Objective To examine and assess the clinical effect of Er ∶ YAG 2940 nm fractional laser resurfacing for skin wrinkles.Methods A total of 16 patients with Fitzpatrick skin type Ⅳ and facial wrinkles,were treated with Er ∶ YAG 2940 nm fractional laser resurfacing and follow-up were given every week after treatment,four weeks in all.Response to treatment was evaluated by observers and patients themselves.Photos were analyzed by the photoshop 12.0 software.Results During the four-week follow-up,the skin of patients was more and more better than pretreatment,and a large part of wrinkles was disappeared.The assessment of observers for wrinkle amelioration rose from (6.50--2.33) ％ to (34.80±5.24) ％ and the scores of content of patients was up to 4.00±0.27(generally satisfied),whereas no one satisfied at beginning.Analyzed by photoshop 12.0 software,the data of average and middle values were on the trend of increasing in all these four weeks while SD was basically on the trend of decreasing.Conclusions Fractional ablative photothemolysis using Er ∶ YAG 2940 nm laser is a promising option for skin wrinkles.

Objectives To investigate the parmacokinetic characteristics of Meropenem used during the shock phase of severely burned patients. Methods The concentration of Meropenem in the plasma, blister and urine of 11 burn patients during the shock phase (S group) were determined by high performance liquid chromatography after the iv injection of Meropenem. Pharmacokinetic parameters were thus produced by 3P97 software. 6 healthy volunteers served as control group (C group). The t test was used to analyze difference between pharmacokinetic parameters of burned patients and healthy volunteers. Results Compared to those in control group, pharmacokinetic parameters of Meropenem in S group showed significant difference, such as prolonged elimination half-life (t1/2?):[(2 29?0 54)h vs (1 34?0 16)h] and decreased clearance(CLs): [(11 34?3 08)L? h-1 vs (18 76?4 60)L?h -1 ], and enlarged area under the serum concentration versus time curve(AUC):[(47 85?16 15)?g?h?ml -1 vs (27 54?10 76)?g?h?ml -1 ]. Conclusions Meropenem at the dose 500mg iv 3/d can show good activity (both in plasma and wound tissues)against most of pathogens which are common in burn clinic. The intervals should be prolonged when maximum dosage of Meropenem was administered in burn patients during the shock phases.

Hypoplastic myelodysplastic syndrome(Hypo-MDS),with the derangement of BM texture,is characterized by the hypoplasia of bone marrow(BM)accompanied with the deterioration of MDS. Hitherto there isn't a definite therapeutic definition about Hypo-MDS. Is therapy should be paid more attention to. This article introduces the study of therapy of Hypo-MDS.

Objective To evaluate the effectiveness of spiral stone dislodger combined with pneumatic lithotriptor under ureteroscopy for managing upper ureteral stones. Methods 106 patients with upper ureteral stones with spiral stone dislodger combined with pneumatic lithotriptor under ureteroscopy were treated. The transverse diameter of the stones was 4～12mm and the vertical length 6～15mm. Results 87.7% (93/106) stones were fragmented for one session of treatment. 8 cases were pushed upward then undergoing extracorporeal shock wave lithotripsy(ESWL) after surgical operations. Operations in 5 cases had to be changed to open surgery,and ureteral perforations happened in 1 case. Conclusion Successful entrance of the uretersocop is a prerequisite for crushing the stone,appropriate fixation of the stone is the key to their crushing,spiral stone dislodger is an effective means of fixing ureteral stones.

Objective To study and compare the effects of Fentanyl transdermal pain patches and Pethidine in postoperative analgesia of malignant tumor and its nursing methods.Methods 100 patients with malignant tumor in our hospital from January 2008 to November 2010 were selected as research object,all the patients were randomly divided into group A (Fentanyl transdermal pain patches group) and group B (Pethidine group)with 50 cases in each group,then the VAS score 2,4,8,24 and 48h after the surgery,incidence of adverse reactions,satisfaction rate and serum catecholamine,cortisol,blood glucose before and after the surgery were analyzed and compared,and all the patients were given corresponding nursing measures.Results The VAS score of group A at 2,4,8,24 and 48h after the surgery were all better than those of group B,incidence of adverse reactions was lower than that of group B,satisfaction rate was higher than that of group B,serum catecholamine,cortisol,blood glucose after the surgery were all lower than those of group B,there were significant differences.Conclusions The effects of Fentanyl transdermal pain patches in postoperative analgesia of malignant tumor is stable,and it gets good reputation from the patients,the effects is obvious combined with nursing.

Administration, Inhalation ; Adrenergic beta-Agonists ; adverse effects ; Child ; Extremities ; Humans ; Male ; Paralysis ; chemically induced ; Terbutaline ; administration & dosage ; adverse effects

Objective To explore the dose-effect relationship and optimal concentration of sodium taurocholate (NaTc) to establish acute necrosis pancreatitis (ANP) complicating MODS in a rat. Methods 280 SD rats were randomly divided into control group (n =40) and 3.5%, 4%, 4.5%, 5% ANP group (n = 60, respectively). ANP groups were induced by retrograde injection of NaTc solution into the pancreatic duct of rats. Rats in each model group were sacrificed at 1, 3, 6, 12 and 24 h after the model induction. Serum amylase, serum total bilirubin, creatinine, blood gas analysis, and pathological changes of pancreas were determined. Survival rate at 24 h after the model induction was observed in other 20 ANP rats in each group. Results In each groups, the serum amylase level, creatinine, blood gas analysis and pathological changes all increased corresponding to the increase of NaTc, and there was significant dose-effect relationship and time-effect. In 4.5% group, the dysfunction of liver and kidney reached the peak at 6 h,while the respiratory dysfunction reached its peak at 12 h. Its incidence of MODS was 52.5%, which was significantly higher than those in 3.5%, 4.0% group (15.0% and 37.5%) ;and 24 h survival rate of 4.5% group was 65%, which was significantly higher than that in 5% group (30%). Conclusions 4.5% NaTc solution may be the optimal concentration to establish the ANP model, which had higher incidence of MODS and 24 h survival rate.

Objective To investigate the time-course change of intra-abdominal pressure (IAP), TNF-α in rat with acute necrotizing pancreatitis (ANP) and its mechanism. Methods 80 SD rats were randomly divided into ANP group and control group. ANP group was induced by retrograde injection of 4.5% sodium taurocholate into the pancreatic duct in SD rats, while control group was induced by injection of saline at the same dosage. Eight rats in each group were killed at 1 h, 3 h, 6 h, 12 h and 24 h, respectively. The serum levels of amylase, TNF-α were determined;IAP, amount of abdominal ascites, pancreatic pathologic changes were evaluated. Results The levels of amylase in ANP group increased progressively with time, which were 32-folds higher than those in control group at 24 h. The serum levels of TNF-α in ANP group reached the peak at 6 h, and were significantly higher than those in the control group. The amount of abdominal ascites increased post-ANP induction and reached the peak at 24 h, which was 4.7-folds higher than that in the control group. The IAP significantly increased 1 h after induction, which was 3 times as high as the control group in 3 h group and 9 times in 12 h group. Pathologic injuries deteriorated progressively and reached the peak at 24 h. Conclusions Significant IAP occurred in ANP rats and reached the peak at 12 h, TNF-α reached the peak at 6 h, therefore IAP may be the secondary response to inflammatory reaction.

Objective To study ischemic effects on reentrant activities and cardiac arrhythmias using a computational approach. Method The Noble 98 mathematical model of ventricular cell was used in the study. The operator splitting and adaptive time step methods were utilized to integrate the partial differential equations in cardiac conduction models. The ischemic cells were simulated by decreasing the intracellular ATP concentration, reducing the Na+ conductance, and increasing the extracellular K+ concentration in a two-dimensional tissue. Spiral waves were initiated by the cross field technique. Result The results showed that spiral waves in local severe ischemia displayed three different morphologies,whereas in moderate ischemia only two kinds of wave forms exhibited. When the degree of ischemia reached a critical value, the reentrant wave could break. But for larger areas of ischemia spiral wave formed a typical functional reentry around the obstacle. Conclusion The study demonstrates that size and level of ischemia have effects on VTs and VFs. Large ischemic area is beneficial for maintenance of spiral wave and can provide a high probability in the genesis of VTs. Spiral waves can easily break up and degenerate into VFs under critical area or level of ischemia.