Objective To advocate the importance of central venous access(CVA), and compare the technical characteristics and clinical values of central venous access constructed trans right subclavian vein (TSCV) and trans the right internal jugular vein (TIJV). Methods Between March 1999 and June 2001, we operated 348 cases of CVA, including 270 TSCV and 78 TIJV. The durations of reserving the accesses were 13～75 day, average 23 days. Results In 270 TSCV, 268 cases were successful, the successful rate was 99%. 11 cases had critical complications, including: 2 cases of pneumothorax, 1 access was constructed into subclavian artery, 3 accesses obstruction, 3 accesses of anomalous transfusion caused by catheter shift, infection of puncture site 2 cases. In 78 TIJV, 75 cases were successful, the successful rate were 96%. The critical complications occurred in 1 case.Conclusions The CVA is safe, easy, and practical, which would provide the special and immediate medical therapy for the tumorous and critical patients. In emergency, the TSCV procedure would be the choice.

Objective To compare pituitrin resuscitation,hypertonic saline resuscitation versus hydroxyethyl starch (HES) resuscitation during the early stage in a dog model of severe uncontrolled hemorrhagic shock (UHS).Methods Adult Chinese rural dogs of both sexes,weighing 10-12 kg,underwent sever UHS by transecting one branch of mesenteric arteries,followed by blood withdrawal via the femoral artery to target mean arterial pressure (MAP) of 50 mm Hg.Twenty-four dogs with severe UHS were randomized into 3 groups according to resuscitation strategies (n =8 each):pituitrin resuscitation group (group P),hypertonic saline resuscitation group (group SA),and resuscitation with HES (group HES).In group P,pituitrin was infused at a rate of 0.04U· kg-1 · min-1 after a loading dose of 0.1 U was given intermittently.A single bolus of 7.5 ％ hypertonic saline 6 ml/kg was injected in group SA.HES 200/0.5 was infused at a rate of 18-38 ml· kg-1· h-1 in group HES.MAP was maintained no lower than 50 mm Hg in each group.The branch of mesenteric arteries was ligated 1 h after resuscitation and all the blood initially shed was returned in each group.The parameters of hemodynamics were recorded before UHS (T0),after successful UHS (T1),at 15,30,45 and 60 min of resuscitation (T2-5),and at 2 h after hemostasis and return of shed blood (T6).Arterial blood samples were taken at T0,T1,T5 and T6 for blood gas analysis.Venous blood samples were collected at T0,T5,T6 and 3 days after extubation for determination of serum TNF-α,IL-10 and adrenocorticotropic hormone (ACTH) concentrations.TNF-α/IL-10 ratio was calculated.The survival rate was measured within 72 h after hemostasis and return of shed blood.The volume of blood loss was recorded during UHS phase and uncontrolled bleeding resuscitation phase.Results Compared with group P,SBP,DBP,CVP,HR,serum TNF-α concentration and TNF-α/IL-10 ratio were significantly increased,and Hct and serum IL-10 concentration were decreased in group SA,and SBP,HR,Lac,TNF-α and ACTH concentrations,and TNF-α/IL-10 ratio were significantly increased,and serum IL-10 concentration was decreased in group HES (P ＜ 0.05).SBP,DBP,CVP,HR and serum IL-10 concentration were significantly lower,and Lac,TNF-α and ACTH concentrations,and TNF-α/IL-10 ratio were higher in group HES than in group SA (P ＜ 0.05 or 0.01).The volume of blood loss recorded during uncontrolled bleeding resuscitation phase was significantly larger in group SA than in P and HES groups (P ＜ 0.05).There was no significant difference between P and HES groups in the volume of blood loss recorded during uncontrolled bleeding resuscitation phase (P ＞ 0.05).There was no significant difference in the survival rate between the three groups (P ＞ 0.05).Conclusion Resuscitation with continuous infusion of a small dose of pituitrin can maintain the blood pressure stable with less blood loss and inhibit stress responses and inflammatory responses,and the efficacy is superior to that of resuscitation with a small dose of hypertonic saline or HES resuscitation.

Various column chromatography, such as silica gel, Sephadex LH-20, ODS, and semi-preparative HPLC was used to isolate and purify the chemical constituents from Cinnamomum cassia. The structures were determined on the basis of NMR and MS spectral data analysis, together with the comparison with literature data. Fifteen compounds were isolated from the 85% aqueous ethanol extract of C. cassia, and their structures were identified as (2R, 3R)-5,7,3',4'-tetramethoxyflavan-3-ol( 1), (2R, 3R)-5,7-dimethoxy-3',4'-methylenedioxyflavan-3-ol (2), coumarin (3), cinnamic acid (4), (E)-2-hydroxy-phenylpropionic acid cinnamoyl ester (5), 3, 3', 4, 4'-tetrahydroxy biphenyl (6), methylstictic acid (7), epi-boscialin (8), (1R,2S,3S,4S)-2,3-epoxy-1, 4-dihydroxy-5-methyl-5-cyelohexene (9), 4,5-dihydroxy-3-methyl cyclohex-2-enone (10), cis-4-hydroxymellein (11), and 2-hydroxy-4-methoxyl-cinnamaldehyde (12). Compounds 5-11 were obtained from this genus plants for the first time.
Cinnamomum aromaticum ; chemistry ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Mass Spectrometry ; Molecular Structure

Objective To investigate the clinical features of invasive bronchial-pulmonary aspergillosis (IBPA) in critically ill patients with chronic obstructive pulmonary diseases (COPD).Methods Clinical data of 7 COPD patients complicated with IBPA from respiratory intensive care unit (RICU) in Beijing Chaoyang Hospital during April 2006 and August 2012 were retrospectively analyzed.Results All patients were treated with several kinds of broad-spectrum antibiotics and 6 patients were also treated with large dose of corticosteroids before their admission to RICU.The most frequent clinical manifestations were fever,persistent bronchospasm induced dyspnea and bilateral wheezing which were unresponsive to large doses of corticosteroids and broad-spectrum antibiotics.In 5 patients with both aspergillus tracheobronchitis (ATB) and invasive pulmonary aspergillosis (IPA),bronchoscopy showed tracheobronchial inflammation,bronchospasm,phlegm and bronchial pseudomembrane formation.All these 5 patients had a rapid progression from normal to infiltrates or consolidation in chest X-ray,and died of respiratory failure or multiple organ failure.The other 2 cases were diagnosed with ATB and received prophylactic antifungal treatments before infiltrates were shown on their chest X-ray.Both of them survived.Conclusions In COPD patients combined with IBPA,ATB may progress rapidly to IPA which affect lung parenchyma and lead a high mortality.Bronchoscopy and bronchial mucous biopsy may be helpful in early diagnosis and treatment.

Background As a new tonometer,it is necessary to assess the clinical value of Icare rebound tonometer.Objective This study was to compare the intraocular pressure(IOP)values measured by Icare with that measured by GAT,and discuss the clinical value of leare rebound tonometer. Methods IOP measurement was performed on 152 eyes of 78 subjects with suspicious glaucoma,glaucoma,refractive error and normal examinnee by Icare and GAT respectively.The Icare IOP was measured firstly and then the GAT IOP was carried out with the 3-or 5-minute interval.The IOP values were compared between Ieare and GAT.This study was approved by Ethic Committee of Wuhan General Hospital of Chinese PLA.Written informed consent was obtained from each subject prior to this study. Results The mean IOP values of Icare and GAT were(19.16±5.03)mmHg and(18.41±4.52)mmHg respectively.The differences between Icare IOP and CAT IOP were less than or equal to 1 mmHg in 96 of 105 eyes(63.2%).The positive correlation was found between the Icare IOP and GAT IOP(r=0.940,P<0.01).The Ieare IOP was lower than that of GAT when IOPIcare<16 mmHg,however,the IOP of Icare were higher when IOPIcare≥6 mmHg;the IOP of Icare were higher than that of GAT in the total CCT range.The correlation coefficients of IOP of Icare or CAT with CCT were 0.341(P<0.01)and 0.333(P<0.01),respectively. Conclusion Compared with GAT,Icare is more feasible in clinic because it is practicable and reliable.

Animals ; Carcinogens ; toxicity ; Female ; Lung Neoplasms ; chemically induced ; pathology ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Mice, Inbred Strains ; Sensitivity and Specificity ; Urethane ; toxicity

Adult ; Enzyme-Linked Immunosorbent Assay ; Female ; HSP70 Heat-Shock Proteins ; blood ; Humans ; Lead ; toxicity ; Male ; Occupational Exposure

Skin aging principles play important roles in skin disease diagnosis, the evaluation of skin cosmetic effect, forensic identification and age identification in sports competition, etc. This paper proposes a new method to evaluate the skin aging objectively and quantitatively by skin texture area. Firstly, the enlarged skin image was acquired. Then, the skin texture image was segmented by using the iterative threshold method, and the skin ridge image was extracted according to the watershed algorithm. Finally, the skin ridge areas of the skin texture were extracted. The experiment data showed that the average areas of skin ridges, of both men and women, had a good correlation with age (the correlation coefficient r of male was 0.938, and the correlation coefficient r of female was 0.922), and skin texture area and age regression curve showed that the skin texture area increased with age. Therefore, it is effective to evaluate skin aging objectively by the new method presented in this paper.
Algorithms ; Female ; Humans ; Male ; Skin ; Skin Aging

BACKGROUND:At present, the main research fields about coronary stents are the whole degradation biological materials with high biocompatibility and drug control ed release systems.
OBJECTIVE: To evaluate the safety after the two novel biodegradable stents implanted in coronary arteries in porcine models.
METHODS:The normal ful y biodegradable stents were made up of the poly-L-lactide and the antiproliferative drugs paclitaxel, and the novel biodegradable stents were added in amorphic calcium phosphate at the basis of normal biodegradable stents. (1) Five normal ful y biodegradable stents were randomly implanted into the coronary arteries of five porcines, and five novel biodegradable stents were randomly implanted into the coronary arteries of the remaining five porcines by coronary angiography. The blood biochemistry and C-reactive protein levels were measured pre-operation and at 28 days after operation. Coronary angiography was utilized to observe the lumen unobstructed at 28 days after surgery. (2) Under a microscope, seven normal ful y biodegradable stents and seven novel biodegradable stents were implanted into right external iliac arteries of 14 rabbits. Blood urea nitrogen and creatinine levels were measured before surgery and at 28 days after operation.
RESULTS AND CONCLUSION:At 28 days after operation, there were no significant changes in porcine glutamic-pyruvic transaminase, aspartate aminotransferase, triacylglycerol, total cholesterol, low density lipoprotein and C-reactive protein levels compared with that before operation, but urea nitrogen and creatinine levels were significantly higher than that before operation (P<0.05). The result of coronary angiography showed that no in-stent thrombosis or stenosis was detected in either group. There was no significant difference in urea nitrogen and creatinine levels in both groups. These results suggested that it is safe and compatible after the two novel biodegradable stents implanted in coronary arteries of porcine models, and the stents had good histocompatibility.

Objective To investigate the nursing of traumatic carotid-cavernous fistula(TCCF)by intervention.Methods 18 patients with TCCF by intervention were given nursing measures including psychological preparation,eye care,disease observation and complications care.Results All patients gained successful embolization,and the symptoms of proptosis and vascular murmur in patients were alleviated.One case received spring embolism because of balloon rupture.The symptoms of vascular spasm in two patients were alleviated with timely treatment.Hyperperfusion syndrome was relieved after lowering blood pressure in two patients.Conclusions The intervention embolization is an effective treatment of TCCF.Good nursing could improve the efficacy and reduce the incidence of complications.