd,wide-ranging net and grain shadowes of high density, and in companing with a lot of air brunchus sing.Conclusions Computed radiography is the most important imaging method in diagnosis of NRDS bedside ,and shall be improved the ability of diagnosis and differential of NRDS combined with the clinic.

Objective To explore the changes of tumor necrosis factor-?(TNF-?) in serum and cerebrospinal fluid(CSF) of children with acute lymphoblastic leukemia (ALL) and acute myelogenous leukemia(AML) and its clinical significance.Methods TNF-? in serum and CSF were measured by radioimmunoassay and CSF samples were obtained from 31 cases of childhood acute leukemia before treatment, on complete remission(CR), and continuous CR.Results Serum TNF-? was in ALL and AML before treatment [(24.35?4.84) pmol/L and(28.65?5.12) pmol/ L],which were significantly higher than those of healthy controls[(11.2 8? 1.69) pmol/L, P

Objective To understand the risk behavioral networks of newly reported HIV infections in Taizhou prefecture, Zhejiang province. Methods Newly reported HIV infections from May 2008 through March 2010 in Taizhou prefecture were invited to participate in a cross-sectional survey which requested numbers and contact information of individuals with whom they had had high risk contacts as well as risk behavioral acts with them. Persons having had risky contacts with HIV-infected cases were thereof approached to participate in this survey and to receive HIV testing.Those who tested positive for HIV were subject to further round of the surveys. Results A total of 267 HIV cases were newly reported during this study period. Among them, 191 participated in the survey and served as 'index cases', including 158 cases identified from routine HIV surveillance programs and 33 cases identified from the present survey. Heterosexual transmission was the primary transmission route (74.9%, or 143/191 ), followed by homosexual transmission ( 19.4%, or 37/191 )and injection drug use (5.8%, or 11/191 ). These 191 HIV cases reported a total of 1152 individuals with whom they had had risky contacts. They were able to provide contact information of 461 risk contacts. Of them, 129 received HIV testing and 61 (47.3%) tested positive for HIV. HIV prevalence was the highest among spouses or long-term sex partners of HIV cases (45.6%, or 47/103) and malesex partners of HIV-infected men having sex with men (MSM) (60.0%, or 12/20). Condom use wasvery low among them, with only 33.9% consistently using condoms for sex. Conclusion Newlyreported HIV infections in Taizhou prefecture reported a large and complicated risk behavioral networks and low condom use, suggesting a potential risk of HIV among these connected people,especially among MSM. Much efforts are needed to intervene these high risk subgroups and high risk behavioral networks.

Objective To apply Estimation and Projection Package (EPP) and Spectrum models for the estimation and projection on HIV/AIDS epidemics in areas with relatively low HIV/AIDS prevalence in China,and to explore the influences of antiretroviral therapy (ART) on the outputs of the models.Methods Taizhou prefecture in Zhejiang province was selected as the study site.Social and demographic data as well as all the information on HIV/AIDS epidemics in Taizhou prefecture were collected,managed,input to EPP and Spectrum models to estimate and project the HIV/AIDS epidemic in Taizhou prefecture.Impact of ART on the HIV/AIDS epidemic was also assessed.Results According to the estimates from both EPP and Spectrum model,the HIV/AIDS epidemic in Taizhou prefecture was at a relatively low level.HIV prevalence rates among men having sex with men (MSM) and injection drug users (IDU) were relatively high and rapidly increasing.It was estimated that 1773 (1384-2449) people were living with HIV in 2010 in Taizhou prefecture,with an overall HIV prevalence of 0.03％ (0.02％-0.04％).ART had reduced and would continue to reduce new HIV infections and AIDS deaths,but had no significant impact on the overall HIV prevalence and the numbers of people living with HIV and adults who were in need of ART.Conclusion EPP and Spectrum models seemed to be suitable and useful tools for estimation and projection on HIV/AIDS in Taizhou prefecture,and the results could provide reference for the further studies in other areas with a relatively low epidemic level of HIV/AIDS.ART appeared effective for HIV/AIDS prevention and control.

Objective To screen the antibacterial activity of Chinese traditional medicines against Yersinia pestis.Methods Six Chinese traditional medicines(Coptis Chinesis etc)were selected and extracted with pure water to make a concentration of 1 mg/L.Yersinia pestis strain 201 and EV 76 were used to determine the minimal inhibitory concentrations(MIC)of these selected medicines in vitro with liquid dilution method.Results Three herbs had inhibition effects on the strain 201 and EV76 in different extents,among which Rheum palmatum had the strongest effect and MIC was 0.025 00 mg/L.Furthermore,the Chinese traditional medicine had the same MIC on both strain 201 and EV76.Conclusions Chinese traditional medicines commonly used have inhibiting effect on Yersinia pesti.

Objective To study the prevalence of human immunodeficiency virus(Hiv),sexually transmitted infection(Sti),risk behavior and the sexual neworks among men who have sex with men (MSM)in Taizhou city，Zhejiang province.Methods cross-sectional Astudy was applied with venue-based sampling in 2 MSM gathering sites in Taizhou.'Informed Consent'principle was applied and MSM were studied through a structured questionnaire．Blood samples were collected from thee who accepted free and confidential HIV/STI counseling and then tested for HIV,syphilis,HCV and HsV-2 antibodies with ELISA.HIV positive sera were certified with western blot．Results 106 MSM were investigated and 97 qualified questionnaires were collected.25.0％(23/92)of these MSM have ever had l female sex partner while 47.8％(44/92)had 2 or more.14.3％(13/91)of them reported having had 1 male partner who had engaged in anal sex and 80.2％(73/91)had 2 or more.22.1％(19／86)of therh had partieipated in group sex but 62.5％(55／88)of them did not always use condom when having analintercourse.15.1％(14／93) of them had l orfll sex partner while 75.3％(70／93)having 2 or more.38.9％(37／95)of them had sex with female sex worker,and 35.5％(33／93)had sex with male-to-male sex worker.15.3％(13/85)0f them had once been male-to-male sex worker themselves.3.9％(3/77)of them were found HIV positive in blood tests,with 24.7％(18/73)positive of syphilis,15.1％(11/73)positive ofHSV-2 but HCV appeared to be negative.46 csses reported their egocentric recognition networks,with mean degree of 5.91(ranging0-10),and mesa density of 0.548(ranging 0．000-1.000).43 sexual networks were identified,with mean degree of 2.70(ranging 0-10),and mean density of 0.246(ranging 0.000-1.000).Conclusion Risk behaviors,such as multiple sex partners，IOW proportion of condom use and commercial sex engagement both with heterosexuals and homosexuals,were extensively existed among MSM in Taizhou,and the prevalence of HIV/STI was relatively high.Their sexual networks seemed complicated but there might be in place of some sukstantiaUy isolated MSM groups with high risk of Hlv/sTl infection.More study should be applied to identify the relationship between scxual networks and HIV/STI transmigsion.