Coronary Vessels ; Humans ; Microcirculation

Objective To evaluate the value of ultrasound-measured changes in diaphragmatic excursion (DE) in predicting successful weaning from mechanical ventilation during the spontaneous breathing trial (SBT).Methods Sixty-three patients of both sexes,who were mechanically ventilated for more than 24 h and screened for ascertained readiness to wean,aged 45-64 yr,were enrolled in the study.Bilateral DE was measured using ultrasound at 0,10 and 30 min of SBT.The patients who successfully completed 30 min of SBT were extubated.The patients were divided into either success group or failure group according to whether or not weaning was successful.Receiver operating characteristic (ROC) curves were used to evaluate the value of bilateral △DE30-10 in predicting successful weaning.Results There were 48 cases in success group and 15 cases in failure group.Bilateral △DE30-10 was significantly higher in failure group than in success group (P＜0.05).The area under the ROC curves of the right △DE30-10 in predicting successful weaning was 0.958,＜0.175 cm was used to predict successful weaning,and the sensitivity and specificity were 93.3％ and 87.5％,respectively.The area under the ROC curves of the left △DE30-10 in predicting successful weaning was 0.903,＜0.275 cm was used to predict successful weaning,and the sensitivity and specificity were 80.0％ and 89.6％,respectively.Conclusion The fight △DE30-10 measured using ultrasound can serve as an assistant index in predicting successful weaning from mechanical ventilation during SBT.

BacKground:Helicobacter pylori ( Hp ) infection is an important etioIogicaI factor of gastric uIcer. AIthough eradicating Hp can heIp gastric uIcer heaIing,there is stiII a high recurrence rate of gastric uIcer. Therefore,other factors pIaying a roIe in the pathogenesis of gastric uIcer shouId be in concern. Aims:To investigate the non-reinfectious recurrence factors of gastric uIcer after Hp eradication. Methods:A totaI of 164 newIy diagnosed gastric uIcer patients with Hp infection from January 2011 to June 2012 at Ren Ji HospitaI,SchooI of Medicine,Shanghai Jiao Tong University were enroIIed. AII patients were given Hp eradication therapy and treatment of gastric uIcer. Patients with successfuI Hp eradication and heaIing of gastric uIcer were foIIowed up at 3,6,12 months after uIcer heaIing. Suspected risk factors of gastric uIcer recurrence were coIIected,and their reIationships with recurrence were anaIyzed. Results:A totaI of 123 patients positive for Hp infection compIeted the 12 months foIIow-up,gastric uIcer recurred in 18(14. 6%)of them. Chi-square test reveaIed that age,gender,smoking/drinking,non-steroidaI anti-infIammatory drugs( NSAIDs ),negative emotions and unheaIthy eating habits were significantIy associated with the recurrence of gastric uIcer(P<0. 05). Of the unheaIthy eating habits, irreguIar eating, and preference of indigestibIe food and fast food/carbonated drinks were significantIy associated with recurrence of gastric uIcer( P <0. 05 ). Conclusions:Patients with gastric uIcer shouId change their unheaIthy Iiving habits,foIIow rationaI use of drugs,and keep heaIthy mentaI status and eating habits for avoiding the recurrence of gastric uIcer.

Adult ; Child, Preschool ; Heart Ventricles ; pathology ; Humans ; Male ; Myocardium ; pathology ; Pre-Excitation Syndromes ; etiology ; pathology

Coronary Aneurysm ; complications ; pathology ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; complications

Objective To discuss the application of the degree of portal systemic shunting in assessing the upper gastrointes-tinal bleeding in patients with hepatic schistosomiasis. Methods Thirty - three patients with upper gastrointestinal bleeding caused by hepatic schistosomiasis(a bleeding group)and 29 schistosomiasis cirrhosis patients without bleeding(a non-bleeding group)were enrolled as investigation subjects in Jinshan Hospital. The subjects were scanned by the 128 abdominal slice spiral CT. The portal systemic shunting vessels were reconstructed by using thin slab maximum intensity projection(TSMIP)and multi-planar reconstruction(MPR). The degrees of the shunting vessels of the subjects were evaluated and compared,and the relation-ship between upper gastrointestinal bleeding and the degree of the shunting was analyzed. Results In the bleeding group,the occurrence rates of the shunting vessels were found as follows:86.4% in left gastric varices,68.2% in short gastric varices, 50.0% in esophageal varices,50.0% in para-esophageal varices,37.9% in gastric varices,69.7% in gastric-renal varices, 51.5% in spleen-renal varices,25.8% in abdominal wall varices,15.2% in omentum varices,63.6% in para-splenic varices, 34.8% in umbilical varices,40.9% in retroperitoneal-paravertebral varices,and 36.4% in mesenteric varices. In the bleeding group,the occurrence rates and the degree of shunt were significantly higher than those in the non-bleeding group in esophageal varices,esophageal vein,left gastric vein and gastric varices(all P < 0.05). Conclusions CT portal vein reconstruction can accurately display the location,degree and walking of all kinds of shunting vessels. Esophageal varices,esophageal vein,left gastric vein and gastric varices can accurately predict the risk of upper gastrointestinal bleeding in patients with hepatic schisto-somiasis. The patents with higher degree of the shunting vessels have a higher risk of gastrointestinal bleeding.

Adult ; Female ; Graft Occlusion, Vascular ; Humans ; Stents ; Takayasu Arteritis ; surgery

Objective To investigate the number and activity changes of endothelial progenitor cells(EPCs) in hemodialysis patients,and explore its correlation with the risk factors of coronary heart disease.Methords Total mononuclear ceils(MNCs) were isolated from peripheral blood of patients with chronic renal failure in long-term hemodialysis and from a normal control group by Ficoll density gradient centrifugation and then were plated on humanfibronectin-coated dishes.Mter 7 days of culture,EPCs were characterized as adherent cells by double staining with FITC-UEA-I and DI-LDL,and were further identified by the expression of CD34,CD133 and KDR with flow cytometry.EPCs migration was determined with modified Boyden chamber assay.EPCs adhesive assay was performed by replanting EPCs on humanfibronectin-coated plates and then counting the adherent cells.The relationship of the EPCs' number and activity with Framingham Risk Score of ten years was also be assessed.Results Number of EPCs and the migratory & adhesive capacity were significantly lower in patients than in the control(P

Objective To analyze the clinical and pathological characteristics of children with lupus nephritis(LN).Methods The data of 116 inpatients from Mar.2000 to Nov.2008 with LN were retrospectively analyzed.The clinical,immunochemical and pathological data were recorded.Renal tissue was observed by light microscopy and electron microscopy after HE,PAS,Masson and PASM staining according to WHO standards.Follow-up results showed complete remission,partial remission,disease activity,renal insufficiency and death.Results Of the 116 cases of LN,there were 27 male and 89 female with a ratio of male to female 1.03.3,and the mean age was(12.0?2.2) years.The incidence of nephrotic syndrome was 63.8 %(74 cases),and acute nephritis was 21.5%(25 cases).Class Ⅳ LN was the most frequent type(14 cases,50%) and classⅢ was next(25 cases,21.5%).In view of the outcome,rapidly progressive glomerulonephritis and class Ⅳ LN were the worst.LN was initially controlled in 96.5% of the patients.Relapses of LN were most caused by the intermittent treatment.Totally 32 cases showed different renal injury,and 6 cases progressed to death.Conclusions Renal biopsy is important to diagnosis,treatment and prognosis evaluation of LN.Long and regular treatment is important for children with LN.

Objective To explore the feasibility of transform from the sardine like “cramming” to the “inductive” teaching method with provision of necessary conditions. Methods The medical students in class'97 were picked in random for the trial. New learning materials suitable for self-learning compiled by our department of pathophysiology were distributed into study to test the validity of the inductive approach. The students in this group, after self learning the meaterials, were then examined and their records were compared with those in the control group. Results 31 of 117 volunteer students in the trial participate the examination, and 54.8％ of them obtained grades excellent or good (≥80 points), with a record bar surpassing the 608 students of class'96 and 560 students of class'97 (ordinary classes as control groups). Conclusion Students can master the basic knowledge of pathophysiology if proper learning materials are available, on condition they have enough time and good self-learning habits supplemented by necessary lectures and coaching.