Objective To explore influence of different positive end expiratory pressure(PEEP)level on ventilative efficincy of premature infant with respiratory distress syndrome(RDS).Methods Forty preterm infants who were diagnosed RDS and needed ventilation were randomly assigned to lower PEEP(0.49~0.59 kPa)and high PEEP(0.59~0.78 kPa)group.They were treated by ventilation and pulmonary surfactant(PS).When they were medically stable,blood gas was done at 15 min,2,6,12,24 h after ventilation.Then the ratio of pa(O2)/FiO2,oxygen index(OI),ventilation index were calculated.Result The ratio of pa(O2)/FiO2,OI,ventilation index were better in lower PEEP group than those in high PEEP group(Pa

Objective To explore the effects of dopamine and dobutamine on thyroid stimulating hormone(TSH),total thyroxine(T4) and growth hormone(GH) in preterm infants with hypotension.Methods Forty-seven preterm infants with hypotension were enrolled in the stu-dy,and 38 preterm infants remained hypotensive after two dose of isotonic saline solution,who were divided into two groups and assigned to receive dopamine or dobutamine.Drug infusion were all started at 4 ?g /(kg?min) and the dose increased by 2 ?g /(kg?min) in a stepwise fashion until either the mean blood pressure normalized or a maximal dose 20 ?g /(kg?min) was reached.Haemodynamic variables and se-rum levels of TSH,T4,and GH were assessed during the first 72 h of treatment and the first 3 d after stopping treatment.Microplate luminometer was used to test TSH,T4,GH levels.Results Necessary cumulative and mean drug doses and maximum infusion required to normalize blood pressure were significantly higher in the dobutamine group than those in the dopamine group(Pa0.05].Conclusions Dopamine and dobutamine both increase the syste-mic blood pressure,with higher drug doses in dobutamine group.Dopamine reduces levels of serum TSH,T4 and GH in preterm infants but such suppression is quickly reversed after treatment is stopped.

Objective To investigate the pathogenesis of avascular necrosis of the femoral head(ANFH) and to observe the effects of uhrashortwave diathermy treatment of ANFH through animal experiments.Methods A total of 30 New Zealand white rabbits were randomly divided into three groups:a control group,a model group,and a diathermy group.All the groups were injected with horse serum and methylprednisolone to induce ANFH.The path- ological effects were observed.Results The amount of osteoblast in the model group was significantly less than in the control group,while in the diathermy group it was significantly increased compared with the control group.The a- mount of osteoclast in the model and diathermy groups was significantly higher than in the control group,and in the diathermy group it was significantly more than in the model group.The thickness of femoral head cartilage in the mo- del and diathermy groups was reduced compared with the control group,while it was thicker in the model group than in the diathermy group.The empty cartilage cell lacunae ratios of the model and diathermy groups were significantly higher than for the control group,and the diathermy group showed significant degradation compared to the model group.The density of blood vessels under the cartilage in the model group was significantly less compared with the control group,while in the diathermy group it was significantly increased compared with the control group.The width of bone trabeculae in the model and diathermy groups was significantly less compared with the control group,while they were significantly wider in the diathermy group compared with the model group.The diameters of fat cells in the model and diathermy groups were increased compared with the control group,while they were significantly smaller in the dia- thermy group compared with the model group.The adipocyte area rates in the model and diathermy groups were signifi- cantly elevated compared with the control group,and rates in the model group were significantly elevated compared with the diathermy group.Conclusion Ultrashortwave diathermy is an effective treatment for early stage ANFH.

China ; Humans ; Laparoscopy ; education ; Mentors ; Urology ; education

Objective To investigate the clinical significance of prenatal ultrasound examination in the diagnosis of fe?tal digestive tract development. Methods Twenty-nine cases of congenital digestive tract malformation were examined in according to the different characteristics of their different fetal ultrasound images. Results There were 11 cases with non-magenblase or less magenblase (37.93%), 4 cases with combination of multiple malformations, and 9 cases with combination of amniotic fluid in the 29 cases. There were 7 cases (24.14%) with dilatation of intestine and intestinal vesicles, in which 3 with multiple malformations and 3 with polyhydramnios. There were 8 cases (27.58%) with double bubbles, in which 1 case with multiple malformations and 7 cases with amniotic fluid. Conclusion The prenatal ultrasound examination in 30 to 32 weeks of pregnancy is very valuable in diagnosis of fetal digestive tract development, which is worthy of clinical application.

BACKGROUND: Apoptosis secondary to ischemia and hypoxia is the main cause of spinal cord dysfunction. Because of the decrease in atmospheric pressure, patients living on the Qinghai-Tibet Plateau are in a hypoxic environment, which is very unfavorable for the recovery of spinal cord injury. Hyperbaric oxygen therapy can improve the postoperative function of patients with incomplete spinal cord injury, and its effect is better on the plateau than at normal altitudes.OBJECTIVE: To observe the effect of hyperbaric oxygen therapy on traumatic spinal cord injury in patients living on the Qinghai–Tibet Plateau.METHODS: This prospective, open-label, randomized controlled clinical trial was performed at the Department of Spine Surgery, Affiliated Hospital of Qinghai University, China. In total, 164 patients with incomplete traumatic spinal cord injury were equally and randomly assigned to a control group and a hyperbaric oxygen therapy group. Patients in the control group were treated with pedicle screw fixation and decompressive laminectomy. In addition to the surgical treatment performed in the control group, patients in the hyperbaric oxygen group underwent hyperbaric oxygen therapy at 0.2 MPa once a day for four treatment courses. Ten treatment sessions constituted one course, and each course was separated by a 5- to 7-day rest interval. The primary outcome was the modified Barthel index to assess activities of daily living. The secondary outcomes were the American Spinal Injury Association (ASIA) impairment scale grade, sensory score, and motor score. The study protocol was approved by the Ethics Committee of the Affiliated Hospital of Qinghai University, China (Approval number: QHC011K). Written informed consent was provided by a relative or legal representative of each patient after they had indicated that they fully understood the treatment plan. RESULTS AND CONCLUSION: The partial results demonstrated that after four treatment courses (55-61 days), the modified Barthel index and ASIA tactile, pain, and motor scores were higher in the hyperbaric oxygen group than in the control group. The ASIA grades were significantly different between the hyperbaric oxygen group and control group. The proportion of patients with ASIA grades D and E was higher in the hyperbaric oxygen group than in the control group. In this trial, we aim to determine the efficacy of hyperbaric oxygen therapy on the treatment of incomplete traumatic spinal cord injury in patients living on the plateau and to provide clinical evidence for treating incomplete traumatic spinal cord injury in these patients.

ObjectiveTo evaluate the effect of hydrogen-rich saline given during reperfusion on global cerebral ischeraia-reperfusion (I/R) injury in rats.Methods Seventy-two adult male SD rats,aged 2.0-2.5 months,weighing 260-300 g,were randomly divided into 3 groups (n ＝ 24 each):sham operation group (group S),group I/R and hydrogen-rich saline group (group H).In groups I/R and H cerebral I/R was induced by occlusion of 4 vessels( cauterization of bilateral carotid arteries and 15 min occlusion of bilateral common carotid arteries).In group H intraperitoneal 0.6 mmol/L hydrogen-rich saline 5 ml/kg was injected at 6 h of reperfusion,while equal volume of normal saline was injected instead of hydrogen-rich saline.Eighteen rats of each group were sacririced at 24 h of reperfusion,and then the hippocampi were removed for determination of malondialdehyde (MDA),tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6)contents,and nuclear factor-κB (NF-κB) activity and activated caspase-3 expression.Another six rats of each group were sacrificed at 72 h of reperfusion,and then brain tissues were removed for microscopic examination and counting the number of uninjured pyramidal cells in hippocampal CA1 region.ResultsCompared with S group,the contents of MDA,TNF-α,IL-6 and NF-κB activity were significantly increased,activated caspase-3 expression was significantly up-regulated,uninjured pyramidal cells in hippocampal CA1 region were significantly decreased in I/R group( P < 0.05).Hydrogen-rich saline given during reperfusion attenuated the above-mentioned I/R-induced changes( P < 0.05 ).The histologic damage of the hippocampal CA1 region was significantly slighter in group H than group I/R.ConclusionHydrogen-rich saline given during reperfusion can reduce global cerebral I/R injury in rats through inhibition of lipid peroxidation,inflammatory response and apoptosis.

Objective To observe the effect of ultrashort wave diathermy on collagen type I expression in early stage of hormon-induced avascular necrosis of the femoral head (ANFH) in rabbit.Methods A total of 40 New Zealand white rabbits were randomly divided into two groups:a control group (n=10) and a treatment group (n =30).All the animals in the treatment group were injected with horse serum and methylprednisolone to establish the ANFH model,and then divided into 2 subgroups:a model group and a ultrashort wave diathermy group,which were treated accordingly.After 12 weeks of treatment,all the animals were sacrificed and collagen type I expression in the femoral head was observed.Results It was shown that the expression of the collagen type I was significantly lower in the model animals than that in the controls as indicated by the stronger immunohistochemistry staining for rabbit collagen type,while that of the ultrashort wave diathermy group was significant higher than the control group ( P

Objective To investigate the effects of smad7 on transdifferentiation and collagenⅠsynthesis in advanced glyeosylation end-products(AGE)-stimulated NRK52E cells.Methods NRK52E cells were transferred by pTet-on plasmid system and the cell lines of doxycycline(Dox)-regulated Smad7 expression were selected for the study.Transnuclear location of p-Smad2/3 was examined with immunocytochemistry.The mRNA and protein expressions of Smad7,?-SMA,E-cadherin,collagenⅠwere detected with RT-PCR and Western blot. Results AGE-induced expressions of Smad7 mRNA and protein were further increased in NRK52E cells by the addition of Dox in a dose-dependent manner.Overexpression of Smad7 caused a marked inhibition of p-Smad2/3 transnuclear location at 30 min(68.3% vs 31.2%,P

Background Antagonists against vascular endothelial growth factor (VECF) play key roles in treating and preventing neovascular ophthalmopathy. As a novel anti-angiogenic factor, insulin-like growth factor binding protein-related protein 1 (IGFBP-rP1) might be an antagonist against VEGF in eye. Objective This study was to explore the inhibitory effect of IGFBP-rP1, a novel anti-angiogenic factor, on VEGF-induced retinal angiogenesis in vitro. Methods The retina-choroid endothelial cell line ( RF/6A ) was cultured in DMEM containing 10% fetal bovine serum. Culture cells were divided into control group(free-serum culture group) ,10mg/L VEGF culture group and different concentrations of IGFBP-rP1 (50,100,200 mg/L) +10 mg/L VEGF group. The expression of IGFBP-rP1 in the cells was detected by immunofluorescence assay. The proliferation and migration of RF/6A cells were evaluated using MTS colorimetric assay and the chemotactic motility assay, respectively. Flow cytometry was used to detect the apoptosis of RF/6A cells. Results The immunofluorescence assay RF/6A cells showed the green fluorescence in cytoplasm and red fluorescence in nuclei after cells were exposed to any concentration of IGFBP-rP1 ,but only red fluorescence was seen in nuclei in control cells. After stimulation of 10 mg/L VEGF,the proliferation value (A490) was elevated and the numbers of cell migration were increased in comparison with control group (t = -15. 191, P = 0. 000; t = -21. 274, P = 0. 000 ) , but the cellular apoptosis rate was lower than the control group (t - 10. 228, P = 0. 000 ) . After treated with various concentrations of IGFBP-rP +10% VEGF, the proliferation and migration of RF/6A cells were significantly decreased in comparison with only 10% VEGF group (F = 534. 158,P = 0. 000;F = 2742. 323,P = 0.000,respectively) ,and the inhibitory effects were gradually enhanced with the increase of IGFBP-rP1 levels (P<0. 05). The apoptosis rate of RF/6A cells in 50,100 and 200 mg/L + 10 mg/L VEGF groups increased by ( 1. 26±0. 04)% ,( 1. 50±0. 07)% and ( 1. 93±0. 27)% respectively,showing significant differences among different groups ( F = 274. 273, P = 0. 000). Conclusion IGFBP-rP1 inhibits the proliferation and activity of retina and choroid endothelial cells induced by VEGF at a concentration-independent manner. It appears to be as a novel endogenous inhibitory factor in retinal angiogenesis.