To evaluate percutaneous dilatational tracheostomy (PDT) with continuous aspiration of subglottic secretions in intensive care unit (ICU) elder patients.A total of 32 elder patients were selected randomly for PDT and 36 controls for traditional surgical tracheostomy (TST).The PDT group required regular mechanical ventilation with continuous aspiration of subglottic secretions.The operative duration was significantly shorter in PDT group than that in TST group [ ( 10.6 ±3.4)vs.(30.9 ±7.1)min,P ＜0.01].Incision length was significantly less in PDT group than that in TST group [ ( 1.3 ± 0.2 ) vs.(3.2 ± 0.3 )cm,P ＜0.01].Blood loss volume was significantly less in PDT group than that in TST group [ ( 10.4 ±3.8 ) vs.(40.7 ± 11.7 ) ml,P ＜ 0.01].The incidence of ventilator associated pneumonia (VAP) was significantly lower in PDT group than that in TST group ( 15.6％ vs.38.9％,P ＜ 0.05 ).With multiple advantages of mini-invasiveness,safety,simplicity,convenience and easier installation,PDT is quite suitable for elder patients in ICU.

So as to explore the relationship between hypertension happen and combined phlegm and blood stasis,aswell as relations to fi ve zang-viscera,we analysis and study the related articles in literatures of past dynasties about phlegm,blood stasis with dizzy and headache,fi ve zang-viscera with dizzy and headache.We fi nd that there are relationships between phlegm and dizzy and headache,between blood stasis and dizzy and headache,between fi ve zang-viscera and dizzy and headache,as well as between phlegm,blood stasis and disorders of functions of fi ve zang-viscera.Thus,phlegm induces dizzy and headache,blood stasis induces dizzy and headache,the disorders of functions of fi ve zang-viscera cause phlegm or blood stasis,and the diseases of fi ve zang-viscera induce dizzy and headache.Therefore,the happen of dizzy and headache in hypertensive disease has direct or indirect relationships with diseases of fi ve zang-viscera,which should be noticed in clinical treatment.In clinical practices,we fi nd that in the f ive zang-viscera,the heart and kidney have the close relationship with hypertension.In literatures of past dynasties,the discuss about combined phlegm and blood stasis inducing diseases can be found,but there are no records about combined phlegm and blood stasis inducing dizzy and headache,though that is one of the most important pathological factors of hypertension happen in clinical treatment,so we should pay attention to combined phlegm and blood stasis in the treatment of hypertensive disease.

A large number of studies showed that hairy leukoplakia,pseudomembranous candidiasis,Kaposi' sarcoma,non-Hodgkin's lymphoma,linear gingival erythema,necrotizing ulcerative periodontitis and necrotizing ulcerative gingivitis were the most common lesions in patients with HIV infection and AIDS,and their higher prevalence and incidence rates correlated with the falling CD4 counts and higher virus load of the patients.The use of highly active antiretroviral therapy(HAART) was associated with decreases in the prevalence of oral diseases.Oral manifestations may represent early signs of AIDS di-sease and call attention to disease progression.Oral fluid has been shown to possess superior sensitivity for HIV antibody detection as serum.Abstract:SUMM ARY A large number of stud ies showed that hairy leukoplakia,pseudomembranous cand id iasis,decreases in the prevalence of oral d iseases.Oral manifestations may represent early signs of AIDS d i-sease and call attention to d isease progression.Oral fluid has been shown to possess superior sensitivity forHIV antibody detection as serum.Kaposi’sarcoma,non-Hodgkin’s lymphoma,linear gingival erythema,necrotizing ulcerative periodonti-tis and necrotizing ulcerative gingivitis were the most common lesions in patients with HIV infection and AIDS,and their higher prevalence and incidence rates correlated with the falling CD4 counts and higher virus load of the patients.The use of highly active antiretroviral therapy(HAART) was associated with

The compounds were isolated from Aoonitum coreanum (Lev1.) Rapaics and identificd by TLC, IR, MS and NMR, as ?-sitosterol (Ⅰ), daucosterol (Ⅱ), Guan-Fu base A (Ⅲ),GuanFu bas. G (Ⅳ), condelphine (Ⅴ), Guan-Fu base Ⅰ (Ⅵ), hetisinone (Ⅶ), isoatisinum chloride (Ⅷ), atisinum chloride (Ⅸ), and Guan-Fu base z (Ⅹ) from the root. Compounds Ⅲ and Ⅸ were also found in the aerial parts of the plant. compounds Ⅱ, Ⅴ, Ⅶ and Ⅷ were obtained for the first time from this plant. Most of them exhibited antiarrhythmic activlty.

Objective To observe changes on those parameters on pletelet and hemoglobin of urinaemia patients by treatments of dialysis.Methods candidators are divided into three groups respectively-a control group,two case groups.The two case groups are consist of patients who are treated through dialysis on not.In the three groups,the parameters on pletelet,hemoglobin,MPV and PDW are measured on hemocytometer in our laboratory. Results Dramatic difference is made in the parameters on PLT,Hb,MPV and PDW between the formers of dialysis and the control group.(P

Lyophilized storage of red blood cells(RBC) may provide a useful storage alternative Both shelf life and transportation logistics can be improved over those for existing refrigerated or frozen storage. The present study was designed to evaluate the effects of lyophilization process on mean RBC recovery. Blood was drawn from healthy adult having no history of either hemoglobinophathy or abnormal RBC metabolism. Blood stored in plastic transfer bags were lyophilized for 16 hours, then it was rehydrated . In group 1, samples were stored at 4℃ for 6 hours, while in group 2 were stored at 4℃ for 5 hours, then 25℃ for 1 hour. The mean RBCs recovery in group 2 was higher than group 1(81 4?7 6% vs 62?10 2%,respectively). Samples were lyophilized using buffer containing different concentrations of glucose, and studies showed that there was no significant difference in mean RBCs recovery between samples in lyophilization buffer containing high and medium concentration of glucose, but low concentration of glucose in buffer resulted in lower mean RBCs recovery. The mean RBCs recovery was 30% in low concentration of glucose buffer and 45 1%, 47 2% in medium and high concentrations of glucose buffer, respectively. We also observed effects of different rehydration buffer with different osmotic pressure, and it showed that high osmotic pressure buffer resulted in higher mean RBCs recovery than iso-osmotic buffer. There was little change in the cell size and cell volume. The results presented in this report clearly demonstrate that human RBCs can be successfully lyophilized. Lyophilization buffer and rehydration buffer may influence the mean RBCs recovery.

Objective To evaluate the prognostic role of bispectral index (BIS) monitoring in patients after cardiopulmonary resuscitation (CPR) in the intensive care unit (ICU).Methods Thirtythree adult patients after CPR were enrolled and divided into survived group and non - survived group as per 7-day survival.During their stay in the ICU,BIS and SaO2 (saturation of artery oxygen) levels of all the patients were continuously monitored.The neurological status of the patients was measured with Glasgow coma scale (GCS).Acute physiology and chronic health evaluation Ⅱ ( APACHE Ⅱ ) was used to evaluate the patient condition. SjO2 (saturation of jugular bulb venous oxygen ) levels of 23 patients were continuously monitored and then the difference in values between SaO2 and SjO2 was calculated to show oxygen metabolism in the brain. The studied variables were compared between the two groups. The correlations between BIS values and GCS scores,and between BIS and APACHE Ⅱ scores were respectively analyzed. Results The BIS values and difference in values between the SaO2 and SjO2 were significantly higher in the patients of survived group than those in the patients of non-survived group (P ＜0.01 ).There were positive correlation between BIS and GCS (r =0.821,P ＜ 0.01 ) and as well as positive correlation between BIS and APACHE- Ⅱ ( r =0.434,P ＜ 0.05 ).Conclusions The BIS may be useful to predict the post - resuscitative outcome of patients after cardiopulmonary resuscitation.

BACKGROUND: Studies about the mechanism of laser occlusion on the varicose great saphenous vein are rare.OBJECTIVE: To explore the ultrastructural changes of the great varicose saphnous vein after it was occluded with laser.DESIGN: An observational study.SETTING: Laser Department of the General Hospital of Chinese PLA .PARTICI PANTS: There were 42 patients with varicose great saphenous veins that were occluded with laser in clinic of the General Hospital of Chinese PLA from January to April 2004. The inclusive criteria: There must be obvious vein tangles beneath the undystrophic skin at ankle without apparent thrombus inside the vein. The patients involved should be voluntary to take part in the study. Finally 9 patients were enrolled in this study.INTERVENTION: The great saphenous vein was intravenously occluded with laser of 810 nm and the working power was 12 W and the exposure time was 1 s. The occluded vein sample was taken out 3 hours after the occlusion.MAINOUTCOME MEASURES: The ultrastrncture of the occluded vein was observed histopathologically. Normal vein and prereatment varicose vein served as control.RESULTS: The normal vein wall can be divided into 3 layers: the internal layer was composed of the simple endothelial cells; the median layer was composed of the smooth muscle cells, elastic fibers and collagenous fibers; the external layer was composed of the loose connective tissues. However, the internal layer of the varicose vein was incomplete, and the endothelial cells were loosely connected. The smooth muscle cells became hyperplasic, hypertrophic or atrophic. The elastic fibers decreased in number in contrast to the increase of collagenous fibers. After laser occlusion, in the vein lumen there was a large number of blood cells. The platelets became flattened with pseudopods and adhered to collagenous fibers. The endothelial cells and smooth muscle cells near the lumen were damaged and the cytoplasma leaked and fused with extracellular matrix. Broken collagenous and elastic fibers could be seen near the lumen and some were observed in the lumen. There was no structure change in the external layer and adjacent elastic fibers and collagenous fibers.CONCLUSION: Laser occlusion damaged the internal layer and part of median layer of the varicose vein, caused aggregation of the blood cells in the lumen and promoted the adhesion of platelets to vein walls.

Objective To compare the protective effect of trehalose with that of sucrose in lyophilization of red blood cells. Methods Concentrated red blood cells and 30%PVP containing different concentrations (5% ,10% and 15%) of trehalose (or sucrose) were mixed at a ratio of 1 : 3, pre-frozen at - 80℃ for 1h.then lyophilized in freeze-dryer. After lyophilization, the samples were reconstituted and washed in 37℃ isotonic buffer. The experiment was divided into 3 groups: 30%PVP group,trehalose group (containing 5%, 10% and 15% trehalose) and sucrose group (containing 5% , 10% or 15% sucrose). Results After lyophilization and rehydration, the recovery of red blood cells in trehalose groups were (18.86 ?4.63) %, (21.73 ? 7.32) % and (18.01?4.53) % respectively and significantly lower than that of PVP group[(45.97+11.77)%](P

Objectives To maximize the survival of lyophilized red blood cells after reconstitution.Methods The colloidal and crystalloid osmotic pressures of seven reconstitution solutions,including 10% polyvinylpyrrolidone(PVP),6% hydroxyethyl starch (HES),5% carboxymethylcellulose sodium (CMS),0.9%NaCl,0.75mol/L Glucose,isotonic buffer ,and hypertonic buffer (5?buffer),were measured. After washing and equilibrating,red blood cells were mixed with protective solution according to the ratio of 1∶3,then pre frozen at -80℃ for 1h,at last,samples were lyophilized in freeze dryer.After lyophilization,the samples were reconstituted in different reconstitution solutions and at different temperatures,the red blood cell recovery was measured.Results After lyophilization and reconstitution,the recovery of red blood cells in 6%HES,10%PVP,and 5%CMS were (93.65?6.18)%,(88.80?9.49)% and (91.34?8.13)%,respectively,and the recovery of hemoglobin were (93.48?4.67)%,(89.02?4.67)%,and (88.79?)5.35% respectively,significantly higher than those of the other groups[(15.56?12.02)%～(27.77?6.48)%,(17.78?10.80)%～(41.50?6.43)%] (P