Objective To assess the efficacy of recoil of inflating syringe plunger in limiting laryngeal mask airway (LMA) cuff pressure.Methods Sixty ASA Ⅰ or Ⅱ patients aged 22-64 yr with body mass index of 18-30 kg/m2 undergoing elective surgery under general anesthesia with LMA were enrolled in this study.LMA Supreme (Laryngeal Mask Co.Singapore) size # 3 (for patients with body weight ≤50 kg) or # 4 (for patients with body weight ＞ 50 kg) was placed after induction of anesthesia.Correct position of LMA was confirmed by fiberoptic bronchoscopy.The LMA cuff was inflated to 60,80,100 and 120 cm H2O step by step using a 20 ml-syringe.The cuff pressure was measured with a monometer through a 3-way stopcock and maintained at each level for 10 seconds.The plunger was then allowed to recoil.The cuff pressure at the end of recoil (residual cuff pressure) was recorded.The patients were mechanically ventilated.The inspiratory pressure was limited to 30 cm H2 O.The airway pressure at which the air started to leak between LMA and larynx (leak pressure-Pleak) was recorded.Results The residual cuff pressure following the 4 inflating pressures was all ＜ 60 cm H2 O.The Pleak was ＞20 cm H2O.There was no significant difference in residual cuff pressure and Pleak between size # 3 and # 4.Conclusion Recoil of inflating syringe plunger can limit LMA pressure to safe level.

Objective To investigate whether the left ventricular delayed contraction site determined by tissue Doppler imaging might be an optimal left ventricular lead position for improved outcomes of cardiac resynchronization therapy (CRT) in patients with non-ischemic cardiomyopathy. Methods Thirty-three patients subjected to CRT were selected, and all were performed conventional ultrasound cardiography and tissue Doppler examinations before operation. The left ventricular delayed contraction site was determined according to the interval between the onset of QRS and the peak systolic velocity. Retrograde coronary venography was performed during operation, and the left ventricular lead site was selected according to the left ventricular delayed contraction site determined by tissue Doppler examination before operation. The coronary sinus lead site was determined under the guidance of X ray of dorsaventral, lateral, right anterior oblique and left anterior oblique positions. Patients were divided into group A(n=20, the left ventricular lead site was in line with the delayed contraction site) and group B (n=13, the left ventricular lead site was not in line with the delayed contraction site). Results There was no significant difference in age, NYHA grading, left ventricular end-systolic volume(LVESV), left ventricular ejection fraction(LVEF), pulmonary arterial systolic pressure, QRS width and Ts-SD between the two groups before operation(P> 0.05). Six months after CRT, there was no significant difference in NYHA grading, LVESV and mitral regurgitation(MR) grading between the two groups(P>0.05), while the increase in LVEF and decrease in LVESV of group A were more significant than those of group B (P<0.01). Conclusion In patients with non-ischemic cardiomyopathy, CRT significantly improves left ventricular performance, and the more favourable outcomes are achieved in those pace at the delayed contraction site. Tissue Doppler imaging may help to guide the implant of left ventricular lead.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; DNA, Neoplasm ; genetics ; Female ; Gene Rearrangement, B-Lymphocyte, Heavy Chain ; Humans ; Immunoglobulin Heavy Chains ; genetics ; Infant ; Lymphoma, B-Cell ; diagnosis ; genetics ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; genetics ; Male ; Middle Aged ; Paraffin Embedding ; Polymerase Chain Reaction ; Young Adult

Objective To analyse the distribution characteristics of major allergens initiating allergic diseases in children from rural Shanghai. Methods Eight hundred children with allergic diseases from rural Shanghai (rural ease group), 450 children with allergic diseases from urban Shanghai (urban ease group) and 100 healthy children from rural Shanghai (rural normal control group) underwent skin prick tests (SPT), and children of rural case group were subdivided into infant group, preschool age group and school age group according to age. The positive rates of allergens and SPT were compared among groups. Results The positive rate of SPT of rural case group was significantly higher than that of rural normal control group (73.38% vs 26.00%, P<0.05), and was significantly lower than that of urban ease group (73.38% vs 80.22%, P<0.05). Dermatophagoidesfarinae and Dermatophagoides pteronyssinus were the major allergens in rural ease group, with the positive rates of 57.88% and 59.13%, respectively. Except weed and rubber, there were significant differences in positive rates of the other allergens between rural ease group and the other two groups(P<0.05). There were significant differences in positive rates of SPT among different age groups of rural children with allergic diseases (P<0.05). Conclusion Dermatophagoides farinae and Dermatophagoides pteronyssinus are the major allergens in children with allergic diseases from rural Shanghai, whose positive rates of SPT are lower than those of children with allergic diseases from urban Shanghai. The positive rate of SPT is related to age to some extent.

ObjectiveTo observe the characteristic of pulmonary function of children with spastic diplegia and the effects of hydrotherapy on it. Methods30 children with spastic diplegia were divided into hydrotherapy group and control group, who received hydrotherapy and routine rehabilitation or routine rehabilitation only. All patients were tested their pulmonary function and the maximum phonation time before and 2 months after treatment. The longest breath holding time in water of the hydrotherapy group were recorded. ResultsThe vital capacity (VC), expiratory reserve volume (ERV), inspiratory capacity (IC), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum ventilatory volume (MVV), peak expiratory flow (PEF) in all the children decreased significantly compared with the predicted value (P=0.000), but a second rate (FEV1/FVC) didn't （P=0.141）. After treatment, the VC, FVC, FEV1, FEV1/FVC, MVV, PEF values and their percentage of predicted value improved （P＜0.05）, as well as the maximum phonation time （P＜0.05）. ERV, IC values and their percentage of predicted value improved a little from pre-treatment in the control group （P＞0.05）, but significantly in the hydrotherapy group （P<0.05）. The percentage of predicted value of VC, ERV, IC, FVC, FEV1, FEV1/FVC, MVV, and PEF, and the maximum phonation time improved more in the hydrotherapy group than in the control （P＜0.05）. The longest breath holding time in water improved in the hydrotherapy group after treatment （P=0.000）. ConclusionThe pulmonary function impaired in spastic diplegic children, and can be improved with the rehabilitation, especially with the hydrotherapy in addition.

The specific fragment of Pneumococcal surface protein A(PspA)and Pneumococcal Surface Adhesin A(PsaA)gene was amplified by PCR from Streptococcus pneumonia 5 and Streptococcus pneumonia 19.The amplified fragnent of PspA and PsaA gene was ligated into pET-27b(+)vector and transformed into BL 21 E.coli for expression and obtain the expressive production of PspA and PsaA.Induced by IPTG,the expression level was as high as 75 % of the total disolube protein.The result showed that the recombinant plasmid could express a specific 75 kDa and 37 kDa fusion protein in E.coli BL 21,which showed the good immunogenicity and a broadly cross reactivity with the other serotypes.

The validity of fasting plasma glucose(FPG)combined with HbA_1c in diagnosing diabetes was assessed in patients with coronary heart disease.The results showed that the paired determination of FPG and HbA_1c helped to identify potentially diabetic subjects in patients with coronary heart disease.

To construct the Bac-to-Bac expression system of Bombyx mori nucleopolyhedrovirus (BmNPV), a transfer vector was constructed which contained an Escherichia coli (E. coli) mini-F replicon and a lacZ: attTN7: lacZ cassette within the upstream and downstream regions of the BmNPV polyhedrin gene. B. mori larvae were cotransfected with wild-type BmNPV genomic DNA and the transfer vector through subcutaneous injection to generate recombinant viruses by homologous recombination in vivo. The genomic DNA of budded viruses extracted from the hemolymph of the transfected larvae was used to transform E. coli DH10B. Recombinant bacmids were screened by kanamycin resistance, PCR and restriction enzyme (REN) digestion. One of the bacmid colonies, BmBacJS13, which had similar REN profiles to that of wild-type BmNPV, was selected for further research. To investigate the infectivity of BmBacJS13, the polyhedrin gene was introduced into the bacmid and the resultant recombinant (BmBacJS13-ph) was transfected to BmN cells. The budded viruses were collected from the supernatant of the transfected cells and used for infecting BmN cells. Growth curve analysis indicated that BmBacJS13-ph had a similar growth curve to that of wild-type BmNPV. Bio-assays indicated that BmBacJS13-ph was also infectious to B. mori larvae.

Animals ; Ascorbic Acid ; therapeutic use ; Coxsackievirus Infections ; drug therapy ; mortality ; Male ; Mice ; Mice, Inbred BALB C ; Myocarditis ; drug therapy ; mortality ; virology ; Superoxide Dismutase ; blood ; therapeutic use ; Survival Rate

OBJECTIVEThe efficacy of cardiac resynchronization therapy (CRT) in patients with congestive heart failure and the potential factors associated with responder or nonresponder were investigated.

METHODSFifty three patients with congestive heart failure (42 with sinus rhythm and 11 with atrial fibrillation) underwent CRT were enrolled in this study. Conventional echocardiography and tissue Doppler imaging were performed in each patient before implantation and 6 month post implantation. Clinical response was defined as improvement of one NYHA functional class and echocardiographic response was defined as a reduction in LV end-systolic volume by > 15% or an increase of absolute value of LVEF > 5%.

RESULTSThe clinical response rate was 75% and echocardiographic response rate was 69.8% during 6 month follow-up. The echocardiographic response rate for patients with atrial fibrillation was lower than that for patients with sinus rhythm (45.5% vs. 76.2%, P < 0.05). In patients with sinus rhythm, higher response rate was seen in patients with widen QRS duration, lower pulmonary systolic pressure and prolonged left ventricular pre-ejection time (LVPT) while response rate was not affected by LVEF, left ventricular volume, NYHA functional class and intra-ventricular dyssynchrony.

CONCLUSIONSResponse rate to CRT was lower in patients with atrial fibrillation compared to patients with sinus rhythm. In patients with sinus rhythm, QRS duration, LVPT and pulmonary systolic pressure were useful parameters to predict the response to CRT.

Adult ; Aged ; Aged, 80 and over ; Cardiac Pacing, Artificial ; methods ; Chronic Disease ; Female ; Heart Failure ; diagnostic imaging ; therapy ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Ultrasonography